COAMS #3 - Doctors make guesses?

(September 30, 2005 at 06:57 AM)

The more I study medicine, the more I don’t trust doctors… I realized that doctors are taking risks everyday. Every diagnosis made is merely just a guess. You get clues from personal history, family history, medical history, social history… perform physical examination and order investigations (eg. X-rays, CT scans) for further clues… then, with all these hints, you come up with a diagnosis… decide on the best available treatment, and the rest is up to God….
In case you are still not convinced, let me share a personal experience with you:


CASE 1
It was past midnight. I was admitted to Hospital Kuala Lumpur after blood donation. I had seafood fried rice for dinner (but it was like only 3 small tiny prawns)… nevertheless, I supposed I had too much sensitized mast cells (a blood component which causes allergy) that I had a hypersensitivity type one reaction (in other words-allergy in it’s severe form).. to cut short, I had asthma and my left had was frozen-unmovable. The medical staff there said I lack carbon dioxide, and his guess was right. He made me breathe in a bag, fixed my problem, and discharged me. Little did he know, I spent the WHOLE night throwing up and felt terrible the next day.
So, what did I do? I went to the clinic the next day, with my very last energy explained the whole situation to him and what did he respond? He said my problem is fever and dismissed me with paracetamol(penadol)!! OH MY GOD!! I should learn to treat myself!!

p/s: if you happen to live in KL, NEVER go to KLINIK REDDY (this advice is genuine-be thankful that I’m risking my neck to save your life!)



CASE 2
Again, past midnight. This time, my course mate had severe abdominal pain and we rushed to Klinik Reddy (apparently, the nearest 24-hour-clinic). The doctor palpated my friend on seated position and simply scribbled – SUSPECT ACUTE APPENDICITIS – and referred us to Hospital Kuala Lumpur. This was quite shocking as from what I understand, appendicitis is SO PAIN that a patient would practically jumped up when you press Mc Burney’s point – which my friend obviously didn’t and even hesitated to tell whether that part hurts. Either he’s got extremely poor guessing skills or he wanted to go back to sleep. Nevertheless, I lost hope on that doc!

So, we went to HKL, waited for an hour or so. The doctor, fresh graduate from India I suppose, was rather excited when he learnt that we were medical students. He laughed at the KlinikReddy Doc’s silliness, as appendicitis is a rather an unlikely diagnosis. And so, he examined my friend, explained to us that she had epigastrium pain and not at Mc Burney’s point. His guess? UTI –Urinary Tract Infection, which was quite puzzling as well as what does epigastrium pain have to do with UTI? (p/s: epigastrium = upper middle abdominal part) He scribble down a note and dismissed us to take our medicine. On the way out, I couldn’t help but to ask him the question on my mind. He thought for a moment, re-examine my friend,.. then he said ‘hmm… probably gastritis…’… and GUESS WHAT? He did NOT change the diagnosis or treatment. Instead, he added a few more drugs to the list and pity my friend,.. she had like 4 IV injection plus oral treatment and a bunch of drugs….

Thanks to the doctor ‘guesses’….

COAMS #2 - No patient is worth you risking your life

(September 21, 2005 at 09:11 AM)

'No patient is worth you risking your life..' that's what my lecturer, Dr Azmi told us today. 2 years back, i would insist that a doctor should never leave a patient bleeding on the street... i mean, it's inhumane... give that guy direct pressure, first aid, ANYTHING!!

but, after today's lecture, i think i'm having second thoughts... not that medical school made me cruel nor am i suggesting that you let him bleed to death,.. it's just that, do you have ANY idea how many doctors had been diagnosed as HIV +ve, mostly due to medical accidents like this???

well, try to work with me here... you see someone bleeding profusely on the street..a motor vehicle accident,.. so, your first instinct is to attend to him immediately, with your bare hands, stop the bleeding, do your best while waiting for the ambulance to arrive... but, little did you know, the person may be an AIDS patient,.. and the next thing you know,.. you are HIV +ve too!

what you gain? the person survive, but being an AIDS patient, dies few months later. what you lost? your job, your dream, your FUTURE.... you may even risk infecting it to your family or other patients... so, you end up spending the rest of your life doing filing work, counting bacteria, culturing viruses... ok, maybe that's not too bad... but think of ALL THOSE LIVES that YOU COULD HAVE SAVED if it wasn't because of this minor accident?

but, no, that's not a reasonable excuse to abandon patients... it's human lives here that we are taking about, and every life is precious and valuable... like what my lecturer said, a doctor is expected to serve WHENEVER, WHEREVER (it's a full-time job)... so doctors should bring an extra pair of gloves along... this not only protects you from the patient,.. it also protects the patient from you... do prepare a few more extras in your car and at home... you'll never know...

'No patient is worth you risking your life'

Confession of a medical student #1

(September 20, 2005 at 07:06 AM)
i didn't want to be here in the first place!!! this wasn't exactly a choice,... it was more of eliminating other choices,... and in the end, i only left with this,... Well, when i was younger, i wanted those more dreamy options like being a deejay or travelling, or journalism.... i thought it'll be nice keeping others company in the middle of the night over the radio, playing songs that i liked... or maybe earning money as i travel those places i enjoyed greatly!! then, in high school, i was considering chemical engineering because of my love to chemistry, and later actuarial science, considering how much i loved maths...

but Medicine? i was never one of those little kids who wanted to be a doctor since young.. kids who lived their life, growing up, knowing that that was what they wanted... i wasn't like Audrey, so determined... Hell, i wasn't even in the PBSM! (red crescent society)... But why now?

hmm.. perhaps it was by my nature to rebel, as my dad didn't really agreed with me taking this course,... then again, everyone else was encouraging... oh, what the HELL....

exams do things to people... seriously... study week was HELL,... not that i've been there before but it was probably the worst moment ever...EVER... confined to the 4 walls of my room,... forced to sit by the study table,.. fliping through the never-ending stack of notes and books... arghhHHhhh... is this really me??

then i would have weird dreams,... one of them was a funeral,.. my funeral... last night i dreamt of my funeral...

it was a cold rainy morning,.. more like drizzling,... i saw mum and dad,... family members,... friends,... all in black... then mum said ' i should have never let her take medicine... i knew she couldn't handle the stress....' then my teacher would say,'what a waste, dying at such a young age...'

then again, like i said, exams do things to people... now that it past,... it's a relieve... yet, i have this deep fear of the next exam... like always, i made hundreds of resolution... one of them being to reduce my addiction to the internet,... but, hey, here i am... it never works,.. *siGh*...

i look forward to the day... when questioned,'why did you become a doctor?' ... and i would answer.. 'it's my dream! it's all worthwhile...' (smiling)