When I woke up on Friday the 13th, I just wanted the day to come to its end. I was very tired from all the week doings with all those crap assessments, useless PBHell and running around to sort out thousands of stuffs. And you can tell from the way I'm writing that I hate them all.
So despite my endless cursing, I made my way to the surgical ward for a freaking 8am start and joined the Surgeon of The Week (SOTW) Grand Round. 1 consultant, 1 registrar, 1 SHO and 2 FY1s. The SOTW team reviewed almost 40 surgical patients in all wards (surgical, paeds & gynae patients).
I came across alot of unfortunate patients all of which left me so emotionally ridden.
Patient 1: 32 yo female patient who came in with small bowel obstruction. She had hx of a number of pelvic operations following diagnosis of and recurrence of cervical cancer. She has nasogastric tube in currently, as it was decided that her bowel should be rested.
I had a chance to speak to her afterwards. There were some parts of the encounter that I became very quiet as I was lost for words. It was very heart rending to hear someone of her age talk about three small children. For me it was the fact that all the problem started when she was 29 that did it. Thats like me in 5 years time.
Patient 2: 44 yo female patient who was diagnosed with pancreatic cancer post staging CT. She was told that operation will be arranged towards the end of this month. She asked the consultant whether she could have a weekend leave to see her newly born granddaughter. Unfortunately, she had to stay in-patient as she was markedly jaundiced.
Thats awful.
Patient 3: 23yo male patient who came in post vomiting and severe pain radiating to the back. Scan showed generalized moderate inflammation of pancreas. Dx: Acute pancreatitis caused by alcohol binging (while he was watching the Liverpool vs Manchester game nonetheless).
Consultant: Bla3x (re: long term effect of heavy alcohol consumption). You have to choose which one you love more. Alcohol or your life.
Patient: Errkkk....
Patient 4: A 39yo businessman who had been quite unwell (pain, n+v, although he was not jaundiced) for the last few days and investigations showed cancer of the head of the pancreas. Breaking bad news was particularly awful as it was done at the bed side with all 7 members of the SOTW team gawking. He was calm although there was hint of turmoil brooding underneath. The whole group became deafeningly quite when he asked:
"Whats the chance for this lesion to spontaneously heal itself?"
Consultant: Nil. Bla3x (re: prognosis, options, further ix inc staging CT and MDT)
"Can I have a weekend leave to sort out things?"
Consultant: Bla3x (re: potential complication of cancer i.e. bleeding 2ndry to liver problem, pain, jaundice...which might happen when he's away) So its highly recommended if you could just stay until after the staging CT.
"I need to sort out my business this afternoon (Friday). And just be with my family over the weekend. Gosh. Then I have to write a will."
Consultant: (Giving the space a sweeping glance). Well.... yeah, you can leave by lunch today after the girls check your INR but you have to be back by Tuesday at the latest.
It was eerily quiet. Of course, he is this young man who has alot of things to look forward to in his life at this very moment. Ooo... has I mention that he's an American? Who moved here few years ago after marrying a British woman and has established his own business based here in Lancashire.
I stood there at the edge of bed silently praying that he's alright with the news delivered and may he find strength and faith to cope with the diagnosis and its implication.
Those 4 patients were patients that made me shuddered. There were a lot more (ranging from simple appendicitis to ruptured ones, colorectal cancer, bile leak, retroperitoneal abscess, pilonidal abscess and etc) so much so that by the 12 pm I was crying inside. (yeah, a combination of many many many bad news and my own tiredness and worsening pangs of hunger).
Let us take few minute to reflect the value of life and to say prayers to these patients.
Later that day, I watched ComicRelief. For full 8 hours. 7pm on friday- 3am on saturday. The cause for this year is malaria in the Africa. So few more tears were shed after clips showing how kiddies in Africa died of this preventable disease, which is almost eradicated in other part of the world, due to lack of mosquito nets and medication to treat malaria victim.
Again, let us take few minute to reflect the value of life and to say prayers to these children. And say grace for having what we have.
Hugs and kisses with much emotions,
P53.
