The bearer of bad tidings!
I saw a young lady last week with gangrene of her left foot. She had developed a sudden pain in that foot while returning from an errand a month before which left her unable to use the limb. As is usual in this part of the world, 'forces of darkness' had been responsible for the pain and loss of function. It was suggested by many people that she had stepped on some fetish and thus was unable to walk.
She presented a month after the initial episode with gangrene of the foot. All her toes were already very dark. She was cachectic, pale,and very unhappy. I took one look at her and knew right away what needed to be done, I was sure that my diagnosis and suggested mode of management would not be warmly received.
She was my first patient that morning and I wondered at my rotten luck to have to dish out such unpleasant news to a young woman. I did not rehearse the lines running through my head ('young lady, the only way your life can be saved is to have an amputation'). How could I utter those words to a family who had come to me to give them hope. They wanted to know that their daughter would be alright not have some dokita leave them bereft of hope.
Over the months I had decided that the best way to dish out unpleasant news is to go right to the point without trying to hide under high sounding words. It may make me look callous but I don't get the stares or the unasked questions from relations who think you are giving them hope just to have everything come crashing down when the truth is finally revealed.
Anyway I told the lady and her relations that she needed an amputation and only that could save her life. Their response was that of the initial shock and then the deluge of pleas began: Could nothing else be done? What if we take her to another hospital with better facilities? Can't any drugs be given? etc, etc.
I really wish I had good news to give but I didn't. I looked at this young lady who may have had her two feet intact if her folks had done the right thing and brought her to a hospital instead of listening to old wives tales! I looked at the father whose tears mingled with his daughters and shed my own tears unseen. Her mother on the other hand could not contain her outburst and had to leave the building. Why o why did I have to give such bad news?
She presented a month after the initial episode with gangrene of the foot. All her toes were already very dark. She was cachectic, pale,and very unhappy. I took one look at her and knew right away what needed to be done, I was sure that my diagnosis and suggested mode of management would not be warmly received.
She was my first patient that morning and I wondered at my rotten luck to have to dish out such unpleasant news to a young woman. I did not rehearse the lines running through my head ('young lady, the only way your life can be saved is to have an amputation'). How could I utter those words to a family who had come to me to give them hope. They wanted to know that their daughter would be alright not have some dokita leave them bereft of hope.
Over the months I had decided that the best way to dish out unpleasant news is to go right to the point without trying to hide under high sounding words. It may make me look callous but I don't get the stares or the unasked questions from relations who think you are giving them hope just to have everything come crashing down when the truth is finally revealed.
Anyway I told the lady and her relations that she needed an amputation and only that could save her life. Their response was that of the initial shock and then the deluge of pleas began: Could nothing else be done? What if we take her to another hospital with better facilities? Can't any drugs be given? etc, etc.
I really wish I had good news to give but I didn't. I looked at this young lady who may have had her two feet intact if her folks had done the right thing and brought her to a hospital instead of listening to old wives tales! I looked at the father whose tears mingled with his daughters and shed my own tears unseen. Her mother on the other hand could not contain her outburst and had to leave the building. Why o why did I have to give such bad news?
...the tough part of medicine.
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