…:::finetuned:::…

i thought that today was gonna turn out to be pretty boring..slept late and got up early, only to reach the hospital late anyways..stupid jam..

so anyways, the better part of the day was spent on the couch cos there was nothing much to do..my doctor’s patients are all in a stable condition, there was nothing much to worry about, and so the morning ward rounds are just to inspect the treatment progress, take blood pressure and ask if there were any other complaints..

no one was very happy on the floor today and i thought it was becos it was monday and the weather simply was gloomy and dull, even i wanted to doze off on that comfy couch..

then, me and pearly decided that rather than sit around on the couch, we shud just take a stroll to the wards and catch a random patient for some interviewing, since the patients with psoriatic arthritis shud be pretty interesting..

and thats when we passed by the SLE lady’s room..

she had been pretty ill for quite some time and her case file was the thickest i’ve seen so far..she was in a terrible condition and unfortunately she was under the supervision of another doctor, so we only got to see her once becos andrevna brought us along for a consultation..she was the one with the SLE exacerbation, she had pneumonia, a huge bloated abdomen, her left leg had thrombophlebitis, she was unable to walk and had no voluntary bladder control..when we went to see her, she was responsive but after being subjected to such a condition, all that she wanted that friday was to die..

and today, she was not in the ward..i wondered where she could have gone to when my doctor came and asked us to follow another doctor to the morgue, after which we were supposed to explain to him about what we saw..

after running around in circles ( the doctor got into a lift and we couldnt fit in, so we had to ask around and climb dunno how many stairs and finally found the morgue - next to the garage!!! ), we finally entered the morgue and my gut feeling was right, it was the SLE lady..

i duno how but i dont feel anything, up until now..it’s weird isnt it?? i saw her last friday and 3 days later, here she was on that cold hard surface, the chest ripped open from the throat down to the pubis, the contents once held by the body on the sink..the blood,it smelt like chicken that has been left outside overnight..

the doctor’s knife was super sharp i tell you..it just went slice, slice, slice thru the heart and intestine and liver..

and the conclusion was :

> renal and liver insufficiency ( apparently the kidney was sooooo tiny weeny but i didnt see it though )

> multiple organ failure

> thrombophlebitis and possible thromboembolism

> pulmonary edema

> pneumonia

i am guessing that the doctors were all in a bummed out mood becos of this..i suppose she passed away quite suddenly..talk about a wish come true..

what i really found disturbing was that the suspected thrombophlebitis was utterly discarded by the surgeon..he asked to rule out erysipelas..i am thinking that it would have been so easy to just do that damn ultrasound to prove her condition and arrange for immediate treatment..the clots that they found during the autopsy were huge and i would be very surprised if they had stayed spot on..while it remains true that the multiorgan failure she had was due to chronic treatment of SLE, the thromboembolism could have just cut her life short by a few months..a few months??

and so she died..

like my doctor was saying, you dont always have that gut feeling..and when you do, its better to just follow that instinct..maybe you are not an expert on that field but after seeing something amiss, you just know that something is wrong..and the experts in their respective fields have become accustomed to the ideal picture of the diseases they treat that when something unusual crops up, they fail to notice what we see..and of course you being the rheumatic disease specialist doesnt measure up much to the surgeon or the neurologist..and being the junior in the field..

its still gloomy up til now..

This entry was posted on Monday, June 29th, 2009 at 10:00 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.