Eye Speak

Now that all hospital staff have to wear a 3-ply surgical mask when working, all we could see of each other are only the eyes.

Come to think of it, Jimbo still doesn’t know what his quite efficient house officer looks like coz all he saw of her the last 2 days were her eyes!

Jimbo discovered that the eyes can convey a multitude of emotions. This morning, during the ward rounds, he paid a lot of attention to the eyes of his patients and their carers.

The eyes of a patient newly diagnosed with liver cancer registered resigned acceptance, gratitude and sadness but strangely no fear, as Jimbo told him that a CT scan confirms what he and his team have suspected and that they will try and see what else can be done by consulting the experts elsewhere; meanwhile they will try and build up his nutritional status.

The eyes of a man who has just been told he has HIV, Hepatitis B and C got teary and fearful.

The eyes of a man with bilateral pneumothorax registered fear because he knew something far more insidious is happening inside him while the eyes of his wife showed great fear and concern.

The eyes of a intravenous drug user showed gratitude and acceptance when told he has to be on antibiotics for another 31 days for infective endocarditis.

The eyes of another intravenous drug user, flared angrily as he recoiled his hand in pain as well meaning medical assistant attempted to place an iv cannula into him. The anger in the eyes was rapidly replaced by understanding as Jimbo apologised for the pain caused and that a more experienced doctor would shortly attend to him.

The eyes of man with chronic liver disease showed displeasure when Jimbo told him that he has to be kept a day or two longer as some issues have not been sorted out for him.

The eyes of a young man with IDDM admitted with uncontrolled blood sugar showed amusement and a hint of mischief as Jimbo told him that his problem was due to his erratic diet and the timing of his erratic diet.

And what of Jimbo’s eyes?
He couldn’t see his own eyes but he fervently hoped that his eyes conveyed the right messages: that of empathy and reassurance that his patients are in the best of hands.

He certainly hopes so because of this H1N1 thingy is going to be with us for a while, he will have to get used to doing eye-speak.

Thurs, 270809 @ 1400

Doctor jokes

Some times we need to laugh at ourselves (and others!). Jimbo found a site with jokes about doctors and patients: Doctor Jokes

Antibiotic stewardship

Over the weekend, Jimbo attended a summit on infectious diseases in the Asia Pacific held in KL and we dedicated the entire first day to discussing Gram positive organisms and the second day to Gram negative organisms which are showing increasing drug resistance trends. The points highlighted repeatedly by the panel of experts include:
1. We are rapidly running out of options in term of antimicrobial choices
2. We are facing a number of super bugs that have attained higher virulence and higher resistance patterns because they readily accepts these genes from other bugs
3. We have to devise strategies to tackle this growing problem.

One of the strategy talked about in the summit was on ‘antibiotic stewardship’. The speaker pointed out that a ‘steward’ is like a servant, entrusted with something to take care for a duration of time and to use judiciously and wisely; because the entrusted something has a ‘finite lifespan’.

He further said that ‘in UK, we have taken cephalosporins off the list of available antibiotics because injudicious use of this class of antibiotics in the past, has rendered this class almost useless”; he further said that every antibiotic has a finite ‘life span’ after which it would be quite useless.

Hence the concept of stewardship.

One interesting point he raised in the talk was this: in his hospital, even the cleaner is empowered and bold enough to tell him (a consultant) to wash his hands, should he neglect to wash them!

This is something that probably will not happen in this country.

Jimbo was just telling his colleague during one of the tea breaks in between sessions that, if people would self-regulate, then the current problem would not be so big and terrible.

If doctors (or health care workers) would wash their hands often, then the spread of multi-resistant organisms from one patient to another or even from one ward to another, could be minimized.
If the public would self quarantine when they are down with influenza-like illness, the H1N1 may be better contained. Likewise, if they would wear a mask if they are symptomatic, then others would not be exposed to the virus so easily (incidentally, it was during that tea break also, that Jimbo observed a senior consultant coughing vigorously ONTO the variety of cookies on display without covering her mouth!!!).

And so, if a fly can try to wash its hand and legs, why can’t we?

Photos captured during another tea break in the recently concluded IMU exams.

Thurs, 270809 @ 0700