Between Tiger Meat and Inhaler

While I was doing my morning ward work one day, I overheard a visitor talking to the patient's mother:

" I think tiger meat is good for asthma. That what I heard from my friend."

" Yeah? But tiger meat is hard to get. You have to look hard for it, and I heard it is pricey too."

" Otherwise, my grandparents used to serve me crocodile meat when I had asthmatic during childhood. It does cure my asthma. Until now, I never had any attack."

Common cultural practice and medicine is inseparable. As a doctor, you can't stop the patient from practicing what they believe. You can only suggest, but you can't decide for them. Tiger meat, crocodile meat, squirrel meat, termites and even the human placenta are still being use as a treatment modality for bronchial asthma. Do they have a role? Certainly. Do they have efficacy? I am not sure.

Generally, the traditional medicines are cultural bound, passed on from generations to generations and believed to be effective in a way. They are not clinically tested to show their efficacy. The rarer the item, the more therapeutic it become. When does the traditional and modern medicine cross their path? Generally none. We can't force people to take our advice. We can treat a person unless the person want us to treat them. If they take only tiger meat for asthma and be cured of asthma, good for them. It they come in with asthma attack and request for treatment, we will still accepts them the same way.

Everyone has their choice, this I have to constantly remind myself, so not to impose my own value on them.

Doctor, how is my daughter?

"Doctor, how is my father/mother/brother/son/daughter/neighbour's uncle's friends?"

This is the single most asked question I faced during ward rounds and especially visiting hours in the ward. And the most irritating one as well.

If you answer only once to the above question, it's perfectly well. However, when the second visitor come to take shift, they ask the same question again. And then come the third shift again, then they asked again, and again...

Generally, I would predict the worst for the family members. "Oh, your daughter, her condition looks grave. She might need surgery. But everything is 50:50. We can't guarantee her to be 100% perfect after the surgery. She might need Intensive Care support and ventilator after the surgery."

Why would doctors generally do so?

1. We were generally on a VERY TIGHT schedule. I wake up 5.30 am in the morning, reaching the ward by 6.30 am, start working until 7 pm. On on-call days, the working hours will be till the next day, non stop.
   
2. We are generally overworked and underpaid. On top of that, the ministry had slashed 50% of my Cost-of-Living Allowance (RM 100) and 100% of my Housing Allowance (RM 250)for a shared triple room per month. Others get a single room with nice and clean bathroom. Imagine, RM 1050 (350 x 3) for a room that is so horrible?
3. Patient conditions varies by day. No one will remain the same for the same period of time.
   
4. Some family member taking advantage by showing their filial piety by using doctors. Scolding doctors for not doing what they think is doctor's job or not doing fast enough.
5. There is no simple data to what the prognosis is. Everything is calculated based on 50% of the patients with the same illness. And there can be no same patient in this whole wide world.
   

What you can do to help the poor doctor:

1. Please keep your relatives informed about patient's general condition. We will help to bring updates, not to start storytelling one by one.
2. No BS in front of the doctors. We shall know who is the real and who is the fake.
3. Help doctors to help your love one. Let us do more important things to help your important persons in life.

We can't work alone as doctors. We need collaboration from all area. So please help us. Help me.