Bedside with Dr KMM Ma today. Late for 20 minutes, so all the "good" cardiovascular cases were already snagged by other groups. The reserve cases all vanished too - either discharged or no longer existed. :(
Finally chanced upon a CVS case. A very nice elderly gentleman with ESM @ LSB - ejection systolic murmur at the (left) lateral sternal border - barely audible, but I could faintly locate it.
A poorly patient in the bed behind me caught my attention. The nurse was here for blood-taking and other minor procedures, presumably taking the blood sugar (finger-prick) and adjusting the IV cannula. Something about him made me linger in mid air, my focus drifted away from my case and my eyes darted sideways. He couldn't talk - possibly a stroke patient, with multiple co-morbidities. His slurred speech and indecipherable sounds and yelps of pain made me tear up behind my glasses and mask.
I was still recovering from my cold, with a hint of a sniffle and already watery eyes and clogged throat partly filled with thick mucus. I had to put much effort into suppressing my emotions.
Today I finally understood what they meant, when they said "don't get attached to your patients. Keep a certain distance and make the relationship clear - a professional one. Doctor and patient, no more, no less." :(
Having served as a hospital volunteer in the past, and placed in a geriatric ward @ Shatin Hospital, it's not the first time I've seen such cases. Hell, I've even spent days sitting with and holding the hand of a severely affected stroke patient with hemiplegia - couldn't move, couldn't feel, couldn't talk, couldn't eat, couldn't swallow - and required intensive speech therapy every day.
But I couldn't put it past me today.
I knew that I wouldn't be able to specialise in geriatric medicine in the future. Even last year, I knew. The most depressing thing about old people is that most of them do not recover. Though you may improve their quality of life, accompany them, listen to their stories as a kid, "in their days" ... but ultimately it's never a happy ending. With their endless chronic illnesses, masses of co-morbidities, often only able to receive palliative and supportive care ... it gets too much to bear, even for just a day. Not that I don't want to serve them, just that somebody's gotta get the job done, but I just feel that my calling is somewhere else (you will know it if you know me).
My heart weeps for you, good gentleman.
I wish you peace, and a hope for recovery. For relief from suffering, whatever form it may take. That every day may be filled with hidden blessings, that you may discover them, and smile once again.
Though you may never know me, I will keep you etched in the back of my memory, as part of my bedside adventures.
Farewell.
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