LAMENTS, LAMENTS, LAMENTS........
One of my crucial task is to discern what a patient really wants, their real intention of seeing me. Are they out to genuinely seek treatment from me or do they have some ulterior motives? Their body language,facial grimaces and vocal intonations, all contribute to aid me in my daily chore. But of course, a doctor must not have any pre-judged ideas about their patients!
One of my main difficulties is to explain to them when an antibiotic is necessary and when it's not. Some, who are overly 'informed' regards antibiotics as a definite no-no and refuse them even if it is very much indicated. When a bacterial infection is at an early stage and sensing that a patient is a staunch proponent of 'anti' anti-biotic, I'd skip prescribing them to safe time and energy getting into a futile debate.
Even more difficult is to convince those who think antibiotic is the treat-all medicine and request antibiotics for the slightest ailment or even worse, for a non infectious disease! I get frustrated when after telling these people that they or their kids suffer from viral infection and antibiotics won't help, they'd put on a face that says: "Don't tell me you're not giving me any antibiotics when that was my essential intention of seeing you?" So how do you tackle these people who won't take the word of a doctor?
Truth is, it's sometimes difficult to convince a patient regarding certain line of management. How many times have I encountered patients who would interrupt me whilst I am deep into explaining the crux of their treatment. Exasperated, I would usually lose interest to continue advising them.
Another distinctive impediment I face when treating patients , is their inability to relate intelligently their symptoms to me. Most of the time, they have limited words to express or describe their pain. Even when I suggest descriptive words like collicky (memulas), sharp (tajam) or boring (senak) for them to chose, they'd end up looking blank and persistently says 'sakitlah".
It's important for one to be able to describe their pain precisely and locate the exact site. One classic example is to differentiate a cardiac and a gastric pain. Both can originate at the same site i.e. epigastrium or centre of the chest. A learned person would be able to say whether the pain is a central crushing pain, associated with sweating and shortness of breath which is typically being described by an ischaemic heart sufferer. Or if he had acute gastritis, he would convey that the pain is sharp or burning in nature, which is accompanied by lots of belching, nausea and even vomiting. He would know that the discomfort is pertaining more to the abdomen than the chest.
Most annoying is when I get tangential answers to my direct questions. "How many days have you experienced those symptoms?" I would ask. "Two weeks ago, I had the same symptoms. They subsided and now they have recurred" Or "My kids also have them", they would answer nonchalantly. And these are not answers from foreign workers, mind you!
Patients have all the right to chose doctors who treat them but not vice versa! Doctors are deemed to treat everyone in need of their professional help, even when these people irritate them to their bone! At times, you see your name or your colleague's appear next to a patient's name, meaning they have requested to see a specific doctor. Once, a patient had to wait long as the doctor she had chosen to see was spending hours on another patient. Finally she gave up and requested to see me. So did I smirk at her? Of course not, hehe. I acted civil and brushed aside when she became apologetic towards me.
So perhaps it's best you prepare yourself (vocabulary-wise) the next time you see a doctor. And if you have a personal opinion against taking antibiotics, tell the doctor early thus sparing her the time form prescribing them.
Quotable quotes: A thought that came through whilst driving home from work, annoyed with the selfish attitude of many road-users : As long as there are reckless lorry drivers and careless motobikers, Ops Sikap should be renamed Ops Siakap
Friday, May 25, 2007
LAMENTS, LAMENTS, LAMENTS........