Monday, March 7, 2011

dilemma

sekarang aku jd menyadari, jd dokter di masa ini susah. we're facing a new problem. educating people about health prevention and helping them to be aware of their symptoms. but then it backfired at us. kadang ada beberapa org yg psikosomatis, malah memanfaatkan ilmu yg kita berikan ke mereka sebagai keluhan dan they can mimic the symptoms so we doubt whether it's the true symptoms or not. bbrp malah terlalu panik sehingga tiap keluhan muncul dijadikan masalah besar dan minta perhatian sesegera mungkin. even though we've explained that it's not emergency, they couldn't understand it. more over, they are people with money, so they think their money should get our attention to give them priority.

but talking about money, i realize that people with money, they all very demanding. some demand priority, assuming that money should give them priority. some obey our rule and instructions, but others disobey us, thinking that they're smarter than us and they can instruct us which medication they would follow and which is not. this is ridiculous.. kita para dokter terancam hukuman jika kita melakukan malpraktek. what if, malpraktek itu terjd krn mereka yg keras kepala? tidak mau menuruti segala instruksi kita dan menganggap kita ini berlebihan? dan nanti pada saat yg kita pikirkan itu benar, mereka balik menuntut kita dg kelalaian?

meet mrs. Sul and her family. she suffered chronic kidney disease. since the first time she's been diagnosed, the doctor has instructed her to do hemodialysis.but she refused. she bargained. she just wanted the diuretic injection. from time to time, every time she had difficulty in breathing, she would go to ER and quarreled again with us, refused to be admitted to the hospital and then ended up going home after being injected with diuretics. and one day, the diuretics couldn't help anymore. by the time she agreed to do the hemodialysis, it's already too late. the access to her iv were a mess, so we couldn't do it. we had to consult to a vascular surgery to insert a trilumen. Then before she had the dialysis, she couldn't breathe so we intubated her. after few days in the ICU and then regular hemodialysis, she's still stubborn.

AV shunt didn't work out. her trilumen is not working either. so she got no other choice. she had to get hemodialysis, but no access to do it. the other option is CAPD, but then, it couldn't be done soon. she refused to be admitted, but her physics couldn't hold longer. the family didn't help either. they blamed us for not cooperating with all their demands. as institution, we're held back by regulations and protocols, tapi mereka seakan memutar balikkan semua peraturan sehingga terlihat seakan kita yg tidak berperikemanusiaan. mereka yg menolak segala terapi, mengatur semua tindakan, menolak semua anjuran dokter. if i wanted to be rude, aku bakal bilang ke mereka "kalo gitu ngapain ke rumah sakit? kalo minta ditolong, harusnya nurut semua. kalo masih ngatur, ya obatin aja sendiri"

and now his husband cursed me for being cold-blooded doctor. he's the one that still hardened his heart and chose to comply his wife and brought her home despite her breathlessness. aarrrgghhh...what a stubborn, rock-headed family. abis gitu masih nyalahin semua orang. perhaps it's the curse from the nurses back in ICU. krn mereka selalu menyalahkan kita dan terus tidak mau kooperatif dalam tiap tahap terapi, akhirnya para perawat yakin, she wouldn't survive. bukannya kita mendoakan dia meninggal, but according to our record, people like her and her family, ended up dead because of their stubbornness. let's see whether or not she will survive. may God give revelation to her and her family.  

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