I’ve heard it said before, that chefs don’t like to come home to cook dinner. I see the truth in some of that, as the last thing that I’d really feel like doing on returning home from work, is to focus on more medical things.
But sometimes, there is no other choice, and you just have to. Medical problems that my parents or grandma wants advice about are directed towards me when I come home. When things like “I’ve been getting cramps these last 2 days, what is the reason?” are asked, it’s an incredibly difficult position to comment about. So I try and take a history to glean more information, essentially to determine if it is something serious in nature, or something relatively minor that doesn’t require urgent treatment.
When it comes to things such as these, I don’t want to end up completely treating my family members. I’m happy to provide some advice, but when it comes to some medical problems, I don’t have access to diagnostic tests to confirm suspicions, and that’s why I think that if the issue really warrants serious investigations and treatment, it is best managed by their regular GP. I realized that a doctor without any medical equipment, diagnostic tests or medications is the equivalent of a medical student – just full of knowledge and differential diagnoses, but essentially unable to do anything much else.
This concept of being unable to do anything much was best demonstrated just a couple of days ago. My grandma had only been discharged from hospital for less than a day, but she was extremely keen for some lunch at a restaurant. So out we went to eat some greasy unhealthy Hong Kong food (which gave my Dad and I diarrhoea later that night by the way). Part way through lunch, my grandma turned a sickening pale, then blue colour in the face. She became limp, head starting to slouch. Her consciousness seemed to slip away as seconds passed by. I thought she was having a stroke. Fear seized me momentarily, with pure negative thoughts of gradual decline to a terrible quality of life, and what may be a painful slow death after what followed.
“She’s not responding” my father fearfully exclaimed in cantonese. I must have snapped out of my fearful state following that, and pounced into “doctor mode” after out. Bolting to my grandma’s side, I immediately thought of ABCD, checking for responses (COWS – Can you hear me, Open your eyes, What’s your name, Squeeze my fingers). By now, I mentally thought of hitting the MET call button, which translated to calling the ambulance. Enlisting help from the restaurant staff, I calmly told them that my grandma was in trouble and I was calling the ambulance. The manager took over my phone, continuing the call as I couldn’t give the exact address.
Throughout all this, I didn’t feel like I did a good job. I didn’t know aside from thinking about differentials and continuously assessing her conscious state, what else I could have done in that situation. I felt completely powerless removed from the hospital environment. One of the nearby nurses from a GP practice was called over, and helped to take a BSL and blood pressure.
As my grandma become more alert gradually, her only concern was that I attend my job interview with one of the hospitals that I was applying for next year. She urged me numerous times to attend. After what seemed to be about 5 minutes, she was more alert in herself, and the paramedics had arrived. My mum would accompany her to the hospital, and from my grandma’s urging, I ended up attending the job interview.
Perhaps what added to a particularly anxiety provoking day, was when the interviewer gave me a clinical scenario about a MET call patient. What a coincidence – I’ve just been through one already.
Suffice to say, I probably wasn’t performing at my peak after what happened. The interviewer felt I was too nervous, and felt I couldn’t control my nerves (I found it odd for some reason for an interviewer to specifically mention that). I thought the better of mentioning what happened to my grandma – I don’t want to be seen as someone who wants sympathy points.
I went home by bus, and went straight to the hospital afterwards. My grandma had perked up much more, and looked much better. But what a day that was. What a day!