Wednesday, 5 March 2014


I was following my gp for night shift at derrybeg(google it) from 6pm to 12am. It was a long quiet night. with only 5 patients in total that we met. 3 of them came to the center and we went to their house for the remaining 2. so i was able to get a bit of traveling around the county going to the houses.

one of the patients that came to the center was a man im guessing around mid 30s. he came complaining of severe diffused pain around his abdomen that radiated to his back. he did mentioned that he has had this pain for quite sometimes but it got really worse this evening and he just cant bear with it and had to stop his work. He only get analgesics for his previous pain. He has had abdo ct scan but it all came up clear. so my gp took his vital signs and do abdominal examination while he keeps on crying in pain. he even puked a bit. since we cant find whats wrong with him my gp decided to give him morphine as he is in excruciating pain.

as he was preparing the the drug....
Pt: what are you gonna give me doc?
GP: something strong
Pt: i was given painkillers before but thye didnt work and they had to give me morphine to relieve the pain

and so my GP gave him an injection of morphine but damn that man's veins were so hard to find we kept going up and down left and right searching for good vein. took us for quite sometimes.

during that process i was a bit panicking as we took so much time to deliver the treatment but my gp just remain calm and he was humming while do examinations and stuffs.

then, during our free time i asked him regarding the patient and discussed with him. so i gave him my ddx like gall stones, or kidney stones etc etc. my gp nonchalantly said that he might be a drug addict that just wanted to get morphine. i was like "whaaaat????" didnt think of that. then my gp explained that this is not his first time here in the center and there's no finding from his examination. normal pulse, normal blood pressure which can be elevated if he was in serious pain. even when he was palpating the abdomen the patient didnt show any consistency with the location of the pain and he's not even guarding though he said his pain was unbearable.

that left me with a big "oooooooo" though he still gave the morphine shot because the patient might be in real pain and he need to go to the hospital which i dont know how far is it from here. probably about 1 hour drive.

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