One would think that the years of study we put in to become Doctors would make us better prepared to face any health situation that confronts us. Since the pathophysiology, the symptomology, the complications, the investigations done and the treatment needed have been encrypted into our minds, we would in fact be the most resilient and calm patients or patients' relatives. Yeah, that is just a myth. We are humans. And we have every right to create a scene and fear the worst, when our own health is concerned.
As an occupational hazard in our profession, we are capable of being exposed to anything and everything. It is our responsibility to protect ourselves against the worst of scenarios. The most common is, of course, the needle pricks. It has been 4 months of Internship now, and I've managed to get two already. Both experiences contributed to my post today. I feel more confident about handling such situations now, but in the spur of the moment, I acted like any non-medic person would. That is scary. That spur of the moment action or inaction.
We are taught to maintain basic precautions - gloves, covered shoes, masks, glasses, lab coats, etc. We are also told that there are certain norms to be followed to protect ourselves. One is, never recap a used needle. NEVER. More than half of the needle-pricks occur when we try to use our own heads and recap needles. Two, always push the used needle into the plastic cover on the bed. That keeps everybody out of danger. Three, wear gloves. Yeah, that's what I wrote first, but that is just so important!
I want to record my second experience here, because I learnt more from this one. I was posted in Skin (I don't know what it is, there isn't much love lost between me and the subject) and had to put an iv cath for a patient. I'd previously taken a sample of his for HIV testing, so I was wearing double gloves, a mask and doing everything I was supposed to do. While taking the cath to throw it, I felt it pierce my gloves. On removal of the gloves, I looked for any kind of injury on the skin of my palm. There was none - no blood, no inflammation, nothing. I washed my hand, there wasn't any burning either. I thought I'd caught the needle just in time.
That was a mistake - Never think there is no prick. Go to the Medicine guy responsible, immediately.
I didn't think about it too much until next morning, I saw an inflamed spot. At 4 am in the morning. And then everything got twisted. I started panicking. I wanted to cry and scream....I wanted to call up my resident and ask her about the patient's HIV status. Having seen the patient, I kept thinking, there was a possibility that he could be positive. And I hadn't taken that PEP dose immediately. My sleep disturbed, my mind shaken, I spent my morning trying to decide what to do. Ultimately, it was decided, that I should go and do that patient's Tri-Dot test any way, instead of waiting for his report. Before doing that, I took the first PEP dose. That moment, when I was waiting for the lines to form on the strip, was most frightening. I could imagine more than one lines on that strip. I had prepared myself for the worst, because I was so sure that was going to be the case. When only the control line came up, the surge of relief that went through me, filled me with a new life, really. Next day, the patient's report also came as negative. Phew. Close call.
This whole episode made me think. I've learnt about HIV and HbsAg since I was in second year. I've learnt that the chances of contracting diseases like this are pretty slim, that once you take all the necessary measures, you don't need to think much. I've learnt all about the pathophysiology, the spectrum, everything there is to learn, at UG level. This is enough to know that what I was faced with, did not put me in danger at all, especially after that Kit test. Yet, I panicked. Yet, I feared the worst. Yet, I traumatised myself and my parents and my two bestest friends. I told myself, it couldn't happen to me and yet, it was happening. What was the use of all that knowledge then? It didn't matter that I was a doctor. I could easily have been an engineer or an archeologist or a parent. My reaction was a purely human reaction - a scared person, faced with the possibility of a different life. It is like facing a tiger in the middle of a forest - in those initial seconds, it doesn't matter whether you've been researching tigers all your life or whether you're thrown in front of him by mistake. This fear, this panic....it's a part of the innate response of our body. Innate - present since birth. However trained and educated we get, this response always gets the better of us when faced with danger or death.
And at such times, doctors end up acting like patients....
We are taught to maintain basic precautions - gloves, covered shoes, masks, glasses, lab coats, etc. We are also told that there are certain norms to be followed to protect ourselves. One is, never recap a used needle. NEVER. More than half of the needle-pricks occur when we try to use our own heads and recap needles. Two, always push the used needle into the plastic cover on the bed. That keeps everybody out of danger. Three, wear gloves. Yeah, that's what I wrote first, but that is just so important!
I want to record my second experience here, because I learnt more from this one. I was posted in Skin (I don't know what it is, there isn't much love lost between me and the subject) and had to put an iv cath for a patient. I'd previously taken a sample of his for HIV testing, so I was wearing double gloves, a mask and doing everything I was supposed to do. While taking the cath to throw it, I felt it pierce my gloves. On removal of the gloves, I looked for any kind of injury on the skin of my palm. There was none - no blood, no inflammation, nothing. I washed my hand, there wasn't any burning either. I thought I'd caught the needle just in time.
That was a mistake - Never think there is no prick. Go to the Medicine guy responsible, immediately.
I didn't think about it too much until next morning, I saw an inflamed spot. At 4 am in the morning. And then everything got twisted. I started panicking. I wanted to cry and scream....I wanted to call up my resident and ask her about the patient's HIV status. Having seen the patient, I kept thinking, there was a possibility that he could be positive. And I hadn't taken that PEP dose immediately. My sleep disturbed, my mind shaken, I spent my morning trying to decide what to do. Ultimately, it was decided, that I should go and do that patient's Tri-Dot test any way, instead of waiting for his report. Before doing that, I took the first PEP dose. That moment, when I was waiting for the lines to form on the strip, was most frightening. I could imagine more than one lines on that strip. I had prepared myself for the worst, because I was so sure that was going to be the case. When only the control line came up, the surge of relief that went through me, filled me with a new life, really. Next day, the patient's report also came as negative. Phew. Close call.
This whole episode made me think. I've learnt about HIV and HbsAg since I was in second year. I've learnt that the chances of contracting diseases like this are pretty slim, that once you take all the necessary measures, you don't need to think much. I've learnt all about the pathophysiology, the spectrum, everything there is to learn, at UG level. This is enough to know that what I was faced with, did not put me in danger at all, especially after that Kit test. Yet, I panicked. Yet, I feared the worst. Yet, I traumatised myself and my parents and my two bestest friends. I told myself, it couldn't happen to me and yet, it was happening. What was the use of all that knowledge then? It didn't matter that I was a doctor. I could easily have been an engineer or an archeologist or a parent. My reaction was a purely human reaction - a scared person, faced with the possibility of a different life. It is like facing a tiger in the middle of a forest - in those initial seconds, it doesn't matter whether you've been researching tigers all your life or whether you're thrown in front of him by mistake. This fear, this panic....it's a part of the innate response of our body. Innate - present since birth. However trained and educated we get, this response always gets the better of us when faced with danger or death.
And at such times, doctors end up acting like patients....
