Ugliness

I felt so embarrassed and disappointed yesterday, and wish I never would ever face a similar situation here again.

A young Chinese couple walked into our department, cradling their frail and conspicuously jaundiced baby. I happened to have finished reviewing a paediatric case in the vicinity and eyeballed the little one quickly. He looked ill and septic, resting quietly on the maternal arms. I approached them within five minutes of their arrival.

"Hi, how are you? What happened to your baby?" I asked in my friendliest tone after introducing myself. "Oh, he just had a fever. The GP asked us to come straight here", the mother answered looking somewhat baffled. I glanced quickly at referral letter which gave a typed out brief summary of the illness, including a written note towards the end about some "jerking of all limbs" while in consultation.

"So did the baby have any stiffening or jerking of the limbs? Was he unconscious at any stage?", I probed. "No, he was sleeping very soundly" she replied in a very familiar un-Australianised accent. "Oh, someone else is coming over right?" she asked persistently in her crude 'broken-English'. She had overheard my conversation with my HOD regarding a paediatric referral for admission.

"Yes, we are getting a paediatrician to come over because your baby needs to be admitted for treatment." Unpleasant memories of the paediatric emergency department back home and the Singland parents' obsessions with "only specialists are fit to see us" flashed across my mind. I held my breath beneath the seething distaste.

While examining the baby diligently, I tried to break the ice: "So, how long have you been in Australia? Where are you from?"

"We are from Singapore, and we have been here for 6 months." While I was not surprised since I recognised the accent, I explained later as professionally and clearly as I could the diagnosis of neonatal pyrexia and the indications of blood and urine investigations via cannulation so as to institute immediate treatment.

"Blood tests! Forget it...." The baby was just discharged the day before after shots of phototherapy given for neonatal jaundice. "Look at the marks on his hands! I don't think they are good enough..." She started wrapping her baby up, preparing to leave.

I frantically persuaded her to stay, reassuring her that we would not do anything to her baby if she refused, but warning her that there is no oral treatment for NNP and he may eventually require intravenous antibiotics if his fever persisted. She agreed to stay, not before demanding formula milk powder curtly.

As I explained the situation to the paediatric registrar who just strolled into the room, she walked out of her cubicle with the baby in her arms, looking perplexed. "Where is the formula milk? How come no one has come to see us yet? What kind of an emergency is this?!" My HOD approached her and patiently reassured her.

"Who are you? Are you the specialist?" she questioned neurotically. Despite the introduction made by my HOD, she made a dash out of the department towards the carpark with her husband, who remained suspiciously reticent throughout (I could foresee a long personal complaint letter shooting in over the next few days from the smiling tiger). My HOD was shell-shocked but gave chase and kindly persuaded the couple to return.

They relented. I went over and tried to shower more TLC with the nurses. I instructed her to try and catch a mid-streamed urine specimen. "Don't you have the urine bag?" she asked impatiently. I explained that the urine might be contaminated and the clean-catch would be most accurate. "Never mind, I WANT the bag". I gave up trying to talk sense into her thick skull, but continued to flash my usual friendly smile.

After a few hours of observation with no pyrexia documented, they were eventually discharged against advice by the paediatrician. As we flipped through the ward records, we realised that the mother had been giving the caregivers a hard time as well. Perhaps she was simply not mentally equipped to deal with any "stressful" event.

I looked at my HOD apologetically. "You know they are from Singapore....", she mentioned before she left. I nodded, empathetically aware what she had dealt with.

I have hardly encountered such incidences and rudeness among the Aussie patients, at least not until I have settled down comfortably in my current department. Imagine having tens or hundreds more of such characters as parents or patients in Singaland. Sometimes I do wonder if I had been just as unreasonable and difficult subconsciously while I was here, being a born-and-bred Singaporean with the notorious demanding streaks. We do have a long way to go while striving to be a gracious society.