"Auntie, can you understand me?"
There was commotion in the ward. I walked myself upfront to see what was it all about. The senior female surgeon was trying to explain in an agitated manner. Perhaps it was due to lack of understanding. The Chinese old lady could not apprehend what the surgeon was trying to say. She doesn't know English. All she knew was she was there taking care of her very ill daughter lying helplessly on the bed. The daughter was just 27 years old, but she looked as if she was 40. It was a cachexic sign.
The surgeon ordered a coursemate of mine to be the translator.
"Tell her that the tumor in her daughter's abdomen is too large and is inoperable. She will be referred to the Oncology Ward. We'll wait for them to take her from here."
"Tell her that the tumor is getting very serious, there is nothing we can do to cure her. Wait, leave that, just tell her that it is inoperable. "
My coursemate was Chinese educated, but he wasn't fluent in Cantonese. He tried his best to translate, but it wasn't clear enough. That made the surgeon even more agitated. I stepped out, offering my service to do the translation. I told her the story, but the surgeon seemed unconvinced and interrupted me halfway.
"What did you tell her??!!"
I could barely finish my sentence to the patient's mother, although I've passed on the important points.
Cantonese wasn't the surgeon's language. She feared what she could not comprehend. I explained to her with confidence, looking straight into her eyes, with adequate convincing. That was what she needs after all. I retreat into the back row. She would be prescribing pethidine to the patient for palliative treatment. We stood and observed.
All these while, the surgeon never knew that the patient was an educated lot. The patient understands English. How cruel can the surgeon be, to break the message in such a manner? Does she not understand of the medical ethics and professionalism? Was she not educated? Or was it the ruthless medical system that moulded her into such a person? Was it not rude to do make such an approach to the patient?
The patient wouldn't feel any better from her condition if the surgeon had be polite, but would it be more comfortable? I had always thought that medical students were trained to treat the patients in a holistic manner, yet what I see proved otherwise. We do not practise what we learn, in fact. Communication has always been the key in providing quality treatment to the patients. Peraps, it is all of an ideal that we learn in academics, which we would dump in the future. The irony strikes at the moment we cross over to the working side.
And how was the patient after that? Her condition never improved. The people from Oncology Ward never came for the past two weeks. She was there with all the life support, lying on the beath as if waiting for her time to come. She had never complained, she had never cried, she was never mad. And yes, she was never seen happy nor smiling. She accepted it as it is, or perhaps, it came out of sudden that she did not really react towards it. It was the lack of emotion that makes it even more worrisome.
On Monday, she was missing from her usual bed where I would expect to find her there. She must have been moved over the weekends. I wonder what happened to her. Whatever it is, there was almost no hope for a cure, at least in Western Medicine. And I do doubt the ability of Chinese Medicine in treating the tumor the size of a football. But all I could do is to pray for her, and may God bless her.
There was commotion in the ward. I walked myself upfront to see what was it all about. The senior female surgeon was trying to explain in an agitated manner. Perhaps it was due to lack of understanding. The Chinese old lady could not apprehend what the surgeon was trying to say. She doesn't know English. All she knew was she was there taking care of her very ill daughter lying helplessly on the bed. The daughter was just 27 years old, but she looked as if she was 40. It was a cachexic sign.
The surgeon ordered a coursemate of mine to be the translator.
"Tell her that the tumor in her daughter's abdomen is too large and is inoperable. She will be referred to the Oncology Ward. We'll wait for them to take her from here."
"Tell her that the tumor is getting very serious, there is nothing we can do to cure her. Wait, leave that, just tell her that it is inoperable. "
My coursemate was Chinese educated, but he wasn't fluent in Cantonese. He tried his best to translate, but it wasn't clear enough. That made the surgeon even more agitated. I stepped out, offering my service to do the translation. I told her the story, but the surgeon seemed unconvinced and interrupted me halfway.
"What did you tell her??!!"
I could barely finish my sentence to the patient's mother, although I've passed on the important points.
Cantonese wasn't the surgeon's language. She feared what she could not comprehend. I explained to her with confidence, looking straight into her eyes, with adequate convincing. That was what she needs after all. I retreat into the back row. She would be prescribing pethidine to the patient for palliative treatment. We stood and observed.
