As it rains..

A pretty wet week to end my emergency department rotation.

I learnt that in emergency medicine, you cannot forget your anatomy and physiology.

Chinese patients can be difficult to please. Was asked to look for the patient card for a patient, and my mispronunciation of the patient's name earned me a sarcastic jeer from his wife, "You are Chinese, but don't know how to pronounce people's name properly.."

1 elderly patient with bladder cancer was brought in for body weakness, diagnosed with urinary tract infection. He was supposed to have an appointment with the oncologist at Hospital B*, but the wife thought that he was wrongly sent to Hospital A* where I am posted. The patient was discharged with antibiotics, and the initial plan was for him and his wife to go to Hospital B by taxi, but he complained of being weak and in too much pain to walk. The MO told her directly that there is nothing left for them to do, and despite repeated pleas, they cannot afford to use the hospital's limited number of ambulances to transfer the patient to Hospital B. The option of hiring a private ambulance service was deemed not worth the cost. Eventually, when nobody was looking, I took her aside and explained nicely to her that there is nothing we can do, since it is a policy set in place, clearly delineated.. She promised not to tell the doctors that I lent her my handphone to call her relatives to come and transfer her husband (I know I'm not supposed to, but it's something off the record as I see the need - of course I won't do it to everybody). I think she felt touched lor, as she replied in Cantonese "Thank you ar doctor, you are really a kind person." I think it's a sad case, as she can be heard cursing over the phone of how increasingly cruel and heartless the doctors in government hospitals are becoming, all simply because of a lack of empathy as people are just interested in getting their jobs done.

A baby was discharged from the neonatal ward with a poor prognosis of anencephaly (or some brain problem lar). The next morning, the parents awoke to find their child not responsive, and was most probably no more. They made a police report, and by right the police were supposed to arrange for a post-mortem and some kind of burial permit at the mortuary. It was not done. Before coming to the emergency department, the father brought the dead baby to the ward, going berserk when nobody bothered to explain to him what to do. When it was finally settled, I think it's ridiculous and disrespectful to observe undertakers from some casket company harassing and negotiating the cost of burial from the parents, trying to earn a living at a time when people are in grief.