It’s personal policy that I do not let know that I am a doctor whenever I deal with anyone in the hospital. So, I take my number just like the bloke next to me, I wait my turn, I listen to the instructions given, I fret and get annoyed, just like the next twenty or fifty people waiting to be seen by the doctor. Call it a kind of social experiment.
I simply wanted to see how people are being treated. I didn’t want to be accorded artificial special treatment because of my ‘status’.
Several weeks ago, my wife took my 10-year-old son to the hospital for his ENT appointment. Atopy runs deep in my children’s genes (inherited from the maternal side – I’m allergic to nothing except extreme stupidity) and so Ryan was afflicted with allergic rhinitis, albeit mild. Although they were there early enough, it was past noon before Ryan was eventually seen by the doctor. By then, my wife was anxious to go to work and asked me to take over. Thankfully by then, my routine of morning rounds, seeing referrals and taking medical students for bedside teaching was done and so I quickly made my way to the clinic.
“The doctor said he needs to take his puff twice a day now. Just wait near this door for the prescription. His next appointment is in 4 months. I’m off to work now. Bye!”, my wife said hurriedly as she left Ryan in my care while we waited patiently in the clinic packed with more than a 100 people.
It took another 45 minutes for the nurse, an elderly woman, to appear at the door and shouted Ryan’s name. I quickly informed her that I was Ryan’s dad and may I have the prescription.
“Oh, you must be Dxxxxx”, said the nurse, addressing me with my wife’s name, after peering at me over the rim of her golden-frame glasses, and handed me the slip of paper.
I didn’t bother to correct her. Instead I took the slip of paper and exited the clinic with my son. On the way, I happened to look at what was written on the paper. I was surprised to find that his appointment was scheduled for 6 months later while the prescription for the nasal puff was amended to be administered once a day instead of twice and the supply was written for only 4 months.
I stopped my son, who by now was hungry and told him we needed to go back to the clinic to sort out the discrepancy. We went back to the clinic and I knocked at the door of the room where the nurse appeared from before. After a while, she opened the door and peered out and asked me what was the problem.
I explained to her that my son was advised to take his puff twice a day instead of once because his symptoms were not controlled and that his next appointment was supposed to be in 4 months.
“There are too many people in this clinic, so we had to extend the appointment to 6 months”, she explained, with a little annoyance.
“Ok, fine”, I said, “but the prescription is only for once a day and for 4 months only”, I pressed my point.
“Well, the consultant do not think he needs it twice a day”, she barked at me, raising her voice a notch.
“But the doctor who saw him said he needs it twice a day”, I persisted. “And 4 months is not enough, what happens for the two remaining months after the medication has run out?, I asked.
“That, you will just have to take care of yourself”, she said dismissively. I took it to mean I would have to source the medication from elsewhere until my son’s next appointment.
By now I got a little miffed. “You can’t do that! I would never do this to my patients”, I said determinedly.
By then, something must have flickered in her mind and she asked, “Are you a doctor? What doctor are you?” although she was quite oblivious to the the name tag I was wearing which suggested that I am a doctor.
“I’m a doctor at the MOPD (Medical Outpatient Department) and I always make sure my patients have enough medications”, I explained.
“Well, MOPD patients are different from ENT patients. MOPD patients have to take their medications. ENT patients don’t need to. They can skip medications!”, she retorted, looking smugly triumphant.
By then the medical officer who saw my son earlier had appeared having heard the commotion we were creating, and asked the nurse what’s wrong.
“This doctor here wanted bd dose of the puff but the consultant struck it off and only signed for daily dose”, she informed the medical officer.
“No, he needs it twice a day, and it is for 6 months, please make the changes in the prescription”, he ordered the nurse.
“Dr XXX (the consultant) is not going to be happy about this”, the nurse murmured spitefully while making the changes to the prescription.
I thanked the medical officer profusely and left the clinic with the re-amended prescription.
The whole incident left me with a sour taste. The nurse displayed a woefully uncaring attitude and in my opinion has no place working in a healthcare setting. The consultant was careless and flippant in simply striking off the prescription written by his/her medical officer without discussing it with the MO to find out the justification behind the double dosing needed and he/she did not bother to inform the patient (or in this case, me, as the carer of my son) regarding the dosage change. It was also highly irresponsible of them to short change patients with regards to their supply of medicine.
