My First Call.
It is my third day as an intern. I started with Neurosurgery and I am still learning the basics; there are actually a lot to learn. A strike by doctors just started a few days ago and practically all units are discharging their patients or sending the bad cases to other hospitals. My consultants are reluctant to do the same because of the kind of patients we have. The other unit doctors are going home after work; they are not on call because there are 'no patients' to take care of.
In the midst of this confusion, I am told it's my turn to be on call. On a day like today? A fresh intern without older interns to run to in case of problems? How would I survive the night? I've not even set my first IV line! More blows: the Anaesthesiologists in ICU - where we have one of our critical patients - are also going home. There will be no doctor in ICU! The nurses don't like it and they demand that someone stays back. Who will it be?... The Neurosurgical intern-on-call ofcourse. The nurses stare at me; they can tell I'm a JJC. They argue but finally reach a compromise: I will sleep in the ICU and only go down to the other wards from time to time to see the other patients. I agree hopelessly - a prisoner in ICU.
Hours go by and I sneak out to check if there are other interns around. I walk the length and breadth of the hospital praying silently to see someone, especially someone in surgery. To my shock: no registrar or intern in surgery, not even my unit registrar; none in O&G; none in medicine. Finally an intern and a registrar in Paediatrics; but we are far apart and besides their ward is usually locked at night. Perfect setting for a horror movie. How did I get myself in the middle of this? How? From the way things are, I'm 'incharge' of all the patients in surgery. On my first call? Phew!!!
I enter ward 9 silently, just to scope the place. One of the nurses on duty approaches and asks if I am a doctor. I nod and she says that Miss X is really bad; she's been moaning all day. They think she may die this night. I start to panic but only on the inside. I compose myself and ask for a brief history. Miss X is a terminally-ill kaposi sarcoma patient who has been off attention by her unit for about a week now. They practically abandoned her. I remember her; the same we saw earlier that same day while I was gallivanting with some other interns. She was sad and looked dejected. I actually confirmed from her unit intern that his superiors had practically abandoned her. I had thought that they were wicked and deserved to be queried for such a misconduct.
I approach Miss X's bed with the nurse by my side. She is moaning, and occasionally utters a high-pitched cry. I can't make out what she is saying. I look into her eyes and I'm horrified. Two words come to my mind - gloom and despair! She seems to be dying in despair. I look around at her care giver - probably her mother - who also seems to have abandoned all hope. I'm scared and wish that the managing team had taken better care of her. I also wish for the strength of Mother Teresa to bring hope to the hopeless. I mumble to the nurses to inform me if things get bad; as if they were not already bad. As I walk away, I overhear the nurses wishing that morning would soon come so they won't be the ones to pack the corpse. I understand because her sores were really very nasty.
As I walk back to the ICU it dawns on me that I have to be the one to confirm her death if it should happen this night. It is actually supposed to be a surgical resident but since I'm the only doctor around... Besides the nurses can't pack the body if I don't do my part. I would be wicked to leave her body there till morning. I go through the procedure in my head. It would be my first time! I start to pray for Miss X and myself - the only good thing I can manage to do for her. But I'm so confused that I can't concentrate.
In the ICU, I check on our critical patient, she seems to be stable. I try to get a nap, preparing for any eventualities. I am woken by a piercing cry. It's coming from the direction of ward 9. I refuse to believe that it has happened. I try to wish it away. There is a knock at the main gate of the ICU. I know they are here for me. I colllect some of the things I will need: stethoscope, pen torch... My heart is beating fast as I recognise the nurse at the gate.
We go down in silence, while I try to rehearse my next course of action. I repeat in my mind the things I have heard in mortality conferences: I was called to see a patient who was said to have suddenly stopped breathing...
It is my third day as an intern. I started with Neurosurgery and I am still learning the basics; there are actually a lot to learn. A strike by doctors just started a few days ago and practically all units are discharging their patients or sending the bad cases to other hospitals. My consultants are reluctant to do the same because of the kind of patients we have. The other unit doctors are going home after work; they are not on call because there are 'no patients' to take care of.
In the midst of this confusion, I am told it's my turn to be on call. On a day like today? A fresh intern without older interns to run to in case of problems? How would I survive the night? I've not even set my first IV line! More blows: the Anaesthesiologists in ICU - where we have one of our critical patients - are also going home. There will be no doctor in ICU! The nurses don't like it and they demand that someone stays back. Who will it be?... The Neurosurgical intern-on-call ofcourse. The nurses stare at me; they can tell I'm a JJC. They argue but finally reach a compromise: I will sleep in the ICU and only go down to the other wards from time to time to see the other patients. I agree hopelessly - a prisoner in ICU.
Hours go by and I sneak out to check if there are other interns around. I walk the length and breadth of the hospital praying silently to see someone, especially someone in surgery. To my shock: no registrar or intern in surgery, not even my unit registrar; none in O&G; none in medicine. Finally an intern and a registrar in Paediatrics; but we are far apart and besides their ward is usually locked at night. Perfect setting for a horror movie. How did I get myself in the middle of this? How? From the way things are, I'm 'incharge' of all the patients in surgery. On my first call? Phew!!!
I enter ward 9 silently, just to scope the place. One of the nurses on duty approaches and asks if I am a doctor. I nod and she says that Miss X is really bad; she's been moaning all day. They think she may die this night. I start to panic but only on the inside. I compose myself and ask for a brief history. Miss X is a terminally-ill kaposi sarcoma patient who has been off attention by her unit for about a week now. They practically abandoned her. I remember her; the same we saw earlier that same day while I was gallivanting with some other interns. She was sad and looked dejected. I actually confirmed from her unit intern that his superiors had practically abandoned her. I had thought that they were wicked and deserved to be queried for such a misconduct.
I approach Miss X's bed with the nurse by my side. She is moaning, and occasionally utters a high-pitched cry. I can't make out what she is saying. I look into her eyes and I'm horrified. Two words come to my mind - gloom and despair! She seems to be dying in despair. I look around at her care giver - probably her mother - who also seems to have abandoned all hope. I'm scared and wish that the managing team had taken better care of her. I also wish for the strength of Mother Teresa to bring hope to the hopeless. I mumble to the nurses to inform me if things get bad; as if they were not already bad. As I walk away, I overhear the nurses wishing that morning would soon come so they won't be the ones to pack the corpse. I understand because her sores were really very nasty.
As I walk back to the ICU it dawns on me that I have to be the one to confirm her death if it should happen this night. It is actually supposed to be a surgical resident but since I'm the only doctor around... Besides the nurses can't pack the body if I don't do my part. I would be wicked to leave her body there till morning. I go through the procedure in my head. It would be my first time! I start to pray for Miss X and myself - the only good thing I can manage to do for her. But I'm so confused that I can't concentrate.
In the ICU, I check on our critical patient, she seems to be stable. I try to get a nap, preparing for any eventualities. I am woken by a piercing cry. It's coming from the direction of ward 9. I refuse to believe that it has happened. I try to wish it away. There is a knock at the main gate of the ICU. I know they are here for me. I colllect some of the things I will need: stethoscope, pen torch... My heart is beating fast as I recognise the nurse at the gate.
We go down in silence, while I try to rehearse my next course of action. I repeat in my mind the things I have heard in mortality conferences: I was called to see a patient who was said to have suddenly stopped breathing...
1 comment:
It is truly a horror story to practice medicine sometimes in Africa...our uncaring attitude makes me weak to my knees...so sad...I pray things change someday...someday...
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