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Even Doctors Get Sick: What Happens When They’re On Call?

Even doctors get sick, but there is often a difference.

I was rotating through orthopaedics and was on call that night. They tended to relegate us mere general surgeons to casualties during the calls so I was quite excited to get some theater time that afternoon, even if it was for a simple wound inspection and secondary closure and even if it meant there would be a backlog of patients in casualties for me to see afterwards. Once I had finished operating I rushed through the change rooms to get back to casualties. While I was changing I heard the unmistakable sounds of someone throwing up in the toilet cubicle. Quite soon the door opened and out came the orthopaedic registrar who was on call that night with me. He did not look good. He glanced at me but didn’t seem to see me. His face was pale, verging on grey and there were fine droplets of sweat on his brow. He was staggering slightly as he made his way to the basin to throw water over his face. I greeted him but the only reply he gave was a sort of grunt.

Much later that night Read more »

*This blog post was originally published at other things amanzi*

When Cultural Practices Affect The Treatment Of Patients

In quite a few of the cultures in south africa people tie ribbons, strings and tassels around their own and their children’s wrists and waists. These tassels are imbibed with power to keep evil spirits at bay, I am told. If these tassels come off then the patient is completely unprotected from any and all marauding evil spirits that may be lurking around. Of course, not wanting to be responsible for the unopposed assault by multiple evil spirits, most people are fairly reticent to remove these things. I saw it slightly differently.

As a student I took my lead from my senior. If he removed the tassels then I would be ok with it. If he felt that we should respect the culture of the patient and sort of try to move the tassels out of the way of the operating area or even operate around them, despite the increased infection risk, I sort of reasoned it was his patient and even if I medically didn’t agree with him, the reasoning of respecting the patient’s culture surely held some water at least and I didn’t argue. The fact of the matter was that a number of the sisters would become quite aggressive with the doctor if they thought he was going to remove the tassels and strip the patient of his evil spirit protection, and I think some of the doctors were scared. Then one day something happened that cemented my views and actions for the future. Read more »

*This blog post was originally published at other things amanzi*

The Story Of One Medical Professional’s Lack Of Compassion

It affected me.  Not just it, but the fact that it didn’t seem to affect my colleague.

I was a lowly fourth year medical student, delivering babies for all I was worth. Looking back, I realize I enjoyed it. The whole ‘joy of a baby coming into the world’ really gave me joy that a baby was coming into the world. Call me sentimental but I saw each birth as beautiful. Somehow I could look past the meconeum and the amniotic fluid and the episiotomies and see what was actually going on. It was a happy time for the mother (mostly). It was the beginning of hopes and dreams. It was a new start for the baby (obviously) and for the mother, and in a sense, each new birth may have signified a potential new start for me.
She was excited about her new baby, but there was a cloud over her entire admission. The reason she had come in to the hospital was because she hadn’t felt the baby kicking for the last 24 hours and she was worried. Quite soon we were worried, too. Read more »

*This blog post was originally published at other things amanzi*

A Surgeon Watches Helplessly As His Patient Dies

Sometimes different people see the same thing from a slightly different angle, giving a completely different perspective. In my line this can turn out to be quite macabre.

It was one of those cases. It was probably hopeless from the beginning, but he was young and we had to give it a go. As soon as the abdomen was opened everyone knew things were bad. There was blood everywhere. It took a while to even see the damage to the liver because I needed to get rid of the blood in the abdomen before I could see anything. However, once I saw the liver even I was shocked.

The liver was ripped apart with one laceration dropping down to where the IVC sat menacingly behind it. It seemed to spit and splutter at my efforts to bring the bleeding under control in defiance of me. But I did what I could as fast as I could. At times like this the unsung hero is the anesthetist. If he can’t get fluid and blood into the patient fast enough, no matter what the surgeon does, it will be in vain. That day the anesthetist was great. Somehow he kept some semblance of a blood pressure in the patient against overwhelming odds. Read more »

*This blog post was originally published at other things amanzi*

Death Threats For Hospital Pecking-Order Violations

The consultants didn’t always need to know what was happening on the floor. But sometimes keeping things away from them became downright clandestine.

I was a senior registrar at Kalafong (hell). An old friend of mine had just taken up a post as consultant in the department of Internal Medicine. One day he approached me.

“Bongi, what are the chances you can do the occasional open lung biopsy for me?” Now there was no thoracic department in Kalafong so it seemed to me to be a reasonable request. In fact I was quite excited. It would give me a chance to do a few thoracotomies, something us general surgeons don’t do all that regularly.

“Sure! Anytime. Just let me know and I’ll book them on my list.”

“Uhmmm, there is just one small problem,” he continued, “I’ve already asked your consultant when the previous registrar was here and he bluntly refused, so I suppose you would need to convince him.” Read more »

*This blog post was originally published at other things amanzi*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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