It's hardly my place to question if a patient is in pain but man, some cases are dodgy. Somebody will walk up to you one day and declare that their back is killing them, has been for several days, and they cannot take another step so you must deal with them immediately. Of course, you ignore the fact that they managed to walk all the way up to the top of the hill where your hospital is located and even climbed some stairs to get to the floor you're on. You suppress the irritated retort that somebody with excessive back pain can't possibly wear stilettos that high or jut their chest out like that for that matter, and you attend to them. That's the etiquette; the patients are clients and you must treat them with the utmost respect.
And so it was with a tired sigh and strained patience that I listened to groans, moans, whimpers, yelling and all sorts of pain-expression known to man (and beast) that came from a corridor leading to the ER. I honestly expected some beaten up old guy with like fractured bones sticking out from his flesh and blood all over the place but instead, I was presented with a 21 year old male being supported by his family as they half walked, half dragged him to the nearest bed.
I had to turn away so my expressions of relief, disbelief and more than a little amusement were not openly read by the man's attendants.
Allow me to paint the picture for you. Here was a ridiculously tall man (and I mean 6 foot 5” at the very least) being held up by his equally ridiculously tall brothers and sisters as his parents followed behind. If it hadn't been for their distinctively Rwandese/Bahima appearance, I would have believed we'd been invaded by a family of semi-giants; maybe relations of Hagrid, who knows. Well, here was a young man so tall that his legs shot over the end of the bed, whining and twisting like he was in the greatest of pain.
Now, my shift was almost done, so I decided to stabilize him as the doctor on call made his way over to relieve me. I rushed over, took a short history from the family and glanced over his medical papers. Turned out, this fellow had refused admission to hospital the day before and was only coming back that day in great pain. At this point, I shall let you in on a little secret: there's a small amount of hidden smugness felt when a patient who doesn't take your advice returns with the same complications you told them they'd get. Hey, we're only human and sometimes stubborn people need to be slapped over the head with unending diarrhea, itching groins, or even hallucinations from the universe before they can get better. (I'm just trying to be light and comical here; I've seen far worse things happen to these obstinate patients where death would have been a relief).
Back to the story; so this guy was apparently complaining of lower abdominal pain and on examining him, there were no signs of an emergency situation, though he was running a high fever. Being short on nurses at that time, I got the painkiller myself, screened the bed, called a brother to help out (who promptly pulled down his sibling's pants like he did it every day *shudder*) and gave the dude the diclofenac shot in his butt muscle. Oh and how he screamed and howled at the needle entering; he yelled, and swore, and almost cried some “manly” tears. I should have gotten a hint from all this about the kind of patient I was dealing with, but I let it all pass.
I told the parents that I was going to admit him because really, somebody in that much pain with an infection as high as he had, had to be managed as an in-patient. They agreed, got the admission chart and I set to work filling it with the history and medication we were to give. At this point, the guy on call had arrived and so I handed over to him and left.
The next morning, while I was doing my rounds; I was very eager to see how this particular patient was doing considering the scene he'd made the day before but I finished the round without meeting him. Confused, I listed down the description and the symptoms to a nurse and asked her whether they'd received such a patient; she responded in the negative.
Curious, I strode over to the ER and asked the nurses there. Turned out the guy had refused admission to hospital again. After I'd filled out the chart and they were wheeling him to the ward he said he'd never agreed to be admitted and refused to go. Even going to so far as to get off the gurney and walk away. They could have told him that with the tears and screaming he'd done before, as if he was a big baby, it'd have been a surprise if he could understand any adult speech at all (let alone consent to anything) but I suppose they just let him be.
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