Now, it's been almost 1 1/2 years that I've been working here and sharing what-so-ever in my mind. So that you could see me through in back ground of Bhutan. This time I want to share my professional satisfaction and some food for thoughts. I swear I don't have any intention to show off myself cause it doesn't matter between you and me. Nothing but your smile could make me feel good as always.
It was around the X' mas when an old man admitted to my hospital for Chronic Bronchial Asthma. After few days, Doctor who's been taking care of Medical Ward, asked surgical consultation cause the patient said "abdominal pain". Patient was in shock (BP 60/40) and under distress. Of course he had an acute abdominal condition but signs and symptoms were masked by the Steroids given for his Asthma. (Sorry for going in detail for non medical friends) From his sinking condition, I did urgent operation and found to be burst appendix with intra-abdominal abscesses. That was just a beginning.
On second day, delirious patient with septicemia, took out the tube that I put inside for draining of pus from his abdomen. As a result, he developed second shock after 2 weeks because of pelvic abscess and I had to do second operation just before I moved to Referral Hospital for replacement duty. I left him for daily dressing of septic wound. But this patient loved me too much and he had to follow me for fecal soiling from wound.
So, I had to do third operation for gut perforation and spillage of contents to the wound. This time, when I opened his abdomen, all intestines were matted together and very friable. I found two openings in jejunum, repaired them thoroughly but it didn't last for 2 days. I had to plan for forth operation. The patient was too ill and Anesthetists warned me they wouldn't accept for next operation. I knew it would fail again for repair at that time. Then, what I did was leaving open his abdomen and changing dressing twice a day after careful wound toilet. It was not possible to do a stoma with bag. Imagine an old man lying in bed with open abdomen, leaking greenish juice from his intestines. I did all his dressing by myself till I have to come back to my town. It's been for a month.
When I had to go back to my town, I wish I could bring him together. But there was no ICU facility in my town. He was still too ill to take out from ICU. Moreover, I had planned to take my annual leave after a week. Anyway, I had to hand him over to another Surgeon who came for replacement. As soon as he saw the case, he took some photos from far and near and asked me to stand by the patient like a reporter recording a scene of crime. I didn't like it but I wasn't doing anything wrong. So I took my photo with a smile. (At that time, I wrote "God is my witness so I can't have Him as a judge") I thanked him indeed for taking care of that patient in his own way. He's very senior to me and treating me like a student.
After that I had to go back home and kept informed about the patient from my friends. He's been in same old condition, lying in bed, soiling himself for another 2 months. I felt great debts to him. I didn't want anybody to bother because no one wants to clean up others' mess. Besides, it takes time to heal his intra-abdominal condition. Finally, I did my fifth operation as soon as I came back from my country. Time has healed him a lot so that I could finished my job so easily. There was no other things that could make me feel free when I discharged him.
He was a monk. He thanked me so much. But I must thank him much more than he did. Because I could do it if only he allows me. I made total five operations on him. He didn't keep a doubt on my capacity and practice. Even while I was away, he kept his hope on me. (I appreciate all other peoples who took care of him during these days). As we all know, I am nobody. He's a very serious case, beyond my level of skill. But I made it! Now-a-day, doctor-patient relationship is at a stake. People expect service from doctor like consumers. In my opinion, at medical service, there are some miracles. If you want some miraculous cure, you must keep belief on your doctors. It is so far beyond give and take, talk and entertain professions. I agree some of our colleagues were making wrong to their patients. That would be their part. Everyone has to harvest his own crops. What I expect from my patients is nothing but trust. What I could assure from my side is faith. So, the message I want to pass you from here is "See your doctor as a healer, not as a service provider".
Secondly, I assumed on some of misfortunes in our profession is money intoxication. I noticed it since I was a house surgeon. Some patients used to give me some presents and whenever they did it to me, I felt up set. If I took care of that patient more than as usual, they might think that it was because of their present. If I didn't, it's low dose, they said. Because, present doesn't come without expects. I knew most of you might think of me as someone who talks himself good but bad mouths at all others. Money makes the World goes around, I accept. I need money whenever I have to deal with any Government services as well as private sectors. I don't talk about my survival. But, supposing if you want a promotion, a good place, you have to spend a lot of money on it. At last, the result doesn't come out as you expect, blame it on your self only. In contrast, in our profession, ..... I hope you know what I mean. It makes me remind of the Hunter's Verse from Saddhan King Elephant Jartaka. "The Queen, who wanted the defenses, the King, who dictated the tasks, and poor me, who had to obey orders; among these three, I was the only one who soaked in the rain of bad luck."
To make the ends meet, I wish I could get your trust like that old man among our Burmese peoples. Because, I decided so far to come back and serve my native land after this contract. I knew there's a great opportunity for me and my profession out side my country, how nice is the Global village and also a freedom from undue constraints at home. But that is not my destiny. All I want is your kind favor. Please allow me to take care of you.
