Da' drug abuse patient

Funny things do happen in our daily life.. Once, i was attending a patient which was a drug user and retroviral disease. He was isolated at one corner due to unknown hepatitis status and had suspicion of having tuberculosis. Initially, i felt empathy on that patient. He looked so cachexic and had hyperpigmentations all around the body. His leg was ulcerated and necrotic.


I was ordered to take an excisional biopsy from the patient's leg. I spent almost the whole morning calling here and there to get the form and also the sample bottles with formalin just for this particular patient. At last .. everything done. And its time to wear like astronaut for double barrier and universal precaution sake. Spending 10 minutes to put everything on~ apron, goggles, mask and double gloves. Finally, i approached the patient.

So, the procedure had begun. I started irrigating his wound with normal saline and povidone.. Weirdly, when i irrigated his wound on the leg, he shouted for help and crying of pain.. He lifted his leg as high as possible and couldnt let me touch it. He sworn that he rather amputate it than letting me irrigating the wound. I dint even cut a single piece of his flesh, he already yelled like someones going to die.Then , he refused to let me proceed with the procedures. Initially, i felt numbed by his reactions. Of all the preparations i made, he refused to take the sample because i irrigated his wound. And the utmost part was that I HAVENT TAKE OUT THE BLADE...

After all the persuasions, i gave up my attempt. When i sat down at a corner to clear off my mind before doing my tasks ahead... something came up.. I was thinking why he cried for pain while he had been injecting himself with heroin everyday.

On the night itself, i stayed up as i had oncall. At 4am in the morning, as usual, i took blood from patients that need daily electrolytes and coagulation profile monitoring. When i scroll thru the whole ward, i stopped at the corner of the ward. And i double checked the bottle... Oh, it was him again. I was predicting something might happen again.

As predicted, when i entered his boundary, he started to screen for any sharp equipments. He saw me taking a syringe and needle. Voluntarily, he gave me his hand.. Before i sucked his blood, he started to give his lecture. He told me ways to take blood and ordered me to take blood from the particular vein in certain angles and directions. I followed what he said and eventually failed my first attempt. So, he started finding other veins for me and ordered me to take from the site he pointed. ( Hmm.. he do have a more advance knowledge in regards of the anatomy of blood vessels than i am.. ).. He kept babbling and babbling.... giving me his very own lectures.. IT WAS 4AM IN THE MORNING.. (ANd it was the crab teaching the duck how to swim) My patience was then escalating up to the boiling point. Swallowing a gulp of saliva, i finally poke his radial artery. He scolded me for blindly poking his veins without even seeing them. And he reassured that i wont get any blood from him as i didnt listen to his advise. Out of nowhere, blood started gushing into my syringe and i finally took 10cc blood from him.

I exhaled soundly as a sign of relief. At this moment, the environment was as quiet as i could even hear the laughter of the nurses at the counter area. Then i realise that his face turned blue and he finally kept his mouth shut.

-------THE END---------

The lesson for the day is to TRUST YOUR INSTINCT...