Being a doctor

Dear all, this entry is to share with you some tiny bits of experience since I started my clinical phase in the Melaka GH. It may be a long post.

I'm currently being posted under the principle of the medicine department. As per semester 6, I'm required to master the art of history taking. And so, communication skills come to play some very important roles.

The first patient whom I encountered with was a 59 year-old Indian male. He came to the hospital with the complaints of left sided chest pain radiating over the left arm and forearm. I approached the patient sincerely and tried to establish a very comfortable conversation between us. He started having flight of ideas in his speech and asked for my palm. I stretched it out to establish a trust from him. He slithered his finger on my palm and read it. When I told my parents about my first patient, they reacted. 'How can you simply let people read your palm. It is so dangerous cuz they can just cast a spell on you. Even if that is your patient, even if he is harmless, you should never trust people too easily.' I had an internal conflict within. Should I trust my patient like how I wanted his trust? One thing is, I often fail to foresee circumstances. When people ask for my hand, I gave it even without a second thought.

Next I had the opportunity watch a procedure being done on a patient, a catheterization. The nurses were struggling to insert the catheter into the urethra. It didn't went in after several attempts. The tutor turned to me and asked if I would like to try. Since I had done the same procedure on my grandaunt a several times, I confidently said yes! Washed my hands and I slipped in the gloves. After some time, I failed as well. It simply refused to go in after 1 cm. Patient was partially unconscious that time. She was very sick. Chief nurse said we should try it later since the patient was already in pain. When I walked out, many visitors came to her. I was in another room until an aunt sitting opposite asked me, 'Is the old lady dead? Her family members were sobbing and they were reading Muslim prayers'. I was shocked. I hurried to the bed to see what happened. Patient's daughter asked , 'Mak sudah macam ini. Drip itu nak keluarkan tak?' A staff nurse replied from behind, 'Lepas habis doa lah, kita keluarkan.' Though it wasn't my fault, that 20 minutes of contact with her made me felt that I could have done more. When she had expired, I didn't know her age and what she was suffering from. What more to mention, her cause of death.

Today, I came across a 19 year-old female who is a known case of multiple sclerosis since 6 years back. Last night, she came to the hospital with the complaints of difficulty in swallowing and vomiting. When I approached her, she told me how badly her chest area felt and she starting crying. I sat down by her side, held her hand and handed a tissue paper. She started telling me how afraid she is now. She was a good student before. After contracting MS, she had to skip class due to the relapses. Her friends started isolating and mocking her. She lost interest in her studies eventually cuz life is no longer meaningful to her. She was working as a clerk but due to this disease, she could no longer work. She hails from a poor family background and didn't want to be a burden to her parents. Like any other teenage girl, she wanted to don on nice clothes, spend on cosmetics and have some entertainment with her friends. Yet her medical fee has already summed up to a huge amount. She had a boyfriend whom she had to support. She went to the extend of selling her handset(which she claimed it was the only memory left for her by her even previous boyfriend). Then she realized she was pregnant but had an abortion done due to that disease. The boyfriend left her soon after. Now she cried out to me saying she doesn't want to have another disease bubbling up. It will be the end of her and she's having very negative thoughts about suicide.

Yes, this case is so dramatic that I can hardly believe that I'm hearing it. She told me everything about her life. There is just so much of empathy. Now comes the question, how should I encourage this patient? Knowing that multiple sclerosis is a progressive disease and there is no way she can be healed. There will only be more and more signs and symptoms. How do I make the patient stand on her feet again? I want to do my best. I want to be a good doctor. I want the best words coming from my vocals. Not just holding her hands and wiping off her tears.

So much I have experienced from my 3 days of ward work. I'm loving this profession more and more.