She presented with haematuria of 1-week duration. She also feels tired and has lost weight and appetite. Upon further questioning, it was clear that her active problem was the least of a primary cardiac one. She has been diagnosed to have carcinoma of cervix and she had been under the surgical colleagues for an episode of intestinal obstruction. I gather that the staging of her carcinoma would at least be II or III depending on the local tissue infiltration. I hence told him that I would call upon the help of my gynaecologist colleagues to give their expert opinion. At the same time, I explained to him that my department would continue to monitor his grandma but there would be no active management on our side.
He was puzzled and asked me why would his grandma been admitted into my ward instead of gynaecology ward. Before I could react, he proceeded to demand that my department be held responsible for everything and that he would not tolerate any delay in treatment of her grandma. He also threatened to bring this matter up to the hospital director AND to the local politician, as he claimed to know someone 'important' in the state Excos.
I smiled and tried to explain.
I reiterated that the doctors and supporting staffs here were all-out to help her grandma to recover, nonetheless, the expertise in treating the underlying primary disorder, unfortunately was not our specialty, and hence a referral and consult with the gynaecologists would be mandatory as part of the holistic care.
After much explaining and exchange in words, finally he settled down and accepted my terms.
I curiously asked: 'Who's the local politician or state Exco that you know?'
He hesitated for a moment and blurted: 'Actually I just happened to have sold a handphone to him and got his name card. I don't know him that close lah.'
Moral of the story: Claiming to know 'someone' to get 'something' done is a rather common phenomenon the local setting. Doing favours and returning favours are part of Asian culture for centuries. Nevertheless, at times, it could be quite condescending and to a larger extent, unethical, if the favour is done at the sacrifice of other patients interest, especially so in the public healthcare system.