Thursday, June 21, 2018
I had the privilege of reading her recent notes in the time it took her to come through the door. I could see that she had seen another doctor three days earlier with a fungal rash. She was eighteen years old.
Mum was in tow. She pulled the extra chair in the room to make a third angle so I got the hint. This was going to be a three-way conversation.
" You don't mind if I sit in, do you?" She asks, rheotorically.
"That's up to Allie" (Let's call her Allie), I look directly at my patient. She looked very timid but she was legally an adult so I asked "Would you like your mum to wait outside for a minute?"
I have found that to be a much better way of phrasing the question as it appears to alleviate the responsibility from the patient. Any shrug, hesitance or vague response is taken as a Yes.
"Oh no she doesn't mind, do you Allie?" Without much choice, Allie obliges her.
The problem was that the rash was still present after three days of using this cream.
"I can see that the other doctor asked you to use this cream for two weeks and then come back for a review"
"Well she was just worried that it would become very serious like mine did" Mum said. "I had exactly the same rash and I ended up in intensive care and this is exactly how it started"
Getting a bit concerned that we might be missing something serious, I went over the details again.
"How did your rash start?" I ask Allie.
"It started as a small rash under my right bust over a week ago but it spread and became itchy"
"That's exactly what happened to me! I just woke up and my face was swollen. The doctor gave me something but it didn't work just like hers. He gave me some hay fever tablets but I ended up in intensive care and nearly died"
Allie looks a bit nervous now. Mum goes on to give full details of her experience with a severe allergic reaction.
"I think what you had was a different kind of rash" I say to mum. I turned to Allie. "Since you started using the cream, do you think it is still getting worse?"
"It's less itchy but still red." She said.
"It's very itchy and spreading to her face like mine did." Her mum said.
I take a look at her face but cannot find any rash. "Did you say it spread to your face?" I ask Allie.
"My face was swollen, I had to get an ambulance and they gave me some injections and I ended up in the intensive care unit"....Mum.
"Not really, no." Allie says.
I proceed to examine the rash and explain to her that it was clearly a sweat rash. It needed to be kept cool and aerated and allowed time to heal with the cream given. I quickly address Mum's rash history, highlighting the difference between her rash, caused by a severe allergic reaction, and Allie's rash, usually associated with fungal infection.
"Fungal infection? Oh yes! It runs in our family. She must have inherited it from my sister."
They are thankful as they leave. Mum promising to call an ambulance if it got worse and ask her other sister to get checked out.
Monday, June 18, 2018
I recently got promoted to the next level in this School of Life business. So far it's been favourable to me and I am extremely grateful to God. I will not even pretend to suddenly be wise but I have learnt a few lessons along the way:
A smile is a powerful weapon...even in texts 😃.
It's okay not to want it all.
Do not form an impression of anyone based on someone else's opinion.
Listen to hear and to understand, not to reply.
You have no control over other people's emotions. One person will adore you for the same thing another will despise you for.
Enjoy the company of the very young and the elderly. They are less attached to the stresses around the world and help you to detach too.
Respect the cleaning lady, the waiter, the cab driver.
You can respect other people's cultures, opinions and beliefs even if you don't share them.
It is hard to trust people who never express any opinion. Silence is not always golden.
Do your best. After this, there is nothing more you can do.
Pick your battles. Some are just not worth showing up to.
Do not take good health for granted. You are going to need your body for your whole life. Look after it!
.....We live, We learn x
One common sign of drama is tears.
She had not been seated 2 seconds before they started to flow. Heavily, between sobs.
Experience has taught me that patients who are depressed rarely burst out crying in that manner before speaking. Especially when they had been happily chatting with a member of reception staff one minute before. (Yes, we notice these things).
I was in an unfamiliar room and looked round for tissues. There was none to be found. Good.
"I'm sorry, I haven't got any tissues. What's the matter?"
The tears stop quickly. She had made her point that this was very serious....and I had no tissues.
"I am not sure how you can help me" sob, sob. "My husband is hiding money from me!"
I am listening now, my mind is sympathetic. I am trying to recall all the local Domestic Violence and Women support group contact details. I am thinking Financial abuse here, planning my assessment questions.
"I mean, don't get me wrong, he is a nice husband and dad, he gives me all the money I need and I have access to our joint account. He does not monitor my spending or anything like that."
