Thursday, January 7, 2010

A patient's request..


Its been a while i take my break from writing. Time is the most precious and valueable thing right now. However, since i have something i want to share i'll spend some of my time for this post.

This post is about what i've experienced from a patient I've met during my frist week at internal medicine ward..

One of clinical student's routine in the ward is talk to patient and gain their history of their disease/problem (a.k.a. history taking/clerking). So, i came across this patient, a middle age Malay gentleman. Generally he does not look ill or depressed.

He actually suffers from a mild stroke..and some other common stroke patients background history: Diabetes mellitus, hypertension, hyperlipidemia,history of chronic smoking..

The conversation about his illness is about 15 minutes but he talks about his insight and hopes on us future doctors and doctors for nearly an hour.hehe..imagine that..

Lesson 1 : Never do something to a patient without telling them what you are doing and things that the patient can anticipate...

Only recently, the ethical stduies is included in the medical school syllybus. The medical personnel who treat the Pak Cik fails to give proper 'informed consent'. That is the among the first thing to do which is provide an adequate infromation and get agreement from patient in anything you want to do to them.

What happen to him was he was injected with TB antigen for Mantoux test to see the presence of Tuberculosis. He was not informed on the effect which there will be a small rash at the side of injection and it can cause itchiness. What happen to him was, he scratch the injected site due to the itchiness and causing him to get a big swollen bump there. It happen to him years ago when he was admitted for TB at a governemnt hospital in our country.

Positive result of Mantoux is only a temporary effect..

(Extra info: matoux test is a method to support the TB diagnosis. It is injected intradermally and the cell mediated response is within 48-72 hours is recorded. The response is usually shown as rash. COmmon Side effects is itchiness.Positive result is when the induration is >10mm(in people with moderate risk factor and high prevelance country).Induration is palpable raised hardened area of the skin

Lesson 2 : when someone is physically sick, they'll need more attention from their closed one(family,spouse& closed friends). If not, pshycologically the will get sick too..
He did mention that when he is warded, he feels lonely when nobody he knows around. When his children visit him, they didn't bother to talk to him or entertain him. It makes him feels sad and become a burden. He later inform his family members and they started to paying attention to him and visit often. it makes him feel happy and accept his stay at hospital.

My postulation is when someone is sick, the coping mechanism is also disturb. Therefore, it is helpful when there is something that can trigger your coping mechanism to become well and eventually that person will motivated to recover.

That is why people always bring something when they visit a sick person. Isn't it common to see a Get Well Soon card send with a basket full of fruits or a bouquet of flower???

This e-card was taken from

Pshycological health can influence the major portion of our physical health.

However, the most important support is from the people you love..Money can't by happiness, Money can't buy love, Money can't buy health as well.

It is easily to get bored to be hospitalised.Therefore, pshycological health is easily affected also. It is much more worst because the is stay beacuse of our illness and we cannot do anything. They have to be independent and have to rely and trust on the medical personnels.The question is, are we capable enough to be trust on??

Wasalam (",)


kaenua said...

agree.. thakns 4 the lesson.. =)

nur_aishah said...

To kaenua:

ur welcome...all da best for ur studies at UNPAD..we all seniors are waiting for our juniors at HUKM (",)

marmasri said...

nice post,dear!keep it up =)

nur_aishah said...

to marmasri:

may my post cheer & motivate the readers..AMIN..

thanks my dear mar..u too keep on producing the nice 'sajak'(",)