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SATURDAY’S CHILD: Doctors at sea


SATURDAY’S CHILD: Doctors at sea

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A DOCTOR I KNOW insists that sex is perfectly all right after a heart attack provided that you close the ambulance door. I would recommend him if you are at death’s door. He will definitely pull you through. And if you have problems with your heartbeat he will soon put a stop to it.

With all that, my doctor is also a bit of a showman. A patient went in for an appendicitis operation. However, when the anaesthetic wore off, the patient found that his throat was sore. The nurse explained: “There were a number of medical students present and they were so impressed with his technique when he took out your appendix that they started to applaud, so he took out your tonsils for an encore.”

He also has a temper. One day a man staggered into the Accident & Emergency Department demanding to be attended to urgently. The man had three knives protruding from his back, his head was bleeding from a gunshot wound, and his legs had been crushed by baseball bats. When he did not get immediate attention the man started to shout and scream. This got the doctor so angry that he demanded: “Do you have an appointment?”

All these doctor jokes are based on reality and prove that fact is often worse than fiction. Cases that claim negligence by doctors are constantly reported in our newspapers. The fact that doctors here do not bear witness against their colleagues, as one youngster said, is known as the “Hypocritic” Oath.

I remember a case that took place about 13 years ago. Seven-year-old Samantha Adhar was hit by a car and was taken to the Mayaro district hospital. She could not stand on her right leg, which was painful and swollen. The doctor gave her four tablets for pain and sent her home, where she fainted and started bleeding through the nose.

The family took her back to the doctor, who prescribed painkillers. The pharmacy was closed so the family went back to the doctor, who insisted that he had already given them a prescription and could do nothing further.

Under pressure from a neighbour who made a scene about the doctor’s attitude, the doctor gave the child a pain-killing injection. The child’s mother, who sells brooms in the market (the father is unemployed), insisted on a note to allow the child to get an X-ray at another hospital since the X-ray unit at the district hospital is not available after 4 p.m. That X-ray, which confirmed that the child’s leg was broken, was taken to the district hospital, where another doctor told her she must take the child back to the San Fernando Hospital.

When the Trinidad Express newspaper sought to get the doctor’s side of the story regarding his misdiagnosis and subsequent treatment of the child, the reporter was told that the doctor was giving a lecture. On what?

Perhaps the doctor may be lecturing on the same subject as another Trinidad physician, Dr Hector Vasconcelos. According to the Mammoth Book Of Oddities, Vasconcelos, who seems to hold the world record for forgetting stuff inside patients, left surgical gloves, a surgeon’s mask and two surgical instruments inside his patient’s stomach. On discovering the error, Dr Vasconcelos performed a second operation to retrieve the items. The surgery was successful, the items were taken out, but the patient died.

Unfortunately, medical malpractice and negligence are not confined only to Trinidad, although they seem to have very fertile ground here. According to an article by Dr Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health, in the Journal Of The American Medical Association (July 2000), doctors are the third leading cause of death in the United States, being responsible for about 250 000 deaths per year.

Interestingly, for a profession which has as its basic tenet “First do no harm”, a special word “iatrogenic” has been coined for an illness or symptoms induced in a patient as a result of a physician’s words, actions, activity, manner or therapy. The September-October issue of the Consumer Magazine of the US Food and Drug Administration (FDA) confirms: “There is an old saying in the newspaper business that doctors bury their mistakes while reporters put them on the front page. These days, doctors’ mistakes are too often finding their way onto the front page.

“Medical errors – from giving the wrong patient the wrong dose of the wrong drug at the wrong time to bypassing the wrong coronary artery – have become too common.”

“Errors by obstetricians have resulted in local babies suffering brain damage and being born with cerebral palsy,” said Minister of Education Dr Tim Gopeesingh, an obstetrician.

So if you are in a hospital recovering from an operation, and in the midst of the horror stories about what items were left in patients your surgeon seems to be searching for something, pray that he doesn’t ask: “Has anyone seen my gloves?”

Tony Deyal was last seen walking like a crab and complaining of being iatrogenic. He says his doctor put him on medication with serious side effects.