This is a tale of four doctors
Earlier this year right before my reproduction block exams, I came down with a bad case of the flu. I didn’t think much of it until my upper lip started swelling up, developed quite a persistent fever and I had all kinds of pains shooting up and down my face. Because of how close it was to my exams, I decided to self medicate; I got myself some ibuprofen and paracetamol to try get through the next 3 to 4 days. However, the medication didn’t do much for me, needless to say I just couldn’t study effectively. I remember being in so much pain that I ended up walking out of my first exam about half way through, because I just couldn’t handle it anymore. I remember being pretty worried but I had to soldier on, paper two was in less than 24 hours; so more medication, a lot of water and more futile attempts at studying. Paper two ended at about 11am the next day, I had braced through the pain but at this point I knew I needed professional help. I decided to go to the hospital next door, which made sense I mean my school is a hospital. After some wondering about and asking directions from any security guard I could see, I finally reported to the walk-in/emergency department where a nice nurse instructed me to sit in what seemed to be a very bizarre and disorganized queue. I’m calm, probably a little high off the medication, first time in a public hospital so I’m also a little nervous. After about an hour in the queue, I get called in and a nurse takes my blood pressure, writes my name on a form and sends me back to the queue. Now the medications are starting to wear off, I’m starving and my battery has just hit 56% which means my phone will die at any moment now. After about another hour, the nice nurse calls, “Next to see the doctor.” It’s finally my turn, as I walked into the consultation room, Dr X was texting on his phone and without ever looking up, he asks “what’s wrong?” so I started history giving, he interrupts me by asking “did you go to the clinic?” and before I was able to answer he looks up and says “this doesn’t look too serious, let me refer you to Dr Y in area something something”. Now I’m annoyed because I didn’t get to say much apart from “my face was swollen and sore.” There was no CAJCOLD, no history taking format that resembled what I had been taught in any way.
Dr Y was upstairs, I left the consultation room feeling hopeful that my nightmare was about to come to an end, just to be met with yet another queue, by this point I’m dizzy and my stomach is doing the most. I thought about asking the brother behind me to keep my spot in the queue as I ran to grab something to eat at the cafeteria but I remembered the argument that had happened a few minutes ago between these two guys and how one had left the queue and was force to go back its end, plus he just didn’t look like the friendliest oak, so I refrained myself. Fatigue suddenly kicks in as I remember that I hadn’t slept much the previous night trying to prepare for my exam, I had also skipped breakfast because I had woken up late. My face was burning away and my phone had now died. At least another hour went on before the queue started moving, after another 40 minutes or so finally I was in Dr Y’s consultation room, at least he greeted me before again asking me what was wrong, as I started history giving again, he interrupted me a few times, answered a phonecall, spoke over me, and tried to finish off my sentences (I didn’t know we knew each other like that, this is quite intimate). He started talking about sending me to another Dr, “this is a facial-oral issue” he says “I don’t really remember that rotation”, by this point I’m fed up, I keep quiet for a few seconds then say in an almost psychotic calm tone, “I really need to get out of here, I have my reproduction exam tomorrow morning”, he paused and said “oh are you GEMP?”, I nod. He smiles nervously, throws away the form and says “let’s start again”, it went from a consultation to a quiz real quick (I didn’t even see it coming). He’s asking me about possible differentials and some OBGYN stuff too, weird but well at least he’s listening to me now. Eventually he calls Dr Z and says “I’m sending a student to you, he’s not feeling well.”
It’s now a little past 3PM, I’m hungry, tired and annoyed. I get up to a rather empty ward to meet Dr Z, whom without saying much just sends me back down to get an X-Ray, another queue (this has been an amazing day). By this point I’m grumpy and keep thinking to myself, “do I really need a doctor for this?” Took another hour and a half but I eventually got that X-Ray. It’s now 5PM, I’m starving, my arms are shackling but I’ve lost my appetite. I run back to Dr Z who’s now telling me how he’s tired and I must wait for the later shift Dr who’s coming in at 7PM. I keep my cool, because I’m thinking this *insert bad word* could be my registrar next year, so be nice. A few minutes later Dr A walks in; being the only patient in the ward, he approaches me and asks “what’s wrong? why are you here?”, I give him the X-Ray and my history form that has a big sign on top saying ‘GEMP II’ I don’t know why that’s important (no, seriously I actually don’t).
Into another consultation room we go; he palpates my face and then pokes a large needle into my upper lip but he either forgot the anesthetics or assumed I was a tough guy, so now I’m literally holding back tears because I can’t disappoint him, had it been the latter. “Oh there’s no pus in here, there’s just a lot of blood” he says, still quite unsure what this could be he prescribes everything under the sun, but at least he was nice. He gave me some NSAIDs, Antihistamine, antibiotics, even threw in mouth wash (good opportunistic health promotion, I was impressed). By the time I walked out of the hospital, it was about 6:45PM, a whole day had gone by.
I had never been on the other side, always the medical student and never the patient. This was such an humbling and yet infuriating experience. It’s so easy to call patients rude, impatient or annoying but we often forget that they have to take their entire day off work, travel far and abandon responsibilities just to spend 5 minutes with a doctor.
I experienced being a patient in a public hospital that day. 4 doctors 4 histories no one even asked my name, no CAJCOLD or vitals were taken. I had to say that I was a medical student before I was taken seriously. Why must I be a medical student before you treat me like a human being, before you don’t try rush my history and/or finish my sentences. I absolutely hate the lack of respect for the profession and for the patients we treat, just because they are the vulnerable group. We’re so quick to blame patients for poor compliance and bad health seeking behavior but we forget that we are the very same people chasing them away. All Dr X had to do was listen my history, I know I talk a lot but I had literally walked in with a possible diagnose and even threw in a couple of differentials just to be spicy. I can understand that maybe he was having a bad day, or maybe his significant other was stressing him out, or maybe he didn’t get paid for his overtime last month or that he may had lost a family member the day before, but I do not recall asking him to be a doctor or my doctor for that matter. I did not have a gun to his head as he took the Hippocratic oath. We can’t keep blaming the lack of resources and shortage of staff when we’ve gotten so comfortable with providing such a pathetic level of service. The other three doctors aren’t off the hook either.
I saw exactly the doctor I do not want be that day. When your teachers fail at being role models, where do you look to, there’s only so much I can learn from Grey’s Anatomy. I left with the genuine fear that I, too, will become desensitized to my core values and oath, and unless there’s litigation on the line, I might just become one of those doctors. I’ve recited this experience dozens of times, in the hope to never forget it, so that the next time I’m dealing with a “difficult” patient, I remember where they’re coming from or what it must be like being in their shoes.
Oh yeah before I go, one of the medication actually helped, not too sure which one. The swelling cleared out about 5 days later.