By hook or by crook.

I was taking care of a patient diagnosed with locally advanced breast cancer, and just had the mass removed. The other day I dropped by just to make sure she was doing fine, and while we were discussing about her future management plan, she broke into tears.

"I don't want to have that chemotherapy, it would make me suffers more!"
 "I'll consume more vegetables and fruits, stop taking any canned food or processed food, and eat some traditional medications', she was firm about it.
"Please don't make me go through that suffering with chemotherapy".

After spending half an hour explaining to her about chemotherapy, healthy lifestyle and traditional medications, she seemed to be shaken a little bit, but........
"I shall ask Tua Pek Gong for comments", I think my ST elevated acutely.

If a person is willing to listen and believe what a lay person told them about their disease, why can't those with professional knowledge do the same charm? They rather believe the facts (posted by dono-who) on the internet, but not to take in a single word from us, a group of professionals who spent five endless years in med school, and many many more years ahead in order to understand the disease deeper, a group of people known as DOCTORS.

Why are our patients rather turning away from us to alternative traditional medication?
Our drugs are nicely labeled with contents and side effects. (at least you could win a lawsuit shall anything went wrong)
Herbs tasted a hundred million times worse than any of the tablets we could offer, but why are they willing to spend time to boil it from five bowls of water into one saturated bowl of.......well, you know how it taste like.

The only acceptable explanation I could think of is, these every other options give them hope. 
(even if it is a false hope)

"If you take this herb, the cancer will melt away, you will be fine in 3 months time!"
"My friend's mother's daughter's friend once was diagnosed with cancer, doctor said she only left with 3 months time. That was 3 years ago. After drinking this (dono-what health products), she is still alive. I met her last weekend, she just had a baby girl"
 
As opposed to how we sell our treatment plan.

"You will need to go for radiotherapy, where your skin might get burn, but no worry, we will give you some cream to put on it"
"You will have chemotherapy, where we inject very toxic medications into your veins to kill the remaining of the toxic tumors. You might feel nauseous or even vomiting, losing piles of hairs, having skin and nail changes. Ouh yea, your immune system are basically knocked down by the drug too, but no worry, we will take care of it".
"And despite all these, you might still have a recurrence and die from it"

You see why we fail?
They lost hope in us.
Apparently a crook does a better job than us.

We have what known to be the best treatment in hands, but have no idea how to sell it. Other healthcare-related faculties seems to have marketing included in their curriculum, why not ours?

We failed badly in encouraging our customers to use our products, we failed horribly in engaging them in services we provide. Despite being able to label them with fancy diagnosis, we failed every other thing.

Now, try selling that iron tablets to a pregnant mother, push a little harder, and be gentle!
You better make sure she takes it, BY HOOK OR BY CROOK!
(that's a good idea for OSCE counseling station?)


-FiShe-

The reality

Originally posted on Kazayo

Have you ever wondered why the patient rather lie to you than being honest about their medical condition?

Yesterday, a patient was scolded so badly by the Medical Officer, because she defaulted the computed tomography (CT) appointment given to her due to her malignant status. She was in very bad shape, having really bad pain, sobbing away. Having surrounded by 5 fellas at once in a small room,  having to bear with the pain while these people do an ultrasound scan. She was left all alone in the room while the rest just walked away, discussing about her case. The poor thing was shouting for pain more than half an hour ago, no one bother to relieve the pain before doing the scan.
Then, the Medical Officer came in and started asking her why she defaulted the appointment, and refused medical treatment previously. My point of view, that MO was directing her frustration of having to do more work just because she wouldn't have to make another appointment for the imaging if the patient had turned up for the previous appointment.

Did anyone take a chair, sit beside her bed and ask her why she refused the medical treatment at the first place but rather turned towards some traditional treatment which made her condition worse?

I can totally understand why the patient refused treatment. There's no surprise if she is doing the same thing again for this recurrent thing, if she is treated like this.

This morning, I went to the hospital right after my Sahur, it was 6++. A patient stopped me at the first cubicle and told me there's one patient in deep pain, curling on the bed. I asked that patient if she was given any pain medication and when was the last dose. Then I attended to the HO at the nursing counter.

"Dr. the patient at bed x is having very bad abdominal pain, pain medication was last given at 3 in the morning. She came in because of dysmenorrhoea, and diagnosed with.......bla bla bla"

"It was written on the drug chart a BD dose right? At 8 in the morning and 8 at night"

"Yea, but she is in a bad shape now, you might wanna give her something to ease the pain?"

"You saw the drug chart right? It is a BD DOSE", he stared at me.

"Anyway, you might wanna have a look at her", I tried to hold on not to explode.

He walked off so unwillingly.

I almost whacked him with my messily-filled logbook - Eh harlo bro, you have a damn MBBS with you and you can't prescribe a damn pain killer for that poor patient who is curling into a ball because of the pain?! Damn you......
*spit on the basin*

Now I see why the Old Man is so upset.

For the first two weeks, I was really upset about the posting. We have different professors in charging for different wards and taking us for different topics on bed-side teaching. Each of them have different preference, each of them see things from a totally different point of view and of course have different expectation.
These people never came into consensus, but rather expect us to fulfill what they expect us to do. This is very unfair.

Covering all the beds in the wards, crowd around in the clinics, follow patients to the OT for surgery, having to complete the clinical skills assessment, speak up during classes or teaching sessions. We rarely have time to eat or shit, not to say extra time to mug up our medical facts. Then, during bed-side teaching, we screwed it up.
At times, we sneaked back to the school to be assessed by our Sister regarding the clinical skills, which is compulsory, then the Professor in the ward is making noise, saying why aren't we in the ward. When we went to the clinic following one of the professors, another Professor blamed us for wasting time in the clinic where we don't know what we are learning. One said go ahead to get some experience and observe different operations being done in the theater, the other one said there's no point going into the theater. Worst thing, when our logbook looks pretty empty on the procedure page, another one make noise.

We, the vulnerable one, always keep quiet, taking in every blame.

But hey, that's the reality isn't it? In the real world, that's what exactly happening. 
There is never a consensus being made.
You mold yourself according to different situations, and try to survive between the gaps. 
Now that's reality!
Stop complaining and find your way out!
"Be the change you want to see"

You are not here to learn the right things, you are here to learn things right - Prof. S.

-FiShe-

Introduction to Med Tutee.

In conjunction to MedTutor, a group of final year medical students have been inspired to create a platform to share their thoughts and dreams.

In this blog, we would like to share our views and perspectives beyond sickness, suffering and death.

Through each footstep, it helps us in understanding the core of humanity and brings us closer to what is beyond.

In the end, it is not how much you know about the medical world, but what you have gained from it.

How far we've come, and how far to go......

-Med Tutee-