Killing Me Softly...

Spent about two hours in the Changi General Hospital's Accident and Emergency Department's Observation Room when I went over for follow-up treatment last Friday. Immediately on entering the room, I was plonked on an empty bed. There was a patient on my left (Bed 7) and an empty bed on my right (Bed 5). No prizes for correctly guessing for my bed number.

Beds 1, 2 and 3 were empty while on Bed 4 lay this Malay guy who was conscious but hooked to various monitors. He's perhaps in his 30s or 40s and if anything, I'd suspect withdrawal symptoms rather than any real medical emergency. But what would I know.

Bed 7 on my left lay a sleeping guy, possibly a national serviceman, wrapped up in his blanket. I was not sure if he's malingering but I was beyond caring now. I had problems of my own to worry about. Bed 8 seemed to be occupied but the patient was blocked by the mass on 7. Bed 9 was empty. Bed 10 lay this Chinese man who looks like he's from China but I might be wrong. Beds 11 and 12 were empty.

I was waiting for my turn to get my CT Scan done. Right after I was made to lie in the bed, my blood pressure was taken and the nurses manning the OR counter began talking about the age of their new patient and his condition. Yak yak yak...

The nurses woke Patient 7 not long after I was settled in and asked if he could manage to go home by himself. I guessed that was the beginning of the long weekend and the hell he couldn't! So, off he went. I saw the gaunt patient on Bed 8. Bed 10 went up for his scan and I waited my turn, when the machine became available.

Before long, Bed 10 seemed to come back down while I fidgeted, went to the loo, was made to sit on a wheelchair, wait in the wheelchair, wheeled up to Radiology, and got my scan done.

Act 1 was complete when the CT machine fired the last x-rays through my skull and possibly semi-cooking my brains. I was wheeled back to the OR and made to get back on my bed.

* * *

"You must drink water. See, ask you to drink water, you don't want to drink? Today you're back in here again." So goes the son to his father, the patient on Bed 8.

"Yesteday, we came here and you were vomiting. They wanted to put you on the drip and you don't want.

"What can we do now? No point telling me that they use such a big (gauged needle) one on your now, right? Yesterday, if you take, you won't need such a big one.

"You need to drink water. How can you not drink water? Yesterday, when the doctors let you go home, you were told to drink lots of water. But you say the water makes you vomit. Now doctor X cannot do anything for you. God can't do anything for you either.

"Don't worry about anything at home. Everything will be fine. The home will still be there when you go home. You should just stay in here and start drinking water.

"You cannot go home now. See? Even God doesn't want to take you yet. So, how?..."

Apart from some occasional low groans and some raspy, unintelligible sounds, the son persisted on his soliloquy. There was resignation, not anger.

"See? I already take leave today. I got no choice since I have to bring you here. Tomorrow? Tomorrow is Saturday. I don't have to work. And today I take leave to bring you here..."

The battle of making dad drink water was amazing. While I tried to resist turning over to take a look, when sonny left, I sneaked a peek. Old man seemed to be burning. His face is flush reddish purple and his lips were dry and chapped. His eyes were listless as he stared out into the clinically white lighted room, his mouth gaping like a beached goldfish gasping for air.

* * *

"Oh, Mr So-so. I'm your doctor. I've just seen your radiology report. I think you have got a mini-stroke. You know, a TIA..."

Man, I know a TIA. It's short for transient ischaemic attack. I just watched it for the third time on Royal Pains the night before. Oh shit, what if I had a TIA from the car accident...

The patient on Bed 10 must be pretty taken aback. Stroke? How is that possible? He looked perfectly normal. Normal weight range, normal everything.

"Mr So-so, TIA is like a stroke. You see your films? There is this dark region. The blood flow to the area is affected."

I could almost see myself spouting these lines. Man, when I go to the US for studies, I'm going to audition for a role in some medical drama. I could play the role of a plastic surgeon who gets a patient who wants a pair of 38H and midway into the headlights enhancement operation, she had a TIA, wakes up after emergency rescue and decides that, for the sake of her fragile life, she wants a pair of 42L instead. The patient's name? Miss Giant Parts Greenberg. ;)

"We don't know if there is permanent damage. No. You cannot go home. You must stay in the hospital and we need to treat you. We will find out the extent of the blockage and see if you have any permanent damage here.

Such words were not exactly the most comforting to me, since I'm also waiting for the CT scan results.

