INDEXING TITLE: RCHAN’S MAR [5-05]

TITLE: “TRABAHO LANG PO…”

PERIOD OF MEDICAL OBSERVATION: May 2005

 NARRATION:

            I was manning the emergency room together with my junior residents. There was a slow trickle of patients coming in. As I was “enjoying” leafing through my Cameron, a plainclothes policeman approached me, “ Doktora, tapos na po and x-ray nung hinuli naming lalaki, baka pwede na po naming dalhin sa police station”. (Doctor, the man we brought in has just finished having his x-rays done. Maybe we can already bring him to the police station?). I politely asked him to wait while the results were being followed up. I instructed our clerk to secure the wet reading of the plates.

The clerk came back informing us that another view was requested by the radiology department to rule out a suspicious finding. The patient was brought back to the radiology department for the additional views. The policeman, with a frown on his face and a disgruntled voice told me, “X-ray na naman? Kanina pa kami dito. Kailangang madala na yan sa presinto para masampahan na ng kaso!” (Another x-ray? We’ve been here for a very long time. We need to bring him to the police station as soon as possible to file the necessary charges against him.).

 Hearing this, I became irritated. In a calm but firm voice I replied, “Sir, ginagawa lang po namin ang trabaho naming bilang doktor. Kahit po kriminal ang dinala nyo dito, pasyente pa rin po namin sya. Katungkulan po namin syang eksaminin ng mabuti at gamutin. Kung ipipilit nyo po syang ilabas dito, pipirma po kayo at kung may mangyari sa kanya, di na po namin sagutin, responsibilidad po ninyo yun.”(Sir, we’re just doing our jobs as doctors. Even if the man you brought in is a criminal, he is still our patient. It is our duty to examine him and treat him. If you insist on bringing him to the police station now, you  have to sign a waiver that we will not be held responsible for whatever happens to the patient. You will be held liable instead.)

The policeman’s face transformed from the look of annoyance into guilt. He lowered his head and apologized, “Ma’am pasensya na po kayo. Trabaho lang din po kasi. Sige po antayin na lang naming ang resulta.” (Ma’am I’m sorry. We’re also just doing our job. We will just wait for the results).

INSIGHTS: (discovery, stimulus, REINFORCEMENT, physical, PSYCHOSOCIAL, ethical)

            Everyday we encounter medico-legal cases in the emergency room. They come, they go. The tendency for us residents is to get rid of them as quickly as possible. It even came to a point that we use a stamp pad with the phrase “NO EXTERNAL SIGNS OF PHYSICAL INJURY AT THE TIME OF EXAMINATION” for the medico-legal certificates so as to facilitate faster issuance to the patients. This would decongest the emergency room and maximize manpower and efficiency so to speak.

            Attending to a medico-legal case doesn’t stop at just issuing a certificate. It should start with the routine history and thorough physical examination. W e should take note of all injuries and give the necessary first-aid or treatment measures for their injuries. We should still give the necessary advice and prescribe medications if necessary. And then finally we issue the medical certificate.

            On hind sight however, are we really taking the time and effort to examine these patients? Or are we short changing them of the medical attention they deserve because they  violated laws and committed crimes? Are we discriminating them because they are a menace to society? We SHOULD NOT.  We should not be judges or jurors to these patients. We are first and foremost DOCTORS. We are still physicians and have the duty to serve and treat people regardless of who they are, what they are, what they did or did not do. All patients should be treated equally and fairly and provided with same quality of care and attention.

            As quoted in the Hippocratic Oath, “I WILL REMEMBER THAT I REMAIN A MEMBER OF SOCIETY, WITH SPECIAL OBLIGATIONS TO ALL MY FELLOW HUMAN BEINGS, THOSE SOUND OF MIND AND BODY AS WELL AS THE INFIRM.”