Thursday, November 07, 2002

After being literally thrown in the deep end, I'm happy to report that my first week in the medical intensive care unit has been a fruitful one. The usual consultant covering the ICU with me is on leave, so I've been mentored in the meantime by a young registrar, who's a really really nice guy and supervised me on loads of procedures. As a result, I've gained the confidence to do most line insertions solo. And let's not forget my horrendous but extremely exciting call last Sunday, during which 6 cases came to the ICU, 3 or 4 of whom were sick beyond imagination, requiring me to set lines on more than half of them ( also solo, had an easygoing reg on call with me -- many thanks to him for entrusting these sickies to my care ( popping by only when I paged for help ). So to paraphrase a Starship song: Nothing's Gonna Stop Me Now. :D

Patients here in Changi, however, are a far cry from those in the Singapore General Hospital, and even the National University Hospital. Most people there aren't fussy, and they're honest with you. Sure, there're a few unreasonable ones who make stupid complaints about small things, but I currently have an ill patient here in the MICU, whose son INSISTS on speaking to a consultant everyday -- he refuses to talk to anyone more junior. He's also trained in biochemistry ( though I'm unclear about his exact job ), so he'll ask to see his father's blood test results and will then grill you on what treatment is being instituted for the various abnormalities. He once even asked to read the case notes, but I told him outright that it's confidential and only medical personnel are allowed to see them. Don't think he was too happy about that.
My main peeve, though, was during my Sunday call, when this same guy strolled up to me while I was frantically scribbling in the file of a new admission ( unstable, intubated, you get the picture ), and asked to speak to me about "something". He was brandishing a thick file at the time, which I assume contains tonnes of information regarding his dad's medical history. But I'm the sort who can't care less about stroking someone's ego when there's an emergency going on, so I told him ( nicely, might I add ) to wait while I attended to the ill patient, and that I would talk to him later. He gave me a sweet smile and said, and I quote, "Don't worry, I understand. It's okay."

Guess what he did next?
First, he went up to the nurse-in-charge and told her I "wasn't very receptive", then he walked out of the ICU and didn't return. So after I settled the new case, I thought he'd left, and so I popped over to another ward to review other admissions. Later in the afternoon, the nurse told me he was still waiting to talk to me, but by that time, other new cases were arriving in droves, and I again couldn't find any time to chat with him.
Monday morning, he waylays the consultant upstairs, and tells her nobody downstairs wants to speak to him, but she's aware of this guy and his attitude, so she sends him back down. And that's when he starts this habit of talking only to the ICU consultant, and has left me alone ever since. ( And believe me, I am NOT complaining! )

I'm sure I'll meet more of such unreasonable relatives, and patients. But my stand is, if you want doctors and nurses to jump whenever you snap your fingers, go to a private hospital and pay for the service, instead of pushing your weight around in a government institution. Unfortunately, the administration is always sympathetic to the "clients", and fully investigate any complaints that are filed -- a huge waste of time and resources, in my opinion. Hence, one of the main draws of emergency medicine is minimal contact with any nasties, and even if we need to carry balls, it's usually only for a short time ( unlike daily rounds and worse, clinics ).

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