Wednesday, May 30, 2012

THE MALE NURSE.




I remember him now, after many years.

His wide grin, revealing the gap in his teeth, one of the two front teeth chipped by some previous incident giving him an awkward, yet, still pleasant smile.

He had marks on his face - etched deeply into both sides of his cheek, yet unable to completely disfigure his face and his alluring smile.

He was always neatly dressed, his white uniform spotless despite the hot and sandy environment.

He was the nurse assigned to the village.

I met him on a compulsory youth service scheme, I had been assigned to man a remote hospital in a remote part of the country; I was essentially the only doctor in the village. The senior Doctor only came on weekends.

My male nurse more than made up for this deficit.

I remember the time a young boy had cut his hand with a matchete. His thumb had almost been severed from his palm, the skin, blood vessels and tendons were all dangling, longing to be disconnected from the rest of the hand - This was my first major test as the village doctor - and I was ill prepared for it. Finally, my mainly theoretical knowledge was about to be exposed.

My nurse came to the rescue; he showed me how to properly inject the area with a local anaesthetic, how to properly hold the needle holder, how to pick up a layer of skin and attach it to another, how to properly cross and tie the suturing thread. He supervised as I went to work, though I secretly hoped he would take over completely. In a little while, the job was done and the thumb was again part of the palm. I looked with pride at my finished work.


That was my introduction to the amazing world of male nurses. A group I have the utmost respect for.

If I am stuck on an island of sick people and I'm asked who I need to help me between a Neurosurgeon, Cardiologist, Gynaecologist and a nurse, you can be sure of my choice.

What are your experiences with male nurses and nurses in general?

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Tuesday, May 29, 2012

HOW TO GET THE BEST FROM NURSES.


I have come to realise that the most important and influential group of health workers are not neurosurgeons, physicians or pharmacists - they are nurses.
As a Doctor or a patient you take them for granted at your own peril; they can make you have a difficult stay in the hospital (if they wish), or a blissful one, depending on how you treat them.

As a young Doctor, I learnt two of the most important skills of my career from nurses; suturing a wound and delivery of babies.

I have found that if you are a cocky doctor, with your head in the clouds, they have a way of bringing you down to size without saying a word. They are the mafia.

I've witnessed patients and relatives of patients get their fingers burnt when dealing with nurses just because they don't know the formula. So, I will give some tips:

1. When nurses say they got it covered, they got it covered.

Don't keep coming to remind them about your relative's drugs, once is enough - unless, you might end up being attended to last.

2. When you see them talking in a group, don't go to accuse them of being idle.

If you do, you just made about 4 or 5 enemies at once, and they are sure to pass your report to the next shift.

3. Get to know their names.

This brings some familiarity and may eventually work to your favour.

4. Always say thank you.

Nurses love this - finally, someone notices the enormous work they do. When you are well, try to come back to say a little thank you to the nurses in the ward, this will go a long way in helping their future patients get the best care.

5. Take time to converse with them.

You would realise they are everyday people with problems too. They are sure to remember you after this.

6. They are not maids!

Speak or refer to them as maids and they will chew you alive, spit your guts out and send you to the cleaners.



It doesn't take a lot to be on the right side of nurses, I believe nurses are still angels (if you know how to deal with them); do you agree?



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Wednesday, May 23, 2012

REWARD IN HEAVEN.


It is rare to have a patient give you a gift.

It is even rarer to have a gift worth thousands of dollars.

It is most unlikely to have a gift in the form of real estate.


I remember the day I met Mrs W; She came in with abdominal pains of a non- specific type. Fortunately, I was in one of my rare 'good doctor' moods.

Mrs W was middle aged and slightly frail - there was something about her which made me want to help her to the best of my ability.

I took the necessary history of her condition and went on to give her a thorough examination.

That was when I found it - hidden in a corner of her anatomy - a suspicious lump.

Mrs W had Breast cancer, and it was spreading.

Suddenly, a previous diagnosis of an ulcer had suddenly turned into one of the most feared conditions.

I wrote my notes, referred Mrs W appropriately and consequently forgot about her.

But she didn't forget about my accidental discovery, she sought me out on another visit to the hospital.

Her appreciation knew no bounds, she called me out to thank me for discovering the true cause of her health problems, and she wanted to give me a token of her appreciation.

That token was a land in an exclusive area.

That was when it all began: The visits to the surgeons, the chemotherapy, Radiotherapy, loss of weight, continuos illnesses, travelling and referrals to other facilities.

Mrs W died before she could fulfill her promise.

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Monday, May 21, 2012

INFERTILITY - UNDERSTANDING THE MALE VIEW.




I have on occasion, been called upon to play an intermediary role in a couple's relationship. A role I often feel ill equipped to perform.

One of such roles is convincing a husband to have a fertility test.

In our society, infertility is usually believed to be a problem of the wife and not the husband.

