Almighty Bean

In the medical field, your seniors are like idols… Supposedly they are put there on that spot to inspire you, so that one day you can be in that spot too to inspire the juniors that follow you.  Like in any typical medical series like Scrubs or Grey’s Anatomy though, there are those seniors that are just out there to get to you, to make your knees weak so that you’ll realize that you are not cut out to be a doctor.  These people I have learned to handle.  You just take what they say, let it go in your left ear and out the other ear.  These things should make you a better person, because like the saying goes, “What doesn’t kill me, makes me stronger.”

But this article isn’t about the power-hungry residents of teaching hospitals… It’s about the other kind of terrible doctor.  The ones that are in my opinion, unforgivable, and should never be copied.  They exist.  I know for I have seen this a lot.  But never to the extent like the one I saw yesterday.

Right now, I am rotating in the OB-GYN department.  It was a relatively benign time, and so I decided to take a breather and read on my case.  Then I heard yelling from outside of the Labor room.  It seems that a knew patient has come in.  The difficult kind.  Not the annoying arrogant type, but the silent type with mixed and confusing answers.  The patient was pregnant, but did not seem to be in a healthy state.  She kept her eyes low and refused to answer directly.  I could tell that they wanted to know the answers quickly because this patient looked like she could die that very night.  She had bruises on her body, with one particular bruise on her pelvic area.  And as this fragile patient sat on the wheelchair provided for her, some of my seniors (no names promise) swooped down on her.  They started yelling at her to make her blurt out what really happened to her.

In Tagalog, they said:

“WHY ARE YOU COVERED IN BRUISES?! WHERE IS YOUR HUSBAND?!”

“YOU KNEW YOU WERE PREGNANT AND YOU STILL DIDN’T GO FOR A SINGLE CHECK UP?!”

“HOW MANY TABLETS OF MEFENAMIC ACID DID YOU TAKE?  3?! DON’T YOU KNOW THAT’S BAD FOR YOU?!”

“YOU ARE THE MOST DIFFICULT PATIENT WE’VE HAD TO INTERVIEW THIS WHOLE NIGHT!”

This patient apparently never went for a single check up for prenatal care because she had no one to go with and she didn’t have any money.  A few days ago she was severely beaten up by her own husband for reasons she would not divulge.  This result in blows to her pregnant abdomen, cause her placenta to bleed (abruptio placenta).  For the pain, she took Mefenamic Acid 3 times a day for 3 days which caused her to start vomiting blood streaked material (NSAID induced gastritis).  They are also thinking of a coagulopathy or bleeding disorder (Disseminated Intravascular Coagulopathy) that could potential kill her.  And because of this, her 21 week old fetus was already dead for days inside her womb.

I could see why the residents were stressed about this patient, because she wasn’t a typical pregnant patient that they just had to deliver.  There was going to be a lot of explaining and managing to be done.

But I just couldn’t see why they had to resort to verbal abuse.  To think that this patient already suffered so many injuries from her own husband who probably verbally abused her as well.  Patients see us doctors as saviors right?  I could already see your faces shaking in disappointment.  I couldn’t help but feel ashamed that I was a witness to this embarrassing deed.  I don’t mind getting verbal abuse from my seniors because I know that they just don’t want me to make fatal errors in my own practice.  But verbally abusing patients to teach them to seek help urgently?  Do you think that patient is going to come back to such a mean doctor again?  I don’t think so…

There are just some things that I could never stomach.

I told my friend Hannah about this… She told me that there are just some people who are all brains but no EQ…  They know all the diseases and management, but when it comes to patient communication and rapport, they just don’t cut it.

I know I got a lot to learn regarding textbook knowledge and clinical practice guidelines.  I am just an intern after all.

But if there is one thing I will never forget, it’s that there are problems that you cannot solve by yelling.

If that’s what I need to be in order to be a smart doctor, well, no thanks.

Please don’t let me turn into them…