Thursday, May 12, 2005

Wishing you could do more

Having a patient get really worked up and angry is probably one of the most distressing things that can happen when you're a bumbling novice in the wards and are just trying to get more practice in taking history. It made me feel frightened and sad and helpless and angry all at the same time, and perhaps even more. Frightened because it's always scary to have someone scold you. Sad because I sympathise with his problems and his concerns, and how horrible he must be feeling to be sitting around and not get any immediate relief for his condition. Helpless because, being at the bottom of the medical chain I can do nothing but tell the MOs on duty regarding his problem. Angry at myself for not being able to do anything, and at the general incapability of an individual to do anything when hospital administration is totally disarrayed against you. You can't even do the minimum for a patient that's in pain, and that really sucks.

I don't know if I have a knack for picking disenchanted patients to take history from, but so far I've had a pretty hefty history of interviewing patients who end up ranting to me about the inefficacy of the doctors and the system in CGH and how they're just sitting around and not getting better while more and more tests are being done on them. I suppose most people think that it's a given that there are so many conditions you cannot completely treat, nor even provide alleviation for, and yet there's just the feeling that maybe something more can be done, if only we'd take the effort to do that extra bit. Feeling like you're getting in everyone's way is just horrible, and I can't delude myself that all this is for the greater good of becoming a better doctor in the future, because that seems hollow when you're there hearing a patient complain about how he's had so many people come up to him and ask all the same questions and yet nothing is being done for him.

Despite all the unhappiness of encountering patients with so much unhappiness in them, there are always the nice patients who joke about their condition and gladly oblige when you ask to examine them even though you know they must have been examined countless times already, and then sincerely wish you all the best in your studies and that you become a good doctor. It's so moving to have someone tell you that, and it's really not easy to come by.

We had a 5 hour-long break today and I couldn't arrange an extra tutorial or anything so we did some clerking before lunch (during which I was both scolded and wished all the best) and then sat around playing two rounds of Citadels when we were supposed to be studying physical examination. Well maybe not supposed to, but there was a little twinge of guilt at not doing work. But Citadels was a lot of fun. As usual I'm the horrible player with lousy luck and a lot of vengeance. I did bad things to Jon Chia like many times, and surprisingly didn't get a table thrown at me. Haha. Evil me. The Dark Side is ever-enticing.

Bizarre little things I've learnt from clinics:

1. Doctors in CGH are really really laid back. They take 2+ hours to finish ward rounds in the morning for just 20-30 patients. (I think that's quite slow, but maybe I'm wrong)

2. Doctors can look like they're walking normally and yet move along a lot faster. It's something I'll have to learn, because it looks cool. These little things make me feel like an Aes Sedai novice looking at full sisters.

3. Endoscopies and colonoscopies make me want to scream. Our "mother ward's" consultant is a gastroenterologist who takes us to watch "up" and "down" scopes seemingly so we can see something interesting (but really because there are too many people in the ward during ward rounds), and just looking at how difficult a scope is makes me really impatient and want to scream in frustration. I probably don't want to do scopes every day for the rest of my life.

4. More patients can only speak Malay than I would have ever expected. I probably need to learn some basic Malay. Right now the only things I know in Malay are "Pain?" and "Breathe in".

5. It's one thing to think you know how to do something, but another to do it with doctors looking at you and look like you know what you're doing.

6. There are so many patients suffering from dengue, so much so that I've got a mental framework of all the questions to ask a dengue patient.

Lots of people are setting up separate blogs to write about clinical stuff. I don't know, I think it's so much trouble to do something like that. Most of my readers are from Medicine anyway, so I don't think I'm killing the majority of my readership with all these unintelligible gibberish. Sincere apologies to the other readers who have no idea what I'm writing here. I shall try not to write on medical stuff all the time. After all there's always my perennial love, anime, to write about. Especially SEED.

Avaris / 5/12/2005 08:31:00 PM

0 consumed