Healthcare
This Is What The ER Taught Me
And painfully so
Doctor as a profession can be really tough at times. One important reason is that we deal with the human resource. We talk to them, listen to their problems, and try to provide a solution.
Emergency Room is the hotspot of the hospital. You will never find things mellow and serene. It is a constant chaos. A fish market. There are just so many things to be taken care of that the doctors there are always overwhelmed and overburdened, especially in India. But still, amidst the waves of panic, the men in white come as knights in shining armor and try their best to save lives, provide comfort and alleviate pain.
On one such similar night, I received two different patients.
A frail, old man in beige pants and a crooked posture came rushing in shouting for help. He held his tummy tight and jitterily addressed me, âDoctor! Do something please!!â.
The poor guy couldnât pass urine and his bladder was hurting from over-distention. Age, gender and history clenched the diagnosis of Benign Prostatic Hypertrophy (BPH) â a disorder wherein the prostate grows in size and throttles the tube-like urethra leading to difficulty passing urine. I immediately pushed in a Foleyâs catheter all the way inside his penis to drain the bladder. The release of urine commenced a sense of relief in his facial expressions.
An old lady with a history of diabetes and poor compliance to medicines was brought in by her equally aged husband. She complained of a burning kind of pain in both the hands and feet. I elicited a history of illness and performed a complete general and neurological examination. A diagnosis of diabetic neuropathy was made.
Itâs a complication of uncontrolled diabetes when high blood sugar starts damaging the nerves in the body. As the nerves of the hands and feet get affected, they send false signals of pain to the brain which makes one feel pain sensation in the body. Now the lady was already on painkillers suitable for neuropathic pain and had multiple co-morbidities. We tried to relieve her pain but failed. After consulting the medical specialist on call, I asked her to review in the OPD the next day and to regularly take the medication.
Now came the time to counsel the patients and send them back. First, I approached the old man with BPH and counseled him about his disease and treatment options. He thanked me umpteen times. I was delighted. As an intern in the beginning of my tenure, I had for the first time independently catheterized a patient and cured him of his emergency. He went back, holding a bag of urine dripping down the catheter, and before exiting, blessed me and my family. It felt good as I was appreciated for my work.
I went back to the diabetic lady and counseled her. She was still in pain but agreed to whatever I said. Her husband, however, seemed not so pleased. He expressed his disappointment and labelled me a bad doctor. He didnât acknowledge my efforts in examining and giving proper time before disposing of the patient. Just because I couldnât provide the pain relief, I was termed a bad doctor.
My competence and sincerity were questioned in the midnight hour. By then, I had attended to hundreds of patients and had not even had dinner. My stomach grumbled. My back ached. My eyelids fought to shut close. Add to it the feedback and my heart sank.
The medical profession is both funny and sad. Ten minutes of my time and energy made the first patient ecstatic with pleasure but one hour to the second patient made no difference. It is difficult for people to understand that a doctorâs hands in the ER are tied when dealing with chronic conditions. We can treat acute cases but not chronic ones. High blood sugar can be reduced by a shot of insulin but the damage that has been done over a span of years canât be undone by magic. It requires months of treatment and a regular follow-up. But I think as a layman, the patientâs family had no fault.
It is not easy for someone who is not a medical professional let alone literate, to understand the gravity of the situation and the workings of medical science.
TheUnknownDoktor
