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Why doctors can't disqualify themselves when handling patients

By Kizito Lubano | July 8th 2015

A judge of the Industrial Court had been rushed into the emergency room from the court where she was presiding over an employee dispute between the doctors union and the Health ministry. From the brief history, I gathered that she was well, then around 10a.m. she complained of a sharp pain in the lower abdomen before leaving the courtroom for the washroom where she collapsed.

She was rushed to a city hospital. I happened to have been passing by the accident and emergency section when one of my young colleagues asked me to quickly review a middle aged woman who had collapsed with a likely gynaecological issue. The patient had four intravenous fluid lines and was on oxygen. Her pulse was very weak.

I felt her abdomen. It was distended and tender to touch. She was being prepared for an ultrasound scan. But my old school instinct told me to stick in a needle to find out. I remember in undergraduate surgery class of 1990 I was taught that, assume any woman in reproductive age with pain in the abdomen to be pregnant. I further recalled the four ‘Fs” - that the distention could be foetus, fluid (blood, pus or water), flatus (gas), or faeces.

The needle aspiration yielded non-clotting blood. I made an instant diagnosis of a ruptured ectopic pregnancy. From then on, it was all systems go to get her to theatre as soon as possible. We were in theatre within a record five minutes and opened the abdomen and arrested the bleeding.

In a dramatic 30 minutes like the TV ER series, we had completed the operation and the patient was now in the recovery room. I came back in the afternoon to review her and that is when I discovered she was the same judge I had encountered in a matter I had an interest in but lost. She recalled the details but we avoided dwelling on it since the matter was still alive.

She was discharged in three days. At 45 and her last born being 15 years, she never thought it possible to conceive. At her next visit she came with her husband. We talked about many things and her husband told her that doctors, unlike judges, cannot disqualify themselves in an emergency even if they know you. This is because for doctors there is no appeal if an intervention is delayed!

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