Saturday, March 31, 2007
Friday, March 30, 2007
Tuesday, March 27, 2007
without any obligation
change the station?
When they blew my house
soiled my room with their feces
turned my brother into pieces
I aksed for help
and you changed the station
When my mother was taken
her dignity, forsaken
without any explanation
I asked for help
and you, sir, changed the station
When they told me I should not resist
that there's no reason for me to exist
I turned to you, sir, for a hand or a tear
or a word to quench my fear
but you, again, changed the station
I can see you sir
in five years, maybe ten,
holding a baby with an amputated leg
dragging your crippled mother with her broken neck
and when you'll look at the camera in the eye
thinking of the lens as your only salvation
you'll know how brutal it was
to just change the station
Sunday, March 25, 2007
The patient arrived to the hospital. I went to talk to him
"So you keep falling"
"Yes, I've been falling for more than a year"
"Any idea why?"
"Whenever I laugh I get short of breath and suddenly pass out for a few seconds"
"Does it happen at other times?"
"No , just when I laugh"
We ran a few tests on his heart and nothing showed up. I went again to this 56 year-old guy
"Your heart seems to be working very well"
"So what's causing me to pass out?"
"Laughing, whenver you laugh you stimulate some nerves that slows down your heart and make you pass out for a few seconds, it's not serious...you'll wake up"
"So how can I avoid that"
I thought for second.... "Stay away from funny people"
It looked like he thought the answer was funny, and I felt the danger approaching. He opened his mouth and started laughing. His face turned red. I looked at him very seriously in the face and he stopped laughing. I wrote orders to discharge him home, and before I left I checked the board to see who his nurse was. It was Ellis, a nurse whom I have never seen smiling in three years.
Then I thought to myself, "he's in safe hands"
Wednesday, March 21, 2007
Yesterday was one of those crappy busy days and the ER was so packed that patients, laying on beds, were placed in the hallways outside rooms. The patients thrown in the hallway were more than those inside the rooms. .
I was called to admit a lady (I'll call her Dickens) with a hand infection. She had some psychiatric issues (i.e. she was crazy) and she tried to kill herself once so she cut herself and her hand kept getting infected since then. Her dcotor in the clinic thought that she needed to stay in the hospital. He called me at 2 pm to admit her to the hospital. There were no beds and she had to stay in the hospital.
At 5 pm the clinic closed, so they had no option but to send to the emergency room until they find a bed for her in the hospital.
I went to the ER and she was standing in the hallway waiting for someone to place her in a room or a bed or a chair and leave her there, but there was absolutely no palce for her. I asked her to wait in the lobby but there were no places. She did not require urgent treatment and all patients inside the ER were really sick so it was not reasonable to kick them out.
I went to a nurse and asked him, "Can you place Mrs. Dickens somewhere in the ER? "
"Doc it's full as you see, send her to the lobby"
"the lobby's full"
"I dunno doc I dunno I have a patient with a BP of 40 I gotta go, maybe we'll have a place for her in the hallway in half an hour"
I went back to the lady, "Hey Mrs. Dickens do you wanna wait in your car for half an hour then come back here, maybe we'll find a spot for you."
"I don't have a car, I came by bus"
I felt helpless and started to understand why Arizona scored an "F" in the emergency room care grading last year. Every winter we have hundreds of thousands of people called "snow birds" come in from the cold states because winter is beautiful here. Most of them are old so they get sick and come to the hospital.
I looked around and the area OUTSIDE the hospital was even packed with people and their families. Oh my God, where the hell should I send this lady? My patient got very angry and unpleasant and said that she would leave the hospital against medical advice if we don't find a place for her. I couldn't blame her.
It was about 8 pm then, I went to the coffee machine and looked outside and found an empty zone.....
I went back to the ER where she was standing and shaking with rage.
"Hey Mrs. Dickens, I have a suggestion"
She looked at me
Then I paused, and I had one of the biggest internal conflicts in my life. I wasn't sure if I should say it or not, but I found myself suggesting, "Why don't you go out there near the coffee machine, there's a smoking area where you can have a cigarette, take your time and when you come back maybne we'll have a spot for you"
"Sure", she walked oputside and I went back to my computer and started writing orders. She became back two hours later (probably smoked the whole pack) but we had a bed for her.
Before she went upstairs I wanted to feel better.... "You know, smoking is bad for you"
I cleared my conscience completely when I convinced myself that this lady who had four previous suicidal attempts would probably kill herself before smoking kills her.
Also , that day, I realized why they had a smoking area just outside the hospital!
Thursday, March 15, 2007
Dr. Michael Debakey is the most successful doctor in the 20th century.
He is the pioneer in almost every single field in heart surgery. He was the first to design and perform different heroic heart surgeries including open heart surgery and his name is mentioned in many basic medical textbooks.
