It was a bad call,
patient coming in on 15min basis. The sleepy bug was chased away by the 2
female patients sent in by the ambulance at 3am. They had ridden a bike and
rammed onto a tree along the roadside. The rider was confused and the back seat
passenger was alert. The back seat passenger suffered from multiple contusion
and abrasion. The rider was however noted swelling of her face with epistaxis
and rt ear bleeding. A sign of skull base fracture and I had proceeded with the
essential CT scan and other imaging examination. Both of them were nursing
student on their way down south for a holiday.
The imaging had
revealed a rt maxilla bone fracture with pneumocranium. She was lucky as there
was no intracranial hemorrhage.
Unlike the
backseat passenger’s parents who came within an hour; the rider’s parent came
late. I had presented the backseat passenger (BP) condition to her parent on
their arrival. Since they are not residing around our area, they had requested
a referral to a medical facility near their residence.
The father had
asked my opinion and I told him it would not make any difference as the on call
surgeon would review her and make the proper arrangement. The couple had a
further discussion and told me that they wish to refer to YT hospital. I overheard
their discussion and apparently the father had proudly told the mother that he
knew the special assistant to the chairman of the board of the YT group.
YT group was
initially a property developer and later venture into education and medical
field. They had secured a land near the outskirt of K city. Theme park with
shopping facility, university and hospital were built over the area. They had
wanted to start a medical faculty but however restricted by the government as
the quota of medical student was used up. As the chairman of the board had a
good relation with the former president, the university was allowed to set up a
special medical class for African student – training them to become qualified
doctor. The condition was that the graduates from the class were barred from
practicing in Taiwan upon completion of their course.
The
“connection-relation” culture is a rooted deeply in the local community; If you
have connection with big gun than you should be in good hand. From time to
time, there is always some patient/ patient’s relative came to the desk and
asked our staff if “who or who/aka Big gun of the hospital ” is around. They is
showing off that they know the “big gun”, and they deserve better service. If
the big gun is around, they would request the big gun to approach the medical
team asking for “special treatment”. Frankly speaking, I hate this kinda of
culture; one of the reasons I left my ex-employer.
The girl was sent
over to YT hospital later and I had dragged myself to the govt clinic in the
land of lion after the hazardous call.
At around 9:30am
while I was taking a nap…. My head nurse had called me up and told me that the
parents of BP had called up and wanted to speak to me….My heart sunk as I
thought I must had missed something; the parents had demanded an explanation.
I called back and
the voice of the anxiety mother over the phone pacified my soul; it was nothing
to do with me. Apparently the ED physician had referred the case to the plastic
surgeon instead of the neurosurgeon. The plastic surgeon on call had told the
parents that if they agreed for ops later, the girl would be admitted to his
service. If they are not willing to do any surgery for the facial bone, then
they should discharge straight from the ED. The parent was in a dilemma and
hesitated to do an early surgical decision. They called me to ask me for a
second opinion. Well, sometimes the pulling string magic failed, I guess.
Few weeks later, a
group was tree was sent to ED in a busy afternoon. The reckless youngster had
rammed onto a small van; none of them had fastened their safety belt. The front
seat passenger was noted with severe depressed skull bone fracture(closed). But
luckily there was no intracranial hemorrhage. The father of the victim was
gangster’s honcho type of person. He used strong language and had raised his
tone from time to time during the conversation with me. I had called up our
neurosurgeon and during the explanation session, the father had expressed his
in-confident with our judgment and suggestion. He had asked for a transferred
and our neurosurgeon had gladly complied with his decision. After a long period
of working together, we had developed a mutual consent about such patient –
transfer as the patient wish to avoid further medico-legal issue if the
patient’s condition deteriorate.
The father had
then raised his tone while telling the other family member that he had known a
big gun at the related hospital.
When I told the
father that the relevant hospital’s NsICU was full and refused our referral.
The father had tried to make some calls and failed to secure a bed. He had then
called up another neurosurgeon and passed the phone to me for further
explanation. The neurosurgeon after hearing my presentation had however
suggested the father to stay back at our hospital for ops as our neurosurgeon
was his senior and in his opinion is a well trained and reputable surgeon.
Our of my
expectation the father had changed his attitude and acted like a bug wagging
his tail and begged our neurosurgeon in his clinic for further management.
However, his begging was in vain and later the patient was forced to transfer
out to another setting.
The patients and
their family’s attitude decide what they get. Somehow, they deserved it…
