I recently came across a website that aims to build up the blood donor database in Nigeria. It's by a group called the one percent project who want to create a 10,000 strong army of volunteers who regularly donate blood.

This is a laudable project that i support fully. Read here my post on blood.

It's not everyday you get a chance to 'Be a hero, it's in your blood'.

Of medical errors

Here's a great anecdote lifted from the blog of Dr Kavanagh a rheumatologist:

In my first few months working as a rheumatologist a referral letter arrived from a local doctor about a lady with rheumatoid arthritis. She had recently moved to the West of Ireland from the UK, where her original diagnosis had been made. Her GP had originally referred her to a general physician in a small local hospital who had struggled with her care and she was looking for second opinion.


After assessing her, it quickly became apparent that original diagnosis had been incorrect. The patient had numerous explanations for her pain other than rheumatoid arthritis and the investigation that was likely to have prompted her original diagnosis (a positive rheumatoid factor test) as due to the fact that she had Sjogren’s syndrome (a condition which causes dryness of the eyes and mouth).


My specialist pride congratulated itself on making such a clever diagnosis and for being smarter than either the physician who had cared for her of late or the rheumatologist who had made the original diagnosis. Gosh I’m good, I thought.


‘That’s wonderful news Doctor. You mean I don’t have rheumatoid arthritis after all?’


‘Not in my opinion you don’t.’


‘Its great to see someone who knows what he’s talking about. Do you mind me asking where you did your training?’


‘In the UK. In Cambridge mainly.’


‘Really Doctor? In Addenbrooke’s?’


‘I was there for 4 years.’


‘That’s amazing. That’s where I was told I had rheumatoid.’


With that she thanked me, stood up to leave, and just before she left the room, turned to me and said;


‘I knew you looked familiar.’


It’s never a bad idea to get a second opinion. Even if it’s from your self.

Blood

Blood courses through the vasculature of mammals bringing vital nutrients to every cell and ferrying waste substances away to be excreted. Blood flowing is synonymous with life, a lack of or stagnation of blood similarly signifying death or at least its proximity. Blood is central to all that the body does. A simple biopsy of it with appropriate testing can reveal the onset of disease, its severity, rate of progression and whether or not disease will respond to treatment. When lost it must be swiftly replaced with a suitable type.

Pro reason

The recent death of a pregnant woman in Ireland has caused huge furore in the polity of the republic. While the exact details of the case are yet unknown many have been up in arms over the claim that the pregnant woman's life was lost as a direct result of the prohibition of abortion in Ireland. Many pro life and pro choice groups have clashed repeatedly and the debate rages on. This series of events resurrected in my mind the thoughts I've had regarding abortion. 

Abortion is always a difficult topic and with most difficult topics there usually isn't one right answer. In my mind's eye i can see situations where i will be in favor of abortion. One such instance is that of rape where contrary to Sen. Todd Akin, pregnancy can and does result. Conversely i would be against situations where a pregnancy is unplanned and abortion is used as a form of contraception. Grey areas exist in my mind regarding abortions for fetal abnormalities and severe congenital/ genetic conditions. I can understand why a parent may want an abortion in these cases but I can also see how permitting that would begin a descent down a slippery slope towards eugenics, a practice many will agree is less than desirable. 

I believe that a baby has a right to life. The real issue is determining when that life actually begins. Is it when the sperm fertilizes the egg, when the morula is formed, when the fetal heart begins beating or when... i could go on. The bottom line is we don't know and we probably never will. What i do know though is the immense joy children bring into the world often regardless of the circumstances surrounding their conception or the state of their health at birth. Children bring hope and joy, the possibility of change and a new beginning. They also bring lots of poo and tears but we'll gloss over those! Abortion on the other hand in my experience brings adverse emotional and psychological  effects to not a few women. Some psychiatrists argue that research hasn't revealed measurable difference in the mental well being of women who have undergone abortion. I however still have my doubts probably due to the anecdotes i have come across that suggest otherwise. 

Finally you ask, so what should we do? legislate for or against it? What i have thought up is an independent panel that consists of legal and medical experts that women can apply to and have their case for an abortion to be heard swiftly. They'll always be available, take into consideration all the potential issues and ramifications and give a decision accordingly. I know this will give rise to many new issues but that's my little stab at the problem. The real answer: I don't know. I spare a thought often for women who have to consider this difficult option.

  

Our very own prof

Prof Osotimehin, former Nigerian health minister is now executive director of the UNFPA.

After the break is his profile and an interesting interview with him, Culled from the BMJ

His response to the last question is one that resonates with me.

The end is in sight

As i sit in my room procrastinating another study session for my fast approaching exams, i mull over the journey that medical school has been so far. After 5 years of hard work and studying, i complete my undergraduate medical training in 4 weeks. The time has flown by so quickly, it's been full of many great and memorable experiences as well as many hard times.

Now it's on to the intern year. I don't yet know where that'll be, maybe in the first world, maybe in the third world, either way i know it will be fun and eventful and full of stories for this blog.

I hope to write more in the coming months and years

Communication skills

So I'm back writing again thanks to someone whom I spoke to sometime ago who had read the blog and liked some of it. I'm sure she's representative of millions of others (in my dreams maybe).

Well speaking to her reminded me of several experiences I had while doing a rotation in surgery at the national hospital Abuja that I'm yet to write about. One such experience I relate below.

I've been doing psychiatry for the past few weeks and there's been an emphasis on communication skills and its importance in the interaction with the patient. So why tell us about it I hear you ask. It's simple, learning about communication reminded me of the awesome skills of the great surgeon I worked under in the hospital. This is an excerpt of how a consultation with an elderly cancer patient went.

Says he: 'ah na cancer oh! Wetin we go do!'

Patient (replies with some trepidation having heard for the first time she has cancer): whatever you say doctor.

Doctor: we go cut am off.

Patient: ah! Cut am off?

Him: yes na. Abi you day use am for anything!

Where was the cancer I imagine you asking. Well wait for it... it was in her left breast!