Dermatologist/Counsellor!?
Well, before I start the real post here, let me say happy riddance to Lili. I think we have had enough rain to last for a while and we could not have taken much more. So, having been a shut in for the past weekend, and seeing the good weather we had today, I decided to resume walking this evening. So, I feel good.
at work today, i had an interseting chat with one of my inpatients. This is a young man in his twenties. He has Sickle Cell Disease. On account of this, he has Chronic leg ulcers on both legs. I recently offered him admission in order for us to prepare his ulcers for grafting. I do not suppose that any of you (unless you have personal experience with leg ulcer patients) are aware of the social problems that these patients undergo. They frequently have a hardme finding employment, people scorn them saying they are cursed, that obeah is following them or that the sins of their forefathers are responsibe for their illness. culture odes play a hell of a role in the practice of Medicine in a country like this, and if one is not awre of the cultural practices in the country where one practices, it can seriously affect the ability for a doctor to practice good effective medicine.
Anyhow, I am straying from the point. I have always that that this patient has had issues bothering him, that he wants to talk about, but he seemed to be reserved in perhaps asking for help. Well, this morning when I was dfoing my round, as I was about to leave his bed, he asked me if he could ask me something. Instantly, I realized that he wanted to talk, and perhaps has started to trust me. I told hi i would come back and talk with him when I finished seeing the otyher patients, as I suspected that this was noit going to be a three minute rap session. I finished doing my ward work, and returned to his bed, drawing up a chair to sit on.
I wasted no time and told him to tell me waht was bothering him. I also told him that he could level with me in the way he would a bredren, in order to break down the doctor-patient formality, making him feel at ease. I think he appreciated that.
He went into great detail aboutb his life, saying that he felt depressed. he told me that many nights at ho,me, he would sit in his room and cry bitterly. i asked him if he had ever thought of committing suicide. He said yes. In fact, he said he tried it about three months ago, by overdosing on Ibuprofen. Of course, not a damathing happened to him, thank God! He also told me how he considers himself a failure. He asked me to answer the question as to WHY HE got Sicle Cell disease, and not someone else. i told him that no one can be blamed for him having it, certainly not himself. He did not go out and buy it, it is a genetic disease.
We spoke further and I think I helped to get him to think more positively about himself, and I helped him to formulate some basic plans of action that he needs to pursue in order to get his life back on track. At the end of it, he thanked me, we knocked fists and I thinmk that we can now consider ourselves friends, but at the same time, maintian the doctor -patient relationship. I know there are those of you who may think that this is not possible. However, I beg to differ. I do have a number of patients that I relate to on ‘bredren’ type of level, but still manage to practice good medicine with. In fact, I feel that speaking with them as friends helps to improve thier level of compliance.
At the end of it all, i felt good about myself as I was glad to have been able to offer this guy some advice that may well help to add direction to his life. It made me realize that there are many people walking around with troubles and cares on their minds, and sometimes, with not a damn soull to talk to about them. Perhaps the reason why some people commit suicide. I will end by saying, if you have problems bothering you, do not heesitste to seek out advice or help. As busy as individuals may seem in their daily lives today, there are people who do care and are only too willing to offer a kind ear or a few comforting words of advice. also, bear in mind, when you find yourself ina situation that may seem totally impossible to get out of, it is sometimes difficult to see what is cleraly the only logical solution, because your thought processes are clouded by the problem itself. Ask a friend, more often than not, they wil be able to see the answer to your problems. And if they do indeed care, they will only be too happy to listen and help you solve your problem. Hasta la vista!