Wednesday, January 25, 2006

A Second Opinion from God?

In the last 3 months, I have done many of the everyday things that a 26 year old might do. I have been ice skating, gone dancing, caught a show at the theatre, seen numerous films, worked my arse of, and lazed around on the couch to name but a few. All well and good, you might say. Sharon is the same age as me and previously her life was little different. She probably even had a little more fun: there's a history of cocaine and ecstasy and the hope of a career in the fashion industry. Recently, however, things have been a little different for Sharon. For the last 3 months, she has been in a encephalitic coma. Her only trips have been to the ICU and HDU. Considerably less well and good, I might say! Nobody held much hope for poor Sharon.
Imagine our joy then when she started to improve at the end of last week, culminating in her opening her eyes of Friday! This week, to everybody's amazement, she started to talk. OK, so she's not quite there yet - there are psychiatric and cognitive problems, which may or may not get better, and most of her speech involves telling people to fuck off - but it's a start and she may improve still more.
All the same, we still need to know what has caused this illness, if only because the symptoms were so odd that finding an organism may help us to treat any future victims with this very atypical clinical picture. We have a single lead: an area of infective looking tissue on CT which we could biopsy and culture. Sharon cannot consent to the procedure; she does not currently have the capacity. In the morning, we spoke to her mother who agreed that the biopsy should go ahead all the same and that she would consent to this in place of her daughter (as the law allows).
That was the morning. By the afternoon everything had changed. Sharon's mother had some news. She had gone to the church and spoken with the Elders. The Elders has listened to the story, considered, and pronounced their verdict. Sharon had had no brain infection. God punishes those who live dissolute lives and Sharon had taken drugs. God does not like drugs. His punishment had been severe but he had heard the prayers of Sharon's mother and, being a good and merciful old chap, he had relented. Sharon would recover and all would be well. There was no infection and, ergo, there need be no biopsy. Sharon's mother, a devout Christian, swollowed it whole. She withdrew her consent for the biopsy immediately. Now our last chance to find our what had caused this illness will dissolve away as her body clears the infection.
We could still do it, of course, but we won't. It's not worth the trouble of a court fight. Besides, it's not really fair on her mother. It's not her fault, after all, but the preachers who interfere in areas where they have no expertise. It's bad enough that they profess superiority in the moral arena, let alone in the understanding of medicine. The consultant psychiatrist whose job it is to assess a patient's competency sees this often. He is annoyed but resigned. He knows that people are vulnerable at this time and we cannot always give the exact answers they crave. Preachers like these feed on uncertainty; they've had a market-share in plugging gaps in human understanding since time immemorial - it's their raison d'etre. Yet, the most disgusting fact has little to do with the biopsy. Without a qualm, these finger-pointers have pinned the blame on poor Sharon for an unpredictable illness of which she is an innocent victim. How unfair. How cruel. What bastards!

6 Comments:

Anonymous Anonymous said...

So selfish: just to make a point.

As you say, the course you'd hoped to carry out could go some way to saving the life of an as yet unknown individual.
Religion (or a good number of those religious leaders who nag the rest of us about it, anyway) sucks.

6:43 pm  
Blogger Smalldoc said...

I thought humility was supposed to be an intergral part of most religions? Where is the humility in declaring that a sick young woman is a sinner and instructing her mother to refuse investigations? Makes me sick.
Completely unrelated to this post -I quoted that lovely little paragraph from your diary cards to someone from the RCP, who feels it might be worth emailing the head of the Junior Doc's Committee at the BMA, as it blatantly goes against what diary cards are supposed to be for and something might actually be done about it. Just a thought.

10:21 am  
Anonymous cunning fox said...

What a horrible story. No wonder religion gets such a bad name.

smalldoc - seconded on both the humility and the unrelated point. The BMA are definitely the people to speak to. You could also try workforce development at your health authority - they get all the diary data. They too have a big stick but wield it gently so your management may respond to that approach. But the BMA is there to investigate this sort of thing.

As both a religious person and a diary card administrator this has been painful reading lately - but that's why your posts are so good. (I am probably the last reader you want at the moment, but that's blogging for you.)

1:29 pm  
Blogger The Venial Sinner said...

Yes, I must admit I do find it hard to keep a tolerant approach to religion some of the time. I do try but sometimes I just wish it would all go away.

As for the diary cards, I did think about sending it to somebody at the BMA. That would have been the logical thing to do. As it was, I just filled in the actual hours I worked in spite of their warnings as a mini protest. It's apathetic sods like me that they rely on to let them continue getting away with shit like this, I know, but apathy is soooo hard to fight.

5:05 pm  
Blogger NHS Manager said...

It isn't "religion" that's the problem, but the organisations who use it as a stick to beat people with.

What I would say though is you question their "expertise" in this area. Have you considered that they may also question yours? It's just a matter of perspective and from their they are completely correct.

4:33 pm  
Blogger The Venial Sinner said...

I don't think it really is just a matter of perspective. Were these 'Elders' some other doctors who thought our management was incorrect then it would be a matter of perspective. Two opposing views from two sets of people with knowledge of that field - fair enough However, these poeple have no knowledge of medicine; so what right have they to use their sway with Sharon's mother to undermine her confidence in our diagnosis? None, in my opinion. Let the magicians stick to attacking each other's belief systems and let medicine get on with taking care of the sick unhindered.

6:14 pm  

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