Throughout our medical training and in the actual practice of medicine, it is expected that we should always do the best for our patients and their care must be our first and foremost professional concern.
In our interaction with patients, it is assumed that we will give our full and undivided attention to them and focus exclusively on their problems. Most times we do but at times, it can be difficult. Other irrelevant and unrelated thoughts intrude: that pile of unfinished and overdue medical reports sitting on one’s table, an ailing parent, a child’s impending school enrolment, and all the minutiae of life. And that can lead to unpleasant consequences.
A few years ago in my outpatient clinic, I attended to a patient whom I have known for years and treated for schizophrenia. She still had the occasional auditory hallucination but was otherwise well enough to have meaningful relationships and hold a steady job. It was a routine clinic visit: for me to check that everything was fine and for her to get her usual prescription filled.
She was indeed fine – we chatted and, with a couple of taps on the keyboard of my computer, I printed her prescription. As I handed her the prescription, my mind strayed to the next patient and a meeting later that afternoon. Fixing the date for her subsequent visit (I had been seeing her on a two-monthly basis), I realised that I would be away on a trip abroad. I told her and gave her an appointment in ten weeks’ time.
Nine weeks later, on the day of my return to work, I found out that she had been hospitalised. She had suffered a severe relapse after her medication ran out. Mortified and stricken with guilt, it dawned on me that I had omitted to make that change to her prescription. She told me later that she thought that a couple of weeks off her medicine wouldn’t make much difference.