I read with interest the “doctors are doing their own thing” hulabaloo in the newspapers. Though as a general rule I don’t comment on current events, I feel I want to say my piece on this matter.
To give a little background to those who don’t follow the situation, a deputy minister visited a patient at the Accidents & Emergency (A&E) unit in Hospital Kuala Lumpur (KL General Hospital). He alleged that there were 20 patients waiting and none were called into the treatment room. So he went in there and caught a doctor reading a newspaper and another doing his “own thing” instead of treating patients. He scolded them, called the supervisor and scolded him too. Then he promptly proceded to call a press conference to express how upset he was with the situation.
(IA’s note: I use the male noun in this post, but I don’t know the gender of the doctors in the case).
Ok, cue the public flogging.
Subsequently, GHKL’s director and Ministry of Health released their statement to say that:
HKL’s investigation showed that there were only eight patients and 20 relatives waiting for treatment and that none of the patients were in pain as stated by Saravanan; and the two doctors were housemen who had just completed their shift.
The director then went on to explain that the A&E receives about 550 cases a day, with 9 doctors (of various capacity and seniority) attending to these cases in 8-hour shifts. If you do a quick math, that means each doctor can only afford to spend an average of 10 mins per patient. If you are patient no 25 in that particular hour, the minimum waiting period for you (assuming each case is a breeze and the doctor spend no more than 10 mins per patient) would be 27 minutes.
Ok, put that into context. If you were wheeled into the A&E, bleeding and vomitting, would you like for your doctor to just spend 10 minutes with you and then shoo you out so that he can attend to the next patient? Chop chop chop. You want to beat the clock to make sure that no one waits more than 27 minutes each.
Are you fucking kidding me?
But I don’t want to make this post into a rant. So instead I will share with you these 3 stories, to show that there are many decent and caring public health workers – you just don’t hear about them because rants are much sexier than saying thank you for the good work :
When I was 17, I broke my wrist during hockey practice. The warden on-duty took me to the Balik Pulau District Hospital, and after the attending doctor took my vitals and assesed the situation, he gave me painkillers and arranged for me to be transported to the Penang General Hospital in an ambulance. My warden went back to school, so I was 100% at the mercy of the public health system.
I was promptly sent to the A&E, again my situation was assessed and two rounds of X-Rays were done; and after more painkillers I was warded while waiting for the orthopaedic specialist to be available. Later, I was woken up and transferred onto one of those hospital beds with wheels and wheeled to the orthopaedic clinic. I protested and said I was able to walk on my own, but the nurse told me gently that I should just lie back and relax. By then it was already 8pm and I had been in the hospital for about 4 hours.
The specialist looked at my X-rays and did his assesment. The houseman that attended to my case earlier in the day was also there. They fixed my wrist, put plaster on it, then made me count to 10. And yes I fell asleep somewhere between 6 0r 7. When I was warded, I didn’t have any change of clothes or undergarments or toothbrush or anything on me at all except for my dirty, sweaty tracksuit. The nurses took it upon them to provide me with these things, they even made sure that I had a cup and a thermos of water by the bedside so that I could take my meds on time.
I was discharged 2 days later, and after the cast was taken off, I had weekly physio-sessions at the hospital to rehabilitate my wrist so that I can do the normal things that you with your hands.
Ok, had it been your child, would you throw a fit because it took the hospital 4 hours to finally put a cast on my wrist? I am betting the answer is yes.
But, as the patient, all that I remember was how helpful and gentle the hospital workers were. They cracked jokes at my cast, bought me chocolates, made sure I combed my hair before my principal came to visit me. My principal made a fuss when he found out that they put me in Class 3 ward and insisted that I should be transferred into a private or quad room. But honestly, I was not a critical patient. I was not in pain. Sure, going to the bathroom and showering took a lot of manouevering and contortions of gymtastical proportions but otherwise I was fine. And the fact that they held me for 3 days was already more trouble than it was worth. It meant for 3 days, someone else who could have been in a lot worse medical condition than me was not able to be warded. All the hospital beds in the ward that I was staying in was full. N0t a single empty one. Yet there I was, a 17 yeard old kid with nothing more than a broken wrist.
Did you think they went beyond their call of duty? Well, I know they did.
Later that year, while I was waiting for my SPM results to come out, my auntie was struck down by a teribble stomach pain up to the point where you could not even touch her without her screaming in pain.
My father drove her to a nearby clinic, and after an ultrasound was done, the doctor told us that we need to get her to a hospital immediately. We sent her to the Batu Gajah District Hospital, where another ultrasound scan was done. The doctor then explained to my father that there was a growth inside my aunties’ uterus, he could not tell if it was cancerous or just a benign fibrosis but he was arranging for her to be sent to the Ipoh General Hospital immediately in an ambulance.
On that day, it was my uncle’s wedding. My father then asked me if I could accompany my auntie because he needed to go back home to organize the wedding. I said sure, so I sat in the ambulance with her. By then, she was half-conscious from the painkillers, which was a bliss because she was literally doubled up and moaning in pain.
