Tales From the cubicle no. 10

Sitting here as a patient in the cubicle no.10, I began to see the medical world in a completely new light, a world so different from that depicted in all my medical textbooks. Here, I see all kind of people wandering in the ward with their own agenda. A distinct advantage of being in the A&E ward is that people normally don’t bother to disguise themselves in front of dying patients so I get to see their true colours.

I spent most of my time with bunches of nurses around so I shall start with them. To my surprise when I first met one of the senior nurses there, she knew exactly everything about history taking. It then dawn upon me that doctor are not the exclusive holder of the knowledge of clinical examination as the nurses and other health professions also go through the same pre-clinical and some clinical curriculum. Ermm, I shall not take lightly of my fellow nurses next time when I started working.

However there are a lot more things that nurses can do far better that it makes the doctor pale in comparison. IV infusion supposedly should be an elementary task in clinical practice and yet the cardiologist that did this to me in the second day really sucks. He tried three different spots on my left arm, without the swipe, and finally managed to shoved the needle into my dorsal vein. I was already half dead by the end but he just simply ignored my agony. Worst still the needle was later proven to be a failure by the radiologist so I have to had another infusion done on my right arm. Until today there are still bruises on the three spots of my left arm and none on the other. In contrast the nurses are really skillful in this and a whole host of other primary care and I shall praise them for their superb technique. There is only one complaint during my first night. I was constantly being waken up for blood pressure monitoring and transfer to the rapid transit admission ward. Why do they want to deprive me of my slow wave sleep while it is the time when physical repair most needed… Now only I know what do they meant by “ we need to keep you overnight for (constant) observation”…

And there are the housekeepers that in charge of all the meals and cleaning tasks. The one that I first meet seems always grumpy because of the never-ending work and I was a bit frightened to ask for anything at first. Anyway after several meals I began to know her (mood) better and I can see that she is getting along well with other patients and nurses. However she is always the busiest figure in the ward working incessantly from the moment she steps into the ward. Patients eat three meals a day and she have to know who require a special diet, who is fasting etc. at her fingertips. One thing patients are quick to notice the who’s who in the ward, as long as they are not unconscious. Then they will know who to direct their request to whenever they need something. Sometimes I think they will rather all patients are comatose, then they don’t need to feed them and be sure that they won’t create any problem at all.

The assistants on the other hand are there to assist in the running of the hospital. They bring patients to various tests, dispose the clinical waste and manage the supplies. When it’s time for my CT scanning the guy just popped in and put me on a wheel chair. I don’t know is that a routine or a policy to use wheelchair for fetching patients because in my case I obviously still can walk. I understand that they trying to save time for the imaging process. However I felt slightly disempowered sitting in a wheelchair. Not that I am fussy about the hospital procedures but the feeling just strike me. In the past when I was reading the sociology textbooks I always wonder why people are so finicky and concern about all the small details in the patient-doctor encounter. Who on earth will care about things like gender inequality when they are very sick? Well now I know the answer.

The doctor above all is the people that care the least about the patients. They only come in at their own sweet time, make sure that you are not die yet, take the history and do whatever they need and then leave all the patient care to the nurses and housekeepers. Sadly enough despite all the sociology textbooks have been harping on to treat the patient as an individual, To them I am nothing more that a living pathological specimen lying there awaiting to be salvaged. Having taken all they want, they will just analyze your history and try to find out what’s wrong with you. If they are uncertain they will rush you to all sort of uncomfortable even painful tests. I think they just get a kick out of solving a jigsaw puzzle and if the puzzle is too badly torn (because of the illness or iatrogenic), they will just discard the puzzle and go for a new one. Just happen that I was reading a book by Michael Sparrow about tales of a country doctor. He was advised by a senior surgeon that “you will never become a good surgeon, or even a good doctor, until you have filled an entire graveyard with your mistakes.” (p114). So this is the kind of words they whisper outside the ward, I started to feel a strong distaste for doctors despite the fact that it is my future career also.

And the patient at last. The only poor fellow in the hospital who is only asking for a good night sleep and peace of mind. Unfortunately his peace is often disrupted by those uncaring doctors and overcaring nurses. Sometimes I think that excessive medical interventions are causing more harm than good to the patients. My neighbour next bed was suffering from a reaction from the penicillin administered. Starting from an arm fracture he ended up worse than when he first came in. Quoting statement in the critique of biomedicine: half of the drugs prescribed in the hospital are used to correct the side-effects of the primary medication, it appears to me now it is true that more people are suffering from iatrogenic effect of medicine…

Despite all the conflicting agendas of four groups of people, I still think that everybody enjoy staying in the hospital though. As a patient I am having a good break as I am momentarily excused from my duty and responsibilities. This is termed the “sick role” in sociology which a lot of busy people like me are more than welcome to take up the role for an occasional break in the hectic life. I am just carefree of my own illness as the doctors will take care of them. All I do is just sit back and relax, meal will be served at regular time. Strangely enough I had been having the most high-cholesterol food in my life in this 3 days despite I had informed them of my hypercholesterolemia.

There are no free lunch in this world though. Later in the day a lady came to me claiming to be an officer from the patient account department. I had been expecting the bill since my first day and finally the doom came. To my delight I was charged at the same rate as the Irish which i dunno what it means but i supposed is a good thing. Anyway I don't care and I just want to enjoy my holiday wholeheartedly until I was discharged.