It was around the X' mas when an old man admitted to my hospital for Chronic Bronchial Asthma. After few days, Doctor who's been taking care of Medical Ward, asked surgical consultation cause the patient said "abdominal pain". Patient was in shock (BP 60/40) and under distress. Of course he had an acute abdominal condition but signs and symptoms were masked by the Steroids given for his Asthma. (Sorry for going in detail for non medical friends) From his sinking condition, I did urgent operation and found to be burst appendix with intra-abdominal abscesses. That was just a beginning.
On second day, delirious patient with septicemia, took out the tube that I put inside for draining of pus from his abdomen. As a result, he developed second shock after 2 weeks because of pelvic abscess and I had to do second operation just before I moved to Referral Hospital for replacement duty. I left him for daily dressing of septic wound. But this patient loved me too much and he had to follow me for fecal soiling from wound.
So, I had to do third operation for gut perforation and spillage of contents to the wound. This time, when I opened his abdomen, all intestines were matted together and very friable. I found two openings in jejunum, repaired them thoroughly but it didn't last for 2 days. I had to plan for forth operation. The patient was too ill and Anesthetists warned me they wouldn't accept for next operation. I knew it would fail again for repair at that time. Then, what I did was leaving open his abdomen and changing dressing twice a day after careful wound toilet. It was not possible to do a stoma with bag. Imagine an old man lying in bed with open abdomen, leaking greenish juice from his intestines. I did all his dressing by myself till I have to come back to my town. It's been for a month.
When I had to go back to my town, I wish I could bring him together. But there was no ICU facility in my town. He was still too ill to take out from ICU. Moreover, I had planned to take my annual leave after a week. Anyway, I had to hand him over to another Surgeon who came for replacement. As soon as he saw the case, he took some photos from far and near and asked me to stand by the patient like a reporter recording a scene of crime. I didn't like it but I wasn't doing anything wrong. So I took my photo with a smile. (At that time, I wrote "God is my witness so I can't have Him as a judge") I thanked him indeed for taking care of that patient in his own way. He's very senior to me and treating me like a student.
After that I had to go back home and kept informed about the patient from my friends. He's been in same old condition, lying in bed, soiling himself for another 2 months. I felt great debts to him. I didn't want anybody to bother because no one wants to clean up others' mess. Besides, it takes time to heal his intra-abdominal condition. Finally, I did my fifth operation as soon as I came back from my country. Time has healed him a lot so that I could finished my job so easily. There was no other things that could make me feel free when I discharged him.
He was a monk. He thanked me so much. But I must thank him much more than he did. Because I could do it if only he allows me. I made total five operations on him. He didn't keep a doubt on my capacity and practice. Even while I was away, he kept his hope on me. (I appreciate all other peoples who took care of him during these days). As we all know, I am nobody. He's a very serious case, beyond my level of skill. But I made it! Now-a-day, doctor-patient relationship is at a stake. People expect service from doctor like consumers. In my opinion, at medical service, there are some miracles. If you want some miraculous cure, you must keep belief on your doctors. It is so far beyond give and take, talk and entertain professions. I agree some of our colleagues were making wrong to their patients. That would be their part. Everyone has to harvest his own crops. What I expect from my patients is nothing but trust. What I could assure from my side is faith. So, the message I want to pass you from here is "See your doctor as a healer, not as a service provider".
Secondly, I assumed on some of misfortunes in our profession is money intoxication. I noticed it since I was a house surgeon. Some patients used to give me some presents and whenever they did it to me, I felt up set. If I took care of that patient more than as usual, they might think that it was because of their present. If I didn't, it's low dose, they said. Because, present doesn't come without expects. I knew most of you might think of me as someone who talks himself good but bad mouths at all others. Money makes the World goes around, I accept. I need money whenever I have to deal with any Government services as well as private sectors. I don't talk about my survival. But, supposing if you want a promotion, a good place, you have to spend a lot of money on it. At last, the result doesn't come out as you expect, blame it on your self only. In contrast, in our profession, ..... I hope you know what I mean. It makes me remind of the Hunter's Verse from Saddhan King Elephant Jartaka. "The Queen, who wanted the defenses, the King, who dictated the tasks, and poor me, who had to obey orders; among these three, I was the only one who soaked in the rain of bad luck."
To make the ends meet, I wish I could get your trust like that old man among our Burmese peoples. Because, I decided so far to come back and serve my native land after this contract. I knew there's a great opportunity for me and my profession out side my country, how nice is the Global village and also a freedom from undue constraints at home. But that is not my destiny. All I want is your kind favor. Please allow me to take care of you.
