A 40 year old male, with a long history of Hypertension walked into the consultation room one day, and “fell” down.
Worried about a possible cardiac and neurological cause, I immediately got my team together and started giving out instructions on initiating basic life support protocols and referral to the hospital.
“I need his vitals including a random sugar STAT! Prepare the AED (Automatic External Defibrillator). I need a size 16 cannula with normal saline. Look for his ID can call his relatives up!”
My team, having been trained and drilled in similar scenarios started going about their duties while I began my examinations. The paramedic ran to start the ambulance, some of the staff nurses and medical assistants were preparing the ECG and AED machines in the ambulance. Others were ripping his England Jersey up, checking his pulse, pupils, applied probes, and also pressure on his chest, trying to elicit a physical response from the patient.
The atmosphere was electrifying.
But, as my staff pricked his hand to insert a cannula (a needle we insert for immediate access for administration of life saving drugs and fluids), he grabbed my arm, sat up, sweating, a frown over his forehead and said, “Doc, jangan marah, saya cuma mau MC bah. Saya penat puasa, malam tadi tengok bola, England kalah. Jangan cucuk doc, saya takut jarum!”
The room went silent. The only sound was the cursing and swearing I hear in my head.
So I looked at the patient, smiled, a hand on his shoulder and slowly “No, I’m “not” angry. But you owe a lot of people, an apology.”
Welcome ladies and gentlemen, to the holy fasting month of World Cup fever.
I’ve seen my share of weird MCs over the last 8 years. No, I’m not talking about genuine cases like pain, fever, infections, cuts and wounds. Those are clear cut cases, and form part of the medical bill. I mean patients who come up crying, and say, “Doc, my cat died two nights ago. At first I couldn’t sleep. Then yesterday I got a new cat, and now I feel guilty of betraying the old one. How ah?” And another, “Doc, saya tengok Hunger Games semalam. Hari ni saya stress la. Boleh bagi MC?”
Or, “Doc, I wanted to dye my hair orange, but it became red. I’m too ashamed to go to work! So if you send me to work I’ll have to shave off my head. Please help me! I need MC to dye my hair back to black. I have a bad headache just thinking about it. Bad headache Doc!”
And when I was in Nilai, there was a patient who said, “Doc, my vet told me that my dog is depressed and need to spend more time with me. So I’m here to collect a few days of MCs. Can give three ah?” Those who know me, you’ll know that I am lenient with MCs. I believe that my duty is to the patient first, and their companies second. If the patient has a valid reason to benefit from a rest at home, I will issue one.
But when it comes to stress and headaches from watching “Hunger Games”, sick cats, colourful hair, depressed dog, I really don’t know.
I don’t, do you?
You might say, “What is so difficult about being a doctor? Treat the diseases lah.” And you would be somewhat right.
But treatment and protocol regimes are made to deal with diseases. Specific diseases that were taught in medical schools and internships. Rest assured that we were made to memorise among others the signs, symptoms, manifestation of diseases including relevant drugs for treatment and their mechanism of actions.
We were drilled time and again in classes, in wards, over many sleepless nights and sat for countless exams in preparation to be doctors.
So you are somewhat right. We treat diseases. But let me share with you a secret.
Treating diseases is the easy part.
The hard part my dear readers is treating beings called homo sapiens. Yes, that includes you. Any doctor worth his salt will be able to treat a number of illnesses. Diseases. Depending on experience and specialty, the number could rise exponentially.
But the tough part is when we treat the patient as a whole, not just the diseases. The patient brings with them a whole list of unsuspected variables that we just couldn’t expect in advance and fathom.
As Patch Adams once said, “Our job is not to delay death, but to also improve the quality of life.”
Issuing sick leaves is not the problem, the problem arises after issuing them, when we have to justify not only to bodies that govern us, but most importantly to our conscience when we lie in bed at night.
Have mercy on us. And let us enjoy Ramadhan and the World Cup in peace.
Happy fasting everyone.
Dr. Kamal Amzan is currently practicing Public Health in Sabah, and at the same time a Columnist for The Malay Mail Online. You can reach him at firstname.lastname@example.org and on his twitter @drkamalamzan
This is the personal opinion of the writer and does not necessarily represent the views of The Malaysian Medical Gazette.