Monday, June 14, 2010

hospital relationships !!

In a hospital as an intern, you tend to spend a lot of time with your patients, and interesting relationships develop that probably won’t be understood by many..

Probably one such patient who Il never forget, is Mr.X..

One day after finishing a busy Surgery OPD, I headed to the private ward, to find Mr.X admitted with a large insicional Hernia. No one had any idea who admitted him as his surgery was not scheduled for next 20 days. As our Head Of Department(surgery)  wasn’t in town and none of us were sure about what to do and since he was a private patient, which meant no one was willing to upset him and end up facing the music from the management, we decided to make him as comfortable as possible and do routinue pre operative workup.

“Ok you, work up the patient, you have to present the case to sir tomorrow”, the final words my PG uttered as he left the ward.

I looked at the big ward clock, 11 PM, probably not the best time to disturb a patient but my other choice was 5 AM which din’t seem any better..

With a huge sigh, I got up from the nurse’s desk and headed to the patient’s room, he was sound asleep, which after almost a year of internship was no longer a deterrent, I put on my, im the busy doctor expression, and knocked the door, rather loudly twice, before entering.

Mr.X stirred sleepily while his bystander got up rather hurriedly and greeted me. For a millisecond I felt bad about my insensitivity at waking up a patient when it wasn’t at all necessary medically, the thought of leaving the room entered my head for a very very brief moment but it was almost instantaneously replaced by other frivolous thoughts like pending discharge summaries.

After convincing myself that my patient was awake enough to answer me, I started to elicit the history of his ailment. I usually prided myself on taking elaborate histories but today I wasn’t really up to it.. I just wanted to finish the work, go back and hit the bed, but my patient had other plans. Now that he was finally awake, he seemed to find it a rather good time to chat, and wanted to talk about everything under the sun expect his medical problem ..

As I half paid attention to him, while battling the irresistible urge to shut my eyes and my mind wondered about how the private room mattresses are nice and springy, I realized the futility of this attempt.. After 15 mins the only relevant information I had was his name, occupation, and I also had had a quick update on all the newsworthy events in the world.
I left the room with a polite goodnight to enjoy my 4 hours of sleep.

The next day wasn’t much better off, with Mr.X veering off the topic every 2 seconds, but somehow with great difficulty I managed to elicit the required information.. I managed to present the case, not the best iv presented but considering the circumstances, it was ok..

Since Mr.X had some insurance issues, we decided to prepone his surgery and keep him admitted till then. This meant that over the next 15 days I visited his room atleast 7 – 8 times daily, and with each passing visit I got increasingly irritated with him… don’t get me wrong, he was a nice old man, although he may have been suffering from hypomania as one of our medical students diagnosed after her brief conversation with him, but my main concern was the 30 – 45 min extra that I had to spend each visit which I could have used to do a million better things…
This cycle continued of me trying to politely escape from the room while he continued to chat upon every issue ranging from American politics to his daughter’s marriage to marine geography in the same breath, till that one fateful day…

I had been on call for 4 continuous days and was now suffering from what I can only call somnambulism (sleep walking), and after answering my bleep for the umpteenth time I decided to get a head start on the day and do my morning rounds at 4 AM, yes, ur right, in my zombie state I totally forgot that my patients are still human and may be asleep..

So I headed to the ward and started to check my patients, when I reached Mr.X’s room it was around 4.30.. I entered the room, Mr. X was awake and he smiled broadly at me, I smiled back while all the time thinking at the back of my mind, how long is this going to take.. “you are up early” said Mr.X , “ Im on call so I din’t actually sleep Sir” I replied , “ ur on call again, u have been on call the whole week now, right ?” asked Mr.X , I was too surprised to answer, I never knew patients actually followed duty rosters of their doctor… I silently nodded my head, learnt some new information on football, finished checking vitals and dressing and left the room.

The following day was grand rounds, our entire team entered Mr.X’s room, he greeted us all brightly and then to my greatest surprise decided that his topic of discussion today would be ME.. He started by telling my unit head about how polite I was, how nicely I spoke to him, and efficiently did my work, and finished with praising me for doing such long hours without complaining.. With every word he spoke I felt more and more guilty, till by the time he finished I was drowning in a big pool of guilt…

He continued to speak about how doctors were doing the best possible work in the world cause what they did was not just a job, how they were God’s gift to mankind, and how much he appreciated them.

As I heard him speak, I felt all the love I had for medicine return, I was reminded that these were the reasons I took medicine in the first place, to help people, and it din’t matter how tired I was or how long my patient spoke unnecessary things, it was part of who I was to listen and serve...

Mr.X continued to stay for another 10 days and during this time he continued to chat incessantly each day I visited him, he shared with me many wonderful experiences and knowledge that he had gained with age, and this time I listened.. :) :) 

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