Indexing Title:  HABalucating 01-06

MAR Title: My Sick Role

Date of Medical Observation: February 2006 

Narration:

                It was amusing to say that the most memorable patient I encountered in my first month as a Level I Surgery Resident of OMMC was myself.  I was on my ER duty when I noticed a swelling on my left upper eyelid.  I consulted the Ophtha-OPD and they gave me an antibiotic eye drop, which I used liberally, even exceeding the prescribed dosage and frequency.

                After my 24-hour duty, the swelling progressed that my co-residents have started to notice and advised me to start oral antibiotic. As soon as I got home, I took oral antibiotic and continued the prescribed eye drop, hoping that the swelling would resolve.

                I woke up the following morning and felt that my eyelid has swelled even more partially blocking my vision.  I knew then that the medications did not provide the result I was hoping.  I had a sudden rush of panic and got up from my bed and examined my eyes in front of the mirror.  An abscess has already developed.

                I called up our chief resident and told her that I will not be reporting for work.  I also called up my Ophthalmologist friend and told him about my case.  He advised me to continue my oral antibiotic, shift my eye drop to antibiotic ointment , and see him at his clinic the following day.

                The next day, I went to his clinic and was expecting he would do incision and drainage of my abscess but rather, he advised me to continue my medication and see him again after 2 days for I and D.  I really wanted to have my I and D done but then I just complied to his instructions.  I went straight to OM for my ER duty.

                At OM, almost everyone who saw me noticed the abscess on my eyelid, including one of our consultant who was doing his rounds that day. He told me to go home instead of staying for duty.

                I then decided to have my I and D done that day instead of waiting for 2 more days.  I went to see the Ophthalmology resident-on-duty that night and asked her if she could do it.  She said it was a chalazion and the treatment is I and D with curette.

                It was then I realized how painful it was to have an I and D done, particularly during infiltration of anesthetics and curetting.  The 15-minute procedure felt like hours.

                The succeeding days were even more agonizing.  I had to clean my wound twice daily and using cotton buds, I have to compress the wound to extract the pus.  After that, I have to cover it with gauze so I have to walk around with one eye closed.  Thankfully, the wound started to improve after 2 days and I was ready to go back to my normal routine again. 

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcement) 

                This was not the first time I got sick and had to consult other doctor for my ailment, but this is the first time I reflected on the situation I have been through.  I just took the SICK ROLE. I remembered this being lectured to us during our first year in medical school.  Unfortunately, I already forgot the textbook definition of the term.  However, now as a doctor that became a patient, I realized that I could use my experience as a guide to how I deal with my patient.

                What I went through is not even close to what most of our patients in Surgery experience.  The pain I had would not even be .01% of the pain suffered by some of our Cancer patients.  The discomfort I had for less than a week will not even be close to the patients who underwent major surgery and lost a limb or any part of their body permanently.

                The experience I had will always be a reminder for me to empathize and be more compassionate to my patients.