Wednesday, December 19, 2007

A Special Patient (4)

23500975This post is a continuation of an earlier post.

As Maria started complaining about feeling sick (nausea), the nurses were very worried. The feeling started around the same time as we gave her morphine for pain relief, so they were suspecting that the morphine caused the nausea. Aih, those anaesthetics and analgesics are all funny unpredictable things, for the same kind of drug some patients deal with it just fine, feeling all comfortable and easy; but some patients flush, throw up, feel drowsy and get funny feelings in the head.

When Maria started complaining, my heart screamed "DAMN!". Look, I waited for the whole day since early morning, and at that time it's already near 7pm. I had also already spent half an hour setting up the patients with the belts, wires, monitor and all the fancy stuff. If the patient turned out to have allergy or adverse reaction to morphine, that meant I must cancel this patient, and all my effort on that day would just go down the drain.

Also, do you remember how I mentioned that I had not-too-good good first impression about the patient's history, with her smoking marijuana everyday since 13 and all? If she's feeling uncomfortable, just imagine if I continued to strap her up with those equipments, she might actually go find her "bad" friends and beat me to death. Okay I am exaggerating this, but my worry about the cancellation was real. It's simply a major pain in the ass whenever I have to wait for the whole day but end up with no useful work.

The nurses called the consultant to see whether it's okay to change the morphine to other pain killer. If they changed it, I was basically screwed since my research requires morphine to be given. Turned out that the consultant decided to change the morphine to a morphine-related pain killer called fentanyl which has a lower incidence of adverse reaction. The nurses told me, "Sorry, I think you can't do this patient this time."

Determined not to give up, I called my supervisor to ask whether it's possible to continue the study. To my delight, he said YES!! What happened was, in my research we were supposed to keep track of the morphine and analyse its effect on the obstructed breathing; so in this case, although they changed it to fentanyl, we could still convert the fentanyl to its "equivalent dose" of morphine and perform the same analysis. That meant my effort was not wasted after all!

So I went back to the bedside, but unfortunately the patient was still in clear distress. Just as I was figuring how to tell her "Hey despite your discomfort just now, we are still going to do the research anyway", she told me something that I will never forget:

Hey I heard that you can still do the study? I am really glad that you don't have to cancel the study! I really want to help you with this. I am a market surveyor and I know how important research work is to us.
Imagine being so magnanimous and helpful when you are feeling so nauseous. Can you do the same thing? I was so touched and grateful I was brought to the brink of tears.

Maria will always remain one of the most special patients I have ever had. She taught me so much about medicine, and how bad it is to let first impression cloud my judgment. Those things, we don't learn from textbooks.


sophisticatedsoul said...

You finally completed your story. lol.

It's a good read. Indeed something that we don't normally get to learn from textbooks. Thanks for sharing. ;)

Feeling said...

it's a great one!

youngyew said...

No worries. :)