an unfortunate

im currently doing elective in HKL on infectious disease. My partner and I are more interested in studying infectious disease especially on those of airway diseases. So we were assigned by our external supervisor to be in the Male Medical Ward 26. Yesterday there was an event that made me to witness the damaging effect of drug abusing.

There happened to be a young Malay man, aged 18 from Kelantan who was admitted due to shortness of breath. He is an active IVDU with positive Hepatitis C and syphillis. Upon further questioning, he is currently staying in Chow Kit area. In Malaysia, this is a well-known black area for immoral activities such as prostitutions and drug addicts. So, just based on this history alone, you can have a rough idea on what his prognosis would be like.

Differential diagnosis for this young man is TB. On general inspection, he appeared to be cachexic and weak. He was on nasal mask and was in respiratory distress (dyspneic, tachypneic). I did not do any physical examination on him since, yea, i gotta admit, i was a bit scared to attend to this patient. Perhaps the negative perception still persists in me. However, i should do something about this cause as a physician, you cannot be selective on the patients. Honestly, this was my first encounter with such case.

Moving on, this patient could not feed himself or tolerate orally. Hence, the physicians planned for cvp line insertion in order to feed and rehydrate patient. Since he was an active drug addict, most of his veins were already collapsed. Next, the physicians tried to access for his femoral veins but failed. Finally, they decided to go through his subclavian despite the fact that the procedure has higher risks and complications. In this case for instance, the patient was too thin and hence, increasing the risk for lung puncture during the procedure. Since there were no other options for the patient, they had to proceed.

In less than 5 minutes after the poke, the patient was gasping for air. The physicians were already anticipating this and told the emergency team that the lung had collapsed. They tried to revive him but in the end, he lost the battle.

Truth be told, i was a bit affected by the event. It was such a tragic event for such a very young man. I could not understand why the drug addicts could hurt themselves in the first place. Don't they wish for a brighter future and a happy life?

Hence to my all dear friends, please, make your life as beautiful and colourful as it is. i described my life simply just like an empty book that needs a touch of creativity to make it as interesting as possible. do not simply let it to end like that and please, remind your young ones as well. We live for only once and it is our responsibility to make it was worthy as possible.