Tuesday, October 19, 2010

Dear Doctors – Are we guaranteed enough to be saved in our own grave??

We, Muslims believed that everything that we did during our lifetime will be questioned back, the moment we have been put in our own grave. All these while, it involves good deeds and of course the negative sides of our own mistakes that we have done.

In fact, we will receive punishment in our grave prior to the “judgement day” in which life in the hereafter.

Do bear in mind that all the things that we did will either help us or punish us. I don’t think I need to explain more regarding the duty on how to perform prayers, fasting, paying zakah as well as performing haj. These can be referred directly to our pillars and all Muslims will say that they knew about it.

Moving on to the next agenda on the matter of our duty as doctors? Well, let’s talk about what we did all these while. Believe it or not, we will definitely be asked in our grave and yet, Islam has always being the way of life as it practices equal judgement. Hence, I would like to highlight once again about what we do in our lifetime will be asked in later life.

The medications that we gave to our patients, various investigations that have been carried out and others will be taken into account. Thus, this is for sure that we will be asked either it has been justified or not.

So, let’s ask ourselves, “Have we caused harm to our patients?, Do we really care and allow our patient with peritonitis to just lay down on bed at 2am and plan to do laparotomy at 8am?, Can we say that all emergencies CT with contrast need a renal profile and let them wait?. Did we fight for our patient's right or simply keep our mouth shut letting things be?

Can we answer all these questions comfortably in our grave? Perhaps, almost all of us will say a big NO. All of us must have done something during our career timeline thus that will lead us to answer it as such. I would say that nobody’s perfect in this world and we all did mistakes. But then, mistakes can be very subjective based on different views of people. It can always be intentionally or unintentionally.
In this blog entry, let us focus on the “Big Intentional Mistakes”. Big Intentional mistakes may be seen and overlooked by some of us as it is small and perhaps some may be saying that it is not a mistake at all.

An example of this big intentional mistake will be a surgeon who is preaching everyone during lectures, seminars, and conferences regarding an urgent exploratory laparotomy in an unstable intra-peritoneal bleed. Surprisingly, in his own department, it has not been done. Patients will undergo CT Abdomen to rule out other things. When they have been asked whether this “other things” can change the management or not, they will keep their mouth shut. As a matter of fact, even a surgeon in training will answer in his examination that an urgent laparotomy is needed in an unstable intra-peritoneal bleeding. But then, in real life, he would waste valuable time ordering repeating ultrasound and CT abdomen prior to the procedure. This kind of person has no insight in answering and supporting his statement yet this is the person among some people who might have hard time in their grave answering all these questions.

But, do think twice. We are “The Doctors”, the one with high ethical value. We have been taught and trained well. I personally can’t remember the exact number of various ethics’ lectures that I’ve attended. But then, think again…. I’m not talking about coming late to work. I’m talking about the simple life saving procedure and simple way to ease patient’s burden.

So, here are some questions to be pondered about:

Why each time during examination, you answer exploratory laparotomy, but in practice you delay the definitive treatment with investigations…?
Patient with meningeal signs: Why for patient A you will do CT with contrast urgently but for patient B you let him wait for hours wanting to see the renal profile first?
So, What is our answer?. Are we guaranteed enough to be saved in our grave?

Perhaps, let us start correcting these “Big intentional mistakes” and then start focusing on the small ones.