Thursday, September 17, 2009

On the Retroviral Uncle

"Got retroviral just say lah! Diagnosed already, what's the point of hiding like that! Frust frust frust!"

Kinda gave me chills when there's this voice full of blocked nose of a senior complaining about the case he clerked earlier I suppose. I wasn't sure whether it was his end of posting case or what, but it was quite obvious that he was pretty upset the patient didn't tell him he's got HIV.

"This kind of people also got. I asked so many times already still don't want to tell. I asked one by one the past medical history. Got hypertension or not? Got ischemic heart disease or not? Got diabetes melitus or not? Got asthma or not? Got any other things that I need to know or not? Still don't want to tell. What's the point of hiding? You already got it, so deal with it."

Some gibberish conversation followed suit, assuming it's from the other senior to whom this one was talking to.

"No, he's already 60 years old. Came in because of prolonged diarrhoea one. His HIV diagnosed 5 months ago already. Not like he didn't know about it. This kind of people also got."

I agreed it's pretty frustrating when you can't get that piece of important history. A patient who was infected with HIV would probably be susceptible to almost anything under the sun, which could probably explains the prolonged diarrhoea, despite most of the time it would be the opportunistic infections which normal healthy people wouldn't be infected.

But I totally understand what the uncle feels when he refused to tell about that part. Most probably the medical student would just prode more. Social history and such. Have he been having sex with men? Sharing needles? Unprotected sex with multiple sexual partners?? The stigma will always be present. If I were in his shoes, I would find it very difficult to share that piece of news myself.

What annoyed me was the tone of that senior of mine. The way he put it, it was as if it was all the patient's fault he didn't get that piece of information. He was annoyed and frustrated and plain bitchy about it. If anything, it's his own fault for not asking, "You got HIV or not?"

I empathied the uncle. No matter how he contacted the virus, despite it could show how 'naughty' he was in the past, it's still an incurable disease. Some might say serve him right for screwing around.

But I'll most probably just look at him and not say anything, hoping he'd be able to see how sorry I feel for him...



P/s: Got me worried of my own irritable bowel syndrome as well..
P/s/s: written 25/8/09

17 Jujus:

KY said...

Sometimes, I think what the patient need most is someone to stand by their side; no words required.

manglish said...

well, i think as a medical personnel, we all ought to be sensitive also...you know sometimes even if we dont say it out, our eyes give away the stigma....pity that patient...so much for growing old with dignity

Medie007 said...

KY, yes indeed. sometimes i just feel like go and sit next to them in their bed. but most often than not, a lot will think i'm weird... lol

manglish, i agree... but i hope they'll see tat mine are totally genuine and i don't discriminate...

kenwooi said...

never really experienced any serious medical situations.. but yeah.. some people do get over-concerned about their health.. =)

kenwooi.com

KY said...

You better to do so. If I'm the patient and wake up seeing someone sit by my bed, will think it's ghost!!!

Gratitude said...

The law of karma. It is times like these that our compassion as healers must reveal itself minus all the other negative judgemental feelings.

Little Dove said...

It takes experience to elicit a history for HIV. It would take lots of sincerity and care of the medical student or doctor for the patient to be comfortable enough to share his condition. The senior sounded a little discourteous to me. If you were the patient, would you have told this senior?

Janvier said...

Senior's gotta learn to understand people a bit more. He probably came off as rather blunt and unfriendly to the patient as well.

Evann said...

How very insensitive... His unapproachable attitude was probably why his patient didn't tell him in the first place. And look, he's singing about it (that the guy has HIV) to everyone. What happened to patient-doctor confidentiality?

[SK] said...

yeah, that senior is not professional, i agree with you he did not even put that question to the patient and expect the patient to tell?? if you are not asking, how would the patient know that he would want to know?? what's wrong with that?? and as a medical personnel, his care on the patient's feeling is as important as the patient's health..

Medie007 said...

kenwooi, well i'm a bit hypochondriac. :P

KY, so i should do so and scare the patient? ahaaks. :P

gratitude, true. but sometimes, there's still all the stigma that's hard to change lor.

Little Dove, i'd prolly tell the MS off if i were the patient.

Medie007 said...

Janvier, i'm nt sure whether it's an exam or what not. but i guess from the way he spoke to his friends, it's seemed that he blamed the patient for his inability to elicit that piece of history.

Evann, ouch. that's so true. meaning i don't respect that confidentiality too nw that i'm sharing it in my blog?

[SK], agree with you. mmm am glad that you empathized the patient..

SJ said...

patients need steadfast support esp from family

ps you're invited to comment on my post too. =)

bluesoul said...

u sure its just IBS and not HIV? LOL..

Medie007 said...

SJ, true.

bluesoul, choi choi choi!...

A Common Singaporean said...

Is your senior very old? Why so grumpy? This kind of people also got. Lolz

Medie007 said...

ACS, at most2 years older. lol