In medical world, we see idiocy all the time.
Recently I had a patient who is a 60 year old Indian Muslim man with underlying diabetis mellitus came in to medical ward for right leg cellulitis. Initail sugar on admission was HI (high index or above 30 mmol/L), but was not ketoacidotic (ketone <1.5, ABG no acidosis). So we gave him some course of IV cloxacillin. After 3 days, the branula tissued, means that it cannot be used anymore. He refused branula insertion, strongly insisted on oral antibiotics only. We gave him oral antibiotics while persuading and counseling the patient the importance of IV antibiotics and sugar control. We counseled him for insulin injections, but he only wanted oral antidiabetics. We had no choice since he is afraid of needles so much. Then couple days later his family came in talked rudely to us houseman and MOs that they wanted to bring the patient home or AOR (at own risk ) discharge. We reluctantly gave in although the cellulitis not getting better and sugar not well controlled (HBA1C 16% thank you!). We counseled the patient importance of antibiotics and sugar control, especially when he has this cellulitis. The family still rudely insisted on going home anyway. We discharged him with oral antidiabetics and oral antibiotics.
Then one week later, this idiot came back. Guess what? His sugar is still HI (high index) and wound getting worse with foul smelling and pus. When I presented the case to a new MO of the ward, I said aloud in front of patient and everybody else “this is the rude patient who was AOR discharged last week. They always come crawling back to us”. And again, when the MO explained the importance of sugar control, he smartly said “my sugar has nothing to do with my wound”. Guess what? The medications we gave him – NOT COMPLIANT!
Yes, these kinds of patients that stresses the doctors a lot, especially houseman. Why would we go all out to this kind of stubborn patient? Wasting papers, wasting time on documentations, wasting bed for the more needed ones. It’s not just him anyway, I just highlighted this man because he is by far the rudest and the stupidest. Whenever the relatives of a patient ask me about the patient’s condition, I’d like to say “this patient is an idiot, we gave him free medications and he didn’t take it, now he will suffer. Don’t waste our resources coming in and out of the hospital, might as well die and at least he can contribute to earth by being organic after rotting”. Well, of course I didn’t and I won’t say that. It’s just inner curses from an angry, young, overworked doctors as these patients are making us work and stress EVERYDAY for at least four months.
I cannot refuse to treat him because I am under oath. But I can treat him badly like many other government doctors do; no smile, slow, saying no if he requests some non-urgent things, not conversing much. I can give my time and energy to other patients who need my attention much more.
And then today people go to this Bersih street rally. Teargas – admit medical, bad bruises – admit medical, dehydrated – admit medical. Yes, medical is a dumping place for all these kinds of admissions. Hello, you are an adult who can think on your own. Nobody asks you to go to this rally. Ambigous Ambiga and KJ arrested early, ralliers walking with no purpose or directions, big boss Anwar Ibrahim admitted to private hospital for CT head scan to rule out intracranial bleeding (so nice that the big boss goes to private getting all necessary investigations and treatments very fast while the idiotic ralliers end up in government hospital, queueing so long). In the end, it’s always the doctors who will clean up the idiotic mess. I’m not oncall today, but I pity for my colleagues who do.
Almost 1 year as a houseman and 3 months working in medical EVERYDAY, do give me a lot of anger against this type of idiotic patients. It’s not just me you know. Nurses and other doctors also speak bad of patients behind their backs, only that I have a blog and I am expressing it. Doctors must treat patients with passion and without prejudice? Sure, why not go to private and they give you a smile all the time, while cursing your foul-smelling wound and your idiocy behind your back, at the same time taking your money away.
I am really not suitable for medical specialty. Yes all the findings, diagnoses sometimes awed me and made me learn a lot, but the loads of idiotic patients who are not compliant to advice and medications, defaulting follow ups are a lot too. Medical department has 17 medical based wards, and they are always crowded with patients who always want the doctors to take care of them instead of taking care of themselves at home.
Apologies for my pre-call ramblings.