i am going to start work next week. it is a depressing thought, therefore i decided to put up something cheerful about my work from my previous personal blog (which i no longer have time to update). it was written on 19th January 2008.
It has been a while since i blog. Juggling between endless household chores and the non-stop flow of patients into my clinic is not an easy feat. It is very funny really, to think that when i was in surgical department, i was (if not ecstatic), at least satisfied, but on the other hand, my personal life was a total mess. I hardly see my husband, my staple diet were mee sedap and lousy, hospital oncall food and my son didn’t even recognise me. Now, i get to hone my culinary skills and receive compliments from dear hubby, i draw spongebob with my son during my free time and yet, my workdays are totally drab and depressing.
After a very terrible Wednesday last week (Wednesday has always been the worst day of the week; all the stubborn, fussy and paranoid patients will come on Wednesday), I came up with an idea to make life more interesting. What if I follow up on the patients whom I admit? That way, I will know what actually happen to them, what is the final diagnosis and I can learn if I did any mistake.
So , my heart set on my little project, i met a thirty-ish woman on last Monday, came with cough for more than 2 months, with loss of appetite and weight, sister had PTB, raised ESR. Lungs revealed decreased air entry over the left lower zone and stony dull on percussion. Guess what, chest radiograph showed loss of costophrenic angle over left hemidiaphragm.
Boom - left pleural effussion secondary to PTB- that’s what i thought.
So I admitted the patient. Went to see her in the evening, apparently not seen by the oncall M.O yet, but the senior H.O did agree with my diagnosis. He told me the next day, his specialist thought so as well, started her on anti TB treatment, KIV for pleural tapping and biopsy.
I felt elated. At least, I did something right there.
The next one was an 18-year old girl , complaining about fainting episodes for three consecutive days. Same time everyday, recovered her consciousness 4-5 hours later. No eyewitness, lives with a very old grandmother who can’t even wash herself. Parents separated, living several states away. Claimed had cancer over her ear, operated but defaulted further follow up and treatment.
Although full neurological examinations were normal, I cant help but being worried. It could be a thousand things under the son. Is it epilepsy? With no eyewitness, difficult to tell. Electrolyte or metabolic disorder? Possible, but blood results from JPL will take days to be done. Brain metastases or recurrence? Maybe. But the fact that worried me most is that she lives alone, what if she faint in the bathroom or during cooking and sustained burn like what happened to my previous patient?
Well I had to do what I thought was right. I had to admit her.
Turned out that she did not have any medical problem at all. It was something even more sinister, a major life-changing event that happened just a day before she came to hospital. I guess, being so alone, she did not know where to channel her anguish or seek guidance, so she came to hospital. Till now, nobody knows whether the fainting episodes really happened or not.
The weird thing is , the physician told his housemen that this problem should have been managed at JPL level. Something like saying I should not have admitted the patient.
Well, after I talked to my close friends, I think quote from House MD "people do what they think is the right thing to do." I thought it was the right thing , so I did it, and I still think I did the right thing. The physician probably thought he had to do the right thing as well, so he did what he thought is the right thing.
This entry is mainly to remind myself , should I do something I feel doubtful in the future, that you have nobody to answer to except to God and your conscience. So just do whatever you think is right and to h*** with whatever other people think about it.
To desh; see, this is a happy entry after all 
