Sbg seorang pelajar masters..we have been trained to answer questions mengikut skema...sometimes we dont even have to stop to think, because we already know the standard answer...for an example..if there is a question about a patient who does not have any symptoms but requested for a full check up including tumour markers, CT scan etc, we know that at the end of the day, our answer will be- to politely decline the request..in fact we even come up with our own scenarios and test ourselves on how to answer it the best way..just so we could go into our 'automatic' mode during the exams and just write the answers without thinking much...coz time is really an issue during exams..
So, i've already been drilled a few times on this rather popular question on a patient who have an acquired physical disability who would like to continue driving. A common scenario would be :
A 40-ish year old lorry driver who have very poor diabetic control complains to you that he has numbness over both of his legs for the past few months.
Well, other than solving his present complain of numbness and trying to achieve better control of his diabetic condition (by denying him practically all types of food that u can think of..hehe), we also have been reminded again and again that he should be referred for a proper driving assessment by the JPJ to see whether or not he is still fit to drive that big lorry. And, if for some reason, the JPJ decides that he is unfit and may impose some liability to the society, he will then be advised to stop driving and we will just assume that he will simply look for another job and settles down happily ever after full stop. And we will insyaAllah at least pass the question with 5/10.
The mind boggling thing is that...things are not as simple in real life.
Two weeks ago, a patient came to me with a form from the social welfare department. He appeared nervous but at the same time determined and i could even sense a bit of...'arrogance' in the way he walked and held his nose high. Looking retrospectively, i think that bit of arrogance that i sensed was perhaps just a shred of pride that he was holding on to while handing me that piece of paper seeking for help that he needed.
He was a 45 year old man with 2 amputated fingers on his right hand due to industrial injury 16 years ago...Since 16 years back, he had never gone to the welfare department requesting for any sort of financial help because he was still able to work in a nearby factory (hard labour which involved carrying heavy things without the need of fine handwork) however, since 6 months back the factory had to shut down and he was left....jobless...
This patient is a regular guy with a family, 5 children..all still schooling....youngest 6 years old...and was in serious need of money when 4 months ago his neighbour offered him to drive his groceries van...and so, he took the offer gladly and Alhamdulillah with that little amount of pay, the family of 7 was still able to breathe, not as comfortably maybe..but enough..
However, thinking that his little ones still have a long way to go, he finally decided that it was time to get some financial aid, which i supported with no hesitations.
The problem that i had while looking at him was however...how do i tell him that the only source of income that he has now; which is driving a van (with 2 amputated fingers if i may add) may jeopardize his own life and the others on the road...how do i tell him that i have to refer him to JPJ for a driving assessment where he runs a risk of getting his licence being revoked by the authorities?? who am i to deny his children food and money to go to school...??
A toughie it was...but thinking of those who may get injured on the road just because i failed to do the right thing when i had the chance to is just unacceptable...so i took a deep breath and told..whatever that needed to be told..i tried to be gentle but firm at the same time..and all the while that i spoke he just looked at me with that sad expression on his face...God, it was tough...
But in the end..he looked down at his shoes and gave me a small nod...he told me that he agreed with whatever that i said...and he understood the risk that he was imposing on to the others on road...and he himself didnt want to be held responsible for injuring others while driving....but he told me he needed time...time to come up with a new plan...to discuss with his wife on how to generate income for the family....i agreed...provided that he does not take too long...okay he said..so we fixed an appointment for him to come back..where i could refer him to the occupational therapist and the JPJ for a proper driving assessment...i pray that the JPJ passes him though...it will be less complicated...but even if he fails the test, hopefully by then he would already have a back up plan insyaAllah...
I suppose that incidence really showed me that life is not like what we learned in the textbooks...and ideal situations may not be easily applied to every single scenario that we go through everyday...it's these litte things in life that make us wiser and prepares us for the next challenge...and when we should never abandon the things that we learn in the textbooks or the standard answers in the exams, we should also also learn on how to make the best out of any situations in life- and that's exactly what i've got to do now :)