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DUTY OF CARE

I was listening to the morning show on the radio yesterday. I was glued to my seat because the topic then being discussed was an interesting one. It was a narrative of how a 28 year old man had reported to the hospital for simple appendectomy (surgical procedure to remove the appendix) resulted in extensive third degree burns to his abdomen, waist and knees. A procedure scheduled to last 10minutes by a very skilled surgeon, inadvertently left the man being discharged from the hospital with severe complications.

The cause of this was from a malfunction of a diathermy machine (a machine which utilizes electric current to either cut through tissues, or to cauterize (burn/close) small blood vessels to stop them from bleeding.

This had happened at Ridge Hospital some months ago and left the patient admitted for several months, inspite of the medical condition he came with.

I become worried because this wasnt an expected complication. Checks were seemingly not done before the surgery. Was this the first time the diathermy machine was used? Who has to perform such checks? Doctors? After the surgery, he recuperated from the appendicitis 2 days afterwards, but the appalling state of his wounds warranted the desideratum for his daily dressings, that he spend months on his hospital bed.

According to him, he hardly saw his doctor around because of his busy surgical schedules. Surprisingly, the nurses neglected him without exception. He thus wondered the responsibility of care he had to be offered. To make matters worse, he had spent of a lot of money on drugs and hospital bills that he had run out of money.

Later, the hospital assumed responsibility for everything that had happened and paid him back every penny he had spent; but the scars still lingered.

A lot of people have openly lashed out at us with concerns on the state of health care in the country. On my recent facebook post, a user suggested the relatives of the patient sue the doctor who failed to perform adehiolysis– a surgery intended to improve the condition termed frozen abdomen in my previous post.

A lawyer well versed in medical knowledge, was then invited on the show, to inform the populace on measures they could take, if they questioned the health care rendered by a health care practitioner. According to him, before any consent form was signed, the patient of a sound mind, or a close relative had to agree to the procedure and be informed of the risks involved. In addition, they were supposed to know the complications to expect after the surgery and finally, where to report to, if things went wrong.

I literally laughed in my head, when the long list was metered out by the lawyer. Indeed, that was standard practice! I recall the first time, I asked a patient to sign a consent form for surgery. I was interrupted mid-way as I was explaining the procedure to him, not because he did not understand the language being used. He said he was going to die one day, whether he consented to the surgery or not. He did not give me the opportunity to proceed further because He was of the firm belief that his life was his and no one else’s. “Health care knowledge cant be forced! Stop talking!” As rude as he was, i hurriedly took back the paper because I was relieved that I had enough time to attend to the fifteen patients who were yet to be seen to that day.

My next session was hilarious, you should have seen me trying to explain to an 80 year old woman; who has never sat in a classroom; how a tumour of the pancreas had obstructed the flow of her intestinal contents, and the fact that she needed surgery to get better. The relatives of the patient requested she was discharged the next day because they had heard of a miracle man who could melt “stomach things” just by the touch of his hands. Further explanation fell on their stony dull ears. They brought a letter requesting for her discharge the next day.

I wont pull out the many encounters we have had with patients, but it is with unmarred patience that, we as doctors endure this profession. Many people see the labcoat and think we sleep and wake in a bed of riches, oblivious of the things we go through physically and emotionally.

They are amnesic to the fact of how it feels when your wife does not see you in 3 days? Blind to how it feels when your sleep is interrupted at 1am by the patient who is pouring his bowels out at home; right after you have returned from duty? Incognizant to how it feels when you are attacked in the middle of the night with knives because your duty could not afford you the luxury of getting home early. Inattentive to how it feels to empty your pockets everytime your duty of care conscience probes you to give willingly.

This is not the time to apportion blame, or direct fingers; as to whether the government has provided the necessary things needed to optimize health care, or unbalanced doctor-to-patient ratio which has rendered health care suboptimal. I believe it all starts at the bottom – the mass! We have to join hands as individuals to move the nation forward; by understanding things that could adversely affect our health, we have to know when to report to the hospital for health care, and know how to help doctors to help our own selves.

Its astonishing how doctors spend a majority of their time in the hospital, but so little time in church; but believe healing comes from God. There are many instances we have to gallop out from church service, just to ensure we keep the patient, on the hospital bed, who is near death, alive!

Before you lash out at any doctor or health care practitioner, please take the time to ask questions, clarify your doubts and keep a clear conscience; and not just fling insults at us, because you were treated unfairly by a doctor.

We as doctors have sworn the Hippocractic oath to make the lives of our patients our topmost priority. We are of the firm avowal, going against an oath like this carries many repercussions.

Anytime you go on your knees, pray for that doctor you have not seen yet, who spends 48 hours a day, to complete his shift, completes eight surgeries in a day and beats himself mentally and physically, that the inmates under the umbrella of his care, get well.

Pray for God’s supernatural strength for him and the mental capacity to take care of any person, with the same love and compassion. Because we, as doctors, are also human!

Eliezer

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