When I started my internship, i often found myself so busy I would be frantically walking around the wards in internal medicine trying to complete all the ward work.
I once met an mkhulu of 89 years of age. He frequented the wards with asthma attacks and lower respiratory Tract infections. Pleasant and always well dressed with a wooden cane and a flat ironed crisp shirt.
I would often pass his bed, sweaty and unkept, darting around with my iv line trolley. He would nod in acknowlegement. Somehow i thought he pitied me. I would see him packing his beside drawer every morning at exactly 7 30am. Neatly aligning his books to the left then settling down and making a note in a small black book. He spent his time deep in thought, staring at the book then quickly scribbling notes down.
He had one visitor every day. An oldish chap with the same sharp nose bridge and a broad smile whom i assumed to be his son. When it was time for him to be discharged I happened to be the one writing the discharge summary.
“Mkhulu do you have your pumps at home?”
” no i don’t. They are finished. I only use 1 spray”
Now anyone who has asthma will know that the standard treatment of asthma consists of 2 inhaler pumps-a controller(bronchodilator) for the acute right chest scenario and a preventer (steroid to reduce inflammation). The steroid is the hero in the treatment as it keeps the inflammation at bay.
Upon further probing I realised mkhulu was only using the controller. As odd as this sounded I remained silent. I took a piece of paper out of my nifty file and drew a simple diagram of lungs and inflammatory cells. I grabbed a nurse who assisted me with the translation.
Mkhulu was staring at me in deafening silence. “Haibo. You mean ive been taking the wrong treatment for 40 years ?”
“No mkhulu just the incomplete treatment.” For fear of being the reason of a heart attack on the day of his discharge , i slightly downplayed the situation.
“Wait. Is this how am i supposed to be using the spray? He then proceed to do the unthinkable, took the asthma pump and sprayed it on his under arms like deodorant!” . that left me in complete and utter shock causing me to take a step back and feel my pulse rise to the ceiling. I was waiting for a laugh. An indication he was obviously pulling my leg. He was serious.
“Sometimes i spray it on my chest without my shirt on bad days when my chest is tight”
I gulped. I Sat down. I took my diagram out of my file and i explained the correct method of using an inhaler pump. He was completely astonished. He kept his composure and leaned back and folded his arms.
“It goes in the mouth. I would have never known. No wonder this asthma will never leave me”. after 15 minutes of silence and shock , mkhulu looked me square in the face and said” thank you my daughter. How will I ever repay you? “I was touched.
Just please use the pumps and not the spray i chuckled. He took out his little black book and scribbled something and tore the paper out and handed it to his son who some how immediately knew what to do.
I proceeded with My day as usual. As I was finishing up with the last of the discharge summaries , mkhulus son appeared walking toward me with mkhulu and his belongings. At the corner of my left eye I thought I saw a feather swaying in the wind behind him and a small squeak.
Then I saw it. The most arb picture ive ever seen. Mkhulu with his belongings in tow and a chicken on a long string attached to its neck obediently following mkhulu.
All I could do was stare, wide eyed. A real live chicken. On a leash. Walking toward me.
Mkhulu then thanked me profusely and did something even stranger. He handed me the leash. “This is for you my daughter. I could never repay you but please accept this small offering” .to top it off, out of his pocket he pulled out a small packet of osmans red curry powder and placed it infront of me.
I burst out laughing. Mkhulu where will i keep this chicken? I dont have a kraal. I was beyond amused.
He insisted. He then turned and went on his way leaving me with 12 discharge summaries in front of me and a chicken on a leash and osmans curry powder. What a combination.
The chicken was quiet. He looked at me with eyes of excitement. He stayed with me in my DQ room for 1 day.
After the complaints from the cleaners and neighbours i eventually had to drop Patrick off at KFC..
I would certainly blame the doctor that had no time to show Mkhulu how to use the pump as this has been a common issue which I was once a victim of,,, but not the pump.
I am so relieved to know that your main purpose as a doctor is not only prescribing medication BUT showing patients how to use it is FAR more important.
Well done Doc Moosa and May The Almighty keep you steadfast and bless you with a long healthy life as we need doctors like you.
We love you.
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Sadly due to the congestion of the system, time spent on counselling patients is limited. You are right, patients are people first!