"Dr, Klinik XX nak hantar satu patient. NCC*, non-local post-SVD** 3 hours ago at home. Patient unconscious--"
"--S^#T!" I responded in the most dignified manner possible.
There are several cases that warrant the most dignified response possible when you're located in a remote setting over an hour from a specialist hospital:
- Maternity cases with a high chance of morbidity and mortality
- Paeds cases (especially under 5 years old) with a high chance of morbidity and mortality
Those two are the most important to remember; the rest are nowhere near as frightful.
Because at the end of the day,
even when the patient was roused from a deep and seemingly unrousable slumber by you;
even if the blood pressure picked up and heart rate dropped rather dramatically after your fluid resuscitation;
even if the patient managed to arrive at the referral hospital with almost-perfect blood results, normalized vital signs, fully conscious and cheerful;
if the patient dies at the referring hospital
- leaving you flabbergasted as to what the heck happened there after all that??,
YOU
ARE
GUILTY
OF
...
SOMETHING.
Trust me.
Cry two nights in a row and then, puffy-eyed, go to the mortality meeting and explain how you have done everything within your means to help the patient; fingers will still point toward you for something completely out of your immediate control.
How would you think the patient will die because of a diagnosis you cannot arrive to, simply for the fact that it hasn't developed yet at your center nor do you have the facilities to diagnose it?
Doesn't matter, you were the cause for not having prophetic powers.
Conclusion:
1) Mortality meetings exist solely to shift the blame and not, as they are touted, to improve patient care, avoid further mishaps or 'banana trees fruiting twice'.
2) Don't become a doctor. It sucks.***
*NCC - non-clinic case
**SVD - spontaneous vaginal delivery
*** Okay it has its perks. But seriously don't do it unless you have a ten-metre-thick face and a heart encased with 5-ft steel, resilient to the most pointed misfortunes, insults and humiliation directed to you. Or just go non-clinical, heard the grass there is so green it's fluorescent.
"--S^#T!" I responded in the most dignified manner possible.
There are several cases that warrant the most dignified response possible when you're located in a remote setting over an hour from a specialist hospital:
- Maternity cases with a high chance of morbidity and mortality
- Paeds cases (especially under 5 years old) with a high chance of morbidity and mortality
Those two are the most important to remember; the rest are nowhere near as frightful.
Because at the end of the day,
even when the patient was roused from a deep and seemingly unrousable slumber by you;
even if the blood pressure picked up and heart rate dropped rather dramatically after your fluid resuscitation;
even if the patient managed to arrive at the referral hospital with almost-perfect blood results, normalized vital signs, fully conscious and cheerful;
if the patient dies at the referring hospital
- leaving you flabbergasted as to what the heck happened there after all that??,
YOU
ARE
GUILTY
OF
...
SOMETHING.
Trust me.
Cry two nights in a row and then, puffy-eyed, go to the mortality meeting and explain how you have done everything within your means to help the patient; fingers will still point toward you for something completely out of your immediate control.
How would you think the patient will die because of a diagnosis you cannot arrive to, simply for the fact that it hasn't developed yet at your center nor do you have the facilities to diagnose it?
Doesn't matter, you were the cause for not having prophetic powers.
Conclusion:
1) Mortality meetings exist solely to shift the blame and not, as they are touted, to improve patient care, avoid further mishaps or 'banana trees fruiting twice'.
2) Don't become a doctor. It sucks.***
*NCC - non-clinic case
**SVD - spontaneous vaginal delivery
*** Okay it has its perks. But seriously don't do it unless you have a ten-metre-thick face and a heart encased with 5-ft steel, resilient to the most pointed misfortunes, insults and humiliation directed to you. Or just go non-clinical, heard the grass there is so green it's fluorescent.