Doctor turned to Patient 10's wife and asked, "Do you know if he complained of any weaknesses on one side of his body...?"

A poignant Miss Saigon moment descends. I feel walls in my heart closing in, I can't breathe, I can't win...

* * *

I had quite enough by then. Between the time I was sent for the scan and my return, which was less than 15 minutes, the OR room dynamics had changed. There was now a Patient 5 on my right now and he was offered lunch. That junior category senior even asked to see the lunch menu. He really thinks that when the ambulance crew euphemistically call hospitals hotels, they are thus hotels? Crazy.

Patient 1 was an old man/woman - honestly, when you are old and shrivelled up, no one can tell your sex any more - and s/he was sleeping. Or maybe unconscious. S/he is awaiting admission.

Bed 2 was occupied by a huge Indian lady who was to be admitted. When the enrolled nurses asked her to sit up, they asked her, "Can you sit up?" and then asked if the bed, which was supposed to wheel her to her ward, could support her weight. Somehow, after watching Nurse Jackie, I feel strangely comforted.

On Bed 3 was a Malay old man who wanted to be given his painkillers, forget about any treatment and scoot home soonest possible. He looked like he wished to be home, never mind should anything happen to him. I doubt he was of dischargable patient calibre but to subject a senior category senior citizen to more treatment seemed brutal. And what do I know? I'm just an aspiring medical drama quack.

Patient 4 was more sober by then. Maybe they injected a little something into him? I was not sure. By then, I was already pretty much killed inside by the flurry of bad news and the negative vibes.

"Can I leave this place?" I asked the nurses. "I wanna get lunch."

"Do you have relatives with you?"

"No, I came alone. Oh, never mind. How long will this take?"

"About 1 hour."

"1 hour? I can wait. It's just another 15 minutes."

In an environment where it's bad news galore - the sign at the OR entrance
read, "Due to high occupancy, you will only be allocated your bed in the wards when it becomes available," or something to that effect - find an excuse and get out before your heart gives out when your news come.

Still, high occupancy rates in "Cannot Go Home" Hospital? Amazing. Singaporeans must be damned desperate to go there.

As I waited, there was a fresh commotion in the nurses area about how they intend to complain about a staff nurse or doctor who passed disparaging remarks about the hospital. Apparently, the fellow said something like, "No wonder people say Changi is a bad hospital. If I had a family member who was ill and needed to go to the hospital, I wouldn't even send them (sic!)here." And to make matters worse, this utterance was made in front of the public. Apparently, the OR nightingales are going to launch a joint attack on the hawk by claiming that he was out of line, unprofessional and whatever.

Ah, at least some bitching near my comfort levels. I don't know what transpired but the nightingales seemed perturbed enough to say words to the effect that Changi is a great hospital and if any of their loved ones fall sick, they would have no qualms to send them here because of the high levels of care. Oddly, I feel a little more confident, even if Changi is not even on my shortlist for anything.

* * *

1.15 pm. The wait was getting unbearable. The OR was not exactly changing much in terms of patient numbers but there was clearly a need to get rid of bed hoggers. My case came up for review at the counter. A re-triage of sorts.

"This patient looks all right."

"Yah, 29 years old..." - goddammit, there is ABSOLUTELY no one who's 29 in the OR! I'm the youngest and I'm way past 30! - "and the signs are stable. Blood pressure ok."

"Ok, let me call Radiology."

29 years old? Ha! I was 29 once. But how could they work out my age to be 29 when that was half a decade ago?

"Hello, Radiology? A&E OR ah. Can I discharge this patient? We need the beds."

The next thing, I was told I could leave the observation room.

At that moment, I knew there was nothing very serious. But honestly, the lack of privacy in the OR and the deluge of bad news bombarding the patients in the room can rapidly cause anyone to slip into a transient depression. The what-ifs can really be heart stopping and mind blowing.

I quickly bundled out of the OR and went back to the waiting area, where the doctor walked out of his consultation room and asked for another 2 hours to clear my case as the senior enough radiologist wasn't available to countersign on my CT report and a verbal ok from Radiology and from only one radiologist wasn't good enough to get me discharged as an emergency case.

Still, being able to get out of the A&E for a quick lunch and some shopping to remove the negative thoughts and vibes that plague the free mind - despite the giddiness from the mild concussion - can be a little uplifting.