Liar liar

This needs to be documented. Of patients who lie.

As healthcare workers that becomes the first point of contact for patients, it is of paramount importance that we should be informed of risky health points. Nowadays, Covid-19 is one of them. Every time a patient walks into our primary care facility, it has become a norm to ask if they have been in contact with those who are Covid-19 patients or suspected of Covid-19. It is a simple yes or no so that we could decide whether we need to attend the patient wearing the full astronaut PPE or the basic PPE. It’s a cost and personal health issue.

When a patient fails to declare this, it will put me, my family and other patients that I see, at a risk of getting Covid-19. You need only one HCW at a facility to get it before the whole centre shuts down. So honestly, I don’t want that to happen. While I may remain healthy and asymptomatic, others may not be that lucky.

Last week I was in charge of Fever Counter. This means we see all patients who present with fever, upper respiratory tract infections, those who come for other ailments but with the said symptoms, those who come from high risk areas with/without symptoms and whoever that fits the bill. I was dismayed by two separate encounters. But I will share only one story today. And of how thankful I am for gut instincts especially with this 1st family.

Photo by Anna Shvets on Pexels.com

She was a lady in her 50s who had underlying non communicable diseases. Unfortunately, she defaulted her appointments at our facility and bought the meds at her nearby pharmacy. She presented with undocumented temperature and URTI symptoms and mentioned a short trip to pick up her son from a high risk area because PKP was due soon. Her son, according to her, was well with no symptoms. I asked the lady to come back in 2 days time to repeat another set of bloods because her counts were a bit low and I was more suspicious of dengue.

The next time she came, she brought over this son. To be honest, we wouldn’t have known this if I hadn’t ask her back ‘how old was her son and why did she had to fetch him?”. That’s when she pointed to the young lad beside her and said,” this is my son “. Suddenly bells just started buzzing in my head. There was a knot in my stomach that signaled me something is wrong somewhere.

I reconfirmed with the son, a young man in his 20s, of where he stayed in this ‘high risk area’ and his answer was totally different from what the mother told me a few days back. He had already declared earlier with the nurse that he had no contact with any Covid-19 cases but I asked him again ” Is there anything else you need to tell me, that I need to know?”. He said NO. That restless, suspicious feeling lingered. So, I directed him to the Covid-19 tent to wait for his turn and had his mother did the same too. I referred the case to my MALE COLLEAGUE who is in charge of any case who may need a swab test. I had to BOLD the male part because in this part of the city, patients still think that male docs are better than females, chinese docs are the smartest of all, docs serving the suburbs or rural areas graduated from the jungles and other prejudiced thoughts.

Guess what, the young man revealed that he went back to his hometown here because his housemates there all have Covid-19. When my colleague asked, why didn’t he said this earlier, he said “no one specifically asked me about it”

Well. That is just BULL *&%^*!! Did he expect a question like “what kind of house do you live in? do you share it with other people? is the housemate in Room 1 well? how about room2? room 3? ”

He and his mother ended up having a sample taken and well.. as you’d guess, they were both tested positive for Covid-19. I am concerned for the mother because she is at risk of deteriorating whilst the selfish son may survived this episode due to his young body.

I was disappointed with the young man’s attitude towards this pandemic. Undeniably, some patients do fare better than others but shouldn’t that trigger you to protect those at risk from harm?

Gajah berjuang bersama gajah, pelanduk mati di tengah2

It was nice to end the day with a humorous pantun. And dinner for 2 adults (with a sleeping kindie). After all the drama!

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Today I am reminded of a comic picture I once came across on Facebook. Of how 1 person saw the number 6 and the one opposite him saw a 9. Theoretically they are both right if we were to look at it from where they are standing. But wouldn’t it be nicer if they could show the person opposite them what they are seeing by bringing him to where they are standing. So they could both see the number 6 and 9. Coming from that same figure. 

While it is interesting to have a patient with a list of differential diagnosis to work out – at the end of the day, when something needs to be done quickly – we want these opposing parties to agree on a common ground which will benefit the patient. But who are we to make suggestions. So its like how a friend puts it – let the big guns decide. We will be the little elves helping magic to happen.

You don’t agree with me? You become a specialist first, and then you come back and argue with me …