DW...!!!
DW !!!
They are the ultimate attention seekers.
And 99% of them are young girls , newly married brides, and below 30.
I’m talking about a very distinct group of patient who are brought to emergency ward quite often carried on arm (not on a stretcher) by husband or close relative in a state of RED ALERT. Most common complains are : breathlessness, chest pain, Ghabrahat (a very unique complain, mostly used in North India, not mentioned in medical text-books. But my speculation is that it is combination of nausea, uneasiness, feeling of sinking, diffused headache, heaviness of heart, giddiness and confusion. Hence we doctors write this word as it is in our treatment sheet without translating it to English). Sometimes the symptoms are so severe that it may appear on the fist glance that the pt is about to die.
Another frequent complain is sudden loss of consciousness without any apparent cause whatsoever. And an unconscious patient without definite medical history is most notorious case to treat. We doctors have been told by best of the authors worldwide to take these patients very seriously because here u have to make your diagnosis all of yourself-without any assistance from relatives or the patient himself. But somehow, just a minor look or the preliminary clinical examination and our previous experience exposes the diagnosis-“FUNCTIONAL CASE”. I mean ACTING. Yeah functional patient pretend their illness. The truth is more often the less revealed within first 10 minutes. We spend next 20 min to rule out the remote possibility of genuine problem before coining the pt as FUNCTIONAL. Then order the sister to bring the “magic Drug” –DW.
It acts wonder. The pt gets relief within 10 min. and our diagnosis is confirmed. Sometimes we repeat the dose over 5 min interval. But mostly we get results in 2nd or third repetitions. Shall I tell u what this wonder drug “DW”is????? It is pure distilled water loaded in a 10 ml syringe given with a big bore 20G needle deep intramuscular-rather painfully. The first dose silently threatens the pt that if u continue doing your tantrums we are going to repeat this maneuver over every 5 min interval. Our order to the nurse is- “sister! Paanch minute ke baad agar takleef kam na ho toh yeh injection repeat karna hai aur har paanch minute pe karte rehna hai”. We also make sure that this order well heard by the patient and the attendants. Some stubborn patient last up to three doses but in most of the cases best result is achieved at two doses. The highest dose ever required by any pt ever treated by me is 12 doses over 3 days. Actually somehow the patient could know that we are aware of her acting and to prove us wrong she stopped responding to our “treatments” . I have deep sympathy for these kinds of patients. They should be properly counseled and treated, but then this is a complete treatment in itself involving psychiatrist and counselors. I, as an emergency Medical officer have no role to play- Not only for the time factor but for other reasons as well. The first patient whom I tried to counsel myself got emotionally attached with me after 3-4 sessions. She thought I am the only person who can understand her. And after numerous phone calls, private meetings and late night disturbances on phone, my gave up my patience some how I could detach myself from her. Since then I haven’t try to bother myself again.
So you all young ladies who are reading this blog, my special request is –Don’t attempt these kind of things. These put no effect except burning a big hole in your pocket. At least you can’t fool a alert and able doctor like me on duty.
Beware of DW!!!
DW !!!
They are the ultimate attention seekers.
And 99% of them are young girls , newly married brides, and below 30.
I’m talking about a very distinct group of patient who are brought to emergency ward quite often carried on arm (not on a stretcher) by husband or close relative in a state of RED ALERT. Most common complains are : breathlessness, chest pain, Ghabrahat (a very unique complain, mostly used in North India, not mentioned in medical text-books. But my speculation is that it is combination of nausea, uneasiness, feeling of sinking, diffused headache, heaviness of heart, giddiness and confusion. Hence we doctors write this word as it is in our treatment sheet without translating it to English). Sometimes the symptoms are so severe that it may appear on the fist glance that the pt is about to die.
Another frequent complain is sudden loss of consciousness without any apparent cause whatsoever. And an unconscious patient without definite medical history is most notorious case to treat. We doctors have been told by best of the authors worldwide to take these patients very seriously because here u have to make your diagnosis all of yourself-without any assistance from relatives or the patient himself. But somehow, just a minor look or the preliminary clinical examination and our previous experience exposes the diagnosis-“FUNCTIONAL CASE”. I mean ACTING. Yeah functional patient pretend their illness. The truth is more often the less revealed within first 10 minutes. We spend next 20 min to rule out the remote possibility of genuine problem before coining the pt as FUNCTIONAL. Then order the sister to bring the “magic Drug” –DW.
It acts wonder. The pt gets relief within 10 min. and our diagnosis is confirmed. Sometimes we repeat the dose over 5 min interval. But mostly we get results in 2nd or third repetitions. Shall I tell u what this wonder drug “DW”is????? It is pure distilled water loaded in a 10 ml syringe given with a big bore 20G needle deep intramuscular-rather painfully. The first dose silently threatens the pt that if u continue doing your tantrums we are going to repeat this maneuver over every 5 min interval. Our order to the nurse is- “sister! Paanch minute ke baad agar takleef kam na ho toh yeh injection repeat karna hai aur har paanch minute pe karte rehna hai”. We also make sure that this order well heard by the patient and the attendants. Some stubborn patient last up to three doses but in most of the cases best result is achieved at two doses. The highest dose ever required by any pt ever treated by me is 12 doses over 3 days. Actually somehow the patient could know that we are aware of her acting and to prove us wrong she stopped responding to our “treatments” . I have deep sympathy for these kinds of patients. They should be properly counseled and treated, but then this is a complete treatment in itself involving psychiatrist and counselors. I, as an emergency Medical officer have no role to play- Not only for the time factor but for other reasons as well. The first patient whom I tried to counsel myself got emotionally attached with me after 3-4 sessions. She thought I am the only person who can understand her. And after numerous phone calls, private meetings and late night disturbances on phone, my gave up my patience some how I could detach myself from her. Since then I haven’t try to bother myself again.
So you all young ladies who are reading this blog, my special request is –Don’t attempt these kind of things. These put no effect except burning a big hole in your pocket. At least you can’t fool a alert and able doctor like me on duty.
Beware of DW!!!
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