Indexing Title: NALUDINOs Medical Anecdotal Report [04-4]

MAR Title: “Simon says?”

Date of Medical Observation: July 19, 2004

Narration:

The day started uneventfully. We did the morning rounds, examined the patients and wound care was administered to the all patients. When we finished, we went back to the computer room and started making the daily census. It was during this time that I was informed that we failed to visit one patient, a 1-year-old male patient at room 310. This patient was admitted for 2^nd degree scald burns covering 23% of his total body surface. We went to the patient, noted adequate urine output and saw that the patient had low grade fever.

Seeing that the wounds were already dry, we instructed the mother to give the baby a bath to facilitate removal of the old dressing and to help in lowering the fever. The mother refused, citing previously held beliefs that a person who has a fever should be given a bath and that she was afraid of what might happen to her baby. After a while though, she conceded and agreed to give the patient a bath. I then gave her further instructions and went back to the computer room.

While doing the daily census, I was surprised when somebody knocked loudly on the door and started looking for me. Thoughts quickly rushed though my mind thinking if I had offended anybody that day or during the tour of duty at the ER. I opened the door and was immediately confronted by the father of the child.

He was asking why I told the mother to do such things. He was actually scolding me and was trying to convert me into his way of thinking. I stood my ground, calmly explained the situation and eventually won him over.

Insights (Discovery, Stimulus, REINFORCEMENT):

This is not a simple game of Simon Says and they immediately follow. We must realize that different people have different beliefs. Most of these beliefs have been handed down from generation to generation, from “lola” to “nanay” and from “nanay” to “anak”. Some of these beliefs are good and some are counterproductive. I believe it is unwise for us to approach this problem with a closed mind and a combative attitude. It is incumbent upon us, the physicians, to teach not just the patients but also those who would be the caregivers the “proper” way of doing things. However, we must be careful not to make it look like we are ridiculing their beliefs and put them on the defensive.