Romeo: The Best Example of the Need For Medical Schools Reform
When the anaesthetic for my heart operation wore off, and I woke up, I immediately experienced a multitude of strange symptoms. Whenever I closed my eyes, I dreamt of falling into a pit filled with snakes or a plunging waterfall. It did not matter whether it was night or day. Every time I closed my eyes, I would experience a feeling of being in some form of danger. I stayed up all night, afraid of closing my eyes and having more nightmares. The following morning when the doctors made their rounds, I informed them of what I was experiencing.
One of them began asking inappropriate questions — he did not take my complaint seriously. After asking them a list of relevant questions, I gave up, and they moved along. I overheard the patient next to me complaining of similar experience. As in my case, the doctors continued the same line of questioning and left her bedside. That night, sleep evaded me again, chased off by the recurring nightmares. The following morning, I explained to my new nurse what I was experiencing.
She told me she would look at my medication and see which one might be the culprit. When she looked at my chart, she said she thought it was codeine because it was the only medication with opiate properties. So, we agreed that she would not give me codeine that day, and we would watch to see if the hallucinations continued. Lo and behold, I was able to sleep that night without hallucinating. That evening, before the nurse clocked off her shift, I informed her of the result of our experiment.
The following day, I did not bother to tell the nurse on shift of the change — assuming it had been recorded in my file. She included codeine in my medications that morning, which again caused me to hallucinate the moment I shut my eyes. I explained to her what transpired between myself and the other nurse and told her that I thought the previous nurse had recorded it in my record. She informed me that no such change had been made and that the nurse had no authority to change my medication.
When the doctors made their rounds that morning, I informed them of what had transpired and asked if they could replace the codeine with another painkiller. They did, and I stopped hallucinating. That same day, another nurse came to my bed with a pack containing sterilised gloves and other materials to remove some of my stitches. He donned gloves, cut the tip of the stitches, and tried several times to pull them out, failing each time. At one point, it became too painful; I asked if he could get someone more experienced.
He called the head nurse, who did precisely what the previous nurse had done. While they were struggling to remove the stitches, I noticed a scalpel and asked why couldn’t they cut the stitches.? They both looked at me as if I had said something inappropriate and continued trying the same painful method. By my estimation, the process had taken half an hour, and they still had not removed a single stitch.
When the pain became too much to bear, I asked if they could get someone else to help them. The head nurse went away and returned with the consultant on duty. When the consultant arrived, she took the blade I had suggested the nurses use, cut the stitches, and within seconds removed the stitches. She looked at the nurses with contempt as if to say, couldn’t you think?
Even as a layman, I had noticed the scalpel and could figure out its purpose. Yet, the nurses —engaged in that activity daily could not recognise that the scalpel was there to cut the thread. The incident puzzled me because the nurses only needed to use common sense. There were stitches to be removed, and there was a scalpel to remove them.
It scared me, lying there inhibited, with my life in the hands of people who could not figure out such a simple thing. Having gone through those two experiences, I took control when the third experience occurred on the ward. In the high dependency unit, I was in the middle of a conversation with the nurse and consultant when I blacked out.
The blackout only lasted a few seconds, but the nurse noticed and asked if I was okay. When I arrived on the ward, the blackouts continued. I reported this to the nurse, who informed the doctors. The doctors came to see me and asked me to explain what I was experiencing. They asked me precisely when it happened. I responded that I did not know and informed them that it occurred randomly. They asked me to inform the nurse the moment I experienced it again, which I did.
The nurse called the consultants, who initiated an investigation. Fortunately, on one of their visits to my bed, I blacked out, and the consultants saw it themselves. They asked several questions about when it started and whether I had such an experience before the surgery, to which I answered no. After several conversations amongst themselves, they concluded that they needed to rule out a brain tumour. Even in my confused state of mind, having just recovered from anesthetic, I knew such a starting point would have led to a dead end. I had just undergone a heart operation three days prior and was experiencing blackouts. It seemed prudent to me that the blackout might be connected to the surgery.
But in my weakened state, I was in no position to argue with them, so I went along with everything. They conducted several tests, including an excruciatingly painful MRI scan that required me to lie flat in a machine that stretched the stitches in my heart. After completing tests and asking me more questions, they were still no closer to working out what was causing me to become unconscious. One of the essential skills of a good management consultant is the ability to recognise patterns.
Being a management consultant, I endeavour to practice my craft in every situation I find myself. Having experienced the codeine incident in the intensive care unit, it occurred to me that one of the drugs I was taking might be the culprit. To test my hypothesis, I decided to do a Google search of the side effects of all the medications I was taking. The hospital Wi-Fi was not working, so I asked my partner to go outside and complete the search. The Google search revealed that one of my medications, Bisoprolol, was causing the blackouts.
We found this information on the NHS website. I asked them to stop the Bisoprolol, but they refused, stating that it was an essential component of the treatment. However, we convinced them to try a lower dosage to see if it would stop the blackout. When they reduced the dosage, the blackouts immediately stopped. When I went for the post-operation consultation, I met one of my ward mates. I asked how his recovery was going. He said his recovery was going well, aside from the hallucinations he experienced the first few days after surgery. When he said that, my partner and I looked at each other because we knew exactly what caused his hallucinations.
