Thursday, July 10, 2008

Many firsts

Everybody seems to remember their first time for everything. The first time they kissed a girl or boy for example. It is suppose to litter your life with memorable events that you look back on when you're older. In my short lifespan as a slave to the Hospital Authority, I've experience quite a number of firsts. Not all of them were great but some where.

I had to deal with my first difficult patient in the General Clinic, who insisted having a colonoscopy despite there was really nothing wrong with him. Yeah, he was a bit constipated and was reliant on medication to take a dump but the guy was in his late fifties and most people are starting to depend on lactulose or senna to prevent constipation at that age. Thankfully the medical officer in charge stepped in to save me from the hassle of dealing with this patient. I was eternally thankful, having been arguing with the patient for more than ten minutes. I'm just grateful these people are a minority.

I've been approached by my first drup rep during my shift in the Breast Centre. I don't know why they put a guy in the Breast Centre but they did. Probably more disappointing was the gender of the drug rep - it was a guy. I know most the drug reps in the industry are women, just to entice the male doctors into buying drugs they don't need to prescribe. Thankfully he was courteous enough to explain the drug trial I knew nothing about, about a drug I knew nothing about and gave me a free gift - a placemat for your car to prevent items like your keys and mobile phone sliding all over the place. I know it must sound daft to some people to think this is your highlight for the day but it just reminds you that you're a doctor and these people are giving you a bit of respect for what you are.

The last 'first' I'm going to write about is one 'first' I didn't expect to be doing. I was on call last night and after having done the night round, I was settling in for an episode of 'Bones' before I got a call from the nurse. I had to certify the death of a patient. My mind thought, "Jesus Christ! Isn't this suppose to be a job of a medical officer!" I was going to ask the nurse to phone the medical officer instead to certify the death. Yet I thought I will eventually have to do this. So after getting changed quicker than an adulterer who hears the partner coming into the house, I whizzed to the ward and at the same time brushed up on my knowledge on how to certify the death of a person. I had seen it done before but I had to make sure since this was somebody's life (or death as it was).

After reaching the ward and asking the patient's sisters to wait outside the room while I conducted the examination. It just dawned at me at that point this was no longer a person but just a body. I know it sounds harsh and cold but it is true. I just had to get this over with, with respect, dignity and professionalism. After making sure I had all the signs to confirm death and double checking just to make sure, I told the relatives that their brother had passed away and I was sorry. I had to get down to the business of writing all my findings and documenting everything. I had to call the medical officer on-call just to inform her what I did.

Probably what scares me most is that I don't know the patient's name - even now after 18 hours post-mortem. I think it is easier for me to not know, to actually detach myself from the event and not to personalize it. The patient (whoever he was) was from a different team which I'm normally attached to during the day. I just so happened to be the house officer on call who had to perform the necessary duties. It just is a fact of life.

I just hope that I don't encounter too many of these incidents in my career.

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