Sunday, February 15, 2009

My first prescription

I was happy. I did not write it from my mind; this Associate Professor (AP) had me written it. It was my first prescription in real life. My patient in out patient department was Shazia, young female, a mother of four and a pure, naive, Punjabi speaking house wife. And she was afraid of doctors and diseases, naturally. She had come for burning pain in the epigastrium and as I took her history, she told me all symptoms of reflux esophagitis. I thought this is an easy case and I wont be having any problem presenting it in front of the Associate Professor. But then I did her general physical examination (GPE). Her blood pressure (B.P.) was 180/110 (normal average: 120/80) and her pulse was 106/min (normal average: 72/min) and there was swelling on her face. When I was done, she asked, 'theek hai?' and I saw the fear in her eyes, I said, 'G'. I couldn't tell her that this much blood pressure wasn't theek, I just couldn't. I couldn't figure out why her B.P. was so high, perhaps it was just anxiety. Anyways when I told her that I'm going to present her case to AP in front of whole batch, she got scared like hell. She thought there was some grave problem and started crying. I melted, from head to toe. I felt like patting her and holding her hand. Thank God her husband was there. He condoled her, I condoled her and together we were able to stop her tears. I told her that there is nothing wrong and every patient in OPD is presented in front of AP.

This AP, Dr. Sajid was unusually good. He was supposed to be suffering from initial stages of Professoritis. He wasn't. Therefore he didn't insult me or got mad if i did any mistake in presenting my case. I told him Shazia's B.P. and pulse. He got alarmed. He checked for pitting edema, which I hadn't. It was positive. He knew what it was. He asked her if she had taken any Hakim's medication recently and she said yes. Then Dr. Sajid told us that Hakims usually give steroids or heavy metal salts in their medicines and Shazia was showing symptoms of steroid toxicity. Then he asked me to write omperazole for her reflux oesophagitis (which was her only presenting complain) and prescribe kidney tests to see if the steroids had damaged her kidney.

How a simple GPE changed the course of investigations and treatment. If I had skipped that, we could have sent her home with just omeprazole. (Dr. Sajid would have picked up the mistake of course) I wouldn't forget Shazia's face. I am happy.

8 comments:

Unknown said...

Having written your first real prescription calls for a 'real' treat Doctor Sahib.. :p !!

Abdullah Shahid said...

I bought new clothes yesterday. Do you want a treat for that too? :-D

M. Umer Toor said...

Tricky job. But, naturally, doctor's a shelter, a nice motherly, fatherly shelter - to me least I say.

but any design thinker would have differentiated b/w himself and a doctor just for the delicacy of your job.

Thanks for posting.

Humble regards!

Abdullah Shahid said...

'but any design thinker would have differentiated b/w himself and a doctor just for the delicacy of your job.'

I didn't get it. What do you mean by 'design thinker'?

M. Umer Toor said...

I rue for it.

It's very simple to explain.

Consider this situation: You've a problem with no best solution existent. You've 'A' and 'B' products. Design thinker won't choose A & b, he'd create 'C', as a best innovative soltuion 9in the form of product/service).

But how?

That's the point, how do we it everyday? Allow the father of design thinking, David kelley (founder of d.school Stanford) to explain the core of this concept:

He says, "I was sitting at a big dinner in Pacific Heights recently, and I told my hostess I was a designer. 'Oh,' she said. 'So what do you think of my curtains?' " That, Kelley says, is not where we're going.

"[W]e moved from thinking of ourselves as designers to thinking of ourselves as design thinkers," he continues. "What we, as design thinkers, have, is this creative confidence that, when given a difficult problem, we have a methodology that enables us to come up with a solution that nobody has before."

Hope it helps!

Humble regards.

[Source: http://www.fastcompany.com/magazine/132/a-designer-takes-on-his-biggest-challenge-ever.html]

Abdullah Shahid said...

In simple words: creativity/innovation. Believe me medicine is simpler than that. Lol.

iram tahir said...

Good luck for further prescriptions

Abdullah Shahid said...

Thanks :-)