sabato, ottobre 01, 2005
:: a moral responsibility ::a patient came in third trimester with a blood pressure of 145/96 (which in a pregnant woman is considered moderately high... and at risk of developing eclampsia ie. fits)
doc: your bp is a bit on the high side, i would advise you to get hospitalised, so we can monitor your condition and do more tests for you...
pt: but doc, i feel ok wat. dun need to stay hospital la, so troublesome...
doc: can you see clearly? any stomach ache recently? headache?
pt: no... i'm ok la doc. no need any more tests...
doc: ok... i understand you dun want to stay in the hospital... it's ok, you can come for more frequent checkups, but today, i would like to do some blood tests for you.
pt: but i already did the blood tests that time...
doc: that was quite some time back, and your pressure not high then.
pt: hmmm.... ok, must do ah?
doc: the blood tests are optional, but i'd advise you to do, because now your blood pressure is high and we're worried...
pt: oh ok.... if u say so...
pt's husband: what, doctor, must do more blood tests? thought that time do liao? do somemore for what lah? waste money only!
doc: mr xyz, as i told your wife here, it's optional, but i advise you to do, because her BP is a bit on the high side, so we want to check. the last time you did was quite some time back, things can change...
pt's husband: hmmm... don't want to do lah! waste money only!
and with that they left... i couldn't help wondering, would it have made a difference if the doctor put in more effort to persuade them? at least if it were me, i would have explained to them what the danger of high bp during pregnancy was... ie. get fits, risk of affecting baby, and risk to the mother. that it is something serious and not to be underestimated. i would have prescribed some medication (if not already done) and advised her to come for 2-weekly(?) checkups until she is term (if she is very against hospitalisation), as well as counsel her for bed rest and reduce physical activity. oh and warn her to get herself to the hospital immediately should she get stomach pain, blurred vision, headache... here, i believe that the reason why they did not wish blood tests to be done was due o the cost. i suppose, we could get them some financial help somewhere?
on the other hand, i'm not sure if the doc had his own reasons for not trying to encourage them more to do the blood tests... or he simply got too tired of facing such situations that he just gave up. sob. v sad. i hope i won't lose the passion to help people in the future. despite how many situations i face where in spite of my gdwill, i'm unable to do anything to change the outcome.
but right now, i think i shall need to fulfil my moral responsibility towards my parents: mug mug for OG exam! dun waste my school fees!
PS: is everyone else's blogspot 'create a post' page weird? with all the icons malaligned?
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