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Archive for the month “November, 2013”

The ten golden rules in rescuing the (medically) troubled

ten golden rules

Situations in which medical care or advice should be provided vary considerably as regard place, time and the extent of the medical problem, i.e. patient’s state as regard consciousness, cooperation, presence of patient’s relatives, etc.

Here are 10 rules that I wish to conclude from my experience in the clinical field.

1- The sense of being attended: the health care provider should stress and make sure that the patient perceives that a good medical care is being present. This would be achieved by speaking gently and confidently with the patient and/ or with the relatives. The doctor may state clearly that he/ she would have no problem to see the patient for free when the patient’s condition money-wise is not favorable. The doctor should be cautious as much as possible to protect the patient from possible negligence by his/ her relatives.  In case of a patient with perturbed consciousness the doctor would call the patient by his/ her name (if known) and hold the patient hand warmly.

2- Resort and handing: the doctor would have preliminary assessment of the medical problem, and recalls his/ her knowledge and may need to find some source as a book or contact a colleague for consultation. The doctor may have to urge for a referral to a more experienced doctor.

3- Fulfilling continuum: the doctor may inspire that human body is one continuum with dynamically operating modes and proportionately distributed components. This should be very useful in determining the dose, rate, and intervals of the medicines to be used.

4- Hierarchical approach: the management plan should be almost clear from the beginning. The management should assume a hierarchical concept as regard the relevance of interventions/medicines to one another from one side and to the human body function from the other side. It should start from natural means to encourage the self-curing power in the patient, e.g. warming the patient, changing posture, etc., and proceeding from a less invasive to more invasive.

5- Multi-footed treatment: this means that using more than one point or target in the treatment, if allowable, would help reach a more smooth response with less likelihood of misfortune. This integrated approach would allow less and more tolerable medicine doses.

6- Proof tracking:  this means that on following certain treatment the doctor keeps an open eye checking back and forth for the consistency and appropriateness of a given step in the management for a possible need to change the treatment plan.

7- Case cliché: by the time the medical condition is being resolved the doctor should formulate a clear definition of the case (diagnosis) and inform the patient or the relative(s), orally and/ or in writing.

8- A Gift-outcome-art: this means that the outcome of the medical care is quite unforeseeable. Here, the outcome is usually expressed as percentages or probabilities and not as a definitely individualized result.

9- Non obligation: the medical care should not bear any obligation from both patient’s and doctor’s side.

10- Medical ethics: the doctor should be aware of and fulfilling the medical ethics applicable to the particular medical problem being managed.

A first lesson in love

a first lesson in love
The smart and noble looking teenager, though still in his 14th year, looks much adult in both his stature and way of thinking. He feels much responsible and takes on his academic career as a matter of life or death. Intelligent and unchallengeable goes the compulsive super pupil from a year to the next in the prep school. The life conqueror is getting by time more confident that he deserves a better life, in terms of financial and social aspects, than the modest one he used to have. And therefore, he holds firmly on a self-imposed oath to be straight and to obtain high degrees and honors. On the way for his goal, he listened carefully to the moral and ethical constants in his community which he saw almost reasonable and natural.

Among the trivialities that the growing idealist has to overlook is the ever increasing behavior of needless talks and claiming love among school boys and girls. According to the way he was brought up, he saw such things ethically unacceptable and childish or shameful. “Those pupils cannot be serious, because it is too early to think about love”, he thought, “This heavenly demand should be sought in a community-approved way and by people warranted to bear such a responsibility”. It was, thus on this conservative background, quite manageable for a faithful and ambitious young man to contain such nascent instincts of this age period.

While studying his lesson on the roof of the house at the midday came to him the daughter of a good neighbor of his. The girl gave him a small piece of paper in which she wrote by a pencil the famous statement of announcing love and appreciation: I love you. The little girl, while giving the note, stared seriously at him and never spoke any word. The girl was so little that he perceived her initiative quite neutrally. He could already find her big excuse as he saw himself as a true idol; “still so young for such commitment rather.”

The actively studying pupil was impressed by the character that very keenly imposes herself and writes her first words of love, if not her first written words ever. Yet, he did not get how serious the little might have been. Even he could not think that such a little first-year primary school girl may have the insight and the readiness to think of what love would mean. He answered her silently with a very brotherly smile. In that time it was too early for him to consider seriously such a socially stressed issue such as love or marriage. He went on studying his lessons, getting a bit closer to his goal of brilliance and meanwhile overcoming his ordinary personal and social obstacles.

A few years later, while he was to finish his university degree, he learnt that the daughter of his former good neighbor has entered the same prestigious faculty as that he has just finished. Of course, her good news cheered him, while as an idealistic and sensitive newcomer he was struggling in the beginning of his practical life. As time passed and he got a bit more mature, the life conqueror thinks it was his first lesson in love that had been given by the daughter of his good neighbor, the 6 years little girl at that time.

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