Abortion Care: Did I Provide My Best?

It’s funny how sometimes, long after the fact, you start questioning your levels of care and competence.

During my first rotation of internship (last year), which was Obstetrics and Gynaecology, I was one of the few interns willing to do pregnancy terminations. (For the purposes of this blog, the matter is not up for debate – I have been pro-choice for nearly half my life, and have thoroughly evaluated my own beliefs.)

Just recently I’ve found myself thinking back on those four months and wondering if I did everything I could, and if I was empathic enough. Continue reading “Abortion Care: Did I Provide My Best?”

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My Evolving Opinions About Doctors’ Working Hours

I started working on this post two days ago. Since then, I have received news of a colleague who died in an accident while driving post-call. She went to my alma mater and graduated last year, and though I did not know her personally, my heart breaks. A country with a shortage of doctors has lost a young doctor who was just starting in her career. She was well-loved, and we will all feel her absence.

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 * * * Continue reading “My Evolving Opinions About Doctors’ Working Hours”

Sometimes I Don’t Want To Know

a4c50964f550a70443d53e51fe887a82I didn’t want to know that the man with the compound skull fracture had fallen into a sewer drain while being chased by the police because he was the man that had been scamming poor people out of their grant money for months.

I didn’t want to know that the man with the gangrenous arm had been bitten two weeks ago, by a girl he was trying to rape.

I understand the importance of a good clinical history. But right now, while I’m saving their lives, can I not simply know that he fell in a ditch? Or that he suffered a human bite?

I don’t want to know WHY these things happened to them. Not right now in any case. Tell me later, when they have pulled through the worst. Tell me then, if you must.

Is this wrong? Continue reading “Sometimes I Don’t Want To Know”

What If Everything You Knew About Breastfeeding Was Wrong?

24612267How does one react to seeing a book cover that claims breast feeding is “big business and bad policy”?

If you’re me, you request a review copy of that book, fully intending to expose how wrong it is.

As a medical student, one of the important things I was taught again and again is this: BREAST IS BEST. We were given a nearly 100-page document to study about infant feeding during second year. We were expected to know the constituents of human milk and be able to compare it to cow’s milk and formula. We had to memorise tables of the various formulas on offer and their indications. In fourth year, an entire oral OSCE station was dedicated to breastfeeding.

Breast was best and formula-feeding was undesirable, and it all made perfect sense to me; and of course I never read up the literature because our professors had surely done that FOR us. Continue reading “What If Everything You Knew About Breastfeeding Was Wrong?”

Book Review: An Epidemic of Empathy

“The best strategies in healthcare begin with empathy.”

An Epidemic of Empathy in Healthcare: How to Deliver Compassionate, Connected Patient Care that Creates a Competitive Advantage by Thomas H. Lee was kind of a mouthful of a book. It attracted me, predictably, because I am serious about empathy in healthcare.

I’ve seen many examples of healthcare where empathy is lacking, and it breaks me. And, as I have progressed in my own career, I have witnessed in myself instances where my ability to empathise has been eroded, too. It’s not an uncommon occurrence for medical students and young doctors to notice how they become hardened during the early years of their clinical training. Continue reading “Book Review: An Epidemic of Empathy”

What I See In Your Photos With “Poor African Children”

1. I see someone who was lucky enough to travel to a magnificent continent

And we welcome you. We welcome you to feel in your bones the wealth of our loam soil. Listen to the stories whispered by our winds. Immerse yourself in our skies. We welcome you to open your heart – and your eyes – to see that our narrative is more than one of suffering.

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Base image by Stephen and Melanie Murdoch, click for their Flickr Photostream.

Continue reading “What I See In Your Photos With “Poor African Children””

Land of the Disability Grant

Despite my love of clinic days, Orthopaedic Clinic Days are proving extremely demotivating.

On a clinic day we see more than 200 patients. We are an extremely stretched department but we try extremely hard to keep our patients functional. By far the majority of South Africans are reliant on their hands and feet for their daily work, and so it is important that we preserve their ability to make a living. And we make a massive effort to do so.

Susan Dorothea White, "Right Hand" 2010
Susan Dorothea White, “Right Hand” 2010

And yet on clinic days every second patient tells me that they want a Disability Grant. A measly grant that brings 1,1 million South Africans at the most ZAR1,400 (USD112) per month. Hardly a worthy income. Continue reading “Land of the Disability Grant”

Ownership of Medical Data: A South African Anecdote

There is a worldwide, profession-wide debate about the ownership by patients of their own medical records. Eric Topol deals with it in his book The Patient Will See You Now and in April this year the New York Times published a piece about The Healing Power of Your Own Medical Records.

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Only twice have I ever had access to doctors’ notes about me: after I got the Paeds Sick a few years ago, I was provided with a duplicate copy of my notes. I didn’t request them, or need them, but I liked having them. And when I was diagnosed with subclinical hypothyroidism I was provided a copy of my blood results, so that I could show them to whichever clinician I happened to visit subsequently. Continue reading “Ownership of Medical Data: A South African Anecdote”

A Tale of Three IODs

Exactly one year ago I had an injury on duty. It changed the course of my final year of med school and my general approach to medicine. It put me through four weeks of awful medicine and several terrifying blood tests. I won’t forget it, and I wish it hadn’t happened, but today I want to share three snippets where I was involved, but did not suffer the injury myself.

needlestick Continue reading “A Tale of Three IODs”