Indexing Title: RCHAN’s Medical Anectodal Report [04-5]

MAR Title: "Father Behold Thy Son, Son Behold Thy Father..."

Date of Medical Observation: March 2004

Narration:

            My patient was a 65-year-old male who underwent exploratory laparotomy, evacuation of intraabdominal abscess, resection, terminal ileum with ileostomy for multiple perforations secondary to TB ileitis. The operation was stormy, the patient having emphysema, he had low oxygen saturation levels and had tight air entry. The patient had delayed extubation and was not transferred back to the ward from the post-anesthesia care unit till the following day.

            At the ward, the patient was toxic, with episodes of hypotension, difficulty of breathing, fever, vomiting, etc. He was closely monitored for the next three days. All throughout his son watched over and patiently and lovingly took care of him. I saw his devotion to his father as he nursed him on his way to recovery He finally improved and slowly regained his strength on his fourth post-operative day. He was able to sit up on his bed on his own. For the next few days, we all thought he has passed the crisis. However, managing this patient was not as easy as I thought it would be. His course was a rollercoaster ride. There were days where he would be up and about. And there would be days when he would not eat, be weak, dyspneic, hypotensive, etc, the classical patient who seems to be “seeing light at the end of the tunnel” . We would institute the proper medical intervention he needed and he would again improve after a few days. He would be back to his old self, giving me his edentulous smile and even affording to give me an occasional “Sandara-wave”.

            For several weeks my stress levels coincided with his prognosis. To top it all even after having wound infection and an eventual dehiscence of his wound occurred, he surpassed them all, and with flying colors at that! Most of the toxic patients who were admitted long after he was operated on even expired ahead of him. They were dropping like flies left and right and yet here was my fragile and unpredictable patient relishing every minute of his life, hanging on to his dear life. His son never left his side and stuck with him all the way. Weary and tired as his son was, he never gave up on him. He diligently fed his father, gave him his medications, cleaned up after him and provided him with his needs at beck and call. There were no questions or complaints uttered by his son. He served his father and he served him well. The patient was eventually discharged and hopefully improved.

INSIGHTS: (DISCOVERY, stimulus, reinforcement)

            We encounter hundreds of patients all our medical life. We see them taken cared of by their “bantays” as they recover from their illnesses. Unfortunately some of our patients are not as lucky in having their loved ones take care of them. They get admitted with no relatives around, either them living alone by themselves or they are what we call “NPAs” or patients with no permanent address. You see them at the wards, with their linens soiled in their own excretions and if strong enough to walk towards the comfort room, holding their own IV bottles in their free hand. They eat and drink what is provided by the hospital and of the relatives of the other patients who are kindhearted enough to do so. If they are benign enough, they will recover, but slowly compared to most that have “bantays”. If they are toxic, sad to say the road to their recovery is dim and difficult and to the extremes no recovery at all will take place.

            As long as there are loved ones who have the commitment to take care of their sick relatives, even the patient with a bad prognosis will improve in whatever little way that they can. The love and care that they are provided with will see them through their illnesses. The best and most expensive form medical management will never make a sick person get better if nobody is there to take care of him with the same dedication a loved one can give.