Medical students’ vs patients’ saga
5/10/2009 10:01:00 AM | Author: fadzly
Quote from Deanna Lee. Really nice and i managed to get a copyright from her. HEHEHE

So, its time to clerk patients again for the conventional long case presentation, as usual it starts form patient hunting and rummaging through the case notes in search of a suitable presentable case. It was like any other typical day for us and we stumbled on this aunty who has osteoarthritis in the orthopedics ward, so as students we begun questioning from the history of the presenting complain to the other details which we think were crucial to be asked and some which were not so crucial - to avoid unnecessary bombards from the consultants.

Aunty was in some pain but was 1st quite comfortable with our interviews, but soon (after 10 mins) she got restless and we just finished our interview and roughly examined her so that she could rest. Aunty had a daughter who accompanied her in the wards and she was really nice. Nonetheless, the daughter could not provide other vital history especially pertaining auntie’s function in her daily activites. Nonetheless, she was kind enough to help us a little and proudly added to us that she says that she had a daughter who was also a medical student in clinical phase (ie also going around interrogating and examining patients). Then we ended quickly by saying thanks and left so she could rest.

The next day, we had our ward rounds with 15 of us encircling the patient with Pf Sengupta mentoring us, aunty was uneasy and her daughter came around looking concern. Prof informed her that we were having a discussion about her case and told her to wait outside. Aunty got more restless and soon after 50 minutes our rounds finished, her angry daughter then went up to prof and with a stern tone that we should have cared for her mother’s feelings that we should not bring such a huge group of students around to aggravate her condition, she CLAIMed that a lot of students has been examining her mother and that she wants it to come to and end or else she would take some serious action. Prof was certainly very ‘yeng’ (suave), he just said ok ok and walked out- our mighty saviour cum hero. (We felt so protected by him that time). Then her angry daughter then came up to the whole bunch of us and warned us with her angry tone again that she will take actions if we were to examine her mother again…

Well I think this is a rather typical scenario for us here as a medical student, being chased away by unwilling patients (hiyo medical students again, asking d same questions over and over again- tiring la, why so many of you come wan, orang dah sakit nak kacau lagi – amongst the typical remarks made) who themselves have the RIGHTS to REFUSE our interviews, examinations and etc as truthfully we were not involved directly in managing them- at this point of time at least. So here is it, of being a medical student/ doctor- here is how we learn and earn money, from people’s misery and illness. But if we don’t learn from their illness, how are we going to be independent, competent, trustworthy and knowledgeable doctors? How are we going to manage them in well bout less then a year’s time? What these patients do not know is, well we may be treating them in like – soon! So where is the boundary to this issue, if we don’t see and do enough, we will not know, but if it’s too much, then it’s very overwhelming to the patient themselves? From that case scenario, it is really difficult to judge who is right and who is wrong, well I’m writing form my point of view and certainly there is the bias. Then again, I would also apologize to the patients whom I’ve caused some inconvenience in the process- i did what I had to do.

On the other hand, I would sincerely and gratefully thank those patients who was been so kind to us- most of them which we meet in during our klang days especially, those who allowed us to make a beeline/ “student jam” for us to auscultate them over and over again for the murmur they had, position and reposition them for the various maneuvers, letting us asked the same old question over and over and OVER again, allowing us to stuck our fingers in their anal canal, palpating and percussing their abdomen and lungs, pull their limbs etc. I still remember the uncle with Eisenmenger’s, Marfan’s, dystrophic myotonica and other similar nice patients who relentlessly shared their experience with us the inexperienced despite the whole jing gang of us coming perpetually to disturb them. I would say all these patients were the greatest teachers of all, which no Harrison’s, Bailey’s, Appley’s, Talley’s-(I know it rhymes) could ever teach us and no mentor could enlighten and impart to us knowledge without such great examples.

It was because they have shared their symptoms that we understood,
Saw their signs that we knew and learned,
So that the next who comes- we know
Allowed us to stick our fingers in the rectum that we would be able to detect the next patient, who has a malignant prostatic or rectal mass,
Gave way to our multiple attempts of painful venepuncture so that the next patient will have an expert phlebotomist who suck out their blood painlessly and effortlessly,
Patiently waited as we maneuvered the Foley’s catheter so the next patient had a quick drainage,
Bearing the pain during our pioneer toileting and suturing so the next will not experience the same fate.
Benevolent allowed our multiple auscultation attempts so that we could detect the next patient with lethal infective endocarditis
Because we heard you wheezing that we know how to deliver oxygen to the next silent chested patient
You told us how massive ur chest pain which no medications could relieve that we knew to get and ECG done ASAP
Because you told us how you took care of your diabetic foot that we need not amputate the rest,
Because you regretted smoking that we are able to encourage the rest to do the same.
you gave us the human touch and soul to what we have learnt, you taught us realitism.
Above all you have INSPIRED us all and TAUGHT us well. So THANK YOU not only from me but on behalf of the next patient and the society that we are going to treat- SOON!
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