A Doc's Life is a underground Medical Blog about some poor Singapore doctors. They are sibei sian and very buay song. Best practices not observed!
(Warning: Grammar is non existent in this blog. Those obsessively compulsive about good English please go no further and book an appointment to see your psychiatrist in Singapore.)

Saturday, August 20, 2005

The Time I Almost Cried

Jusme commented:

"i guess your caring profession makes you numb and devoid of feelings after a while, no offence intended....."
Doctors are often misunderstood creatures. The reason being we do not explain ourselves enough. Let me tell you a story.
There were 4 doctors belonging to the same team working in the oncology ward (cancer ward). One day, a 14 year old patient in the ward became short of breathe. Suspecting that he might be suffering from pulmonary embolism, the HO rushed to arrange an urgent scan for him. In that few minutes he took to arrange the scan, the patient collapsed and was intubated by the Registrar and MO. He was then transferred to the ICU.
Despite being in the care of the ICU team, the 4 doctors made their way to the ICU each day after their tiring ward round to visit this child. There were tubes all over his body and the size of the machines around him made him look small.
On the 4th day, the boy woke up. When the team visited him in the ICU, the motherly Consultant took the boy's hand and gave words of encouragement. He could not speak as he was still intubated and he could not move as he was too weak. There was a look of despair and desperation in his eyes and he started crying uncontrollably. At this point the Consultant could no longer contain her emotions and teardrops welled in her eyes. The Registrar turned towards the wall to hide his face while the MO quickly wiped her tears off with tissue. The HO who was standing at the end of the bed had no wall to turn to. He too felt the despair of the child. A 14 year old boy who would otherwise be kicking a ball in the soccer field was here, gaging on the endotracheal tube as he cried, tied to the bed by the numerous IV lines. He tried to hold back his tears, he was the only real guy in the team and he did not want to cry in public. Maybe a drop did trickle down his cheeks.
The team was quiet after leaving the ICU. They did not talk about their feelings. Perharps they felt embarrassed by the public show of emotions. How unprofessional! The HO felt puzzled. The hospital is a place of great emotions. The oncology ward even more so. Depressed patients going through terrible sufferings and families devastated when their love ones succumb to the illness. How was he to cope with all this? How was he to continue doing his work if he could not control his own fear of death and suffering? How was he to help the patients feel that there is hope if he was a depressed wreck?
He promised himself: he will not cry again.

8 comments:

  1. Personally I found the rollercoaster of emotions too much to handle on top of the heavy work load. As such I told myself that in order to function as a MO/HO in the hospital I had to seperate emotions from duties always remembering that compassion and empathy WAS part of my DUTIES.

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  2. Anonymous2:44 PM

    Whoa its awesome that i chanced upon your blog. Im pretty much an aspiring med student possibly 5 more years to go and my doctor friends like to tell me get out of it while you can.

    Whats your take on being a doctor so far? Ups Downs? Best Moments?

    Just curious.

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  3. Not all doctors are heartless. Although crying infront of patients seems unprofessional, but we are still a human beings with feelings. Till now, after 1 year in nursing i still dunno how to control my tears. And i still dun like patient pass away infront of me.

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  4. numbing is just our way of defending ourselves. how else can we go on day in day out feeling each and every pain....

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  5. Anonymous9:30 PM

    I remember during HO days in oncology ward, my consultant cried when a terminally ill patient was becoming weaker, was passing out pure blood and not motion. He died a few hours later. I always thought my consultant was the harder than stone/steel type..

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  6. I really cried very badly ONCE.

    I was a HO in SGH Urology. There was a patient who came in for an elective removal of a double-j ureteric stent.

    I recall clerking her on a sunday and taking consent from her. She asked me is it going to be dangerous? And I said "Not high risk lah anutie" (in mandarin) She was very anxious and she asked me that question like 5-6 times when I was asking her to sign the consent form. I reassured her several times. Anyone HO clerking elective admission cases on a Sunday who is not on call would know what I mean.

    Anyway the next day she had her op. And the following day she was due to be discharged. Anyway at about 12pm on the day she was supposed to be discharged, she developed sudden chest pains, tachycardia and hypertension.

    We did the usual emergency work up, ECG, CXR, full bloods, call cardiologist, move to HD bed. The working diagnosis initially was that of anemia her Hb was 9 and she received a pint of PCT. I remember she held my hand in HD and asked me "why is this happening? You told me nothing would happen." About 2 hours later she collapsed. And despite our best efforts, she passed away. My urology consultant, urology registrar, the cardiology consultant, the cardiology registrar were all there.

    When the relatives came they asked me to speak to them! Anyway I went out and they started crying. When I finished I went to the room to cry. I had reassured her.....

    Anyway I never felt the same about taking consent for operations that I really wasn't going to perform myself, had never seen one and might never ever see one. I thought the system was silly.

    I learned that with anaesthesia and any operation, there will always be serious risks. The post mortem showed she died of a massive pulmonary embolism. There was probably nothing anyone could have done besides God. But will doctors tell every patient going under the knife that they had a small possibility of dying from massive PE? Probably not.

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  7. sigh, remember once an otherwise fit 60 odd year old lady had a right hemicolectomy for Ca. She was well for two days but just suddenly collapsed and died the next morning. Her daughter was crying out loud "the doctors killed my mother! I will never see a doctor even if I die!" it was really heart wrenching.

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  8. Anonymous8:23 PM

    You said doctors are misunderstood creatures. But why? I know numbing is one of body's defence mechanism. I understand you have to act professional and separate duties and emotions to carry out your duties, but it does make a difference to both patients and families to show slight emotions, to show that you are human too, like a touch of a hand. Is that too much to handle or too much time consumed??

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