Indexing Title: TMEDINA’s Medical Anecdotal Report [04-5]

MAR Title: “Athena’s Daughter”

Date of Medical Observation: August 4, 2004

Narration:

Perhaps one of the greatest legacies of Greek Civilization to scientific thought is the power of observation. Rather than attribute diseases as manifestations of God’s wrath, Hippocrates used astute examinations to diagnose and treat patients, casting away magical thinking that so clouded the minds of the ancients. Indeed, no amount of sophists’ philosophizing can equate to one young physician attending closely a patient, noting every changes, to discover what occurs in the poor being.

It was a busy morning when I reported for duty at the Emergency Room. The air reeked so strongly of toxic splendor; most beds were filled, the residents were tired and the clerks buzzed around like bees. Several patients were endorsed to my duty group and one of them began to catch my attention…..

She was a 16-year-old female who came in due to abdominal pain. At first glance, you may think of an acute appendicitis, however, on subsequent evaluations, this became less likely and a gynecologic pathology looked more salient. She was then referred to OB-GYN for clearance but it was inconclusive and a gynecologic pathology cannot be totally ruled out, so an ultrasound was suggested. No big deal, I told my self, I just have to perform the necessary exams and voila! I will have my diagnosis served to me on a silver platter. Not so……

In the midst of deep thought as to patient management, I received a phone call from a “consultant” who apparently held a high position in the hospital. My 16-year-old patient, it seemed, was what hospital parlance so euphemistically call a “C/O”. The consultant scolded me for the “delayed and inappropriate” management and questioned our diagnosis based on gut feeling. Complained of no aggressive action had been done, since the patient had been there for almost 24 hours. To rub salt to the wound, another so called VIP called me up to push me, giving orders to bring the patient direct to the Operating Room and do necessary operation. I told them that according to our clinical observations and serial abdominal examination done quo hora, the patient did not appear to have a surgical abdomen (not an appendicitis). That to say it is so might rouse Mc Burny and Rovsing from their graves.

There was never a delay in my decision. Each step in my management was logical & based on the patient’s physical and clinical manifestations.

The day came when an ultrasound was done and revealed normal findings. Eventually, the consultants’ whims were given and an appendectomy was done. Alas, it was a gangrenous appendix waiting to be cut. They were right after all.

However, these consultants’ voices still echoed in my ears.

Perhaps they were correct to order an appendectomy and it is a lesson for my proud soul to keep but to override another physician’s impression without actually seeing and touching the patient is a mortal sin, asking for the Gods’ and Goddesses’ wrath and fury.

Insights: (Reinforcement, Stimulus, Discovery)

I may be young and too dreamy-eyed of this profession, hubris may be my cup of coffee. But it bruises my spirit to learn that those claiming to be gods of modern Medicine, can easily trample upon the basic principles of science and the power of a perceptive observation to serve their own personal interest. Reminiscent of the oracles of Delphi who claim derive their power from above, claim to know everything and decide on matters based on gut feel, these VIP’s have tasted some powers, thus making them eligible to decide on patient care, even without a glimpse of my patient’s skin.

As a true daughter of Athena, Goddess of Wisdom, the tradition lives in my spirit. Medical training has taught me that a careful history and physical examination is essential to diagnose with high precision, that so as long as I am able to examine a patient thoroughly, I will be correct most of the time; that nobody, even one who purports to know more than I do can bowl me over if I have firm grounds to support an opinion.

Indeed the greatest legacy of Greek science is the power of observation. And as long as the fire burns in me, I shall uphold that paradigm. No amount of coercion from so-called experts can force me to do something that I do not believe in.