Monday, October 6, 2008

Daily ditties

Sri Lankans frustrate me in general.

Those in my ward are frustrate me in particular.

But they are my daily fare.... my bread and butter, so to speak. Every day I ask patients about their bowel movements and whether they are peeing comfortably. I stick my finger up innumerable back-sides. I poke and prod and tap and listen. I feel sweaty and uncomfortable and sick at times. These days, dehydration is almost a by word. And still, in spite of doing our best, patients don't do what's best for themselves... why do people have so much trouble in taking responsibility for their own health?

Take the guy in bed X for instance. After devoutly fasting for 20 days, he decides to prematurely break-fast by going on an alcoholic binge.... which lasted till sunrise. He then lands in our ward with a ruptured stomach ulcer, bleeding like mad and has to be rushed into emergency surgery. After days of being kept nil by mouth, we cautiously asked him to drink water - and water only - not exceeding 30ml an hour. The next thing you know the guy is found with a huge buriyani in hand! Aaarrrgh!!!

Then there's the fellow who stabbed himself in the stomach with a bread knife. He seems to have wriggled it around a bit also because his bowels were cut and torn in multiple places and he needed 6 hours of surgery in the wee hours of the night, ICU care and constant monitoring after that. After looking disgruntled for a day or two, he starts yelling at the doctors accusing them of starving him to death. After frustrated conversation and repeated explanations that food will kill him if taken too early, our only conclusion was that next time, he should aim slightly higher and to the left. Hmmmph!

My last casualty saw three admissions with bad diabetic foot ulcers. All three patients had delayed coming to hospital by at least 2 weeks after developing what was initially a small sore. This is in spite of repeated verbal and written information by doctors, nurses and medical and nursing students of the importance of foot care and getting early treatment. One foot ulcer was actually swarming with maggots!! (Eeeeuw!!!) They all turned up after 11pm in the night and all had to undergo amputation. Depressing.

Come to think of it, our countrymen and women seem to have a particular affinity for coming to hospitals in the middle of the night for quite routine complaints. I guess they finish up the house work, sort out their accounts and bills and feed the poor and hungry before they come. Almost every casualty has an admission or two where the patient has been constipated for days... sometimes weeks... who then decides that they want to move their bowel at 2 o'clock in the morning! Honestly, if they came at a decent hour that day... they would have got prompt treatment, a date for endoscopy and been sent home quite comfortable... instead of having to sleep on the floor because there are no beds. And probably wouldn't have had a sleepy doctor (virtual pitchfork threatening alarmingly) getting irritated at their complacence.

Finally there's the guy in bed Z... the bane of my existence. He has multiple anal abscesses caused by constipation, caused by his not taking his thyroxine for 3 frikkin years. The abscesses are oozing pus (eeeuw... why am I in this profession?) and the area needs to be kept meticulously clean with frequent dousings of salt water. And he refuses to wash. Instead he asks for more tablets and pills and injections. Jeez... he frikkin refuses to wash!! (Did I say that already?) And he refuses to go to the toilet - which is the root of all the evil in the first place. The only thing that finally got him to the bathroom was my dark prediction (said out loud and to the ward in general) that unless he does so, his bottom will completely rot and fall off.

Well, that's all for now, folks. I have to go early to the ward tomorrow... there are more back sides that need examining.

Sigh...

10 comments:

Dili said...

Sympathies Angel, @ least there's bound to be a spot in heaven reserved for you after all this :D

realskullzero said...

ohhw...man...ok first my hats off to you..having cope with such INTERESTING daily chores!

well my brother is off to finish off his med school in a few years...this will be a quite interesting read for him..if he havent gone thru such stuff already!

DeeCee said...

lol...bottom will fall off. aw angel...what to do...

Lady divine said...

oh my....
what I can offer you right now... is one BIG HUG...

You're the saviour who helps all thes idiots...:D
way to go Angel!!:D

Jack Point said...

This is not entirely unfamiliar territory to some practitioners I think. Have you ever read James Herriot's stories? Of how farmers decide to look at their stock after a late night at the pub and decide to call the vet at 2am?

Anonymous said...

Hey SL patients are the best ever, inspite of their ignorance and lack of hygiene..I don't think any doctor will ever get the respect the patients give anywhere else in this world- especially in the Western hemisphere of earth:)
So be thankful Angel even though it is gross to do PRs daily you will always have the satisfaction of treating an innocent soul .

Indunil said...

man oh man, i'm glad i stuck to engineering! :-)

note-to-self: wave, bow, say hi, whatever... just never ever ever shake hands again with angel!

Sachintha said...

Err... that was a bit depressing... honestly.

Can't imagine how you go through all that everyday! Lucky I'm not a doctor! LOL
One of my friends showed me some pics of a guy who was attacked by a bear. And he didn't have a face - literally.
All I could say was "Jeez"!!!

Actually I passed out from a Uni also, so I got some - well, a lot of - friends who are doctors and interns. The thing is, not many of them talk about their profession the way you do...

Keep up the good work!

rosetintedview said...

woah... next time ill be nicer to my doctor..

Sids said...

wow, its so nice to read ur blog doctor. I have seen similar situations at wards, and HO akka's and aiya's always hv to struggle so much with those patients who think they know everything. some times I wonder why I wanted to become one. but I guess its too late now. anyway really nice to read these. please continue