Friday, 1 June 2012

Diary of a young doctor(part 1)

(published in The Friday Times on 1st June, 2012)
felt as if I could not move my legs. It was as if my body was disobeying my mind.It was 4:45 a.m. and my alarm bell was piercing my eardrum. I did the only thing I could do at that time: I pushed the snooze button. I knew I had to get up in a few minutes and by then my legs probably would have enough energy to crawl out of bed and move. It was a Saturday morning and I had to be in the 'Accidents and Emergency Department' for my 12-hour duty from 6 a.m. to 6 p.m. I had returned the previous day after doing a 28-hour ward duty which included very little sleep and quite a bit of leg work. The reason my body was temporarily refusing to obey my mind was my tiredness and lack of energy. In the end, I made it to the emergency department and performed my duties as a House Physician for 12 hours straight. This is how the life of a young doctor unravels.
A lot of patients visit the emergency ward because they want "urgent" treatment of things that can be easily dealt with on a regular schedule
I am a medical graduate undergoing my first year of medical training known commonly as House Job. Being on the junior-most rung in the ladder of the public health care system, we are the first point of contact for the people coming to public-sector hospitals. We have to perform emergency duty once a week and twice every other week. In the emergency department, we treat the patients who require urgent consultation with a physician. The patients come in, we examine the patient and write medications for them accordingly, their attendants get the free medications from the medical store located inside the department and those drugs are then administered to the patients by the nursing staff. This chain is the usual protocol followed in most public sector hospitals. In some cases, some drugs are not available in the medical store inside the department so the attendants are asked to get them from any nearby store.In the hospital where I work, we have the Hospital Management Information System through which we enter medications for patients using laptops and they can get their medication from the medical store without any hassle. On a regular basis, we treat patients suffering from gastroenteritis (caused mostly by unhygienic food and water consumption), fever and body pain, and patients who are already on medication for chronic conditions like diabetes, kidney failure, liver disease or heart disease. Patients are charged only for the minimal admission fee; laboratory tests and radiological investigations, including X-rays, ultrasound and CT-scans, are done without any charges.
I return home with an aching back, an empty stomach and pain in the balls of my feet
Emergency Duty is mostly spent by us while moving from bed to bed and not being able to sit for more than five minutes. There are very few seats available in the emergency department and most of the work is done without much respite. During the duty hours, more time is spent by us counseling the patients and their attendants than actually treating people. Everyone wants to get our attention first and it can become hectic very fast, with beds filling up to twice their capacity and still more patients streaming in. Things can get heated as well and incidents of fights between the doctors and patients have been noticed in the last few years. There are no security guards in the emergency rooms, leaving the duty of self-defense to the doctors themselves.Incidents of bullying by attendants led to the formation of the Young Doctors Association 5 years ago.The facilities that I have described above are at par with almost any private hospital in the city. But the only people who tend to visit public sector hospitals are of the lower-middle class or the lower classes. One reason for this is that there is a shortage of both space and personnel in public sector hospitals. We cannot refuse treatment to any patient and this puts a strain on our already scarce resources. A lot of patients visit the emergency ward because they want "urgent" treatment of things that can be easily dealt with on a regular schedule. I have personally seen patients of sinusitis, occasional headaches, acid peptic disease and increased blood pressure in the emergency ward while all of them are theoretically out-door department cases.In the emergency room, a house officer examines patients, takes blood samples, passes nasogastric tubes or folley's catheters, checks blood sugar levels and blood pressure and has to write prescriptions on discharge of the patients. These few tasks are repeated from the start of the duty till the duty finishes after 12 hours. There are times when the inflow of patients is very high and it becomes extremely difficult to shuttle between patients based on the severity of their symptoms; and there are times when most patients are stable and the doctor can catch his or her breath for a while.Apart from fulfilling our duty, we also receive many prayers and good wishes from patients who are successfully managed. The road is not full of roses, though, and patients complain if the treatment is not working. The toughest aspect of the job is to face the incidents of mortality in the emergency. In most of the cases I have seen, attendants raise a hue and cry at the death of their loved one, and that frightens the rest of the patients. In those moments of grief, all the doctor can do is to inform the attendants and get signatures from them on the death certificate.As for me: at the end of the 12-hour duty, I return home with an aching back, an empty stomach and pain in the balls of my feet. I try not to walk much after I reach home and after a few hours of rest and some dinner, go to sleep, ready for another day at work.

1 comment:

  1. i have read it today its cent percent representation of what happens n what we face ...keep it up bro