Nurse J was having difficulty becoming pregnant again after her first child who was almost twenty.

Nurse J had tried everything, she had done all the required tests, taken all of the medications but her husband of almost two decades refused any medical intervention - afterall there was nothing wrong with him.

She tried all the tricks in the book to get her husband checked medically, but he had refused. So she came to me.

Obviously something had happened in all those years to reduce his fertility (If he was indeed the Father). Nurse J suspected he'd gotten an infection, probably from his many acts of infidelity.

I adviced a letter be written to her husband to come for a general check in the hospital, there was no response.

WHY MEN FEEL INFERTILITY IS A WOMAN'S PROBLEM


1. They are men duh!

2. They are physically normal.

3. Ignorance.

4. Past/ Present Illicit affairs.

5. Advice from other men.

6. Societal beliefs.

7. Parents didn't have such problems.

HOW TO HANDLE INFERTILITY.


1. Simple, both partners should see the doctor together.

2. They should go with an open mind devoid of blames and name calling.

3. They should trust the doctor.

4. They should be patient.


What are your views on this?

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WHY IT IS IMPOSSIBLE TO BE A GOOD DOCTOR.




WHAT IF...

1. You get to the hospital and the doctor greets you with a smile, offers you a seat and brings out some fresh oven baked cookies and serves you tea.


2. The doctor sits and listens to all your problems for the next two hours without any interruption, all the while still smiling.


3. He examines you from head to toe, checks your eyes, nostrils, ears, tongue, fingernails for anything you may have missed.


4. He does a CT Scan, MRI, kidney, Liver and blood tests for that cough.


5. He takes time to explain his diagnosis to you, then asks if you fully understand. He also calls in your relatives and explains same to them, patiently answering their questions.


Wake up!

Some things are ideal, but not all things are needful, some things are ideal, but not all things are beneficial.

Which would you prefer - a doctor that does what should be done, or a doctor that is nice?

Where do we strike the balance?

How do we know when the doctor is doing his 'best' and when he's being plain negligent? Is there a universally acceptable definition of a doctor's 'best' effort?

What makes you feel satisfied after seeing a doctor?

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Sunday, May 20, 2012

WHEN YOU'RE BURNED OUT!


The signs are all there - You get to work exhausted, you find it hard to relate with co-workers, you flare up at the slightest provocation, you find it hard to make any definite decision and are either carefree or forgetful - its no fault of yours, you're witnessing a burnout.

WHEN A DOCTOR IS BURNED OUT.

This is easy to spot: The doctor breezes through the cases he has to see, doing the absolute minimum he needs to get the job done, questions are not encouraged and there are no smiles. Procedures are done with little empathy towards the patient going through pain. You snap at nurses when they remind you there is another patient you have to see.

In a Doctor's case irritability is defined as disagreeing with more than one nurse every 24 hours.

There are also feelings of regret when one remembers past errors and feelings of guilt when one wants to take time off.

CAUSES OF A BURNOUT.


Inadequate income
Workload
Tiring co-workers
Poor working environment
A lack of motivation
Outside work relationships

EFFECTS OF A BURNOUT


These include
Depression
Guilt
Insomnia
Stress
Reduced Libido
Alcoholism and substance abuse,

MANAGING A BURNOUT.


Take Holidays
Develop a hobby
Learn new professional skills
Consider early retirement
Seek professional help.
Talk to others that have faced same challenges.

How do you cope when you feel burned out?


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Tuesday, May 15, 2012

NOW I AM A DOCTOR - SO WHAT?

(Guest Post by Dr Busuyi Abu )




Growing up in the hinterland of the sunshine state of my country, I was fascinated by a doctor.

He seemed to know everything about the human body, he seemed to have the power of life and death. He carried an aura around him; he was the village demi-god.

People ran to him when they were in distress; he was empathic and also sympathetic - an epitome of human kindness.

I had to be a doctor.

I can't recall exactly when I made the decision, I just wanted to touch humanity.

I had no idea it would be a very long walk.

Nobody told me a substantial part of my productive years would be taken up chasing my dream, I wasn't told about the long hours of reading. Nobody warned me most of my classmates would graduate before me. Nobody told me I would lose my life to the practice of medicine.


But most of all - Nobody told me the awe my society held for medical doctors would have changed before I became one.

It was a very long and tortuous journey on a lonely and deserted road. Sometimes, I needed a shoulder to lie on, but all I had were my big fat books. Sometimes, I read and talked to myself, like a person with schizophrenia. Sometimes one became like a bipolar patient.

But at the end of the journey you are deemed to have "satisfied the examiners". You are now authorized to have “Dr” affixed to your name. Just like that!

Now you are the king of your consulting room, a high priest in the kingdom of medicine. Men and women come in to make confessions. You hear things that make the ear tingle - things that can lead to the Third World War if revealed.

