Since I am about to finish the O&G posting, I’d skip all the whining about why I hate this department. I’d like to share a couple of things that I learnt during my O&G posting, the ones not related medically. As for the medical part, you just have to go through it yourself.
Doctors don’t save lives. Statistics show that toilet and good sanitation save more lives. Thank those who invented or improve our sanitations, a lot less people dying from unwanted infections. However, doctors do save lives a little bit, here and there, when patients are at the verge of life and death. Here’s the thing, what can you do when you can’t save lives?
What can you do when a patient comes with intrauterine death (IUD)? What can you do when a mother-wanna-be miscarried a 20 weeks fetus? What can you do with an advanced cervical cancer patients? Are we just going to say, I’m sorry there’s nothing we can do for your loss, let’s proceed with our medical plans?
As doctors, we do what is needed. Proceed with the delivery of the dead fetus. Proceed with dilatation and curettage. Offer supportive therapy. But we can offer human touch as well. We can offer to talk to them about their kids at home, their families, let them share their thoughts and expectations, lifting their worries. I do regret that I didn’t do those things sometimes, when my patients are really in need of some emotional support.
At times, I see 20 miscarried patients a day, I keep doing the same thing. Clerk, speculum, scan, counsel, plan and move on to the next patient. Cycle continues. I do that all time till I become a robot, saying the same things to patients over and over again. I was rushed because I have many other patients waiting to be clerked, speculumed, scanned, counselled and planned. What I forgot to do is how to calm a mother-wanna-be who is in denial that she was miscarried. What I forgot is that not all patients have to be admitted to the ward because they have other kids at home needing attention, that they can’t afford a babysitter.
Not all invasive cancer patients need series of blood investigations and repeated scans. Sometimes all they wish on their deathbed is to have loving family around, and a passionate doctor who’s asking them how are they doing every morning, have they eaten, have they ambulated, have they pooped or peed, although we know they are deteriorating.
We doctors do not abandon the medical aspects when the hope is lost or almost lost. We offer them with a human touch.
Maybe I am more suited in geriatrics…
Be assertive but humble
As I go through postings, first second third fourth fifth, I grew a little bit more confident in patient management. I might not be right all the time, but I play safe. I’m also not as easily bullied, unlike when I was in junior postings. Most senior HOs are quite the same, all over Malaysia.
O&G department in my hospital do have its share of bullies, especially some medical officers (MOs), but I am quite confident enough to stand up for myself. Ask me to assist in Cesarean, I will gladly do. Ask me to run for blood, I will deflect those responsibilities for those who should have done it in the first place (PPK, Porter darah). Yes, I get some yelling the next day, but I raised my voice sufficient enough to let the medical officer know that me running for blood only compromise the time for patient to receive blood products, compromise my safety, doing something of no clinical value.
Some nurses, PPK and even sisters tend to bully house officers to do things that they don’t need to do. Lucky me, I can find flaws in their reasoning and my voice is somehow louder than theirs (oh yes, I learn to shout in this department).
But as you grow more senior, your responsibilities grow too. We need to be humble as well. We admire humble seniors. What seems to be the problem is that some seniors thought it’s time to bully all the juniors as they wield power. What power, really? House officers, medical officers, registrars, specialists, consultants – are just separated by hierarchy. A complain letter goes through, they become power-less. Especially at this time when more and more people are listening to the plight of house officers (or more like when house officers have bigshot parents in the government service).
You can assert yourself on what you want, but be reasonable. Don’t overuse your blessings, as you might not have one when you need it most.
I pray I am the humble type.