olaoluwatomi

My dreams to read medicine coincided with the emergence of HIV/AIDS on the global scene. It was I presume one of the reasons my dad tried albeit unsuccessfully to dissuade me from the pursuit of a career in medicine. My first inklings of the disease had to do with the pictures of patients with full blown AIDS, My first glimpse of a patient with AIDS was exactly as the pictures portrayed. I can still remember him, he was dark in complexion, he lay back in bed hardly able to move, he stared at us with sunken eyes, his body emaciated, fat pads long disappeared, he was too ill to even talk. It was my first posting in clinical school; patients with AIDS were something of a novelty then. We all stared at him from a distance of about two feet as if the virus was waiting to infect us if we dared come close enough. He may have been the subject of a residents teaching (I can’t remember now) all I remember is how we stared at him, unwilling even to offer a word of comfort lest he grasp our hands ...

I have never sat down to critically analyse old wives tales especially those that relate to my practice as a doctor until an incident that occurred yesterday jolted me back to have a rethink. As medical students we were told to critically analyse the responses of our patients, inquire into certain points of history deeper and we may just realise that the history given is not a true representation of the facts. Why? Cultural practices, taboos, faith based beliefs etc. Yesterday i was on call and as is the practice was around in the emergency room following the arrival of victims of a road traffic accident, after attending to them, we had a brief respite so we decided to sit down. All of a sudden shouts of doctor, nurse come and help us rent the air, the nurse went out first and i followed soon after, apparently one of the women who had been seen earlier and told to wait outside while we were attending to the accident victims because of the constraints of space was having a seizure. In t...

One of my earliest childhood memories is of a trip to the dentist, it was a saturday morning and we woke up early to make the appointment as our house was a long way from the clinic. Fortunately i had no holes that needed filling or teeth needing extraction so my memories remain pleasant. I remember champing down on a mold of my teeth filled with ?toothpaste. Unfortunately over the years my clean dental record has been marred by several fillings, one root canal and one tooth extraction. My record however will not win me a guiness world record. Thank God and i still think i can appear anyday as an advert on for any toothpaste company worth its salt. Anyway i visited the dentist yesterday were i work for the first time, i had been having a few painful reminders from my right upper premolar about the presence of a crater that needed urgent attention. This visit was different since i had never attended this clinic before and now everyone who saw me knew that the doctor had a problem. I hav...

One of my favorite songs is by ‘Point of Grace’ the lyrics of the chorus goes thus; God loves people more than anything (2ce) More than anything He wants you to know He’d rather die than let you go, God loves people more than anything I was on call over the weekend and I saw a middle aged man who was brought in by His children and other family members with a three day history of sudden onset abdominal pain, he cold tell you exactly when the pain started. The pain was severe, constant, worse in the epigastrium. He had not passed any urine for twenty four hours. On Examination he was without a pulse or blood pressure, his extremities were cold and clammy, he was breathless, and his abdomen was tense with generalized guarding. An erect chest X-ray showed a lot of gas under his diaphragm. We made an assessment of a perforated Duodenal Ulcer. His condition did not improve despite our vigorous attempts to resuscitate him which included 11 liters of Normal Saline, he did not make any urine an...

The food chain was something I learnt several years ago in primary school and I had no fears about suddenly finding myself at the bottom of the chain, after all I am a human being and not some miserable plankton. I just realized that the food chain can be extrapolated to life situations and in that case I may as well find out that i am some miserable plankton after altheir experiencesl. What do I mean? Well join me to draw parallel lines from a food chain to hierarchy in the medical world. Man................ Consultant Lion .................Senior Registrar Goats................Junior Registrar leaves................Medical Officer/ House Officer There is a pecking order and our teachers never let us forget it, why should we? Experience of over thirty years as a medical doctor is no mean feat and a junior doctor with less than a few years practice had better remember that! My classmates will not quickly forget our whispered comments whenever a snr. Doctor made it known either by his w...

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Why is it that when men are ill they become absolute babies? I just met my patient and his wife who had surgery a few days ago, and what struck me again was the way in which he displayed his helplessness as he described the not so unfamiliar symptoms associated with his post operative state. He is of average build but is bigger than his wife who is slim. But in matters relating to his health he is not able to pull himself together without her help and support. He came into our hospital on an emergency basis but he was subsequently stabilised, his post admission days were not without hiccups so we decided to take him into surgery. he viewed everything that was happening with an extra measure of fatalism and he would almost begin to weep whenever he had problems we considered minor. His wife however was a study in contrasts the roles of defender and helpless seem to have been reversed, where he was whining she was stern telling him to pull himself together, where he acted the weakling s...

When I was a medical student I vaguely became aware of the underlying currents that exist between nurses and doctors. I was at a ward round during my outside posting as a student when my senior registrar was giving the matron an instruction to have a patient with a thoracolumbar fracture log rolled every two hours. Just as he had finished speaking a thin piped voice was heard to say “We will not move him, we were told not to move patients who can move themselves”. In shock we all swiveled to the direction the voice had come from and saw that it was a student nurse that had spoken, of course my senior registrar was incensed and turned the full wrath of his anger on her she also gave him the full edge of her tongue. The matron that had a few seconds ago been with us on the ward round had quietly moved a few feet away and asked us very innocently what the trouble was even though she had been a witness to the way the student had behaved. To cut a long story short, the student was asked to ...

Just did it again. What? Prescribed paracetamol for a patient who sustained what i thought were minor injuries after being involved in a motorcycle accident, she happens to work in my hospital. Of course she came to work barely able to do anything. My boss happened to see her and was apalled at my use of paracetamol and not something stronger. He suggested that if i had an operation and was in the place of the patient i would probably demand something stronger than the opiod analgesic we use here. Anyway this message on the management of pain is taking hold of me, I promise to be a better pain manager than ive been. So help me God!

Its so easy as a physician to overlook the pain your patient is suffering.And not just think that he is just seeking to be noticed. Ive had a few incidents in the last couple of days which have made me reflect on the pain my patients feel and not just shrug it off as their being unwilling to stand a small amount of discomfort. Im naturally someone who cannot stand people who whine especially when i see absolutely no reason from my point of view for their crying or sniffling as the case may be. My mum and sister have given up on the two physicians in the house (my dad and i) who are not moved by their sniffles when they have colds or the aches and pains which to us can be cured with some panadol and rest and not by us putting the kettle to boil for some tea and speaking soothing words of comfort and our undivided attention for the period of time they are not feeling well. To put it in their words we are hard! Anyway i have this bad habit of classifying pain into categories depending on...