Cast iron system

I have to admit that the work at the dispensary is growing on me. Maybe it has to do with outlook. I used to travel to the dispensary with the feeling that I somehow had to be here for a few years, till I could go back to my city, at the next due General transfer. But nowadays, the journey is easier, made pleasant by the recognition that people bestow upon me.

At college, one of the questions put to us as students in first year during impromptu sessions was the question, “Why did you become a doctor”. The hated cliche, was to answer that it was to serve humanity. That always brought out the boos. I never felt that this was the reason for choosing the medical profession. As for me, I never even considered joining a medical college, till the first year of engineering college. Yea, that’s as good a tale as any, but we’ll save that for later. It was the most sought after profession, and a different experience when Information Technology was the in thing. Anyway, now I’m beginning to understand the service aspect of it, and welcoming my role in it.

Though the junior most doctor in the dispensary, thanks to the seniors here, Dr Devarajan and Dr Muhammed Riaz, I’ve never felt looked down upon. It may have been partly the experience of being a Casualty medical officer at X Hospital, Trivandrum. I had my share of proud moments, some of the more memorable ones being when I rightly diagnosed a patient misdiagnosed by the senior consultants at the private hospital. A particular incident jumps to my memory. A patient had got himself admitted in the care of Dr Name Redacted, a physician at Jubilee the previous week. Part of my job as the Resident Medical Officer, was to take rounds in the wards. I came across the case due to some trivial complaint made by the patient. However after a summary history taking and brief examination, it became apparent that the patient was not having a simple case of “Generalized tiredness”. In fact, I got a history of weakness in his feet, and a sensory impairment in his legs. I heard the warning bells go off in my mind. Some finer examination made me make a provisional diagnosis of Guillain Barre syndrome. I informed the consultant as was my duty. However, Dr Name Redacted, is, well, let’s just say that he has his own style of clinical approach. But he redeemed himself by referring the patient to a neurologist.

Unfortunately the neurologist either missed my notes, or didn’t pay much attention to them (After all, who trusts a doctor with just an MBBS, right?). He gave more attention to the low blood sodium values in the patient, and his advice was to add more salt in the diet. Dr Name Redacted called me up and explained to me in no uncertain terms, how I had been wrong in diagnosing the patient as a case of GBS. I didn’t argue. I probably should have done so for the patient, but I didnt think it would make a difference. In an altercation between a junior doctor and a consultant, the consultant who is a valuable asset to the institution always has his way. I didnt see the patient until 4 days later, when on another night duty, I was asked to write a referral note for a patient. It was the same patient, and I was disheartened to see that now he was paralysed from the neck down. He had not fully developed motor weakness when I’d first seen him, and could have gone home that week if started on some anti-inflammatory medicines early on. Instead, he was made a cripple. I can’t blame Dr Name Redacted for his approach. He did his due, and referred him to a neurologist. However it is still saddening that a case which a junior doctor diagnosed just after spending a few minutes did not receive the proper attention from a consultant just because the junior doctor did not have a list of post graduate degrees following his name.

In such cases, what can you do? Fight the system? Go head on against the senior arguing for what you think right? I did make my argument. I clearly outlined my examination and history findings, as well as any neurologist does. Thankfully, my alma mater and my extracurricular reading had bestowed me with those skills. But when you’re ignored, and just a part of the system, and not the decision making part, at that, you often have to resign yourself-bite the bullet and accept fate. Right?


You are reading this post on The Eyrie, Joel G Mathew’s Blog.
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