Sick

I really thought I had dengue fever.

High-grade fever with chills. Headache with retro-orbital pain. Diarrhea and vomiting. Loss of appetite and lethargy. Which perfectly fit the typical presentation of dengue fever.

There I was alone in pitch darkness, covered under my blanket and tolerating what felt like the worst headache I'd ever experienced in my life. Despite the words of concerns that I'd received from McVet and Ambrocius, I couldn't help but feel extremely lonely.

I thought of the old spinster whom I attended to during my 2-week feat in the high-dependency ward. She passed away mainly because of poor family support. It seemed her family members weren't very close to her. She had multiple co-morbidites. Hypothyrodism. Congestive heart failure. Hospital-acquired pneumonia. And also acute on chronic renal failure. And the saddening part was we couldn't dialyse her because no one in her family agreed for it. My specialist said it'd be pointless to dialyse her too if no one's send her for follow-up in future.

I saw her wither away. On BiPAP. Day by day. Occasionally, when I examined her, she'd tell me she wanted to see her elder sister, who works as a dish cleaner in some restaurant. However, there's nothing we could do except to support her the best we could medically.

A few days before I left HDW, her heart just ceased to continue beating.

Obviously, I'm going to grow old like her. Unmarried without offspring. And with family members and relatives I might probably be estranged from.

Will I die as tragically as her? I mean, to say the truth, she would have ameliorated clinically if she had undergone some sort of renal replacement therapy. Yet, when you delve deeper into the social issues of your patients, you'll realize that what you can do as a doctor is limited.

Yeah. I know. It's normal to think of all kind of nonsense when you're sick and alone.

But, thanks God. I got better today. Hopefully, it's just some non-lethal viral fever.

I didn't even have the guts to go have my full blood count and dengue serology taken. Getting warded is the last thing I need at the moment. Guess it's true when they say that doctors make the worst patients.

Spiritually uplifted

I performed a neurological examination on a boy with a non-neurological pathology today. 

Nothing warms your heart more than a co-operative kid who beams broadly at you and obeys all your instructions. He's very very adorable so much so that, for a brief moment of insanity, I actually wished that I had a son like him. 

It's so heart-warming to hear his chuckles when I tested his Babinski's reflex. To see his cheerful facial expression when I stroke my tendon hammer against his patellar tendon. And to see the joy and innocence in his eyes as I built my rapport with him.

It's impossible to describe in words how uplifted I felt just by these simple gestures. You have to experience it yourself to understand what I'm trying to convey. 

That's one thing I like about paediatric patients. They have no pretense at all. And when they smile, you know that they like you and it just miraculously makes you feel good and boosts your confidence.

The kid was treated for acute post-streptococcal glomerulonephritis. He's doing absolutely fine. Doubt he'll develop any complications. May he be discharged soon!

I feel so great now that it eclipses my underlying melancholy which is in a way related to my previous post. Occasionally, I wonder why certain things seem so ordinary and easily attainable by others and yet, to me, they always appear to be so indistinct on the distant horizon, blurred by a thick mist of impossibility in between and forever out of my reach.

Never mind. I still feel great now. And I also feel a tremendous sense of achievement for I correctly calculated the amount of fluid correction needed for another kid with acute gastroenteritis with severe dehydration.

Now, who wants to make babies with me? 

Although I'm apparently not a good candidate for fathering a child, considering that I lost my wallet twice within a year, I still want to. Period.

The kids

Medicine has always been thrilling to me, be it internal medicine or paediatrics.

However, in internal medicine, almost half of the patients in the ward are there due to self-inflicted damages. You see people with chronic obstructive pulmonary disease due to chronic smoking. Chronic liver disease due to alcoholism. Uncontrolled type 2 diabetes mellitus. Sexually transmitted infections. AIDS.

However, in paediatrics, the picture is rather different. Stanley had biliary atresia and his liver is now cirrhotic although surgery had been done. For some reason, his mother refused to let Stanley undergo liver transplant though she knew that's the only option available to increase the lifespan of Stanley and without which his liver would definitely fail. She spoke to me so nonchalantly which reflected her courage and readiness for whatever that might come. I turned to look at Stanley. He shot a handsome smile as if he had lived his life to its fullest and didn't seem to be afraid of death.

There's another adorable girl with end-stage renal failure secondary to late cresenteric glomerulonephritis. The puffy girl with lupus nephritis who looked so depressed as a result of long-term steroid therapy. The constantly centrally cyanotic girl with pulmonary atresia whose mother declined to have her heart lesions surgically corrected.

The children are deprived of so many things in life that I've taken for granted. I don't know how they cope with their illnesses as such a tender age. It's sorta saddening to look at their angelical faces under which lie the suffering and torment only their mothers can understand.