I went straight to one of the medical wards,enterered the antechamber of the respiratory isolation room, and put on my N95 respirator.
I was the first one to see the patient, who by the history alone the team and I knew had active tuberculosis.
Typical physical exam with the pertinent lung and lymph node findings. Straightforward, started the right medicines and set up follow up.
But what I remember best was making time for the patient. I was a little nervous since I never had an encounter with Mycobacterium tuberculosis, but I stuck with it since you have to do what you're told as a medical student.
I would make time to ask the patient about their family, work, trying to bring some human aspects to the bedside of someone thin, ill, sweating, coughing.
It has to feel dehumanizing being in isolation when you're so ill. I think infectious disease in particular has the strongest effect on the psychology of the patient in this respect.
I never saw the patient as some kind of biohazard, but someone who placed high importance on their family, a hard worker, someone who desperately wanted to get better, someone who always voiced their thanks.
We can't let diseases or microbes prevent us from having respectful, genuine interactions with our patients, whether they're medicine or surgery patients.
I wanted to write this entry so I'll have something to remember from my medicine wards. I think of treating a patient with tuberculosis as a small rite of passage in a young apprentice's journey.
I'll be honest and say that isolation rooms scare me. I used to be a janitor in a hospital and sometimes had to clean the isolation rooms. They were beasts and we had to drench everything in soap. Appreciated this thoughtful post.
ReplyDeleteThanks for your readership, Sam. The first iso room has to make everyone nervous, especially when you know there's a patient with active TB in there.
ReplyDeleteEventually you get comfortable, and even operating on patients with bloodborne diseases becomes less scary.
Thanks for your past efforts as a hospital custodian, I think the work they do is some of the most important in infection control
In my country, TB is endemic; there's too many patients with TB so you can't put them in isolation rooms. We do it the other way around: those in isolation rooms are immunocompromised patients, like HIV/AIDS and those undergoing chemotherapy. Often I find myself having to reassure these patients that we fear them getting infections from other patients more than fearing them infecting others. Usually they feel better afterwards.
ReplyDelete