The gargantuan spectrum of disease makes me wonder how am I, a single doctor, to know about all the possible afflictions for a population of 135,000 that we serve, including the outlying areas, that is. How am I supposed to train our local medical assistant to recognise the myriad of maladies? Last week I had a 5-year-old boy presented to me with his left eye ball protruding from his skull and very, very ill. I referred him urgently and later found out that he had died from a tumour- Neuroblastoma. His adolescence lost.
This week I had a classic case of Acute Pulmonary Oedema (water in the lungs I guess makes good translation). It constitutes a Medical Emergency. I get the history from the 80-year-old Shahib’s son, do an examination and when he confirms my suspicion by coughing pink frothy sputum into the makeshift handkerchief, I spin into action as the diagnosis is now textbook. The medical assistants inform me the next day that they have never heard of pulmonary oedema or water in the lungs! Alas… how many other Shahibs got an antibiotic instead; at least now he had peed himself dry of all water that hunted gravity and can breathe again, and today even faked a smile for me - and at least our medical assistant can try to make a good diagnosis next time. Both cases clearly demonstrate that I only know some conditions, I read every day to learn more, but I will never know everything in medicine (probably its most attractive quality) and here we expect the these medical assistants, 50% of whom are Shahibs themselves, to save lives. Incredible that we do at all. Odds are against us constantly.