Saturday, June 30, 2012


    I often wonder, if medical doctors or their medical professional colleagues become insensitive to the problems or not . I was quite upset and sad when my own dad was sick and then passed away at age of 88 years. But I do not feel same sadness when I see 88 years old patient . I do however feel very sad and emotionally upset when I know the patient for a while . The age does make a difference, but more often it is the closeness that one develops that make us sad or indifferent . So I don't think we as healthcare professional have become indifferent to the problems of the patients as we face them daily , on the contrary as we see it daily , we develop 'insight' in to it . This story is of a patient where sometimes we did show insensitiveness.

    It was almost 5 pm on a weekday, when I was called by the nurse . One of the patients that I had seen in the morning had abnormal x-ray. I saw him in the morning this 78 years old  patient , who had a stroke . He was OK but was mildly short of breath. His swallowing was not normal and so I had ordered a swallow study and and X-ray . He was quite weak and could not clear his own secretions. The nurse called me at 5 pm , telling me that the x-ray showed that his entire left lung was collapsed. This can sometimes occur due to inability to clear the secretions. We give them what is called ' pulmonary toilet '. This helps in most of the cases. This time however his entire lung was filled with mucous and with his stroke and the advanced age , he was unable to clear it and was not likely to clear it without the help . We do a procedure called bronchoscopy , in which we put in a tube into lung through nose and suction out the secretions . Once this is done most of the patients can 'maintain ' the patency of the airway. So even though it was 5 pm I had to go to do the bronchoscopy . I told the nurse to get the consent for the procedure from the wife and called the endoscopy nurse on call to come in .I was hoping to do the procedure by 5 -30 pm .The nurse called me right away. She was already called by another doctor to an endoscopy. So she told me that I can do it when he was done. The procedure that he was going to do, normally takes 10-15 mins. only. So I decided to go to the hospital.

    When I reached the hospital , I went to ICU, hoping that the nurse would be there . She was not there. She was still busy with other doctor . His patient was in ER . So I decided to go to ER,as I knew that this doctor was easy going and takes his own time , unless pushed .

    When went to ER the gastroenterologist was there , the nurse was there . The patient was a30 years old female, who had swallowed needles . On the X-ray box there were 2 X-ray . One showed 2 needles and one had only one needle . So I asked the nurse if the gastroenterologist had removed one needle. She answered, "No, the 1st X-ray is from last admission, when shw swallowed 2 needles, the second one is from now . This time she has swallowed only one needle. ITHINK SHE IS IMPROVING!

I did laugh. Have I become too insensitive?

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