2 more hours..

Two more hours...and counting down. Gulp!
Finished the rounds about an half an hour ago. Nearly lost my cool with a patient from Sarawak. She is an Iban lady who is so emaciated! She has been in and out of the hospital for the past 2 years or so; each time coming in with low blood count.

And this time, the story is the same. She is in again for low hemoglobin count. The point is, we highly suspect that she has tuberculosis but since late 2004 she has persistently refused any kind of investigative procedures done on her! Each time she came in, she was transfused some blood and she will ask to be discharged. Meanwhile her weight has plummeted to 32kg from 48 kg a year ago.

This time, she is still just as stubborn. Her chest Xray shows progressive damage. Her chinese husband (who wears a blue tooth head phone, wears very expensive clothes and shoes) is equally recalcitrant. It was like talking to a brick wall (in this case, TWO brick walls!). All of us took turn to talk, persuade, threaten....blah blah, u know, the good cop bad cop part but to no avail.

Finally we decided to start her on anti-TB. I just hope we are hitting the right target (since all we have is just suspicion, albeit a very good one) and more so, I hope that her already frail body will be able to withstand the after effects of the treatment (some patients do worst for a while after starting therapy) and if she survives that, I hope she will not be so stubborn as not to complete the 6-9 months therapy! Sigh! Thinking about it just sickens me.

Thinking about my presentation later sickens me even more. I have a farm of fully grown butterflies in my tummy.