Some things in life are just a question of time. Like a heart attack.
My gratitude today goes out to Dr Gandhi at Medway Hospital where I completed my Cardiology rotation. He took unusual enjoyment in making the trainee doctors go to a simulation laboratory where a dummy patient (as in: it was made of plastic and wires, dressed in hospital pyjamas) would simulate various medical emergencies. Dr Gandhi’s voice would be coming out through a speaker hidden in the dummy patient’s neck as he observed us through one-way glass in the control room. My colleagues and I tried to see the funny side, but these simulations were singularly stress-inducing experiences!
I managed to “kill” the dummy patient on one occasion when it was having a heart attack with an unusual set of symptoms. No one had apparently managed to kill it before – a dubious achievement for me then…
With that in mind, the moment I arrived in Lamu and saw the levels of high blood pressure, cholesterol and other risk factors for heart attacks in the population here, I decided that no more heart attack patients were going to die on me if I could help it. One dummy patient was enough.
And then today, after a series of all sorts of other eclectic medical problems, the dummy patient walked in to my clinic room! Alright, not the dummy with wires and hospital pyjamas, but the same set of unusual symptoms in a middle aged overweight gentleman – a feeling of indigestion, pain in his chest radiating through to his back and shoulders, a sensation of tightness and pressure across his chest, nausea (different to the acid reflux problems he sometimes had)… and a previous history of cardiac problems and hypertension!
My super Anti-Dummy-Patient-Death plan sprang into action! I had acquired Aspirin exactly for this purpose previously, and gave him a stat dose of 300mg, and got him shipped to the hospital for an ECG and further treatment.
The moment where I had to tell him, in as calm a way as possible, that I believed he was having an “acute coronary event” was a bit dicey, because of course, massive stress isn’t going to help the heart attack situation! So I did it slowly-slowly (“pole-pole” in Swahili) and explained what had happened in his body, and how it was going to be treated. Very calmly.
He took it pretty well actually. It had happened to him before, and he noted that my Aspirin tasted different to the medication he was given last time. Mine was covered in a pink sugary coat, instead of being a dusty dry white pill. The small things matter.
On the way to the hospital, he said thank you and that he would be back tomorrow to speak to me about his haemorrhoids… I am glad we got his problems looked at in the right order!
And I am glad I met the dummy patient before the real one. Thanks again, Dr Gandhi.
