Saturday, January 24, 2009

Sorry, I need to talk to BOMOH first

This CT scan image belongs to a middle-age man who came to the hospital for prolonged fever and multiple lymphnode enlargement. He was found to have generalised lymphadenopathy involving those in the neck, abdomen, inguinals and in the chest. CT-scan diagnosis was Non-Hodgkins Lymphoma stage IV, and the managing physician advised him to have a biopsy of one of the nodes. This was when I came to the picture.

I explained to him that the biopsy will involve making a small incision in the neck or in the inguinal, and taking out a lymphnode for the pathologist to study. All he said was ..."Sorry, I need to talk to my BOMOH first". With that, he discharged himself from the hospital despite many attempts to make him understand what a lymphoma or a cancer means.
I am speechless ! Whoi !

Last week I joined my gynaecologist operating on this patient; inserting bilateral ureteric stents and assisted him in his surgery. The patient was an elderly lady with advanced ovarian cancer. She had earlier seek treatment for a progressively enlarging abdominal mass and lower abdominal pain in a nearby public hospital. She went to the gynae clinic there; saw one MO (medical Officer - ? trainee gynecologist) who did an ultrasound scanning. Detecting the mass, he requested for a CT-scan examination. During the next visit, CT was done and she was seen by another MO and was asked to come at a later date to see the gynecologist in-charge. On the given date, she came but this time she was seen by another MO and no decision was made. She was then given another date. The time interval from the first to the last visit was four and half months. Upset with the long wait, her childrens later decided to bring her to our hospital; saw our gynaecologist on one day, admitted her and got the CT-scan and IVU done on the next day, TAHBSO surgery on the day after. Now, she is awaiting her chemotherapy.

Look, I am neither comparing (the efficiency or what) nor advertising; but to highlight the attitude of some of our doctors in dealing with cancer patients. When you suspected a cancer, you should put high priority in the case, deal with it 'urgently' . You are not dealing with a reducible inguinal hernia or a lipoma where you can take your sweet time and schedule the surgery electively at the end of your long elective surgery list.

No wonder we are seeing advanced diseases with poor prognosis !

Kalaulah orang lain buat benda macam ini pada kita atau orang kesayangan kita, tentu kita marah. Jadi rawatlah pesakit kita sebagaimana kita mahu dilayani atau dirawati.