Things could be better. A whole lot better.
Strawberries are nice. They smell nice, they taste nice, and they are pleasant to look at. But strawberries are also fragile. Keep them out in the heat for too long and they physically deflate, they change color, they turn bad. They don’t stay fresh forever. They don’t last very long and wilt at the slightest adversity.
The Strawberry Generation is what some of us call the new generation of mass-produced doctors in this country and its not without justification, despite what others who think otherwise. The complaint pages of major newspapers are often filled with letters of frustrations and disgruntlement written by young doctors who could not bear the rigor of working under intense stress and difficulties – young doctors who whine about bad working conditions, lack of rest, unsympathetic superiors, etc.
We have too many strawberries around.
The other day, I did what I have never done before in more than a decade of teaching undergraduate medicine – I walked of my class. I did that after discovering that none of the 10 or more students gathered around me that morning for bedside teaching had done their part of the work – they were supposed to have clerked and examined a patient each prior to the class. Without a good case presentation, there was no point in carrying on with the class.
I expressed my disappointment, mumbled that I had something else to do (I had an entire eard rounds to do and several referrals to see) and not wishing to waste anymore of theirs or my time, I walked through the circle, hearing a few whispered ‘I’m sorry Sir’ and walked away.
I wasn’t happy with what I did and I wasn’t angry, not in the least bit. I am hoping that what I did would push the message home to these young students – that medicine is tough, it’s a life long commitment and it requires a lot of hard work.
I want my students to be made of better stuff and avoid being labelled strawberries when they graduate and start work.
My late pastor used to warn us against becoming ‘so heavenly minded, we are of no earthly use’.
I think the church which I belong to may have become what my late pastor had warned against. Take last Sunday for instance, while we were sitting in church listening in rapt fascination to an invited speaker telling us there will be Spaniards, Mexicans and Indians in heaven through a very animated sermon using a power point laden with every animation options available, we were totally oblivious to the fact, beyond the cosy little church we were all cloistered in was a nation gripped by two major events:
1. Whether a Bible-burning event called by people who were hell-bent on creating religious chaos in the country was actually going to take place – precisely at the time when the sermon in my little cosy church began! Mercifully the event was a non-event, thanks to the intervention of the authorities and level-headed people, and no doubt, the prayers of hundreds or maybe thousands of concerned Christians in not-so-disconnected churches who must have prayed for divine intervention.
2. Whether a 6-year-old boy who was left in a car with two other siblings by his parents who went to look at electrical appliances in a shop, who subsequently left the car to look for his parents and was never seen again, would be found and how his parents must have grieved and wracked with guilt and anxiety. The boy’s highly decomposed body was eventually found at a jetty 64 km away from where he first went missing. The social media was a buzzed with concerned netizens doing their civic duty in drawing attention to the news of the missing boy, all hoping against dwindling hope that by some miracles, the boy would be found safe and sound.
It was not to be and how we, the still-connected people, must have grieved along with the parents, trying to make sense of the tragedy.
The two incidents affected me deeply. They tell me that all is not well with my country. They tell me that the country needs much grace and healing.
I hope I wasn’t the only one who felt this way on that Sunday morning in church. It was all the more ironic because the theme of my church for the next four years centered around reaching out to the community around us.
I think we need to pluck our heads out of heaven and be relevant earthly people again.
Voluptas ex malo (Latin): deriving pleasure from evil/bad.
A man with newly diagnosed HIV infection was seen at the ED for minor complications from his medications. He was received by a nurse at the ED who attended to his complaints and he was subsequently seen by a doctor who decided to admit him for observation. After a few days he was discharged well. After a week or two, he noticed his office mates behaving strangely towards him. A close colleague who often makes him a drink in the morning has ceased to do so. Others made excuses when invited out for a meal.
Before long, he heard whispers circulating in the office – that he has been afflicted with the dreaded disease and that it is highly contagious. Even eating and drinking together might spread the disease! His work life became a living hell. He lost concentration and found it hard to work. He didn’t know who he could complain to and so he returned to his treating doctor and complained to him.
