Monday, July 05, 2010

cakap biar terang, doc!

a friend at work shared with me this one:
- her brother, who i take it from her description, is a bit on the overweight side, asked her opinion regarding a symptom he is having. she advised him to do a few blood investigations, which include few that requires him to fast first...lipid, sugars, etc. so she told him "ingat, puasa tau pegi amik darah2 tu".
so the brother literally "puasa" la.. .. he even woke up at 4 am to drink a full mug of milo as "sahur", and went to take the bloods at 7 am.
obviously, she only has herself to blame, for not clarifying to the brother earlier on how it actually works ;)

this one happened quite awhile ago already, at the previous place where i worked. i probably blogged about it already too, cant remember, but i still think it's funny..hehe.
- a chinese colleague was asking in malay, a young girl's parent whether her kid ever had an ultrasound done to look at her kidneys, "puan, anak puan punye buah pinggang ada pernah tengok tv ka?"


Sunday, July 04, 2010

"to cure sometimes, relieve often, comfort always"

yesterday i saw this early morning show on tv called "tanyalah ustaz".
the topic was "jin & alam ghaib".
interesting, and something i have not much knowledge about, so i sat down to watch while taking my breakfast before leaving for my oncall.
at one point the ustaz was telling the viewers to always consider alternative medicine, in this case, perubatan islam- whenever we fall sick , and especially when doctors/modern medicine are unable to find the cause or definite diagnosis for the medical problem.
but then he also went ahead and made a statement which totally shocked me, that i almost choked on my karipap sardin!
he actually went on to advise viewers "bila2 doktor tak dapat cari punca atau diagnosis untuk sesuatu penyakit itu, mereka mesti nak mintak satu- ambil sum-sum tulang. tuan2 dan puan2.. kalau boleh, cubalah elakkan dpd perkara ini.. ambil sum-sum tulang ini adalah amat bahaya.. boleh menyebabkan lumpuh. jika doktor mintak ambil, cubalah dulu cara lain. ingat ye!"
manalah i tak almost had to heimlich manouver myself!

no wonder lah selalu susah nak dapat consent for bone marrow and lumbar puncture!
the public has already been misinformed enough about how doing a lumbar puncture and taking cerebrospinal fluid (CSF) or air tulang belakang can paralyse people, now he is saying ambil bone marrow or sumsum tulang will also cause the same. both are totally different things, located at different anatomic sites, and the procedures done to obtain them are also different.
sigh..i'm not here to talk about how we do lumbar punctures or bone marrow aspirates, we do it multiple times on a daily basis at the hospital, especially in the oncology wards, and since malaysia still require us to take consent for these procedures, "berbuih mulut" to have to inform patients and parents about them already.
the ustaz no doubt is probably well educated in his own field, but i dont think he should make such bold statements about medical procedures before getting the facts right.
whenever patients at the hospital express their wish to try other means, be it "islamic", bomoh, chinese, homeopathy, etc.. we never say "no", as long as they can still continue their treatments or follow-up with us, and the alternative medicine doesnt interfere with ours. and i know for a fact that whenever most of us do something, or about to carry out a procedure, we always pray that everything goes well... no matter what religion/belief we have, or who it is we were praying to, we know that we are merely humans, bound to make mistakes, and the last thing we wanna do is harm a patient, and so we pray to higher powers to help us.

o well, i'm probably digressing now a bit at least, i'm sure.. but i've mentioned this over and over again, reminding myself, my colleagues, the staff, and especially the really junior doctors out there (although i still consider myself junior as well) that we should always treat a patient just as how we would treat someone dear to us, or just as how we ourselves would like to be treated, should we become patients ourselves.

to quote a few points from the oath:

"I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help."