Monday, July 12, 2010
Heart and Shock!!
My last On-call at night in ICU was a shocking experience...We had this new Resident Doctor for our unit from last couple of days as our regular Resident had been on leave. Now let me tell you what roles a Resident doctor and an Intern plays in a hospital...A resident doctor is generally a Post-graduate student pursuing his MD while an intern is a fresh MBBS passout, while the resident doc actually does the main diagnosis and the treatment prescription in a newly-admitted patient in wards, the intern actually carries out all the procedures like blood collection, securing an Intravenous line,Naso-gastric intubation n many more.It is generally expected that residents train interns in all the things needed to be a Doctor proper, but there are some exceptions and sometimes,as in this case, they present to us a picture of things that shouldnot be done as a Doctor...
That night duty was pretty eventless with one or two isolated admissions of Snake bite or Chest pain to be attended, when at around 2.30am, this old lady was rushed by her relatives with complaints of severe breathlessness with chest pain since 1hour. Ideally when a patient arrives, the resident should wake up and check the patient and pen down his notes and prescription in the ICU. I immediately took her pulse and BP which weren’t very assuring and after ECG recording it was evident that patient was in Cardiac shock (roughly equivalent to heart failure in lay man’s term) due to massive Myocardial Infarction(=Heart attack) , I concluded that patient was bad and rushed to inform our Resident in his room.
By experience I had expected him to get up and come immediately for check-up but I was in for a rude surprise...After glancing sleepily at the ECG in his bed, he told me to start some tablets orally and turned the other side in his bed to continue his sleep. He didn’t even care to come and look at the patient...At first I was dumbstruck! Being my senior I couldn’t force anything on him but I wanted to take him along but he won’t budge... I went to the ICU again and started the necessary drugs he had told, I knew that was inadequate... I again went to his room and woke him to tell him BP was still feeble but he merely told me to increase one more drug and again drowsed back to his dreams. I found my temper raising but couldn’t help being polite.
In the dead of the night, after 12 long hours of Day-duty when already one himself is irked because of untimely waking, it’s very difficult not to get irritated easily and loose one’s temper and there we give chance for grave mistakes to occur... I was angry I admit and was on the verge of giving some Ear-music to him when I decided otherwise (fortunately) but then I just had only option remaining, to sit and look at the patient hopelessly praying that nature take care of itself...
That moment onwards my respect for that Ignorant soul was gone, I couldn’t help but curse that resident for being so devilishly impassionate for his job. A person comes to our hospital with an expectation that there will be someone to comfort his pain, to alleviate his sufferings or at least ease his journey back to the heavens with his compassionate words. And I think nobody of us has any right to breach the bond of trust endowed upon us by the innocent souls. I admit that things can’t be so idealistic every time, especially in our current setup but this incidence could have been avoided. Maybe it was her sheer survival instinct or probably someone Up there does help the helpless, that the old lady pulled herself up to see the next morning. If ideally our resident would have done all what I expected, I don’t know if she would have survived or succumbed, but that night, in a junior’s heart, the seniority of his senior did die!!!
That night duty was pretty eventless with one or two isolated admissions of Snake bite or Chest pain to be attended, when at around 2.30am, this old lady was rushed by her relatives with complaints of severe breathlessness with chest pain since 1hour. Ideally when a patient arrives, the resident should wake up and check the patient and pen down his notes and prescription in the ICU. I immediately took her pulse and BP which weren’t very assuring and after ECG recording it was evident that patient was in Cardiac shock (roughly equivalent to heart failure in lay man’s term) due to massive Myocardial Infarction(=Heart attack) , I concluded that patient was bad and rushed to inform our Resident in his room.
By experience I had expected him to get up and come immediately for check-up but I was in for a rude surprise...After glancing sleepily at the ECG in his bed, he told me to start some tablets orally and turned the other side in his bed to continue his sleep. He didn’t even care to come and look at the patient...At first I was dumbstruck! Being my senior I couldn’t force anything on him but I wanted to take him along but he won’t budge... I went to the ICU again and started the necessary drugs he had told, I knew that was inadequate... I again went to his room and woke him to tell him BP was still feeble but he merely told me to increase one more drug and again drowsed back to his dreams. I found my temper raising but couldn’t help being polite.
In the dead of the night, after 12 long hours of Day-duty when already one himself is irked because of untimely waking, it’s very difficult not to get irritated easily and loose one’s temper and there we give chance for grave mistakes to occur... I was angry I admit and was on the verge of giving some Ear-music to him when I decided otherwise (fortunately) but then I just had only option remaining, to sit and look at the patient hopelessly praying that nature take care of itself...
