Thursday, May 20, 2010

My Lethal Injections

It was another travel clinic day when the young traveler to Chad and Niger walked in the clinic with his father to get his vaccines before his trip. I took a brief history and decided on the vaccines he'll need.
One of the vaccines was a yellow fever vaccine. Yellow fever is a nasty infection, and getting the vaccine is a good way to prevent it. Those who receive it have a 1 in 100,000 risk of getting a severe reaction that can be life-threatening.

I told the kid about it, he and his father agreed to the vaccine. I looked at all the shots that we were going to give him , "Typhoid, hepatitis A, yellow fever.... we are going to torture you tonight"... he3 he3 he3

The father laughed and the kid nervously smiled. I handled the chart to my assistant to prepare the vaccines and went to review another chart.

Less than five minutes later, I saw her rushing out of the clinic, "I need you right now"

I saw the kid laying on the bed, his body leaning against the wall, not moving. His father almost passed out, and my heart almost stopped beating too.

During residency I did calls where hearts stop and lungs fill with fluid and old people fall on their heads and blood pours out from every hole in the body, but that was expected. Drama is the rule in every night call at a hospital. I even used to get surprised if every thing went alright.

But this was different. Thursdays are our travel clinic days. These are light days with healthy people walking in to get protection against illnesses they might get during their travel, and now I have this: a young healthy kid passing out in front of his father.

In a few minutes he became fully awake and talking. This was just another vaso-vagal syncope, where people pass put because of extreme anxiety. Some people pass out after they see blood, get needles, see dead people, whatever scares the shit out of them. So in this case it wasn't the vaccine, it was the needle. If we had injected him with water he would've also passed out.

But at the moment the teenage kid passed out, the only thing that occurred to me was him getting an anaphylactic life-threatening reaction to the vaccine. It always sucks when you get the one in one hundred thousandth complication (although on the good side, you'd feel more comfortable administering the next 99,999 vaccines)

What would have sucked more is my super confidence, even telling the kid "we are going to torture you" before we literally tortured him. That would have made it to the papers. "Dr. Death: Middle Eastern immigrant tells a minor he'll torture him before he tortures him with needles in front of his father", or "Dr. Kevorkian condemns Dr. Masannat"

Doctors are sometimes overconfident, especially if they're about to do something they've done several times before. I have given this vaccine and many others hundreds of times, never saw a single reaction. If your doctor tells you you might die from a vaccine there's a very good chance you will not take it even if it's good for you. The boy's risk of dying from that vaccine was way less than flying to, driving and staying in Chad and Niger for a few days. If someone tells you before you drive you might die driving you will think twice about it. At times that confidence is necessary, while at other times it's risky. Even rational people don't want to hear about all the risks and benefits of any drug or procedure they're having. "Just do what you think is right" is what a lot of people feel, surprisingly enough.

As the teenage boy left the clinic, smiling (thank God!), his father explained , "Uhm yeah I forgot to tell you that he passes out every time he gets an injection". LOL, thank you for the information man!!


Shaheen said...

while reading I was confused and read "passed out" as "passed away" sert a7ki Dr.Hareega 6l3 askham min Dr.horani tb3 il techno il cut el shsmo.

y36ek al3afyh Dr ma gasrat, the last thing we need now is another name name added to the long Jordanian terrorists list :p

Dr.Texas, Dr.Blwoi, Dr.Horani & Dr.3ash all of them made big news in the west.

god be with you, good luck

jaraad said...

That was scary. Alhamdulilah, the kid was fine. You should have punched the father.
"Dr. Kevorkian condemns Dr. Masannat"
This was really very, very funny.

Rand said...

The confidence in Jordan has reached other levels, now doctors can diagnose the case and write a prescription without even seeing the patient, e7na ettawwarna w entw lessatkw betjeebw el mareed la 3ndkom, I'm skinny and I went to see a doctor once and he literally was yelling at me because he thought I starve myself to look like models :( I was so shocked and got out of the clinic teary-eyed. I was already tired and really sick so the last thing I needed was a doctor yelling at me!
Your case is just tip of the iceberg.

lubna said...

I guess he tortured you more that day ;)

Hareega said...

Shaeen, I know, Jordanian doctors now come with a bad sterotype!

Jaraad, the father was super nice, but yeah I preferred if he'd told me earlier about the needle fear!

Rand, yes doctors in Jordan like to lecture people about anything instead of consulting them.

Lubna, I know, a lot of torture going on that day