In 2005, as he turned 97, he had a major vessel disease (aneurysm) and required a heart operation to fix it. He refused to undergo the surgery that he himself had designed because he thought he was at a high risk to have it done. Probably nobody would have it done better than him. He eventually had the surgery done and he survived after a long struggle. He was the oldest person in history to undergo this kind of surgery.
Right now, he is 99 years old and is still practising medicine.
Dr. Debakey's parents, Shakir and Raheejeh, were immigrants from Lebanon.
Ibin Raheejeh became the most accomplished and successful heart surgeon in history.
I am wondering how many "Ibin Raheejeh"s are there waiting to prove themselves but they are not given the chance ?
Sunday, March 11, 2007
Before starting the chemo we had to check a few blood tests. I checked them and they were OK, so I wrote an order to give the chemo to the patient and told the nurse about it. That was just before 7 pm and the nurse shift changes at 7pm, so I told the nurse to pass it on to the next nurse, Layth, who is a very pleasant and hard-working guy with some sense of humor. I wrote the order in the chart to make sure it would be done.
I left the hospital and it was Thursday night, I went home really tired, and at about 10 pm I got a call from Layth the nurse.
Layth, "Dr. Faris regarding Fathiyyeh the lady with the colon cancer, shall we start the chemo tonight??"
I said, "Yes, I checked her labs and they were OK, so start the chemo tonight"
Layth, "So you're saying her labs were OK? Start the chemo?"
"Yes, they were fine, I wrote the order in the chart, it should have already been started..... start the chemo now, start it now"
Layth, "Do you want it to be started tonight or tomorrow?"
"No, tonight, we have to start it tonight, start the chemo tonight, START THE CHEMO TONIGHT"
Layth, "OK, I just wanna tell you that we already have started the chemo at 7 and she is tolerating it well"
"Then why did you call me??"
"Well it's Thursday night and you are probably out with your friends and I thought you'd really feel good if your friends around you heard you screaming on the phone to start the chemo now and yelling on other people"
I got the joke, then hung up and went back to watching, alone, the football game in the second division of the Sudanese league.
Friday, March 09, 2007
I told him "Why are you eating falafel, go have some pizza, it's hot and goood"
He said, "Don't wanna eat pizza, I'm afraid I might like it, and I can't afford it, so I'll miss it then I would feel miserable"
I loved his answer, a man of plenty of wisdom and scarceness of money. If you don't try something you'll never miss it. If you don't get sick you won't know how great it is to be healthy. As my best friend Aerosmith says in his Mo3allaqaat "You got to lose to know how to win".
This could explain why the rich are less happy than the poor; they've got more, and the more they got the more things they are gonna miss as time passes. Being rich is a measure of the things you have that money cannot buy. Those things are very precious and once lost they cannot be replaced.
We have a choice to catch up with the world and sometimes we need to, otherwise the average age of death for any Jordanian would still be 49 years (statistics from 1945) . We're moving forward quickly, we're trying to run as fast as we can to catch up with the pace. Nice, we've got smart and ambitious young generation that can do the job at this point of time.
Our only "oil" according to late King Hussein is the human being and the more educated and skillful a Jordanian is the more likely s/he is willing to leave the country and live abroad, and it doesn't look like it's gonna change soon.
Not a long time ago, most of what Jordanians seeked was some delicious falafel and bread, a bus that can take them to work and the ability to enjoy raising kids and providing them with any kind of education to enable them to grow up in a secure environment.
These days there is true poverty in Jordan that never existed before, real ignorance, amazing levels of primitivism of thinking that were not present at the times people were illiterate and schools were virtually nonexistent, all that on top of a competitive level of corruption that is not spoken about. With all combined I'm only concerned that one day or another we'll stumble and fall and then the falafel will taste bitter instead of sweet and a trip in bus can feel like hell and raising kids will sound like a punishment from God and we will realize then that falafel intoxication was much healthier than a "withdrawal from pizza".
Tuesday, March 06, 2007
Monday, March 05, 2007
Doctor, "We have your results back. I have good news an bad news news. The bad news is that the biopsy shows that you have breast cancer. However the good news is that it is still limited to a small area in the breast. We have two options, one is removing the whole breast and that should take care of it, and the other option which many women prefer is removing only the part of the breast invaded by the cancer and giving you radiation treatment afterwards. There are complications of the radiation treatment that can invlove the skin or the lung underneath and might show up a few months after the treatment, however you will be able to preserve the breast. You can take a few days to think about the options. Meanwhile we need to run some hormonal studies on the biopsy taken to guide us into what treatment options you might require. Chemotherapy is not out of the question and it can cause a few side effects that I am willing to discuss with you however it has been shown to significantly impact your quality of life and survival in ten years. We have rates of resposne as high as 85% in some studies if the hormonal studies come back positive. Here is my number if you need to contact me. After hours call the other number below......"
In Jordan :
الطبيب... والله يا خالتي باين إنو عندكي هظاك المرظ