I've never written anything directly related to my profession, but today is a little different. My professional clients (I've never accepted calling them cases -- it is so inhuman to do so) this morning provided a good mix of the spectrum of feelings that they evoked in me, and it became natural that I made a little log of them.
AA is a 45-year-old lady who first came to see me in February. Hypertension was diagnosed 5 years ago and she was treated with medication with fair control of BP. In the recent 2 years, her doctors stepped up her medication in view of worsening control. When I saw her she was on 4 kinds of antihypertensive pills. She consulted another doctor because of some side-effects of the pills and she stopped taking some of them. Her BP was disturbingly raised, up to 200/108. I explained to her the management plan: adequate control of her BP, assessment of any end-organ damage, and exploration of any secondary causes. Blood and urine tests were normal but USS kidneys showed a discrepancy in their sizes, one being 2.1 cm larger than the other. MRA for renal arteries was suggested but she'd like to consider. Her BP was quite well controlled at around 130/82 in subsequent visits after I changed some of her medications, and she agreed to MRI adrenals + MRA renal arteries after she couldn't get it done free from her past medical carer. Today the results came back and fibromuscular dysplasia is highly suggestive. I'm pleased to have found a treatable cause for her hypertension and also grateful for her trust in me. What is most important in the end is that I can help her. Not at all a bad beginning to a busy morning.
Then came CC who is by now 19. He is autistic with some behavioral problems a few years back. He was brought in by his father and a domestic helper. I first saw him when he was 9. I've always had empathy to his parents. They have gone through so much hardship and pains to raise him. The long necklace with many attached charms of religious purposes worn by CC just shows how desperate his parents are in their attempt to bring peace of mind to him. Empathy is essential in our profession, but sometimes strong empathy will require a long and difficult disengagement after the consultation to bring us back to our previous self.
A big contrast followed. DD is now 23. I remember the shy innocent girl of 9 when I first saw her. She finished her university studies in the UK, and is now working as a professional in an international firm. Without realising how much time has passed, I now find before me a pleasant educated young woman. I feel happy for her parents. Life is full of contrasts, but the grim determination of parents to make sure that their children are safe and sound never changes. I thank my parents, wholeheartedly.
A big contrast followed. DD is now 23. I remember the shy innocent girl of 9 when I first saw her. She finished her university studies in the UK, and is now working as a professional in an international firm. Without realising how much time has passed, I now find before me a pleasant educated young woman. I feel happy for her parents. Life is full of contrasts, but the grim determination of parents to make sure that their children are safe and sound never changes. I thank my parents, wholeheartedly.
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