It not right to feel for the patient you are treating. It is almost wrong when you are emotional connected to a patient that you are treating. They says it affect your judgment and the clinical acumens. Despite all the teaching saying so, I still made the mistake.
Dasuki was a very unfortunate boy. At the age of twenty, almost all of his fellow at the peak of their life. Everyone venturing into working, busy with marriage, but this poor boy was bed bound. Not only he had to depend on his father for the simplest chores as to personal sanitation, he had become the increasing financial burden of the family for his medical need and disabilities.
After a freak accident one day where he lost control of his motorbike and skidded, his life changed. The motorbike hit a sand dune and he was thrown forward and landed head on. On arrival to hospital, doctors pronounced that he had a spinal segment T8 and T9 fracture, which translated into paraplegia for the rest of his life. He lost feeling of both lower limbs. Anything below umbilicus feels numb. Both legs were heavy and felt disconnected o the torso. Passing urine and bowel habit became automatic event, and he has no control whatsoever towards it.
Studying the family dynamic, he is the youngest of eleven siblings. As if to add salt to the wound, his mother is a stroke-surviving patient with hemiplegia as well. Father earn a meager pay by doing plantation work in small scale. He has a sister he used to mention quite a lot. This sister is closest to him, bathing him, feeding him at regular interval. But what to do, his sister has to get on with life. She need to work. She need to take care of her family. After her marriage six months ago, she had moved away from Kuantan to Johor Bharu following the husband.
He came to us with prolonged bed bound, 12 months after the accident. Instead of a young and vibrant boy, we saw a nutritionally-deprived boy, dirty and unkempt. The bed sore already formed over huge area over sacral, the heel and even elbow. A sigmoid colostomy had been made to accommodates faeces passed through anterior abdominal wall. This could prevent soiling of faeces and the sores.
At the last 11 days of his life, we have to open him up, to find the bowel is a mess with adhesion and perforation. Everything necessary had been done. After the operation, he was going down hill. On the other hand, we are giving stronger antibiotic and nutrional support for him.
The day before he is intubated, I was talking to him. There were very few visitior for Dasuki. The father seldom came as to take care the other needy one at home. We talked about many things. All I want is to set a long term goal for him, to make him ambulate by wheel chair. At least he is less dependent if he can whelled to the toilet or to reach for things. He said that he missed his sister, and asked me to called up the sister. He wanted to see her badly. On top of that, he says living has no meaning for him anymore. I just kept quiet as did not respond.
The defence finally breached on the last 3 days. His lung and heart had gave up on this battle. We intubated him and put him on inotropes. Blood pressure on few instances were unrecordable. Most of the time, it was lowish. We rang up the father, told him that his son was not doing well. Soon after that, the relatives, family members came.
The last word he said to me was I am tired.
On his last day, his sister came to see him. After twenty nine days of long winding battle, he finally passed away, fulfilled his last wish. Rest in peace, Dasuki.
Dasuki was a very unfortunate boy. At the age of twenty, almost all of his fellow at the peak of their life. Everyone venturing into working, busy with marriage, but this poor boy was bed bound. Not only he had to depend on his father for the simplest chores as to personal sanitation, he had become the increasing financial burden of the family for his medical need and disabilities.
After a freak accident one day where he lost control of his motorbike and skidded, his life changed. The motorbike hit a sand dune and he was thrown forward and landed head on. On arrival to hospital, doctors pronounced that he had a spinal segment T8 and T9 fracture, which translated into paraplegia for the rest of his life. He lost feeling of both lower limbs. Anything below umbilicus feels numb. Both legs were heavy and felt disconnected o the torso. Passing urine and bowel habit became automatic event, and he has no control whatsoever towards it.
Studying the family dynamic, he is the youngest of eleven siblings. As if to add salt to the wound, his mother is a stroke-surviving patient with hemiplegia as well. Father earn a meager pay by doing plantation work in small scale. He has a sister he used to mention quite a lot. This sister is closest to him, bathing him, feeding him at regular interval. But what to do, his sister has to get on with life. She need to work. She need to take care of her family. After her marriage six months ago, she had moved away from Kuantan to Johor Bharu following the husband.
He came to us with prolonged bed bound, 12 months after the accident. Instead of a young and vibrant boy, we saw a nutritionally-deprived boy, dirty and unkempt. The bed sore already formed over huge area over sacral, the heel and even elbow. A sigmoid colostomy had been made to accommodates faeces passed through anterior abdominal wall. This could prevent soiling of faeces and the sores.
At the last 11 days of his life, we have to open him up, to find the bowel is a mess with adhesion and perforation. Everything necessary had been done. After the operation, he was going down hill. On the other hand, we are giving stronger antibiotic and nutrional support for him.
The day before he is intubated, I was talking to him. There were very few visitior for Dasuki. The father seldom came as to take care the other needy one at home. We talked about many things. All I want is to set a long term goal for him, to make him ambulate by wheel chair. At least he is less dependent if he can whelled to the toilet or to reach for things. He said that he missed his sister, and asked me to called up the sister. He wanted to see her badly. On top of that, he says living has no meaning for him anymore. I just kept quiet as did not respond.
The defence finally breached on the last 3 days. His lung and heart had gave up on this battle. We intubated him and put him on inotropes. Blood pressure on few instances were unrecordable. Most of the time, it was lowish. We rang up the father, told him that his son was not doing well. Soon after that, the relatives, family members came.
The last word he said to me was I am tired.
On his last day, his sister came to see him. After twenty nine days of long winding battle, he finally passed away, fulfilled his last wish. Rest in peace, Dasuki.
2 comments:
hey man, hope all is well. just dropping a line to say hi. it's been a while :)
Thanks Ian. Kinda tired before. But did rejuvenated after a full 5 days of rest. Thanks for dropping in.
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