He waited for the coughing to stop so that he could start talking again.
“I never smoked, but this damn cough makes me feel like I could have.” My patient’s laugh drifted into a staccato of hack and ended with a stridor.
I looked at his chart. A “head-load” worker, he had suffered from a recent stroke, with partial recovery, status post-COVID, aspiration pneumonia. A “head-load” worker is one of those million strong nameless laborers who do back-breaking work, carrying a load on his head at the construction worksite. Working on a daily-wage basis, they keep the Indian urban infrastructure development on track.
“I missed the world-cup final on TV, I was in the ICU that night,” he coughed again.
“Me too. On duty,” I smiled.
“Love football [soccer]?”
“Like crazy”
“You doctors are like referees: when you blow the whistle, we know the time has come — just wish it wasn’t a red card,” he smiled.
He reminded me of my school team coach: “You should be able to use both of your two feet, right or left, with equal dexterity and shoot within a 15-degree tight-arc every time if you want to score a goal,” my coach used to say. “Remember, 2-feet and 15-degrees.”
Suddenly it occurred to me that the distance between me and this patient is small, just about 2 feet, as I stand by his bedside. He is recumbent at 45 degrees, I am perpendicular. Added up, we have 2 feet and 15 degrees of separation between us.
Our vastly different worlds, mine dominated by consultations, appointments, referrals, and case-notes, his with heavy bricks on his head, both lovers of football, are separated by 2 feet and 15 degrees.
The distance between the patient and the doctor, the green tunic and the white coat.
At 20 cm per second top speed in large human veins, the speed of human blood flow is way faster than a Bugatti Veyron’s top speed of 402 km per hour. The traffic in our arterial system is heavier than the 3,000-mile-long I-90 interstate connecting Seattle to Boston; safely transmitting all the multi-ethnic cells, crimson-red, marble-white, and platelet-pale, at breakneck speed without a crash. But a small breach in the kilometer long, glass-smooth, laminated “endothelium” would make the platelets trip, stumble, fall, and end up in a massive pile up. Anything from a micron-size, barely visible thrombus to a large occlusive clot could result in a stroke, in minutes time.
Rogue, sticky platelets believe in “equal opportunity” and do not distinguish between a green hospital tunic or a white coat. Understanding medical Greek or therapeutic Latin or lack of it, does not change the odds ratio of suffering from a stroke; the sticky platelet does not care if you are dead scared at the sight of injection or brave enough to enter the dark MRI tunnel without blinking.
Like a referee in a football match, the doctor is right at the center of the activity, the closest to the game of life. We blow our whistle at the sign of trouble. Irate patients, angry bystanders, judgmental lawyers, media criticism — we handle it all like the referee of the match.
With no red card. Knowing full well that we too are just 2-feet 15-degrees away from an illness.
Tiny Nair, MD, DM, is the head of the Department of Cardiology at PRS Hospital in Trivandrum, Kerala in India.
Source: MedicalNewsToday.com
