When The Doctor Becomes The Patient, Absolute Nerve Wrecker!!

 

Date: 21/12/2017

Subject title: An Absolutely Nerve-Wrecking Situation

What happened?:

 

My most recent duty in the emergency department was a week ago on Friday night. While bent low doing surgical stitching and closure to a deep knife stab wound on the palm of a patient, I felt a bit woozy, needed to have some water as the night had been busy and I have been on my feet for at least the last 8 hours without a break. I managed to make it till the last stitch and closed the wound. Then went to prescribe some prophylactic antibiotics for the patient, standing was difficult so I quickly leaned on a table, wrote the prescription and handed to the nurse. I then went to have a quick glass of water, though it felt better after that and was able to provide the required services for the rest of the night.  After work,  walked down to the car park quite eager to get into my car and drive home, to my surprise, the car would not start. It had snowed so guessed the engine has had its share of the frost, left the car there and had my husband pick me up.

The next day, Saturday, I had a further episode of vertigo and this time with the loss of balance, it was a near fall, luckily I was saved from hitting my head on the floor, ended up in the emergency department, seeing the surprised/disappointed look on my colleagues (they were thinking...better don't go off sick...we need you here..😁).  In ED, the choices were between, possible Menière disease or even BPPV, home on Stemetil.

Later that day it became clear to me that my right ear had become deaf, I wasn't hearing anything at all with the ear, it was also clear I had tinnitus. At this point though didn't think it was tinnitus, but just a constant buzzing sound coming from the inside of my head, (wasn't hallucinating!). In my attempt to play it down and give it a name, I said it was Labyrinthitis and carried on with Stemetil and Cinnarizine.

 

What, if anything, happened  subsequently?:

 

on the 5th day, a Wednesday, the symptoms were progressing which seemed unusual, and thought I'd better ring my GP to at least get a confirmation that it was indeed Labyrinthitis (how callous). It was booked as a telephone consultation for advise but he insisted I come in which I did. After his initial examination, he called ENT(Ear, Nose, and Throat Specialists) who booked me in the next day emergency clinic. At this point, the fear sets in. Fear of the unknown, hardly able to sleep, mind filled with worry. Could this be a worst-case scenario? The symptoms were still there so from another perspective, it was reassuring to be seen by specialists.

The next morning I was on the ENT ward, first seen by a foundation year doctor, then a Senior House Officer,  then a Registrar, and to crown it finally, by the entire clinical team (No, not a VIP treatment......the senior seized the opportunity to do a short teaching session). Now I know how patients feel about that.  Apart from the exhaustion from having to repeat the story about 5++++ times, it was welcomed actually because it meant (a) I am very well examined, (b) I learnt a whole lot of new ideas and techs. A Win-Win 👍.
In conclusion, they could not put a name on it but I was started on a high dose steroid treatment and booked in for an MRI head. 

 

What did you learn?:

 

Just as in different aspects of life, there is usually more than one side to a ball (we all live in our own little bubbles completely oblivious to what goes on in the other bubbles). So far I have been in a particular bubble when it comes to assessing the health care system, the provider's. The other side is a sort of alien experience. As a patient, I felt vulnerable, helpless, afraid of the unknown, exhausted by the symptoms, sometimes confused after telling the same story a zillion times.

There was a huge uncertainty looming around, it just wasn't the best place to be. At some point at the early stage, I even felt I was being a burden, uhrrr! hate to be a burden!
But on the other hand, the undivided patient attention I received from my GP was priceless( possibly because his wife is my colleague), even though he clearly said he wasn't sure what it was and had to refer me, the consultation itself was therapeutic. I felt better after seeing him. The saying that doctors are the best medicine is indeed true in some cases but that, I would change to "good doctors are the best medicine"

This is a completely new experience for me. I am experiencing first hand, the impact our approach and actions as doctors could have in building trust and improving management outcome in patients. Trust is everything. It is often easy to let oneself get carried away especially when the work pressure is skyrocketing, sometimes its more of a reflex reaction and we can't help letting it affect our interaction with patients. It is worth remembering though that every patient number/NHS number/bay number/room number/ appointment slots/alphabets on a handover list, is a vulnerable individual with mind and body. It takes a good doctor to recognise and appreciate the fact that those patients are not aware of the pressure you are facing, they don't know that you haven't had a drink of water the whole day or that you haven't managed to grab a quick lunch. All they are engulfed with is their suffering which is often debilitating and these to them should be our 1st priority ever! More important than your missed lunch (and you dare not argue that as a doctor.....o.k....).

Fitness to practise should be in every doctor's mind notwithstanding but when I am in my role as a health care provider, that is all my patient knows and I should always acknowledge that.

I will be updating on the outcome of the investigations and my experience as a patient.