That moment onwards my respect for that Ignorant soul was gone, I couldn’t help but curse that resident for being so devilishly impassionate for his job. A person comes to our hospital with an expectation that there will be someone to comfort his pain, to alleviate his sufferings or at least ease his journey back to the heavens with his compassionate words. And I think nobody of us has any right to breach the bond of trust endowed upon us by the innocent souls. I admit that things can’t be so idealistic every time, especially in our current setup but this incidence could have been avoided. Maybe it was her sheer survival instinct or probably someone Up there does help the helpless, that the old lady pulled herself up to see the next morning. If ideally our resident would have done all what I expected, I don’t know if she would have survived or succumbed, but that night, in a junior’s heart, the seniority of his senior did die!!!
Friday, June 4, 2010
The ICU and the wives....
A week into my Medicine ward postings and I'm coming to grasp the whole deal and affairs in the wards and the ICU..The job's exciting to the core and a new learning curve nonetheless...Everyday, Patients ranging from Breathlessness to Organophosphorus (OP)poisonings are admitted to our wards..In our part of world, Doctors are considered next to Gods! and its difficult to absorb the sense of faith patients and their relatives bestow upon us...This can certainly be a topic of extensive discussion which we will subsequently do in later posts..
Right from the first day I have been observing that the wives of the male patients admitted in the ICU ( serious ones) silently stare from outside the glass frames and windows at their spouses, too afraid to come in and inquire but too anxious about their Husbands..They just stand there and stare with a look of anxiety which has a tale of itself..Very bravely they control their sobs and hold their tears..its so evident but they never give in to their emotions..
I feel something awkward facing their blank stares and silent questions..Its as if their mere presence is a list of queries in itself but they never ask they just Look..then comes a part when a consent is needed for some procedures to be done on the male patients, and surprisingly females are not included in the decision,its always some elderly male who consents instead of the life partner of the patient...Strange are the rules of society....
That day I was examining this male patient of OP poisoning( suicidal attempt) when I stumbled upon the finding that patient regains a bit of consciousness for sometime during which he only swears at his wife sitting by his bed taking good care of him..and this was told by the wife herself who was probably braver one of the lot...
I thought, would I ever stand such a situation and answer was instantly "no"..then Why did she! because she was his wife? or a women? or his better half? or our society expected (or rather forced) her to?
I belong to that part of world where still womanhood is considered sort-of-shame..just nobody speaks that openly..people talk of women's liberalization and their freedom but our female foeticide rates are sky-high..Women are not involved in any kind of important decisions which even pertain to their own lives..they are just puppets completely at the mercy of their husbands and elderlies in the house..But our so-called modern people donot look at this..They are happy with instances when a lady becomes a Jailor or a pilot, it suffices them to neglect the plight of lacs of unlucky wives all over the country.. Indeed very strange are the norms of society....
Right from the first day I have been observing that the wives of the male patients admitted in the ICU ( serious ones) silently stare from outside the glass frames and windows at their spouses, too afraid to come in and inquire but too anxious about their Husbands..They just stand there and stare with a look of anxiety which has a tale of itself..Very bravely they control their sobs and hold their tears..its so evident but they never give in to their emotions..
I feel something awkward facing their blank stares and silent questions..Its as if their mere presence is a list of queries in itself but they never ask they just Look..then comes a part when a consent is needed for some procedures to be done on the male patients, and surprisingly females are not included in the decision,its always some elderly male who consents instead of the life partner of the patient...Strange are the rules of society....
That day I was examining this male patient of OP poisoning( suicidal attempt) when I stumbled upon the finding that patient regains a bit of consciousness for sometime during which he only swears at his wife sitting by his bed taking good care of him..and this was told by the wife herself who was probably braver one of the lot...
I thought, would I ever stand such a situation and answer was instantly "no"..then Why did she! because she was his wife? or a women? or his better half? or our society expected (or rather forced) her to?
I belong to that part of world where still womanhood is considered sort-of-shame..just nobody speaks that openly..people talk of women's liberalization and their freedom but our female foeticide rates are sky-high..Women are not involved in any kind of important decisions which even pertain to their own lives..they are just puppets completely at the mercy of their husbands and elderlies in the house..But our so-called modern people donot look at this..They are happy with instances when a lady becomes a Jailor or a pilot, it suffices them to neglect the plight of lacs of unlucky wives all over the country.. Indeed very strange are the norms of society....
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