Indexing Title: BCDEVEZA’s Medical Anecdotal Report [ 05 – 4]
MAR Title: Playstation
Date of Medical Observation: May 2005
Narration
It was another day in the hospital. I was on duty and as usual, we received the endorsements from the other teams. The from duty group endorsed 3 patients which they assessed to have Acute Appendicitis. Somehow, I felt excited because most probably, I will be the one to handle these patients. I know that my seniors will give me the chance to do the operation. But little did I know that something will happen which will leave an imprint in my life. I was on my third and last appendectomy on D.T., 21 year old male. He was quite big for his age. Pre-operatively, I re-assessed him and there was direct tenderness on the right lower quadrant. I, together with my senior, proceeded to do the operation. Everything went smoothly not until we reached the peritoneum. Upon opening, we noted purulent peritoneal fluid. Thoughts were running through our minds that this might be a perforative appendici-tis. There was generalized peritonitis, which was not evident on physical examination. And true enough, the appendix was perforated proximal to its tip. We removed it and washed the abdomen thoroughly. Layer by layer closure was done, leaving the subcuta- neous layer open. He was then transferred to the recovery room.Post-operatively, he was stable. I was able to talk to him and he said, “Kuya, pag labas ko dito, itutuloy ko yung paglalaro ko ng playstation.” After that, I went to his room and talked to his parents. I explained our intraoperative findings and the dangers it can bring to their son. It was difficult for them to accept that, but I have to do it. During our conversation, I told them that their son mentioned something about the playstation and they said, “Doktor, naglalaro kasi siya ng playstation bago namin siya dalhin dito.” Later that day, he was transferred to the ward. I made my rounds and he was doing fine during that time. When I went home during that day, I never thought that something bad will happen to him. Around midnight, I received a message that he was not doing well. He had minimal urine output, had bibasal crackles and hypertensive. When I came to the hospital the following day, I noticed that he had changes in sensorium, was febrile and had episodes of hypotension. We did the necessary measures and somehow, we were able to maintain him. I was in shock and was thinking what could possibly happened to him. I talked to the parents, family members and relatives. I told them about the present condition and reassured them that we will do everything to save him. But it seems fate has to take its course. At around 9 pm, the inevitable came. Tears flowed in the room. His mother approached and hugged me, while whispering to my ears, “Maraming salamat doktor. Maski pano, ginawa niyo po ang lahat para sa anak ko pero hanggang dun na lang talaga siya."
Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements):
This incident reminds me of a great lesson taught to me during medicine school. It is something I always keep in mind whenever I am confronted with a situation like this. It goes :
HONORA MEDICUM
OPERA EIUS SUNT NECESSARIA
DEUS AUTEM EST QUI VITAE ET MORTIS
HABET POTESTATEM
HONOR THE DOCTOR, HIS WORKS ARE NECESSARY. HOWEVER, GOD STILL HAS POWER OVER LIFE AND DEATH.
More often than not, as doctors, we find ourselves dealing with dying patients. Patients whom we never know. But it is our duty and responsibility to do all that is necessary in order to extend their life. If we fail, we just have to accept that its something that we cannot decide. We must realize that there is a higher power that has control over us. Acceptance is always diificult but it can be done. The life of my patient has to end there, for reasons I do not know. Perhaps he has already accomplished what he has to do or God does not want him to continue playing with his playstation anymore. Perhaps He wants it to be played SOMEWHERE else.