Was just walking out from the hospital the other day when I saw a small crowd ahead of me. It was next to my bus stop so I took a peep at the commotion. Turns out it was an elderly gentleman who had apparently fainted and fallen down. Some nice folks were sitting him up and gathering up his belongings, but weren't quite sure what to do. Amazingly a car stopped and a couple got out to send him to the emergency department before I could do anything.
The incident got me thinking about how much we are supposed to help in situations like these. We are in a profession that has always been upheld as noble and selfless, and we've got wonderful examples to follow (think Salk and Sabin's free polio vaccines) but we all know that the truth in this day and age is far from that. Profit is now the bottom the line in many institutions, and given the increasingly litigatious atmosphere many doctors are practising defensive medicine.
So it's not hard to understand why some of us, if not all, would hesitate before volunteering help when it is needed. Is it worth it, we will ask. If the victim is bleeding or vomiting, how do -I- protect myself from any unwanted diseases? (We have been told that we should perform CCR not CPR since the former apparently is more effective anyway.) And will I be held responsible should the patient suffer any complications?
Many of us entered medical school with hopes of making a difference. We wanted to help people, and we did our best as medical students, going on overseas trips to far flung places or going door to door giving health checks at the poorer estates here in Singapore. But those two letters in front of our names after we passed the final exams give us not just privilege but also lots of responsibility that we accept if we were to offer our help. That's the reason for the hesitation, and it is an issue that I, as a junior doctor, have yet to come to terms with. I recall noting the surprise of the junior doctors when a senior colleague mentioned that she usually stops to help when there's a traffic accident. Means that it wasn't what they expected to hear, no?
Right after we finished our MBBS a classmate mentioned that he responded to a call for medical personnel while on board a flight during his graduation trip. Would I have done that? A few years ago, before I started clinicals, I would have answered with a resounding yes, but now, especially after one month of work (yours truly is the youngest of the contributors here at singaporemd), I probably would, but with some hesitation.
Anyone has any thoughts on this?
6 comments:
If you are caught without your tools of trade there usually is awfully little you can do.
I'm not sure if doctors actually make a conscious decision to help when they come across a casualty outside of work any more than a swimmer (or too tragically often a non-swimmer) makes a conscious decision to dive into a river to save a drowning person. I believe it's a subconscious thing - the body reacts and the conscious mind fills in the motivations afterwards.
Which begs the question: is an off-duty lifeguard who dives into a river to save a drowning man held to a higher standard of care compared to a non-lifeguard?
(And remember rule number nine - always carry a knife.)
hihi! New blog?
"Many of us entered medical school with hopes of making a difference...", "also lots of responsibility"- I fully agree with these sentiments. Ultimately, I think it is a personal decision. A MD is not obliged to help a random stranger in the street- just like no one HAS to help a stranger being robbed. Based on our own conscience, and abilities. The responsibility unfortunately, is a part of what our professional training entails- as in, the layman will assume that all dcotors should be able to treat a certain condition, but we in the field know that different specialties train drs with different abilities. I would still do what I can to "help" others, until the days comes when the Good Samaritan is wrongly accused and there's more trouble than good. And hopefully I'll be too odl to practice by then!
The correct answer may actually be a little more complicated than that:
http://www.sma.org.sg/sma_news/3301/ethics.pdf
Seems to me if you do not want to help, you'd better make sure no one knows you are nearby.
re: your friend who attended to someone on a flight - if you don't want anyone to know you're an MD, make sure you don't use your title when booking tickets. :)
on a more serious note, i do believe most - if not all - of us will step forward if someone needs our expertise.
while it's true there's little you can do without an iv plug, drugs and monitors, you'll be surprised how much comfort your mere presence will convey, at least until the paramedics arrive a few minutes later.
when in doubt, remember the old adage: DO NO HARM. so as long as you don't try anything too gung ho, you should be okay.
I guess you should help only when you feel comfortable with helping. Don't need to feel pressurized to do something just because you have a degree. I'm sure a few years down the road you'll feel more confident to step out.
On the flip side, I've heard a story about an ortho consultant answering a call on the plane to see a febrile infant. It is hilarious! Think he upgraded to first class and still billed the airlines for his consult. :)
I went through phases of dutifully stepping forward, then avoiding it altogether.... and then back to my current position of just coming forward and doing what can be done. I find that it helps by making it clear what your level of proficiency is. I mean, if you haven't put in a chest tube in 20 years, you shouldn't pretend to be an expert.
I have never billed the airline, nor been upgraded...but SQ does occasionally give vouchers for use on their duty free, and once I received a nice bottle of champagne. When we do step forward, it's never for the reward, but it is nice to be appreciated.
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