Doctors have bad days too

Folks, how do you forgive yourself? When does your body tell you that you have now moved on? I have never forgiven myself for the events that occurred on one Tuesday in November when I was on call. Every time I think of that day, my heart sinks a little, and I become overwhelmed with feelings of shame and guilt. I got a call at 9pm that I was needed in the male medical ward. I had had a rough day which started with a not-so-good round in the morning when my boss wasn't amused with a few things that were out of order. It was painfully cold; the thick fog had descended on the hills overlooking the hospital. I was a little drowsy from the antihistamines I was using to manage a common cold that I was battling at the moment. Honestly, I didn't feel like working that night. I had done almost two weeks straight without a day off. I felt my back was breaking. I was called to see Joseph, admitted to our unit with a history of vomiting blood. He had a basin at the bedside that had quite a copious amount of blood. His blood pressure was low. Even though he was talking, this was a medical emergency. I put in an intravenous line, took blood for a few tests, started intravenous drips, and then went to the laboratory to get him at least a pint or two of blood. Joseph was a tall man, probably in his late 60s. He had scattered white hair on his rugged chin with shiny wrinkled skin. From his face, you could tell that he had been beaten by life, and this vomiting was another beating he would rather deny than acknowledge. I was baffled, to say the least. The man was too casual. It took me about 40 minutes to get blood which I duly administered after that. I then walked around as the blood dripped slowly to see if anything else needed my attention. When I came back, the intravenous line had gone off. Damn! I had to start again. I managed to find a decent vein on the neck, the external jugular vein. I left the blood running. 'Na usilale na hii upande nimeweka line,' I gave my instructions clearly as I left the ward. I reminded the nurse to chart the observations and left a detailed plan of what to be done in case there was a reaction. Transfusion reactions can be very lethal. Up until 2 am, I had not slept. I had the weight of cetirizine on me, wanting me to close my eyes, while on the other hand, I was disturbed by a bad cough and a runny nose. Then I came across some good sleep at 4am or thereabout. I was finally grateful that a decent sleep was assured. Then my phone rang a few minutes past 5am. It was Exchange calling me again. I woke up so angry, clicking, every five minutes. I almost bit my tongue in the process. "Let it be something worth destroying my sleep for," I told myself as I wore my hoodie to brave the cold. I longed for some warm thighs that day. Soft, yummy thighs and a night of raw human instincts. I got to the ward and saw Joseph lying on the same side I had warned him not to. The blood on top had already clotted, and the guy was dead asleep. I was pissed off, and "Joseph, amka, unadhani wewe pekee yako ndio unahitaji usingizi?" I burst. I was trying to be angry and polite at the same time. I couldn't imagine that just one patient was keeping me awake the whole night. I wish I had thought otherwise in those moments. His condition remained a medical emergency. I prayed to God to remind him how serious his condition was so that we could meet halfway in our treatment plans. Anger was burning in me. "Nakuwekea line tena na ukitoa ujue utajitibu, mimi sitaki huu upuzi," I said again to remind him to cooperate with me in his treatment. I removed the dysfunctional cannula and turned to the other side of the neck. Luckily, it didn't take long before i fixed another one. I discarded the blood and got into the business of looking for yet another pint of blood. As I walked to the laboratory, I felt guilty for becoming such a nasty doctor. I wish I had just woken up and gone to help John with my zeal when I joined medical school. What had become of me? Where did all the love go? On some days, I did not measure up to the ideals of our profession, but on most days, I want to strive to. Medicine, being a doctor, can give someone some sense of entitlement, sometimes and for some people most times. I pray that on days that we fall short, may we find the grace to acknowledge and to strive to be better, may we not bend to the cynicism of the uninspired. In all that, and indeed in all what we do, if there is no love, we are only but clanging cymbals.

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