THE PRACTICE OF MEDICINE AS I SEE IT #30DaysOfNovember

By Okiki Oladele

 

‘I solemnly pledge to consecrate my life to the service of humanity…’

The first line of the Hippocratic Oath now commonly known as the Physician’s oath.  I bet you thought for a minute I was writing out a line from Harry Potter or something? You are not too far off because its almost the same idea. No magic here, no waving of wands and spells but we do have our wand read that as stethoscope. We also speak a lot of latin phrases…I guess you could say we make incantations if we want to be fair! Pulsus Paradosus, Pulsus parvus et tardus, cor pulmonale…latin all of it! So yeah, the art of medicine could almost be a scene straight out of Harry Potter…I digress

Back to the Hippocratic oath, the moment you pass your finals and you are being inducted fully into the medical profession, you basically sign off your life to medicine, that’s if you intend practicing all the way anyway…no need to panic! But that’s the truth and there’s more really!

I have always wanted to help people, I know I could help people by becoming a lawyer or an Engineer. Those did not just cut it enough for me. I needed to know what made people tick. I was inquisitive about why we just slept every night and woke up the next day like its nothing. Why do people fall sick? Why did I get chicken pox that year? Why did my Grand-ma get sick and die? How exactly does ones heart fail? (You know you can actually die from a broken heart? Yup. If your boyfriend breaks your heart enough you could have a heart failure and die! It is called Takutsubo’s Cardiomyopathy or Broken Heart Syndrome. Google it)…I digress again!

Medicine is an art. Well at least that is what we are told. The preclinical training is mostly books and lots of books. Imagine my shock the first time in the gross anatomy lab at the side of a cadaver (Cadavers are usually dead folks we dissect to study organ systems). Okay I wasn’t scared…I was intrigued, I couldn’t wait to get cutting…so imagine my delight the period we studied the cardiovascular system and I held a human heart in my hands the first time. Suddenly you understand that this me…is a really big me. That doesn’t make any sense but stay with me here.

Medicine is really stressful…and that’s okay because you get to save lives…or do you? I have seen a lot of things in my really short time in this training. That is what we call it because you never stop learning really. The idea that you only the geniuses do medicine is a big lie! A very big lie and that is part of the reason I am writing this post. I feel a pertinent need to dispel some myths!

While being smart is important in medical school, it is not for geniuses. You have a lot to read and genius doesn’t cover it all. The people who do well aren’t geniuses like me…hehehe…they are people who are really average students if I may. These people need to read things a couple of times before perhaps understanding. They have digested these things they have read. It becomes a part of them. The so-called geniuses however might read and grasp and pass exams. But it is all gone and that’s sad! Now this isn’t an absolute…there are geniuses, like me (did I hear you protest?) who read and understand and apply it.

Back to medicine is an Art, yes it is. Have you ever visited your GP and he listened to your chest checked your eye and ‘pressed’ your stomach? Yeah, those are part of the magic we are taught straight outta Hogwarts. I joke. I wouldn’t bother to tell you what all those things mean because frankly you won’t understand (yes I am looking down on you). Really there are things you learn to pick up from all those physical examinations in order to arrive at a diagnosis. Example: A person presents with Fever, Cough, Difficulty with breathing. After a thorough history taking and physical examination I should be able to decide if this person has Pneumonia, while excluding other 1001 causes of that. Again you get those from the books. Not fun anymore eh?

The health of my patients will be my number one consideration

I will respect the secrets that are confided in me even after my patient has died

That is another line from the Hippocratic oath. Doctors are taught to always serve the best interest of their patients. There is also this new age thing called patient autonomy. It basically means a patient is able to decide his or her own line treatment method. No biggie its all cool. I don’t like it. Why? The patients don’t always know what good for them. I respect my patients a lot and their decisions but there’s this emotional conflict when a patient wants to and insists on a treatment plan far from what the doctor is proffering Example: We had this patient one time she had heart failure secondary to pulmonary hypertension (I had to do that to confuse you, clap for me). She now came down with pneumonia again. She was on oxygen therapy for a week or so…to be fair that’s quite expensive. The family asked to discontinue oxygen. I was amazed!!! This woman would die without oxygen in a day or two at the maximum. They insisted! We counseled. They insisted. We made them fill and sign the form that says they were going to discharge against medical advice. Important for medico-legal reasons. And that just sad. One of the few things we deal with. There is a tough emotional conflict.

About secrets…You don’t want to know about the number of secrets I have stored up in my head that will go to the grave with me! Patients. Friends. Family. Each with their medical issues. These secrets will go down with me. I am that good. Doctors are awesome!

 I will not permit considerations of age, disease or disability, creed,

Ethnic origin, gender, race, political affiliation, nationality,

Sexual orientation, social standing or any other factor to intervene between My duty and my patient.

I will maintain the utmost respect for human life

I can’t let what my moral standing is deter me from giving the maximum care to a patient. I will NEVER do that. It is hard. Very very hard. What if I am a black doctor and a Ku Klux Klan member has been critically injured in an accident. I HAVE to save his life. I MUST DO EVERYTHING within my power to save his life knowing that perhaps when he gets better, he will throw racially inciting slurs at me and that hard. His well being is my primary concern. It is hard to separate morals from the practice. Religion is important. Beliefs are great but when it comes to the practice it doesn’t mean a thing! Now before you start out on me. I believe in Jesus. I believe God can save anybody. I will not prescribe a tablet of Jesus. I will prescribe antibiotics. Tell my patients to call on whatever God they serve IN ADDITION TO the drugs/treatment. That Is my belief.

Then there is the hard part…when patients die. People you battle to save and help. You don’t win all the time. And it is okay to lose at a battle but do you mope in that lose? Nope .you get back up again because another patient is depending on you to save their life. This is the basis of why people say doctors are ‘heartless’. No we are not heartless…it is a coping mechanism I tell people. You try not to get attached or not to betray emotions. A patient is looking up to you for strength, you can’t be weak yourself.

I love this profession. It has its ups and down. There are times you want to give up. There are times you are happy you never gave up. It a love-hate relationship and that’s okay. We signed up for it. So please do me a favour the next time you see a doctor…give them a round of applause!

Follow @DonOkizle on twitter and www.okizle.wordpress.com

Peace. Love. And Chicken Grease!!!

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