Indexing Title: NALUDINOs Medical Anecdotal Report [05-10]

MAR Title: Our role as doctors

Date of Medical Observation: Oct 28, 2005

Narration:

I’ve done quite a number of amputations, from the routine to the out of the ordinary. This case is unique. Something I will always remember. She is a 55-year-old diabetic patient who was referred by the Department of Internal medicine due to nonhealing wound of the both extremities. Examination of the patient, revealed that her feet had gangrene and that both have to be amputated. Breaking the news to an already weakened patient is not an easy task. Would it be the straw that would finally break this camel’s back? It had to be done, and so we did. As expected, the patient did not take the bad news well. Still, she knew that it had to be done and so she gave her consent.

And so the die had been cast. The plan for bilateral below the knee amputation will push through, and the patient was optimized. I prepared myself for the operation, gathered my strength. Orthopedic surgery always required the surgeon to exert more than the usual physical effort.

Before the start of the operation, I noticed that the patient was crying. I asked her why and she said, “ Wala na bang ibang paraan? Ayoko sanang mawalan ng paa.”  I was saddened by her statements but knew what I had to do. Honestly, I had my doubts whether or not this patient will recover from the operation. Her frail body already compromised.

The operation went smoothly and without any problems. At the ward, the patient showed improvement. Day by day, she recovered her strength and soon enough she was already sitting on her bed smiling at us, every time we go on rounds.

After a few days, she deemed fit to be discharged so I gladly told her the news. Once more, she started to cry. At first I though I did something wrong. I asked her why she was crying and she told me that they were tears of joy. She never though she’d see her home again and accepted her mortality. I was moved by the moment and remembered the reasons why I wanted to become a doctor.

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements):

Sometimes we are presented with problems which at first glimpse seem insurmountable. We must not let these obstacles stop us from delivering care to our patients.   With proper preparation, proper training we can overcome most challenges.

 This adage holds true not only for the doctors but also for patients. We as doctors, with constant learning though training, can prepare for most eventualities. In the case of our patients, we must constantly educate them about their condition and help them in their struggle. We must be an instrument for their well being. We must lift up their spirit and give them hope of recovery. If there is none, we must prepare them for their journey.