Coping with heartache..........
I spent sometime talking to my sister and friend yesterday about some of the patients I had managed in the past. I thought I was over them, but talking about them brought back memories I thought had faded from my mind. But you can tell that I still remembered every detail.
My house job year brought me in contact with the suffering of patients for the first time. I had as a medical student been in charge of some patients, but my time with them was limited to clerking them, and following up their progress for the few weeks ( a maximum of 8weeks), we rotated throught the units concerned. A few of them won my affections and I put in a little extra effort to visit even when my time was up. But my responsibility was limited.
House job brought me face to face with death and the dying and it never becomes easier. The patients whose stories shook me were usually the young and strong, previously healthy ones. Sick children too made my heart sink lower especially if the prognosis was bad. People brought in with Cervical spine injuries affected me more than any other trauma case! Malignancies were also another heart stopper.
People say doctors shouldn't get emotionally involved with their patients. Its hard to do so initially but I guess you find a way to cope with it. I walk away! Hold on, I don't shirk my duties or my care of the patient, but I walk away from the knowledge of the path the patient is headed down. I'll explain.I deal with the situation on ground.
I'll give an example, and this example is not just one patient. Its a merger of several people, several cases etc, the only constant is me.
He was a young farmer, the only son of his parents, he was industrious, cheerful, a joy to everyone in his village, evidenced by the large entourage of people who came to see him when they heard of his accident.
He had just that day harvested his cassava and was sitting on top of the tubers in a truck bearing his produce from the farm to the nearest town to sell. The vehicle had only just rounded a bend when the rear tyre burst. The driver lost control of the vehicle which now swerved dangerously making him lose his seat on the tubers and finding a bed on the recently tarred road.
When he was brought in, he was conscious but unable to move any of his limbs, his X-rays revealed an unstable fracture of the 5th cervical vertebrae. He repeatedly called me, the nurses and anyone who passed by him where he was lying to come and help him move his legs and arms. It was a terrible shock that he couldn't for the life of him move around.
What thoughts run through my mind when I see patients like him? Im immediately struck with the sober thought that Im walking and He is not. I can see straight away that it will take a lot for him not to die. His main thought at the moment is 'if I could just move my limbs', How I wish I could get out of bed etc. I see to his catheter for he cant pass urine even if his bladder is full. Im to talk to relatives who do not yet know the gravity of the patients condition and think they are taking him home in a few days!
All these and more add up to make me sad, very sad. 'Walking away' I talk to the relations, giving an overview of his condition, prognosis, cost of care etc. I attend to the patients pressing needs- a full bladder, fluid requirements, write a referral if need be. And when the morning comes and my shift is done, I walk away from the emergency room and the patient but I still carry my heavy heart with me!
My house job year brought me in contact with the suffering of patients for the first time. I had as a medical student been in charge of some patients, but my time with them was limited to clerking them, and following up their progress for the few weeks ( a maximum of 8weeks), we rotated throught the units concerned. A few of them won my affections and I put in a little extra effort to visit even when my time was up. But my responsibility was limited.
House job brought me face to face with death and the dying and it never becomes easier. The patients whose stories shook me were usually the young and strong, previously healthy ones. Sick children too made my heart sink lower especially if the prognosis was bad. People brought in with Cervical spine injuries affected me more than any other trauma case! Malignancies were also another heart stopper.
People say doctors shouldn't get emotionally involved with their patients. Its hard to do so initially but I guess you find a way to cope with it. I walk away! Hold on, I don't shirk my duties or my care of the patient, but I walk away from the knowledge of the path the patient is headed down. I'll explain.I deal with the situation on ground.
I'll give an example, and this example is not just one patient. Its a merger of several people, several cases etc, the only constant is me.
He was a young farmer, the only son of his parents, he was industrious, cheerful, a joy to everyone in his village, evidenced by the large entourage of people who came to see him when they heard of his accident.
He had just that day harvested his cassava and was sitting on top of the tubers in a truck bearing his produce from the farm to the nearest town to sell. The vehicle had only just rounded a bend when the rear tyre burst. The driver lost control of the vehicle which now swerved dangerously making him lose his seat on the tubers and finding a bed on the recently tarred road.
When he was brought in, he was conscious but unable to move any of his limbs, his X-rays revealed an unstable fracture of the 5th cervical vertebrae. He repeatedly called me, the nurses and anyone who passed by him where he was lying to come and help him move his legs and arms. It was a terrible shock that he couldn't for the life of him move around.
What thoughts run through my mind when I see patients like him? Im immediately struck with the sober thought that Im walking and He is not. I can see straight away that it will take a lot for him not to die. His main thought at the moment is 'if I could just move my limbs', How I wish I could get out of bed etc. I see to his catheter for he cant pass urine even if his bladder is full. Im to talk to relatives who do not yet know the gravity of the patients condition and think they are taking him home in a few days!
All these and more add up to make me sad, very sad. 'Walking away' I talk to the relations, giving an overview of his condition, prognosis, cost of care etc. I attend to the patients pressing needs- a full bladder, fluid requirements, write a referral if need be. And when the morning comes and my shift is done, I walk away from the emergency room and the patient but I still carry my heavy heart with me!
You cannot imagine how brave doctors are to me. even from my ife days when I had a medicine student girlfriend, I was morbidly fascinated that she worked with cadavers. well done. we need many more of you with compassion.
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