Kind of busy lately ...

I have been rather busy over the past 2 weeks, having to work through off days and forgoing the regular keep fit schedules.

Suddenly, there is a "deluge" of patients being admitted for neurological disorders over the past 2 weeks. One of them was particularly quite severe and challenging - she present with acute deterioration of her seizures, the underlying cause of which is still a mystery.

It is a real "torture" when treating ill patients who continue to deteriorate clinically despite the best of my treatment plan. And this is exactly my current predicament. I am managing an adolescent girl with refractory seizures despite the use of high dose anti-epileptic medicines. I have proposed a brain biopsy for definitive diagnosis of the underlying cause of her seizures. The caregivers were understandably apprehensive and reluctant to pursue that route. And I could certainly empathize with them - who wants an operation to be done on the BRAIN!

I have been managing many children with acute neurological disorders for over 10 years. It is less tormenting when I was working as part of a team in public hospital; the burden of managing the patients was shared among all parties involved.

However, in private practice, the onus of taking care of the patients falls squarely on me alone. I have encountered sleepless nights on several occasions, cracking my head thinking of all possible options (in treating a sick patient) and being woken up several times in the wee hours of the days (answering calls from worried nurses attending the patients). Sometimes I just feel that I should just "let go" and send the patients off to public hospital. However, it is the trust and appreciation of the patients' family members that tend to spur me on...