But - You are expected to hear but say nothing; See evil, treat evil but require the wisdom of Solomon to know whether to report the evil. After all you have sworn to an oath!

Welcome to the bizarre, agonizing, lonely, but exciting world of a doctor.

Join me as I take you on a voyage. It promises to be exciting. Never a dull moment - I promise.

Are you willing?

Follow Dr Busuyi on twitter @drbusuyi
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Sunday, May 13, 2012

WHAT MAKES A TRUE MOTHER?




It is another Mother's day, again. Another time to show appreciation to the countless mothers worldwide; where would we be without them?

In the course of my medical practice, I've come across many mothers; one mother, however, sticks in my mind.

I recall her from eons ago, during the time I was a green house-officer when we practiced pre-historic medicine.

She stands tall and unshakeable in my mind amongst all other mothers on that fateful day - the day I almost blew up the paediatric ward.







Yes, you heard me right - the day I almost blew up the paediatric ward - I'll get to that in a minute.


Her child was being managed for a long term condition, I think it was meningitis, and was dependent totally on the hospital equipment, IV fluids and the lot, which house-officers like myself had gone through great pains to set up.

I was trying to open a new oxygen cylinder so her child could get some more oxygen (don't ask me if that's part of my job description); when, suddenly there was a loud sound like a mini explosion - It was from the cylinder I was fiddling with.







Pandemonium broke out, everyone scampered to safety, those that could, took their children with them, those that couldn't, well....

I was left alone, scared and sweating, in an almost empty ward, with the cylinder still hissing out the gas loudly - But she stayed.

She couldn't possibly leave her child, could she? Was she going to yank her child off all the medical support? We had become two actors in this play, neither knowing the outcome. She remained cool and even offered me suggestions.

With my heart pounding, and fearing for the safety of myself and the ward, I dragged the loudly hissing cylinder out of the ward to the open air.

She hadn't, in a moment of panic, jeopardised the health of her child, she was a true mother. And this day, many years after, I remember her and salute her.

What makes a true mother?


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Saturday, May 12, 2012

9 MONTHS WOULD TELL.


One of my favourite Bible stories has to be the story of the wisdom of King Solomon; 2 harlots, both with child, one child dies, both claim to be the mother of the living child and want King Solomon to decide.*

Solomon orders for a sword and asks that the living child be split into two and divided between the two women.

The harlot whose child it was, pleaded that the baby should instead be given to the other, while the other preferred it to be split. The true mother was obvious.

That to me, was the very first DNA test.

A young lady was brought to me, she was pregnant and the family wanted to know who was responsible.
Simple enough.

She had no idea who the father was, as she had slept with two men.
simple enough.

I tried to calculate the age of the pregnancy and the time she slept with both men to at least rule out one of them
- not quite simple.

She had slept with both of them around the same time - Complex.

I was almost in a fix.

I looked at both potential fathers and smiled within me.

One was a white Asian and the other a Black African.
Surely 9 months would tell.




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*Story can be found in 1Kings 3:16

Thursday, May 10, 2012

10 QUESTIONS EVERY DOCTOR HATES BEING ASKED.

,


1. WILL I GET BETTER?

Do you really, I mean, really want to know the truth?

2. ARE YOU SURE?

Is there any good way to answer this?

3. HAVE YOU SEEN THIS CONDITION BEFORE?

Yes I have - in the newspapers.

4. DOES THE DRUG WORK?

Yes - or so I was told.

5. CAN I CALL YOU?

Absolutely not - If you don't get better kindly bother someone else.

6. CAN I USE HERBS INSTEAD?

Then why are you here?

7. AREN'T YOU MARRIED?

How does that contribute to the global mortality rate?

8. HOW LONG HAVE YOU BEEN IN PRACTICE?

Long enough to make sure you get a very painful injection.

9. HOW COME DOCTORS FALL SICK?

Never knew we were from Mars.

10. ARE YOU THE DOCTOR?

No, I'm a lampstand.



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Tuesday, May 8, 2012

WHAT GOES AROUND COMES AROUND.




I was hungry and tired - it had been a long call duty and I barely had enough strenght left to get back home. I got into my car and looked for the nearest diner to have a meal.

I finally got to one of my regulars, parked my car and entered, I chose my favourite dish and settled down to devour it.

I was almost done when I glanced outside, only to see my car being clamped by a tow van. I had parked in a no parking zone. Before I was able to come out, I saw my car being whisked away.


Left with no form of transportation, I found some unconventional means ( don't ask me cos I won't tell) to get to the towing agency.

After waiting several hours there, I finally got to see the Big Boss.

Big Boss was huge, with an imposing stature; his troops walked meekly behind him, taking care of his every whim.

Big boss wanted to know how I could have been so carefree; I told him I had been on call taking care of people like him (I had to play the doctor card), and I needed to eat something.

