Health Puzzles

image courtesy of robincooperresearch.com

I don’t know if it’s just me, but in my limited practice I often see patients, or sometimes it’s the relatives, that tend to either try to tone down the ailment or exaggerate it out of proportion.

Illustrative example 1

At the ER of a government hospital:

Doctor: Ilang araw na po ba nilalagnat ang anak nyo?
(How many days has your child been having fever?)

Mother: Dalawang linggo pa lang naman po.
(It’s just for two weeks now)

Needless to say, we admitted that patient right away. He later turned out to be a case of bacterial meningitis. A simple outpatient consult and the danger signs of neck rigidity, poor suck and other clinical clues could probably have been picked up earlier and appropriate interventions done. Why they waited for two weeks to consult a healthcare facility is beyond me.

If I remember right, we were always reminded during our residency training that anyone coming in at the Emergency Room at the unholy hours of the night and early morning must surely be feeling that it is a personal emergency for them, imagined or otherwise, for they will not go to the ER for no reason at all. There is an intrinsic truth in this lesson that we have been taught, but then there will always be exemptions and sometimes we could only scratch our heads and wonder, as the following case would show:

Illustrative example 2:

At the ER of a private hospital, a little after 4 in the morning…

Doctor: Ano po ba ang problema sir?
(What seems to be the problem sir?)

Patient: Constipated kasi ako, wala akong bowel movement.
(I’m constipated, don’t have bowel movements)

Doctor: Kailan pa po ba ninyo nararamdaman ito?
(And when have you started to experience this sir?)

Patient: Mula lang po kaninang hating gabi.
(Just since midnight, sir)

Further history taking would reveal that he had regular bowel movements, in the morning. He just had one the day before. It just so happened that when he woke up at past midnight he thought he was constipated, hence the ER visit.

And here’s the clincher, he wants it to be covered by his medical insurance. Sayang naman daw dahil hindi naman nila nagagagamit (It’s because we haven’t been able to use the medical insurance) And he was also wondering if he could be given a medical certificate that he went to the ER as he was probably not going to make it to work. Go figure.

Such is the inequity and inequality of healthcare in the country. And Here’s hoping that in time, I can contribute and be part of the solution rather than the problem.