I’ve been spending my last single-married days gypsying around a small part of this enormous country. It’s wonderful to pick up conversations and see the years of distance, and some of my lingering resentments, melt with time. I’m surprised at the generosity and tenacity of many friendships through enormous changes within my own family life, and equally varied changes in my friends and colleagues as they graduate, switch careers, retire, get engaged, move cities, change churches, and more. It’s also been a new experience for me to actively seek out and spend time with my parents’ friends who supported mum and flew a long distance to be at her funeral last year. I long to tell her about these catch ups but I suppose they’d never have happened if she was still around because she was so social herself.
My travels took me back to work as a locum hospital resident. Whilst clinical work in itself is pretty much the same wherever, the context was completely different. I’ve forgotten how much quicker mainstream consults could happen. History taking can take a quarter of the time, patients often know or have a list of their medications and doses, you can give a script without explaining what to do with it, and people have their own mobile credit to make follow up phone calls.
It was nice to see say, an 18 year old guy, be responsible and organised enough to catch an Uber back to the hospital for a follow up review. There were some lovely older people and I kind of miss geriatric medicine. Some amusing university students too, as they caught glandular fever from each other at college, or came in with dramas post O-week pub crawls and parties. It was refreshing to not come across any injuries secondary to domestic violence, or deal with heavily intoxicated patients, despite doing several weekend evening shifts.
On the other hand, the level of entitlement was incredible. A category 4 patient, essentially recovered from her mild community acquired pneumonia, complained that we provided a “very poor service” because she had been waiting for 2 hours. A man waiting for a similar length of time to be seen for gastritis after deliberately eating “very spicy” food for an entire week complained about the ridiculous wait times and wanted me to promise him that pathology results will be available within 30 minutes. Oh you have no idea, I thought. At best you’d be waiting 4 hours for these ED presentations at my local hospital.
There were high earning government employees rocking up to ED instead of their GPs, complaining that GPs in town don’t bulk bill enough. Whilst looking up the hospitals I came across locals reviewing these public hospitals on Google, like… complaining about the food. Friends who lived here told me news stories in the past where a MP kicked up a fuss when someone in their family sat in the waiting room for hours like everyone else. Another politician tried to get a specific combined oral contraceptive pill banned in the country when his daughter had a deep vein thrombosis – um, all COCPs have the potential to increase clot risk. Plus his daughter went on a long-haul flight and had a genetic disposition to forming clots (which was discovered during the workup after getting her DVT).
The level of health concern was also a massive contrast to my usual workplace where, for example, a woman with an eGFR of 3 refused to go into hospital to start the process of dialysis.
Here, a mum brought her 7 year old son in because he swallowed a tiny bit of water and had a few coughs afterwards. A couple in their 30s re-presented after being discharged earlier that day because they didn’t know how to give oral paracetamol to their one year old – they almost didn’t let the nurse show them how either because they didn’t want the kid to spit out the medication again. Another man told me he was well informed and knew about antimicrobial resistance, but kept asking what needed to be done about his URTI – furthermore, he wanted me to confirm whether it was a “reoccurrence” of the same URTI from 3 years ago. Someone who self discharged post surgery (hence went home without a follow up appointment) tried ringing outpatients twice and couldn’t get through, so came into ED to get his follow up arranged.
I try to treat patients respectfully and listen to their concerns regardless of why they’ve presented. But I feel that some people living in our capital need a bit of perspective about life elsewhere in this country before complaining that the government doesn’t provide for or spend enough on healthcare in their city.