PS: As we were leaving patient 4's cubicle, he asked "Doctor, is theres any reason why I shouldnt use Viagra over the weekend?"
So despite my endless cursing, I made my way to the surgical ward for a freaking 8am start and joined the Surgeon of The Week (SOTW) Grand Round. 1 consultant, 1 registrar, 1 SHO and 2 FY1s. The SOTW team reviewed almost 40 surgical patients in all wards (surgical, paeds & gynae patients).
I came across alot of unfortunate patients all of which left me so emotionally ridden.
Patient 1: 32 yo female patient who came in with small bowel obstruction. She had hx of a number of pelvic operations following diagnosis of and recurrence of cervical cancer. She has nasogastric tube in currently, as it was decided that her bowel should be rested.
I had a chance to speak to her afterwards. There were some parts of the encounter that I became very quiet as I was lost for words. It was very heart rending to hear someone of her age talk about three small children. For me it was the fact that all the problem started when she was 29 that did it. Thats like me in 5 years time.
Patient 2: 44 yo female patient who was diagnosed with pancreatic cancer post staging CT. She was told that operation will be arranged towards the end of this month. She asked the consultant whether she could have a weekend leave to see her newly born granddaughter. Unfortunately, she had to stay in-patient as she was markedly jaundiced.
Thats awful.
Patient 3: 23yo male patient who came in post vomiting and severe pain radiating to the back. Scan showed generalized moderate inflammation of pancreas. Dx: Acute pancreatitis caused by alcohol binging (while he was watching the Liverpool vs Manchester game nonetheless).
Consultant: Bla3x (re: long term effect of heavy alcohol consumption). You have to choose which one you love more. Alcohol or your life.
Patient: Errkkk....
Patient 4: A 39yo businessman who had been quite unwell (pain, n+v, although he was not jaundiced) for the last few days and investigations showed cancer of the head of the pancreas. Breaking bad news was particularly awful as it was done at the bed side with all 7 members of the SOTW team gawking. He was calm although there was hint of turmoil brooding underneath. The whole group became deafeningly quite when he asked:
"Whats the chance for this lesion to spontaneously heal itself?"
Consultant: Nil. Bla3x (re: prognosis, options, further ix inc staging CT and MDT)
"Can I have a weekend leave to sort out things?"
Consultant: Bla3x (re: potential complication of cancer i.e. bleeding 2ndry to liver problem, pain, jaundice...which might happen when he's away) So its highly recommended if you could just stay until after the staging CT.
"I need to sort out my business this afternoon (Friday). And just be with my family over the weekend. Gosh. Then I have to write a will."
Consultant: (Giving the space a sweeping glance). Well.... yeah, you can leave by lunch today after the girls check your INR but you have to be back by Tuesday at the latest.
It was eerily quiet. Of course, he is this young man who has alot of things to look forward to in his life at this very moment. Ooo... has I mention that he's an American? Who moved here few years ago after marrying a British woman and has established his own business based here in Lancashire.
I stood there at the edge of bed silently praying that he's alright with the news delivered and may he find strength and faith to cope with the diagnosis and its implication.
Those 4 patients were patients that made me shuddered. There were a lot more (ranging from simple appendicitis to ruptured ones, colorectal cancer, bile leak, retroperitoneal abscess, pilonidal abscess and etc) so much so that by the 12 pm I was crying inside. (yeah, a combination of many many many bad news and my own tiredness and worsening pangs of hunger).
Let us take few minute to reflect the value of life and to say prayers to these patients.
Later that day, I watched ComicRelief. For full 8 hours. 7pm on friday- 3am on saturday. The cause for this year is malaria in the Africa. So few more tears were shed after clips showing how kiddies in Africa died of this preventable disease, which is almost eradicated in other part of the world, due to lack of mosquito nets and medication to treat malaria victim.
Again, let us take few minute to reflect the value of life and to say prayers to these children. And say grace for having what we have.
Hugs and kisses with much emotions,
P53.
PS: As we were leaving patient 4's cubicle, he asked "Doctor, is theres any reason why I shouldnt use Viagra over the weekend?"
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