It took some convincing before Big boss ordered my car to be released with no penalty.


Fast forward a month later, guess who presented as my patient in the ER in need of prompt attention.



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Saturday, May 5, 2012

DISAPPEARANCE IN THE CITY.




That morning Steve left home, he had no idea he would spend the night in the hospital.

Steve was a shrewd businessman, he smiled at the thought of the profit he was going to make from this trip - life was good he thought, patting his pocket and feeling the reassuring bulge of his wallet.

He sauntered joyfully to the bus stop to catch a bus; there were already a few passengers seated. Steve sat down and continued his day dreaming as the bus started moving.

Steve never arrived at his destination.

As darkness approached, his worried friends, who had been expecting him back all day, set out to look for him - Steve was found on an abandoned stretch of road, semi - conscious and had lost his memory. Steve was quickly rushed to the hospital.

A DANGEROUS TREND

An unsuspecting passenger is lured into a vehicle filled with hoodlums who pretend they are genuine passengers. The vehicle moves and a drug filled handkerchief is placed over the unsuspecting passenger's nose from behind, overpowering him. He loses consciousness while he is dispossessed of his valuables.


MANAGEMENT OF DRUG POISONING


This varies depending on the type of agent used, but generally involves ensuring a clear airway, adequate breathing and circulation, knowing the offending drug and getting its antidote.
Also, any fluid or electrolyte deficit is corrected.

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WIFE, DOCTOR - SUPERWOMAN.




"Mummy I'm hungry!" Her 3 year old son cried, tugging at the hem of her skirt. She had just settled down to read chapter one of 'The Principles of Medicine and Surgery'; she had been on the same chapter for a week now.

Her attention shifted to her son, his large brown tear filled eyes boring into her soul - she felt guilty. Guilty she had chosen a profession that kept her away from home most of the time, guilty she was always too tired to cook proper meals for her family, guilty she was not quite where she needed to be in her career to provide the best for her family.

Her mind travelled back in time, to that day she became a doctor, the day she took the Hippocratic oath; the dreams she had - to become a world class Paediatrician with a loving husband, beautiful children and a thriving practice. She smiled.

She was broken from her reverie by her son, who was still hungry. She remembered how she met his father, Dave. Dave had since left her, tired of the frequent reading and exams that never seemed to end, tired of the cold meals stored in the fridge, tired of the 48 hour weekend call duties, tired of the calls at odd hours, tired of the fact she was always saying she was tired. She couldn't blame him.

Tossing her textbook into the cabinet where it would remain untouched for the next one week, she got up to prepare a meal for her son who would soon have to be dropped at his grandma's place since she had to go to work that night.

She was a super doctor - her patients always looked forward to her ward rounds, she always had a smile for them and could spend an hour on each of them. She was never late and remembered all their names. What a nice, disciplined and pleasant doctor she is, they would all say, she must have a happy family.

Nobody noticed when she would dash into the bathroom and cry a bucketfull of tears, nobody noticed her constant phone calls to check if her son was okay, nobody saw the carton full of unpaid bills and loans. She was the Super doctor, the woman of steel.

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Friday, May 4, 2012

WHEN IT IS SOMEONE WE LOVE.




Female doctors are a force to reckon with - one can't help but admire the way they balance their medical practice with their family life.

The ease with which they go about their duties makes it hard to believe they also have a husband and kids at home who demand even more of their attention.

They are usually calm, patient and fully composed when dealing with their patients.

But what happens when the patient is their husband? Do they remain cool, calm and composed? Let me tell you of my experience with Dr Dee.

Dr Dee (not real name), was very distraught; from the moment she rushed into the ER that night, I knew I would not have any peace.

She brought in her husband who had developed episodes of breathlessness at work. From the commotion she caused, I thought her husband was dying - she was hardly able to stand or sit still; with a worried look on her face, she kept patting her husband and whispering endearments.

As I attended to him, she never stopped pacing and asking me questions about what I thought, and what management I would give. She cross checked everything I did for her precious husband that I soon became irritated, I struggled to keep myself from screaming, "WILL YOU JUST SHUT UP AND GET OUT!"

Then - the straw that broke the back of the camel - she sat on my chair! My precious chair! My only island of solitude amidst the chaos that is the ER. Oh what effrontery! What blatant disrespect! She had defiled my sanctuary - surely, this was a call to war. I had had enough.

I considered my options, the least of which was to walk away leaving her there to treat her precious husband.

I wondered if she was so empathic when dealing with her patients, whether she ran at the speed of light to attend to any emergency brought to her, whether she checked and double checked if the right management was being given to her patients. I didn't think so.

I also wondered if it would benefit our patients more if we treat them as though they are our loved ones and stopped being so aloof and un-emotional.

Would it somehow compromise the level of care we give them if we become more empathic?

What is your take on this?



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