Okay..... Scratch the financial abuse line of thought.
It turns out her husband is spending some of his own money on things he likes, without telling her. She stopped working to have children, had two children, the younger was nine years old. Her husband had encouraged her to return to work a couple of years ago but she is not prepared to do so.
She is not suspicious that he is having an affair or accumulating debt. She just wants him to tell her how he spends his extra money.
My time is ticking away so I am trying to medicalise this whole doctors appointment business.
I start asking questions to explore depression, anxiety, delusions....all negative.
"I know you are not a marriage counsellor" she says
You do?!!, I do not say.
"But I asked him to go to marriage counselling with me but he won't because he does not see any problem with our marriage. I mean, there isn't any problem in our marriage really. It's just this issue bothering me"
She goes on to give more background to the marriage, children, etc. I look at my watch. Time's up. Now I am running late.
"Is there anything I can do to help, medically?"
"I am not sure really, can you suggest a marriage counsellor. I have found some but they are a bit too far for me."(20 minute drive)
"Might be a good idea to try and convince your husband to go with you first." I suggest. "I'm afraid I haven't got much more time left, you can arrange a review appointment if it becomes a problem for you as we discussed"
"Ok, thank you doctor. Please can you just look in my ears, I think I have wax...."
Thursday, June 14, 2018
The young man slumped into the chair.
I reminded myself to smile and take a deep breath as my impatience started bubbling to the surface.
We were already 4 minutes into his 10 minute appointment. The first couple of minutes had been spent waiting for him to arrive after repeatedly calling his name over the public address system. His name would have appeared on the screen in the waiting room telling him what room to attend.
After waiting nearly 2 minutes, I had gone out to call him.
Sometimes people have popped into the loo or have mobility problems or a huge pram so can take a while getting to the office.
Not this guy. He was sitting right there, headphones over his ears watching something on his mobile.
That was when my irritation set in.
"How can I help today?" I managed a courteous face.
The history came out.
He was a third year university student and needed a letter to explain his absence from at least sixty percent of lectures over the course of the year.
He wanted to defer his end of year exam or apply to repeat the year.
Still hoping I was of relevance to the story, I asked him the reason.
"I couldn't get myself out of bed so early in the morning cos I stay awake till around three or four am".
"And why do you stay up so late?"
"Dunno, just playing on the X-box and on my phone and stuff. But the lady at the office said if I could get a letter saying it was like my mental health and stuff, it would help."
He went on to explain that he did manage to keep going to his evening job because he needed the money.
"But I'm not like "depressed" or "suicidal " or anything. My mum actually took me to the counsellor the other day but they said I need a doctor's note."
I sank back into my chair and sighed.
We had a brief chat.
In the most firm but polite way, I asked him to go and discuss his problems and priorities with his university liaison person.
He had given away his game consoles which was a good start. I wished him well.
He wasn't the first, and certainly not the last person with that problem. In fact, it is a growing epidemic.
And until it was given an actual medical term, I spent the next few moments trying to figure out what to put down as the diagnosis.
I couldn't find "Millenialitis"
Tuesday, June 5, 2018
As I lay soaking in a hot bath a few minutes ago, I reminisced on the events of the week gone by. One particular conversation struck my mind. It went thus:
Me: "Hi I'm here to see Mr. Watsisname*"
Man: "Oh please come in, I'll just get him out of the freezer"
(I had gone to a funeral home to view the body of a deceased man who was to be cremated)
Reflecting on that statement, I realise that at the end of our transient journey here on earth, our bodies are no different from sausages and milk.....kept in the fridge for a short time until finally disposed.
We spend so much of our lives trying to "maintain" this body sometimes forgetting to look after the part of us that will live for eternity- our souls.
May our daily pursuits not overshadow our main purpose. Amen
I shall now proceed to devour my hot bowl of Isi-ewu with a chilled glass of Malta Guinness. It's 10:30 at night and I can hear someone saying calories but who cares. #YOLO
Monday, June 4, 2018
As we grow older, friendships evolve, wax and wane, come and go.
Sometimes by choice, sometimes not.
We love, we learn. We loose, we learn.
Each time, we grow.
The important thing is to leave clean, to live clean.
Life is too short to carry grief and grudges.