Palliative rotation

 

I dont know whats wrong with me, ive been missing my family so bad lately, so bad that it would make me cry, especially dad. Ive been feeling extremely nostalgic and home sick and all i could think about is going home and going fishing with dad. Its so bad that i was seriously considering taking 2 days off of next week and adding it to the weekend and flying to kuwait to spend a day or two with dad :S .. my friends think its the winter blues, we havent seen the sun in toronto for so long now lol, my other friends think its me taking my '' missing-ing '' for some one on dad lol .. hmmm.. wait a second, i just realized something .. im actually Pmsing .. LOL .. now that explains my emotional instability lately .. wow that explains alot .. i was thinking maybe my palliative rotation was gettint into me :S

ohh yeah .. I AM DONE FROM MEDICINE * dances like an idiot* god, HAM O ENZAAAAAA7 !!! wai3 .. wai3 ... WAAAAAI3 !!! no wait, it is NOT wai3. I LOVE medicine and i enjoy LEARNING medicine, but their life style and on call schedule is INSANE!!! I was almost suicidal on that rotation .. so im doing a new rotation and that is palliatuve medicine .. the good side off it, its LIGHTER .. working hours are from 8 am till 5pm, less number of patients, friendlier staff , NO ON CALLS * does another idiot dance * .. BUT .. and its a BIG BUT * lool that made me giggle, god im naughty lol *, back to my but, lol i did it again , ANYWAY, palliative is REALLY depressing .. palliative is the service that gets involved when everyone else fail to help the patient, we are the ones that esnure that the patient is pain free and that they will pass away painlessley .. ill explain more .. so basically other teams call us when they have a patient that they cant fix .. such as terminal cancer, ppl with dementia that are not aware of the surrounding , patients that keeps gettuing hospitalized for the same problem that cant be fixed like bad heart failure or bad kidney disease ... so what happens is their doctors got nothing else to offer and whatever the patient has can not be serevsed so we get involved and start managing the patients pain or psychological distress and follow them until they die ( they usually dont live long now that they are not getting any treatment ) , sometimes they decide to end it in the hospital .. for example, some one with incurable cancer, comes in with a bad infection, so their philosophy is, why treat the infection only to let cancer kill that patient soon after so they DONT treat the infection and give the patient alot of pain killers to make sure he is not in pain and just let the patient die from the infection .. OR say an old lady with dementia and she is not really aware of ppl around her comes in with an infection, they dont give her antibiotic and dont hydrate her and just let her die .. they may give her food but they wont give her IV fluids and usually elderly with infection NEED IV fluids because they get quite sick and oral food/hydration doesnt really help . Ive seen them sedating a couple of patients and they would be sleeping for DAYS with no food or drink till they die ..
WHY? Because they believe in QUALITY OF LIFE .. they thimk by the age of 90, u had a great life and ur life will deteriorate, u wont be able to do the things u used to do, ull be needing assistance in everything, probably u'll be feeling all lonely esp if u outlived all your friends and family so why let your suffering prolong? Say you had a bad heart and you are always admitted for heart failure, they think why are u getting admitted and getting all these expensive medications only for u to be re-admitted shortly after being dicschaged and try tto convince you to sign a paper that says if you feel you are stepping into heart failure, no one should call the ambulance and you should be let home to die ....
i saw family members agreeing to that .. 3AMA EB 3EENKOM, how could you convince your mom or dad to sign such paper !!! HOW COULD YOU AGREE WITH SUCH A THING !!!! this is all cultural shock to me .. this is really common here and patients and their families are okay with it ... im just having hard time accepting such practise ...

it is noble in a way, i mean where the last team to help you, we come in when everyone else gave up on you, we may not fix your ptroblem or prevent death but we will make sure that you wont suffer any

more and ease off your journey to death ...

i just find it really depressing that all my patients are dieing .. and i may be the very last dr to see them. For example, i was asked to see a new patient yesterday, he was in his 80's, had a bad heart attack and his brain was affected by lack of blood so he was pretty drowsy most of the time and unable to stay awake and his heart has sustained a big damage and is enable to pump well and basically without high doses of medication, he will flip into heart failure .. so when i went in to talk to him and take history, HE DIED ON ME !!! can you imagine how scary this was !!!!!!!!!!!!
i have another pt, who is in her early 40s, she has a 1yr old daughter , the patient was diagnosed with cancer that has spread all over her body and she was given 3 months to live ... how depressing is that !!!

i dont know how palliative doctors can do that everyday, im counting the days till the end of this rotation and i hope i will survive it without getting clinical depression :S