The Nightmare Scenario by Duvstig Gunnar

Author:Duvstig, Gunnar [Duvstig, Gunnar]
Language: eng
Format: epub, mobi
Published: 2014-10-27T23:00:00+00:00

AUGUST 8TH, 8 AM, INFECTIOUS DISEASE WARD, HOSPITAL KUALA LUMPUR, MALAYSIA

Jafri bin Mohamad’s favorite part of the day was the morning round. Followed by a trail of grad students, he would leisurely stroll through the patient ward, stopping at the cases he found most interesting, sometimes quite arbitrary choices. Each patient gave an opportunity for pontification and finding fault in the actions taken by the interns and residents who worked the night shift. Most importantly, it offered the opportunity to impress the occasional female students, who were now, for reasons surpassing his understanding, allowed entry into medical school. As the highest medical authority in the infectious disease department, he commanded a certain respect from them and enjoyed certain privileges. When he played his cards right, he could occasionally find opportunities for private tutoring, with in natura compensation in return.

As the students gathered around him he took the time to courteously shake all their hands while sipping his morning cappuccino. He started, as always, with an anecdote from his long and distinguished career.

This was his moment of adaption. He needed a few minutes to adjust to the environment, the harsh fluorescent light, the stench of antiseptics and the occasional wailing of patients in pain, so different from the atmosphere of his comfortable office.

Already in the first room he found what he was looking for – a patient with a persistent violent cough, delirious from fever. He started going through the motions even though he already had his diagnosis clear in his mind.

He studied the chart intently, remarking how characteristic the fever curve was for this particular condition. He took the blood pressure and pulse. He did an audial inspection of the cardiac rhythm. Listening to the patient’s lungs turned out to be slightly difficult as every attempt to take deep breaths led to an explosive cough, which sent phlegm flying.

After a moment of feigned contemplation, Jafri declared confidently to the student group that this was a classic case of bacterial pneumonia and ordered the nurses to administer intravenous broad-spectrum antibiotics.

“Excuse me, doctor, but could you explain how you arrived at the diagnosis a bit more in depth?” asked the supremely annoying Chinese registrar, Suyin Li. He disliked her, not only because she had proven impervious to his advances or the fact that she was Malaysian Chinese, but mostly because she was such an obnoxious know-it-all.

“I arrive at the diagnosis based on years of experience from seeing similar cases,” he responded. “In due time, you too will acquire this skill. Differential diagnostics is not something that can be taught mechanically. It is nothing a computer could ever do. It is more of an art.”

“The reason I am wondering, doctor,” she insisted, “is that, as you can see, the patient has coagulated blood in his left ear. Surely this is not a typical symptom of pneumonitis?”

As always, she didn’t know when to shut up. “No, it is not typical, but it does happen.”

“It might not be my place,” continued Suyin, “and I of

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