The source of the trumour (a true rumour), which the distressed man strongly believed, was the ED nurse who first attended to him. It turned out that she is the wife of one his office mates!
Perhaps it was from an innocent bedtime story shared between spouses or perhaps it was shared out of malice or simply because it was such a ‘juicy piece of gossip’, but whatever it was, a man’s career is in jeopardy because a healthcare professional has breached an expected code of conduct.
The story isn’t an isolated case of course, there’s the blabbermouth at the mortuary who let slip the diagnosis of a deceased man from HIV to the entire kampong resulting in the entire family of the deceased to be ostracised. There’s the hush-hush juicy round going from one professional to another that so-and-so has HIV or so-and-so is gay. There’s the case of specialist-in-training who shouted loudly at a patient in the ward these words: “You have HIV and you deserve to die!” (We didn’t gazette him). There’s the case of an entire family moving interstate to escape the harsh backlash from people whom they used to be on friendly terms with because a member of the family has HIV and they some how knew…because some one blab!
The stories could fill a book or two.
We can do our part – ask before you speak: is what I am about to say, even if it’s true, going to cause hardship to another fellow human being? If the answer is yes, then zip the mouth.
When I got my
precioussss iPhone 5, I passed my iPhone 4 to my daughter. Yesterday I handed my kid an A4 size paper on which the following words were printed:
Hand phone rules
1. It is my phone. I bought it. I pay for it. I am loaning it to you. Aren’t I the greatest?
2. I will always know the password.
3. If it rings, answer it. It is a phone. Say hello, use your manners. Do not ever ignore a phone call if the screen reads “Mom” or “Dad”. Not ever.
4. Hand the phone to one of your parents promptly at 10 pm every school night & every weekend night at 11 pm. It will be shut off for the night and turned on again at 7:30am. If you would not make a call to someone’s land line, wherein their parents may answer first, then do not call or text. Listen to those instincts and respect other families like we would like to be respected.
5. It does not go to school with you. Have a conversation with the people you text in person. It’s a life skill. *Half days, field trips and after school activities will require special consideration.
6. If it falls into the toilet, smashes on the ground, or vanishes into thin air, you are responsible for the replacement costs or repairs. Mow a lawn, babysit, stash some birthday money. It will happen, you should be prepared.
7. Do not use this technology to lie, fool, or deceive another human being. Do not involve yourself in conversations that are hurtful to others. Be a good friend first or stay the hell out of the crossfire.
8. Do not text, email, or say anything through this device you would not say in person.
9. Do not text, email, or say anything to someone that you would not say out loud with their parents in the room. Censor yourself.
10. No porn. Search the web for information you would openly share with me. If you have a question about anything, ask a person? preferably me or your mother.
11. Turn it off, silence it, put it away in public. Especially in a restaurant, at the movies, or while speaking with another human being. You are not a rude person; do not allow the iPhone to change that.
12. Do not send or receive pictures of your private parts or anyone else’s private parts. Don’t laugh. Someday you will be tempted to do this despite your high intelligence. It is risky and could ruin your teenage/college/adult life. It is always a bad idea. Cyberspace is vast and more powerful than you. And it is hard to make anything of this magnitude disappear — including a bad reputation.
13. Don’t take a zillion pictures and videos. There is no need to document everything. Live your experiences. They will be stored in your memory for eternity.
14. Leave your phone home sometimes and feel safe and secure in that decision. It is not alive or an extension of you. Learn to live without it. Be bigger and more powerful than FOMO — fear of missing out.
15. Download music that is new or classic or different than the millions of your peers that listen to the same exact stuff. Your generation has access to music like never before in history. Take advantage of that gift. Expand your horizons.
16. Play a game with words or puzzles or brain teasers every now and then.
17. Keep your eyes up. See the world happening around you. Stare out a window. Listen to the birds. Take a walk. Talk to a stranger. Wonder without googling.
18. You will mess up. I will take away your phone. We will sit down and talk about it. We will start over again. You & I, we are always learning. I am on your team. We are in this together.
They are not my original words, rather I modified it from another parent who just gave her son an iPhone.
I think they are pretty sensible and reasonable rules, don’t you think?