For the last few months, I have been busy. The wards were full with patients. It was a Dengue season. There were so many dengue cases. Thank god, so far we have been doing very well and no mortality among our paediatric patients. However, we did get other cases as well which was related to infections such as lung infections, meningitis, URTI, and others. I want to share a story about one of my patient's parents. Of course, my job is to make my patient well without residual morbidity if possible. Deliver the best treatment that I can give based on the current development in medicine. My priority is the child whom I treated. On top of treating my patients, I will tell the parents of the child about the disease of their child and the treatment. My specialists will give the family of the child health education as well on the disease itself. I guess health education is far more important because it play an important role in prevention of a disease. Like many people say "prevention is better than cure". I absolutely agree with this phrase. Last week, middle of the night, 3 months old child was admitted to my ward presented with fever for 4 days and irritability. The child was seen by my senior MO who was on-call and a diagnosis of meningitis was made. She started the child on the treatment of meningitis. The next morning was Tuesday. As usual Tuesday is the day that I will do my grand round and teaching round with my doctors and medical students. I went to the child's bed. Both parents were there. I introduced myself to the parents and asked my HO to present the case to me. The presentation was good and clear. However. I noticed that the child was sleeping in a strange posture. I asked my HO whether lumbar puncture (ambil air tulang belakang - in malay word) was done or not. My HO said that the parents refused to give consent for the procedure and only that morning they agreeable after one of the consultant talked to them. I touched the child and turn her to supine position. To my supprise, I noted that the child's face was asymmetrical, deviated to the left. She was unable to close the right eye. She also had unequal pupils. One sided of the body was stiff. I think I don't have to tell the detail of the examination because many of you will not understand. I suspected that the child had more neurological problems. I asked my doctor to defer the lumbar puncture but instead to get an urgent CT brain. Our plan of management and suspicion was very well explained to the parents. Both parents are educated people and graduates. They appeared understood with the problem. My doctor managed to get an urgent CT brain that morning itself. However to my surprise, the CT result was reported as normal. I was in the meeting when I got the message. I was not happy because the clinical presentation did not correlate well with the CT findings. After the meeting. I looked at the CT brain myself and I felt the CT was not normal. The next day, we managed to get another radiologist to report the CT and true enough, it was not normal. I asked my consultant to explain to the parents the findings of the CT brain and told them the management that we were going to give to the child. The parents were not happy. They felt the child was being posses by spirit and wanted "AOR" at own risk discharge. My doctors were not happy. Once again my specialist explained to the parents. They insisted to go for the traditional treatment. As a doctor, our concern is the child. We tried to convinced them to stay in the ward so that we could continued the antibiotic. They agreeable to stay after so many discussion and explanation. We practically begging them to stay. Sometimes I asked myself, why do I have to do this and take the trouble to persuade them to stay. If I let them go, I will have one empty bed. Easy life for my doctors and nurses. I will be very happy if I have less patients to see. If the parents clever enough, they should be able to think rationally, for the sake of their child. Despite being educated and well informed, they just couldn't care less about the child. The whole family members think that the child was under the control of an evil spirit. They agreed to stay but refused any treatment from us. No blood taking and no setting lines. Scolded my nurses for no apparent reasons. The next morning, I talked again to the grandmother but failed to convince them to stay. Therefore, I allowed them to go home. No matter how you try, the baby still theirs. You as a doctor, can only do up to a certain limit. The rest, we leave it to the family and God. I can assure you that there are many more parents like this everyday that we have to deal with. Sometimes we given up on them. We pity the child. Occasionally some of them do come back to us in a bad state after taking "AOR" discharge. At that time you feel that you want to kill the parents...???..!!! frustrated.
Please, don't be like this parents. Think about your child's health. If you don't understand what's going on, ask again and again. We have to progress and not regress in our way of life.
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