Sunday, October 14, 2007
something happened a while ago that gave me quite a stir, on more than one level.
being the only private hospital servicing the southern part of the kruger park, we quite often see tourists at our facility.
i get a call from a gp who is in practice just next to the park. 'appendicitis' he says. 'send' i reply.
she arrives in casualties, significant other in tow. i ask the usual questions about pain, nausea, appetite etc. sounds convincing. i ask the significant other if he would mind waiting outside while i examine the patient. he asks why. i explain that it is better that he not be there during the examination. he leaves.
examination is typical of appendicitis. i decide, due to the pretty clear cut history and clinical to omit a pr and pv. (don't tell the prof. he'll do his nut) to be honest i also had a feeling the significant other was going to be problematic and i felt a voice warning me or some such thing.
thereafter, to theater and appendix out (i was going to say chop chop, but...). then i handed the patient over to my colleague and went to the kruger park for my weekend off.
in the park in one of the camps, who should i run into? mr significant other (he continued his holiday rather than stay by the patient's side during her hospitalization). he confronted me. he asked why i had asked him to go out. i was thinking that i should say that i suspected she was abused and i wanted to talk to her in private, but of course i just explained that that is standard practice. and then it happened. he said,' listen doc, in this day and age if you examine a patient without a witness, there could easily be a case of rape made against you.' he threatened me. he basically accused me of raping her. i turned and walked away.
a few thoughts. firstly the patient and the patient alone is my responsibility. yes, i try to involve the family as much as possible, but in the end my contract is with the patient.
secondly, what sort of person continues his aggression after the person he is ostensibly fighting for has been helped.
but lastly, this sort of thing may make a doctor think twice before completing a full physical examination. i already felt i was taking a chance by omitting the pr and pv, which should actually be a part of all appendicitis examinations.
i quietly wished thrombosed hemorrhoids on him and felt somewhat better.