The Doctor’s View: Dealing with bad days
By Denise Kavuma, Uganda:
A brilliant day can easily be ruined by the most random things like a bird pooping on your newly done hair, a rude customer, a dragon stealing your gold or in my case, a barrage of extremely rude patients. It surprises people a lot when they find out (and I know I'm bursting a lot of people's bubbles as I say this) but doctors are not in fact your personal servants. I could be wrong of course, but last I checked, it really isn't wise to irritate the guy in whose hands you're putting your life. Unfortunately for me, there came a night of call when I was dealing with only this particular kind of patient.
It started with a nurse wheeling in a teenager who was having some very loud breathlessness; I could hear her strained breaths from over 200 meters away and as the nurse wheeled her closer, I could see her twisting in the wheelchair in what I assumed to be agony. Following her of course were her very concerned mother and aunt.
When I had a closer look, I got the strangest feeling that there was something amiss. The mother said that her daughter was asthmatic and was having an asthma attack, but nothing in my examination was pointing to that. In fact, save for the ridiculously loud breathing, I'd have sworn that she was just a normal 16 year old girl…and indeed she was. Over months of dealing with patients who pretend to be unconscious, wives who “faint” so their husbands can finally pay some attention and girls in boarding school whose hearts ‘pain’ only over the weekends, I'd gotten pretty good at telling when a patient was faking symptoms. Call it hysteria or Conversion Disorder, the fact is that this kind of patient causes a lot of grief to their parents and us.
Many nurses at the hospital would threaten these young girls with urethral catheters, nasogastric tubes and some other words whispered in their ears that I never quite heard, but my method was to just let the patient sleep it off. And surely enough, the girl's breathing only worsened whenever she saw me come near her bed. I sat down and talked to her and for the first time ever, an asthmatic attack was treated with just some dialogue…but the mother would not have it. She was enraged at how lax we were about the whole issue and refused to accept that her daughter was not in fact sick. What kind of medics were we, she inquired loudly and then began the complaints about how quality of services at our hospital had reduced. The lady completely ignored the fact that her daughter's breathing had normalized and wanted me to manage her child's asthma.
While this was happening, a few other emergency cases came in and I left the lady to one of my nurses. Of course, it was at this time that dramatic attendant B walked in. He'd told the nurses that his kid had fallen into some plates and sustained a nasty cut that was bleeding heavily. Being alone, I quickly rushed to the surgical side of the ER only to find a very happy child playing about but with a laceration on his forehead. Sighing in disbelief, I decided to deal with this case before dashing back to the growing number of patients I had waiting.
The thing about cuts on kids is that you can't just give them local anesthesia and suture the thing up; they'll scream and cry and hiss the entire way through and you'd be left with an even bigger mess in the end. You need a good anesthetist and well, we didn't have one, so I called the surgeon on the phone and as he was giving me instructions, the father walks out in a huff. Knowing without a doubt, that it was because he thought I'd ignored his kid and instead decided to have a chat on the phone with God knows who, I followed him out and explained to him the situation and what the surgeon had instructed me to do. He comes back with me grumbling and as we set to work preparing the child, it was at this time that a nurse came in to tell me they'd just gotten a convulsing child. In the few seconds it took for me to listen to that report, this guy grumbled about how we were not dealing with his child. He walked out again and began telling random patients and attendants how our medics had ignored him since he'd come in.
That was it!
I turned to the father, eyes flashing (or so I imagine) and asked him how he'd gotten that ridiculous notion from all we'd done. I ground out that I left a very sick child to come and see his stable baby from the moment he walked into the ER, all because he was panicking for no reason. Since I'd entered the room, I'd done nothing but deal with issues related to his kid; from consulting the surgeon to running after him as he stormed out like a menstruating female…ok, I didn't add that last part. He in turn just glared at me and informed me that he wanted to leave. So I told him he could go if he thought they'd get better assistance elsewhere and he left, literally yelling how incompetent I was and how our hospital had really deteriorated in service.
I was left standing there, thinking about how easy it'd have been to just join the mafia in the first place; I'd get to revenge in numerous creative ways, including but not limited to using horse heads. But as it were, I shook myself out of that mood and just walked back to my patients.
Some days, you just don't get any closure.