All these while, the surgeon never knew that the patient was an educated lot. The patient understands English. How cruel can the surgeon be, to break the message in such a manner? Does she not understand of the medical ethics and professionalism? Was she not educated? Or was it the ruthless medical system that moulded her into such a person? Was it not rude to do make such an approach to the patient?
The patient wouldn't feel any better from her condition if the surgeon had be polite, but would it be more comfortable? I had always thought that medical students were trained to treat the patients in a holistic manner, yet what I see proved otherwise. We do not practise what we learn, in fact. Communication has always been the key in providing quality treatment to the patients. Peraps, it is all of an ideal that we learn in academics, which we would dump in the future. The irony strikes at the moment we cross over to the working side.
And how was the patient after that? Her condition never improved. The people from Oncology Ward never came for the past two weeks. She was there with all the life support, lying on the beath as if waiting for her time to come. She had never complained, she had never cried, she was never mad. And yes, she was never seen happy nor smiling. She accepted it as it is, or perhaps, it came out of sudden that she did not really react towards it. It was the lack of emotion that makes it even more worrisome.
On Monday, she was missing from her usual bed where I would expect to find her there. She must have been moved over the weekends. I wonder what happened to her. Whatever it is, there was almost no hope for a cure, at least in Western Medicine. And I do doubt the ability of Chinese Medicine in treating the tumor the size of a football. But all I could do is to pray for her, and may God bless her.
I think after awhile, in order for a doctor to be effective, you have to distance yourself from the patients.
I've got a couple of doctor friends now practicing in Singapore. They were talking (over dinner) about patients that they have just declared dead as if the latter are mere objects.
But then again, if these doctors cared too much, they would have neglected the rest of the patients. It's tough but we need our doctors to have a clear head...
i agree with CK..you must learn to distance but still remember to be human...
It's hard but ithink you can do it..
i've had this moment before. with the patient with neurofibrosarcoma. or is this the same patient we're talking about? with the initials c.k.m?
2 ck:
Nope, it is not to care too much to be sobre over it, but at least they could show some respect. Professionalism isn't about being rude after all, it's just to be neutral. The way the surgeon told the case was in a ruthful tone. At least she could be neutral. -.-"
2 falcon:
thnx for the wishes. We are indeed human, just that doctors tend to forget the meaning of respect. Their respect are defined in terms of ranks and positions, and anyone below almost does not deserve respect. -.-" At least, that was almost half the docs are.
2 nyrac:
Surgery ward is very small lar... how many cases can we have? :P
Some doctors become cold hearted after a while. I am not a doctor, just someone who sees them regularly. In the past, I have had doctors who came to a place where they simply did not care anymore.
I disagree with those who believe that you have to distance yourself from the patient. I think that is exactly why people get less from a doctor. The doctor becomes so distant that they, many times, actually MISS the problem that the patient has.
I know this to be true. They act inhuman at times and definitely distant. I do not trust any doctor that acts that way. If they do not care, why be a doctor?
I firmly believe that the passion of the doctor makes the patient believe and trust him or her. If there is no passion, that doctor might not ever know what's wrong with the patient. In my experience, too many doctors no longer care.
I am sorry if this does not fit what people think about doctors but I have known some who believe that they are gods. No, they're human with human failings. They are just as apt to diagnose wrong when they think they know everything and are superior to not only the patient but to those who work with him. Bad idea.
sad case man... hope that in the future u wun be like dat yarh.. =)
My 2cents worth - doing what you do, don't treat others the way you would not want to be treated.
2 jaz:
I do agree with your point too. I've seen many failing and ailing docs before I enter this course. Guess their life's a big mess after all.
2 joshuaongys:
yeah, hope so, crossing my fingers wishing that i would not need to cross over the 'other' side.
2 my bug life:
Ok, point taken. Will treat all of them fairly. n_n
hey..thanks for the help with the layout.. wasnt easy swallowing that huge ego of mine ya know
i totally agree w u~ i rmbr once when i was in ipoh neuro department. The head of department actually told me (a student) to go clerk a pt whom he refered to as "the FAT PIG" .... later i found out the pt has pituitary tumor which is why he is FAT~ that MALAY guy who is so highly educated but yet so shallow~ i wonder wat made him like this. hmmph i hope we will not bcum like that i the future~
2 jean:
I'll make it more swallowable with anesthesia.. :P
2 chubbypenguin:
ya, hopr we're not like that in the future. All the best to all of us! n_n