A new phenomena that I'm experiencing in a mission hospital is family medicine. While being in a tertiary setup, its very rare to see the same patients twice, here, everyone is connected. We are still treating the same patients we were treating 50 years back plus their children, grandchildren, aunts, uncles, nieces, nephews so on and so forth. The loyalty that this incurs is beautiful as well as dangerous. The danger arising when the problem is too big for us to handle.
Even before we explain the prognosis and risks associated with treatment in a small setup, we know their answer. Villagers and townsfolk.... Educated and uneducated...
Like the man with a huge abcess in his right hand who we wanted to send for surgery elsewhere owing the lack of an orthopedician here but who refused to go. So we operated on him with an open orthopedic textbook before us.
Or the woman from a well to do family with a breech baby who insisted on having her delivery here. The baby was so stuck that we had to push from below so we could deliver by Caesar.
Or the lady with twins that walked 200 kms from her village only to reach here at the dead of night when we had just closed the theater for fumigation. On examining her, fetal distress needing emergency surgery. So we sat up monitoring her all night till theater opened the next morning.
Then the ones with not so happy endings...
The young man with cardiac disease who insisted on staying here and died that very night.
The child with encephalitis who died because we didn't have a ventilator.
And yet they come... and keep coming... Sometimes we treat... sometimes all we can do is pray....
Even before we explain the prognosis and risks associated with treatment in a small setup, we know their answer. Villagers and townsfolk.... Educated and uneducated...
Like the man with a huge abcess in his right hand who we wanted to send for surgery elsewhere owing the lack of an orthopedician here but who refused to go. So we operated on him with an open orthopedic textbook before us.
Or the woman from a well to do family with a breech baby who insisted on having her delivery here. The baby was so stuck that we had to push from below so we could deliver by Caesar.
Or the lady with twins that walked 200 kms from her village only to reach here at the dead of night when we had just closed the theater for fumigation. On examining her, fetal distress needing emergency surgery. So we sat up monitoring her all night till theater opened the next morning.
Then the ones with not so happy endings...
The young man with cardiac disease who insisted on staying here and died that very night.
The child with encephalitis who died because we didn't have a ventilator.
And yet they come... and keep coming... Sometimes we treat... sometimes all we can do is pray....
A good Family Doctor, the most difficult job in Medicine, in my opinion, more so than any of the glamorous super specialties. Possibly the most satisfying too.
ReplyDeleteAlwyn