Once in a blue moon a Cambodian doctor will be exceptionally nice or supportive to me.
At the border hospital this week I was asked to see the Pelvic X-ray of a child who had been involved in a moto accident. The pubic rami looked a bit fuzzy on one side, but as there was no left or right marker on the X-ray I couldn't tell you which. I asked if I could see the patient to see if I could match the X-ray to any symptoms she had.
I found her squatting outside the surgery ward where she leapt up from & walked over to us when the Hospital director beckoned her. No limp, not in any pain, fully weight bearing with a full range of movement in both hips. She is fine I pronounced confidently.
Her father - obviously wealthy & connected - insisted she needed a CT scan of her head also.
Was she knocked unconscious?
Had she had a seizure?
Had she vomited more than once?
Did she have double vision?
Any weakness?
Fluid leaking from her ears or nose?
Was she confused?
No to all of the above.
Well then perhaps, I suggested, a CT head was not clinically indicated & would increase her risk of cancer with absolutely no benefit to her. After a long pause I added - and it is a waste of money.
The father acquiesced on the CT head, I am sure the money argument won him over, but he then turned to the Director & said that the X-ray technician had told him her hip was fractured & that I was wrong.
Without waiting for my translator to convey what the father had just said, the hospital director told the father that as I was a highly qualified & experienced doctor from the UK who could read & diagnose X-rays better than any of the staff in his hospital, maybe I actually did know what I was talking about & he should respect my opinion.
As I said at the start, once in a blue moon someone will throw me a little bone.
At the border hospital this week I was asked to see the Pelvic X-ray of a child who had been involved in a moto accident. The pubic rami looked a bit fuzzy on one side, but as there was no left or right marker on the X-ray I couldn't tell you which. I asked if I could see the patient to see if I could match the X-ray to any symptoms she had.
I found her squatting outside the surgery ward where she leapt up from & walked over to us when the Hospital director beckoned her. No limp, not in any pain, fully weight bearing with a full range of movement in both hips. She is fine I pronounced confidently.
Her father - obviously wealthy & connected - insisted she needed a CT scan of her head also.
Was she knocked unconscious?
Had she had a seizure?
Had she vomited more than once?
Did she have double vision?
Any weakness?
Fluid leaking from her ears or nose?
Was she confused?
No to all of the above.
Well then perhaps, I suggested, a CT head was not clinically indicated & would increase her risk of cancer with absolutely no benefit to her. After a long pause I added - and it is a waste of money.
The father acquiesced on the CT head, I am sure the money argument won him over, but he then turned to the Director & said that the X-ray technician had told him her hip was fractured & that I was wrong.
Without waiting for my translator to convey what the father had just said, the hospital director told the father that as I was a highly qualified & experienced doctor from the UK who could read & diagnose X-rays better than any of the staff in his hospital, maybe I actually did know what I was talking about & he should respect my opinion.
As I said at the start, once in a blue moon someone will throw me a little bone.
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