From “A 3 year ulcer”

As I walk into my ward for the morning rounds, I realise that my ward was half full and the atmosphere was unusually quiet. As I made a quick scan of the ward patients, my heart felt burdened as the images that were transmitted into the back of my retina were mainly of depressed looking geriatric females above the age of 70. ” Isn’t it always like that!” I responded within myself. Being in charge of the surgical female ward, the majority of my patients are of elderly females which I must say quite a challenge with their multiple medical issues.

The burden was not their age, but their length of stay and turbulent recovery. I must have been just tired as I seldom feel so. I must say I do get along quite well with elderly women and kids.

As I reached bed 17, it was another elderly lady. She look sad and depressed. “Somebody must have said something bad” I told myself. While listening to my intern rambling away the history, I reached out for her hand with a smile. She afforded a smile – half willing maybe out of respect for the profession. Without listening to my question, she asked, “Must I have the surgery?” I returned a gracious smile and examined her just to find this awful foul smelling lesion which she shyly acknowledges keeping it for 3 years.

This is not the first time I have seen something like this. Why do people keep ulcers for so long? Just recently another lady arrived to the ward with a large fungating ulcerated tumour which was so foul smelling that her office mates and my patients were complaining. After having handled all kinds of fluid of various smells, this almost made me vomit.

I was curious as this lady who spoke well, could not have been so ignorant! She wasn’t! She knew it was most likely cancer. This patient, was scared of surgery and the pain, and worried that nobody would take care of her, after all she was 70. She was adamant and against surgery. I was surprised as how easy my doctors gave in to her — was it her age? After having lengthy sessions with her, and with strict instructed guidance to my doctors on handling her case with love and thoughtfullness, we manage to ease her fears and she agreed for surgery after being with us for a week. That gave us enough time to investigate and stage her! However, I feel the reason she agreed was because for once in her life she saw her children coming together despite their busy schedule, to encourage and support her! Not the talk but the act of togetherness and concerted effort has great influence on an elderly patient.

I am happy we managed to talk her into doing the surgery. Now, she appears much more healthy and cheerful. Now she is doing her part in health promotion talking to my other patients, encouraging my other geriatric patients to ambulate and eat! A wonderful lady! Across her, is another 80 year lady who presented with a bleeding gastric ulcer and another 84 year old who underwent emergency surgery for an obstructed large bowel secondary to colon cancer,who refuses to eat or move and insist that she should have been given some lethat injection. Upon further questioning, I realised that she has 4 children and the only one who takes care of her has severe backache and is often in tears and barely can take care of herself! thus, this patient of mine feels herself to be a burden to her family.

As I sat to ponder another issue came up — why the delay?