Patients as teachers

i had a wonderful experience on friday evening just before i left the hospital. i'm so glad i stayed around to try to clerk the parents of this cute lil girl. my tutor told us during tutorial that the girl has a very rare disorder and we should go talk to and learn something from the parents.

first thought: rare disorder... wun come out for mbbs la!
second thought: rare disorder... could be something interesting...
and hence i was debating whether to go see her at 4.30pm or go straight to orchard. i'm sooo glad i did! cos i had one of the most valuable lessons of my life as a medical student.

She is a 19-mth old girl who was found to have hyperinsulinemia after 3 seizure attacks due to hypoglycaemia at 6 months of age. From then on, she needs to be placed on a strict diet regimen, daily diazoxide and pre-meal hypocount every single day.

Her daddy is a very educated man who could give me an impeccable account of her condition, her control of the condition, every single thing that happened to her, etc. i'm so guilty to admit this but i had zilch knowledge about the condition, the treatment and the impact it has on the patient before i spoke to him. but at the end of it, he taught me SOOO much... even more than any didactic lecture or textbook can ever teach me.

it left me pretty emotional too as we talked about the emotional and financial impact on him and his wife. he had a tone of a man who has resigned to his fate and who sounded totally overworked and overwhelmed by his daughter's condition. he has also changed his job twice so that his work schedules allow him to relieve his wife in the care of his daughter. the finances became so much tighter cos hypocount strips cost more than 200 bucks a month, diazoxide another 200 bucks a month, outpatient appointments, hospital stays, etc...

i sat with him for almost 1 hour and listened attentively to him. when i asked him whether this condition had any impact on his life, i knew i've unscrewed a barrel tap. i think he really needed to unleash his frustrations and talk about it to someone. this is something the doctors in the outpatient clinics and the wards can't give him but something medical students can, if we care to do.

it was a good thing i stayed back n spoke to him. i probably can read about hyperinsulinemia and its treatment 10 times in the textbook but it wouldn't have stayed in my head. but now, i think i'll never forget it. even if i do, i'll never forget HM and her parents. just in 1 hour, i've also learnt how to empathize and how impt it is to just sit down and listen. that is what medical education is about... or at least what medical education should be...