It is a rainy Wednesday morning, and I am curled up on the sofa with my dog on my lap, attempting to nurse my concentration span with a mug of hot cocoa in order to focus on an array of yet-to-be-read journals in front of me. There is, without doubt, a strong temptation to disregard those banal medical texts and just do what I've been wanting to do: sleep. I had only a mere 4 hours of shut-eye last night, no thanks to an unusually busy day at the hospital that stretched long into the early hours of midnight and the next morning. It is the scariest thing in the world, not knowing what to do for patients who seem to be stable but are on the brink of exponential deterioration if nothing's done in time. But the question is, what can/should/must we do? I realise no medical journals are going to give me a satisfactory answer. They are all too academic. In real life, events often sway from textbook descriptions, which is why one sometimes find it hard to manage problems accordingly. As doctors, we all take pride in having an effective management plan and executing it to perfection. For us not to have a plan, it means we're shitting our pants off because the patient is exceptionally complex and will need some sort of specialist intervention. The problem is, the nearest tertiary centre is 400 kilometres away, and phone advise isn't always helpful because no one's cast their eyes on our patients, so no one knows how sick they are-- or can become-- except us. Hence we have to deal with it then and there. Let's try this, or let's try that. Let's do this till the retrieval team arrives. That's just how Medicine evolved-- by trial and error. No doubt, great insightful discoveries have been made, but in reality, what is the margin for error?
4 Durian(s) Thrown at Jun:
That's life too, isn't it? Medicine's not the only field one has to navigate through trial and error.
I'm not sure about margin for error where Life is concerned. Errors or mistakes or failures are often lessons in disguise, yes? :)
kenny: no doubt we all learn through our mistakes, but i guess in a perfect world, when it comes to life and death, there can be no margin for error.
Like it or not, that's how it is in medicine, for every expert in his field was also once a novice, wondering if trial and error was the only way to go. Often, it helps to know one's limitations, and always, always, be a SAFE doctor :)
fibrate: i think the scariest part of medicine is not recognising what needs to be done in time. thanks for the advise- even if i get lambasted at making a "soft" referral, at least i'll know that the pt is SAFE.
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