My auntie was sent to the A&E. More scans and bloodwork. She was then warded and told that they would need to conduct a biopsy to determine whether the growth was cancerous or otherwise so she as put on a nil-by-mouth order and warded. Then we waited. At about 8pm, the lights were dimmed at the ward as the visiting hours were over. Two doctors came to me and asked me to follow them to the side section where they had my auntie’s charts and whatever. I don’t remember the conversation exactly but basically they were explaining to me, in the simplest way possible, that they need to perform surgery on my auntie as soon as they could as she was in danger of internal bleeding if the growth burst. I asked them what are the other alternatives and possible outcomes. And after that, I asked them for some time so that I could explain and discuss this with my auntie.
How old are you? one of the doctors asked. I told them I would turn 17 in November. Then they asked me, if I had to make the decision, what would I do? I said, I would go ahead with the surgery.
I went back to my auntie, woke her up and explained to her the situation. I also explained that the growth inside her womb was so huge and it had been there for so long that it had its own blood vessels etc and basically was draining the lifeforce out of her. I also told her, if there was no way for the doctors to remove the growth without endangering her life, they may have to remove her womb altogether.
She said, where do I sign?
She was wheeled to the operating theatre around midnight. I walked alongside her hospital bed. One of the surgeons took me aside said I should go back to the ward and get some sleep because the surgery would take a while to finish. I told him I would wait.
And I waited.
4 hours later I was still waiting.
Then, the same surgeon came out again and gestured for me to come to him. He said, the growth was too big it was almost like a small melon. And the potential for blood loss was too great. They had been chipping away at it for hours and hardly made any progress. So, they may need to remove the womb.
I told the surgeon my auntie was aware of the situation and she had signed the consent form earlier. The surgeon said to me, yes I know, but I want to keep you updated so that you understand why the surgery is taking so long.
It was another 3 hours before the surgery ended. He came to me and explained that because of its size, location and other factors, removing my auntie’s womb was the best possible option to save her life. Then he asked if I wanted to see it. Why? I asked. In case you don’t trust us and want to see for yourself how big it was, he explained. I told him there was no need to do so. (I asked Awa about this peculiar offer years later and she said, well apparently in Malaysia, it is like some kind of a trophy or evidence. The patient’s family always asks to see, so surgeons would put it in a jar or and show it to them. Eew).
I called my parents later in the morning after I had showered and had breakfast. They were not home because they were at my uncle’s wedding. There were no mobile phones yet. And for the life of me, I did not have my grandparents’ number. So I called the Kg Gajah police station, gave them my grandparents’ address, and asked them to relay the news. My parents came later in the afternoon. I accompanied my auntie at the hospital for 2 more days but I was young and restless and bored so I told may parents that I wanted to go home.
My auntie stayed at the hospital for 2 weeks. We visited her often and she was full of praises for the nurses and doctors, whom she said, had been exceedingly nice to her. One of the nurses even brought her niece to visit my auntie to cheer her up. And yes, the ward where she was staying was also 100% full with patients. There was no empty beds the entire 2-weeks she was there.
I was in varsity and in an ill-advised spur-of-the-moment decision, borrowed a motorbike from a friend and rode to the Kg Kerinchi pasar malam (night market). I was the pillion rider. Everything was completely fine, there was no traffic, no rain, we were not speeding but for some reason, my friend lost control of the bike, we skidded and kissed the pavement.
There were the usual cuts and bruises, and my friend had a huge gash on the right arm, which was a bummer because both of us were supposed to play in the inter-varsity hockey tournament the next week. The pinkie finger on my right hand was bleeding profusely, but I didn’t pay much attention to it; I mean it was the pinkie finger – who cares?
But the next morning my bandaid was soaking with blood and I was worried because the bleeding didn’t stop. So, we went to the student clinic at the (then) HEP building. The nurse looked at it and then commanded me to board the clinic’s van and I was immediately sent to the A&E of University Hospital (now known as Dataran Trauma, University Malaya Medical Centre).
They put me on a wheelchair and wheeled me in; a doctor attended to me immediately and sutured me up. I could not remember the explanation why my wound was not clotting up but I got an earful for not coming to the A&E immediately after the accident happened. After he was finished, the doctor took off his face mask, smiled at me and said, “Eddie Lawson, if I see you in the A&E again with some other form of injury to your hand, I will give you frequent customer discount,”. I went, huh? Then he asked, “Do you still play hockey?”. Turned out he was the houseman that treated me when I broke my wrist 4 years earlier (see #1). I have forgotten, he didn’t.
I think being a doctor, or a public health worker in general for that matter, is a thankless job. People expect you to cure what ails them, very often in the fastest, cheapest, painless way possible. Everyone thinks their case is priority, and most don’t think twice about making this thought known in a loud, obnoxious, entitled way. When the diagnosis was wrong, people are quick to call them idiots. If a patient, God forbids, dies or takes a turn for the worse, the doctors and the treatments are blamed.
Look, health care professionals, JUST LIKE THE REST OF US, are humans. But unlike us, they deal with mortality, theirs and someone else’s, on a daily basis. So cut them some slack and give them some respect and space to breathe.