I’m publishing this blog post a bit late. I can’t stand not writing about a blogger friend and defy her preference for “slipping away” silently.

Goodbye blogger friend. We will miss your blog posts, your writing and your knack for demystifying music to us, cold souls.

Goodbye fellow bone doc. Even if we rarely had a chance of actually doing bone surgeries together, we shared the same tenacity for fishing out the medical absurdities of our work.

I hope you did take the “wave and smile” I made during your induction to the fellows fold a warm welcome and congratulations.

Not a farewell, I hope.

By for now blogger, fellow bone doc.

Copyright secured by Digiprove © 2012 Remo Aguilar

injured kid..they evoke so much pain from injury largely not of their making

Of all orthopedic trauma cases I’ve worked on, my heart bleeds the most for pediatric patients. I don’t know but their helplessness and innocence always evoke this feeling of worry. Many pediatric trauma cases are often a result one adult, guardian or parents, gone remiss in guiding or understanding a child growing up. While many adults blame kids for crossing streets alone or unguided (thus running their vehicles over them), they too agree its the kids guardians or parents that really had an oversight. An irony?

Maybe. But the pediatric trauma patient is almost always a victim. Why? Imagine suffering an injury as a result of a road mishap only adults understands, or being blamed for violating traffic rules even licensed drivers rarely follow? And they wretch in pain for something they rarely know?

This is exactly why treating pediatric trauma patients entails stretching a surgeon’s patience more than you can offer any adult patient. Why adults busy themselves finger pointing on so many things, the child wretch in pain for an injury he or she rarely knew of. That is something pitiful than any other thing. Don’t you agree?

Copyright secured by Digiprove © 2011 Remo Aguilar

Ugh! (photo from here)

It’s hilariously difficult to even get an IV line inserted. “Jesus, are you going to pin prick me to death?“

Or get a good symptomatic history. ” I had my stomach pains and vomiting since 10:30 but I could handle it till 1:00am so you can bring me to ER” She was dehydrated by then.

They have their own diagnosis. ” I only ate small amounts of pancit…maybe its my UTI!” Maybe. But her blood sugar is also 290. With some signs of dehydration..

And their treatment : “ I’ll just lessen what I eat so as not to perk up my sugar“

And discharge plans: “I’ll go home tomorrow, where are you?“

They also can be your chief of clinics :”When are you going to see me? Who is my doctor, what time will he be here??“..

Ugh, well. I just resigned my job and endorsed my patient! I’d rather just be, “the Son”. Good luck doctor!

Again? Yes. Again and against.  I will write about humility in knife wielders until this amazement transforms into a virtue. In the professions of demigods, any opportunity to get enlightened on humility doesn’t come by so easily .  So when it knocks, one should not wait for two or three knocks before opening the door.  The great student doesn’t need the winds to howl before opening his heart to learning. Humility, I should say, comes right into your face before you even knew it did. Like what happened to me recently. When I took the role of patient..

Notes to the Knife II

It probably was just a viral infection but before the lab result got out and the diagnosis made, I took the role of the patient religiously and found time to interest myself with observing people around me. A physician admitted in room 204 is something a phenomena to everyone else. Including myself. Not the fondest role any physician would want, but certainly the most engaging. Of course, not until some real patients ask you about this ‘anomaly’.

Being the patient, in the reversal of roles, is it really that easy for you? You know, relative to us, real patients, you (the actor patient) have almost everything you needed within your reach.(Unlike us patients, where we often cry for help on this and that..)- real patient X.

Hell, NO.

When this  knife wielding body go awry for one infinitesimal  reason, our chaotic hordes of Hippocratic knowledge put more distress on thyself than any other patient could ever think. Let me exaggerate. A hundredth decimal change in our body temperature would trigger a bazillion neuro impulses on our cerebrum that would then, extrapolate a gazillion more differential diagnosis that are rarely confirmed that is true. In short, we have more worries because we knew a bit more. Yes, my dear patient, sometimes, ignorance is bliss. Knowing something worse than just cold, flu or skin allergy as a differential diagnosis is no fun! It burns our distress horns more than you can imagine.

Knife wielders are good actors. But we are not that good as a patient. We are the worst patient a doctor can get. Of course we really wanted to act like we’re patients when we are the patient. But it ain’t easy when you know for example, that a skin test is more painful than a deep laceration. I for one would rather sew myself up  than have someone stick a needle into my arm. There’s too much pain when you know whats coming right into your skin.

Opposite of humility

Okay you try to act like the patient, but does your doctor treat you like your the patient?The nurses?The x-ray man?How many times did you peek at your own chart? In fact, most physicians of physician-turned-patients never mutter a single piece of conjecture to this patient until he or she is 101% sure about the diagnosis. The convoluted fear of the so many possibilities is staggering.   Easy patient huh?

Last, and probably the most interesting phenomena I’ve noticed- when the knife wielder gets sick,  other people  would then say “he’s got it!he’s got it! We’ll get it too!’ This ‘when-doctors-get-sick, its going to be doomsday-on-us’ charade is very annoying. Exaggerated? Maybe. Got something related to the profession’s supposed infallibility. But then again, is it really that way?

Where does humility stand in all of these?I’d say below your humility our dear patients. Doctor turned patients swallow a large chunk of their infallibility grid to be treated adequately. It takes humility to accept diagnosis a mile away from what you knew. It takes a hundred more strength just to keep shut your mouth instead of whining in pain  receiving a cut not from your own knife. It takes humility to be just a patient for even one second. It takes more humility than just humility.

Bottom line is this. When doctors get sick, the implications creates waves more than what a regular patient will. Sort of a celebrity thing but more than that. The ripples are often beyond entertainment. Some even wreck havoc on some patients perception of their health. So maybe this is why some knife wielders need to be good actors and actresses whenever they exchange roles with their patients. Celebrity easy?!Obviously not.