Right Diagnosis

Right Diagnosis

I remember my first call as a resident vividly. The reason I do is because of this particular incident that occurred that day.

A patient was brought in a private car to the front of accident and emergency and while the resident I was piloting with was busy, he asked me to attend to the patient outside.

I got there and at first glance, the man didn’t look good. He was seated at the back of the car, stiff, he was clearly unconscious.

But I did not watch for breathing movements, I did not inspect his pupils, I did not palpate his pulses, neither did I listen to the heart sounds. The only thing I did was apply sternal pressure and when he did not respond in any way, I made my diagnosis, this man was deeply comatose.

I marched back to the older resident and told him that the patient was in bad shape with a GCS of 3/15.

Minutes later, after a series of events, it became obvious that the man was brought in dead. The man who I saw seated in the back of the car was actually dead.

I became mad with myself. “You cannot even diagnose death? Your case is a serious one!”

My overthinking self thought about that incident throughout the call duration and replayed all the things I should have done that would have enabled me arrive at the right diagnosis that I didn’t do.

Why did I remember this incident? During my last call, we had a patient brought in dead, which is an unusual occurrence in O&G. Women often come in bad shape mostly due to massive blood loss or multiple convulsions but rarely do they come in dead, at least in my experience.

And as I walked the house officer through the steps to certify the patient, I remembered my own goof several years ago and decided to share with you. Laugh with care, because I’ve learnt from that blunder.

My total lack of experience and anxiety may have contributed to that gaffe, but I hurried to make an assessment of the patient because I went out there expecting to attend to a living patient seeking care at the hospital, and my mind wasn’t open enough to consider other possibilities.

When you approach any situation with a closed mind, you are not likely to ask the right questions or do the right things, that will enable you arrive at the right conclusion.

In order words, just like it takes an open mind to arrive at the right conclusions, it takes an open mind to arrive at the right diagnosis.

Talk soon,

ajidara

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