How Would You Like To Be This Patient?
15 Mar 2007
If such inefficiency of this medical kind happened in a corporation it would not survive this competitive world. Any business executive consultant would look at these needless delays and fire those responsible.
A 40 year old man noted the onset of upper abdominal discomfort early in the morning. By late afternoon his pain had shifted to the lower right side of his abdomen and he complained of nausea.
Since he had no family physician, he arrived at 6:00 pm at the hospital’s emergency department. Due to abdominal pain he was seen quickly by the emergency doctor. The diagnosis was possible appendicitis.
But in spite of a quick assessment by the doctor, this patient’s luck for speedy treatment began to run out. A surgeon was called, but it was now 7:00 pm and some surgeons don’t like to return to the hospital for a “questionable” case of appendicitis.
So the surgeon requested a CT scan of the abdomen which can diagnose appendicitis in many cases.
The patient’s bad luck multiplied. At 7:00 pm the CT scan technician had gone home. So the scan was scheduled for early the next morning. At this point the technique was able to diagnose an acute appendix.
But luck spreads. If the CT scan had been done the night before, several operating rooms would have been available. Now, the surgery schedule has already started, operating rooms are filled and staff are all busy. Finally later in the day an operation that under ideal conditions should have been done hours before, discovers an acute appendix that has ruptured causing peritonitis. The patient survived due to the use of antibiotics, but could have died.
All of us would like to be treated better. But with tight hospital budgets these problems happen. And I’m sure readers could send me many horror stories of their own.
Every day in North America at least one person dies due to an attack of appendicitis. How many of these are due to delay I have no way of knowing. But, in this age of technology, sophisticated equipment does little good if it’s not associated with some good old-fashioned horse sense.
Nevertheless, we’ve come a long way since Claudius Amyand removed the first appendix at St. George’s hospital in London, England, in 1736. For the next 150 years confusion reigned over how to treat this disease.
The great French surgeon, Dupuytren ridiculed the suggestion that the appendix could be the source of an infection. Later, Henry Sands, a New York surgeon, simply stitched up the hole in the appendix. Another straightened out the kinks. If these patients survived, it was the Almighty who saved them.
In 1902, Frederick Treves, a young surgeon, was called to see Prince Edward who was to be crowned King of England in two days. His Mother, Queen Victoria, had reigned so long that Edward had become the playboy prince. Now, he had become obese, old and flatulent and a terrible operative risk. Treves diagnosed a ruptured appendix and advised surgery much to the consternation of other doctors.
While Treves operated others planned the future king’s funeral. But Treves made a wise decision. He simply drained the abscess and left the appendix alone. No doubt Treves also lifted a few prayers to Heaven. Luckily Edward survived and later was crowned King Edward VII. Treves was knighted for his efforts.
Today, if abdominal pain strikes, don’t wait hours to seek medical help. There’s a tendency to write off the pain as a mild intestinal upset. Or, to take the attitude it will get better in the morning. Precious hours are lost if the pain is due to acute appendicitis or another serious abdominal problem.
Never take a laxative in an endeavour to ease stomach pain. If the trouble is an acute appendicitis this may cause an inflamed appendix to rupture.
Don’t take food or drink. This increases the chance that food could enter the lungs if vomiting should occur during surgery. And don’t take painkillers that mask the pain.
Lastly, pray that you will be treated promptly with the best technology sprinkled with a touch of common sense.
