Fleeting Thoughts

i can't quite believe that it's almost the end of medicine sip - i know i'll be very sad to leave. i'll list the stuff that i liked in an upcoming post (though one of course will not to be mentioned) but let me just scribble some thoughts down now:

today a patient's wife came to update me. background of the case is this middle-aged guy who's a newly diagnosed leukemia, and the family delayed in informing him of the diagnosis because they were afraid he could not take it. his wife broke the news yesterday evening, and so far he's been all right. i'm mentioning this because when i first found out i was posted to haemato, i was a little dismayed because i thought i wouldn't learn much. turns out i've learnt quite a bit, especially in communicating with family members. and it's nice to have relatives speak to you this way, because it means they appreciate what you've been doing.

an interesting thing i noticed about patients is how much superstitions or pre-conceived notions can affect their outlook and subsequent co-operation with the healthcare team. one of our patients is also another newly diagnosed leukemia, and chemo is of course indicated as soon as possible, since his bone marrow is filling up with useless cancer cells. the longer he delays, the harder it will be for the chemo to be successful in clearing the cancer cells. but guess what, he wants to wait till the seventh month (hungry ghost festival) is over before receiving chemo, and that would be in september. it can be hard to understanding sometimes, even though you try very hard and you give your all, if a patient brings to the table beliefs that clash with your desire to heal. this same patient even backed out of a hickman line insertion at the last minute because he was afraid of the pain, despite having been reassured that the procedure is performed under local anaesthetic. perhaps it's denial (he did break down in front of the whole team the morning after his diagnosis) and this is his way of trying to regain control of his life since fate so cruelly took it away from him. either way, it's still very frustrating to have to overcome this barrier which medical school never prepares you for. in the books it's always a protein or a receptor or molecule that is your enemy, but in real life, sometimes, it's the patient himself who is your greatest hurdle. and so, i'm very grateful for this posting because i see more clearly now the purpose of it all, and hope to be inspired by my experiences here.

it's back to the wards this weekend - am on passive haemato call tomorrow. someone in my room has been listed as DIL, so i'm keeping my fingers crossed that he doesn't need resuscitation or an ICU admission!

but going back tomorrow (specifically tomorrow) might bring some perks. and yes, both meanings of the word apply here. heh heh heh.