A Doctor That Cared Enough

Most surgeons don't really care about the patients - they care about the disease. At least this is what I see.

Orthopedic surgeons care mostly only about the orthopedic problems their patients have. They don't really focus or even notice the other medical conditions the patient might have. But not all of them are like this.

There is at least one specialist in Ipoh Hospital who really cares about his patients, sometimes he cares to much. But last weekend, his care paid off.

There was a young boy who was admitted to us after he developed weakness over his lower limbs after a fall. The thing is, it did not occur immediately after the fall. He fell, then got up and went back home, and after a while noticed that his legs were weak. If progressively got worse (in a couple of days) and he was then referred to us.

This specialist, Mr. L was oncall last weekend.
He saw the patient on Saturday and immediately decided that he wants an urgent MRI.
What usually happens is, the specialist tells us HOs to get an urgent MRI and then walk off.

Not Mr. L. He called the radiologist oncall, explained to him why he needs an urgent MRI and got the appointment. Thankfully, the radiologist agreed to do the urgent MRI and the scan was ready by that night. By that time, Medical had already reviewed the patient and said that most probably the patients problem was related to his fall, not a medical condition.

The MRI report said there was a hematoma (blood clot). Mr. L looked at the films. And he looked, and looked. A few of us HOs were following his rounds and got quite bored looking at the films. Me, I can't understand an MRI film, or a CT film, and sometimes even an X-ray film. MRI - all I see is bones and large organs. I don't know which is a hematoma. I can't differentiate a cyst from a tumor from an inflammation from an artifact. I depend solely on the report.

But Mr. L, after staring at the films for quite some time, called up the Ortho consultant, our very own Dr. House. After discussing with Dr. House, Mr. L decided that it was a tumor and referred the patient to Neurosurgical.

The next day, a laminectomy was performed, and it was confirmed that it was indeed a tumor. The patient is no longer an Orthopedic patient, he is a Neurosurgical patient.

A different scenario would have taken place had Mr. L not taken the effort.
Mr. L could have just waited until today, when the specialist in charge of the ward would have done rounds and then asked for an urgent MRI. We might have, or might not have gotten the MRI done today. By the time we refer to Neuro, it would have been tomorrow. If the boys condition could deteriorate so much in a week, don't you think a couple of days is important?

Today, I learnt that caring makes that much of difference, at least to the patient.
Thank you Mr. L for teaching me this lesson.
Mr. L also said this (something like this) - sometimes things are just a coincidence. Medical said that the boy has an Ortho-related condition just because the symptoms appeared immediately preceding his fall. However, it has been proven to be otherwise. His fall has no relation whatsoever to his current problem. Don't dismiss things so easily. Think out of the box (easy to say, not easy to do). :)