Monday, 12 March 2007

The reason why doctors work late...

Friday, 4pm and a patients arrives on the ward from the Medical Assessment Unit. This man is as sick as a dog. Jaundice has turned his eyes and skin bright yellow and we look at his blood test results and his bilirubin level is about 500. This is very bad news indeed. He’s a homeless man and you didn't need to be a doctor to tell that he was seriously unwell. He was all skin and bones and he had the haunted look about him of someone who knew his time was at hand. He wasn’t fighting it.



This man wasn’t well enough to even speak to us anymore. For us to know why he was so jaundiced and unwell, we needed to scan his liver by ultrasound.

In hospitals, half past four on a Friday is the worst time to try and organise things. Departments are shutting up for the weekend and the staff are trying to finish up their workload so they can get to home/to the pub.
Luckily for us, our consultant (effectively our boss), was on site and he came straight to the ward and, after speaking to four different radiologists, found someone who was willing and able to scan this poor man’s liver. The radiologist pages me 16:40 and says “I’m in the ultrasound department, I need to leave at 5pm. If you can get the patient here in the next five minutes, we can do the scan for you.”

So I grab one of the nursing assistants and we wheel this patient on his bed, through the corridors of the hospital to the Ultrasound Department.
I have to say, this was all very dramatic and one of the few times I actually felt as though I was in an episode of E.R. or House or Holby City or any of those medical dramas where people are always running through corridors yelling “Emergency! Emergency!”

The radiologist is there waiting for us and the scan shows that this man’s liver is chock-full of cancer. This is why he was so jaundiced and this is why he was so unwell and this is why he was going to die. As doctors, there is nothing we can do to save this man’s life, but, because we managed to get a scan done, we’ve spared him from having further blood test, needles, catheters and all the other unpleasant things that we do to our patients in order to diagnose and treat their condition. What we can do for him is make sure his last hours are peaceful and painless, and from that we can take solace.

I’m typing this on Sunday evening and I will be very surptised indeed if he’s alive when I get to work tomorrow morning.

8 comments:

Anonymous said...

How can you possibly take a picture of a patient without their permission! He was dying for Christ's sake! And all you could focus was the fact that he was homeless. Worse, you then had the audacity to make yourself sound like some holier than though saint, buy claiming that you actually tried to make his last hours peaceful. I hope when you are and old man, and sick and dying someone treats you the same way. I hope you cry when they do. And I hope they see your tears and just laugh.

Anonymous said...

I'm sure it's the only picture of this man that was ever taken. In his lifetime.

Grow up.

Dr Michael Anderson said...

Anonymous,
Here's some advice. Chack your facts before you start slagging me off on my blog. The picure is NOT of my patient and the picure of the staff and trolley are not of me or my hospital. I'd never dream of publishing pictures my patients without permission.

Here's a clue - type "jaundice" into google images and see which pictures come up.

For future reference, all pictures on this blog are in the public domain.

Stop being so sanctimonious and stop making unfounded accusations against me.

I grew up a long time ago, doing my job - you have to.
Michael

Emma said...

And How can YOU accuse Dr. Anderson of posting pictures of his patients without his permition? You really should have checked sources first.

And how can you really hope that on anyone? That is horrible.

I found this blog by googling jaundice images for a powerpoint I am working on. Pictures like that do come in handy for students going into the medical field.

Meghan said...

oh wow... i agree with the Doc.
I found this by googleing jaundice cause the hospital found i had it as they found i had gall stones.
Now i dont have my gall bladder lol.
Does jaundice go away?

Anonymous said...

Did he live?

Anonymous said...

The chances of that man living, are impossible. He had cancer, and in order for his liver to be replaced, they had to have an organ donor. Though he'd have to be placed on a long list, and the fact was he was in such horrible condition, that he was probably placed on the bottom of the list due to his case. I'm unsure if the lists have anything to do with financial status, or home or no home, but I would believe they would give it to a mother of four, who had a chance, instead of this man. Not to say anything bad about this person, its just he was in such a horrible condition, the chances of him living through the surgery are bleak.

Dr Michael Anderson said...

No, this man died the following day. His condition was untreatable he couldn't have had a liver transplant whether he was homeless or a multi-billionaire. What we could do for him is stop trying to do further tests on him, and we made his last hours as comfortable as we could.

Rest In Peace