Decisions..

How does one make a choice regarding another person's life?

Today, I had a patient who is a foreigner. He had spent the last 3 years in my country working to make a decent living to send some income back to his wife and 4 year old son back home.. Now he comes in, is diagnosed with a chronic liver disease secondary to hepatitis B, which he obtained through vertical transmission (mother has it too), and is in the stage where his liver is going to fail if we don't intervene with medication to reduce the viral count in his blood.

But what holds us back? MONEY.

Being a foreigner means he would have to pay for all the procedures, blood tests, the number of nights he spends in our THIRD class ward, and the medication we give him.

What does he work as? A cleaner or odd job worker in an office.

I some times think we take a lot of things for granted in the government service. But we do these things for our patients rather than for ourselves. After all, they pay taxes too..

But if we take away the fact that this man wasn't born in our country, that he probably doesn't pay tax cause his income is insufficient, and that he is stuck with this chronic disease, we are left with a human being who is unwell..

And my job requires me to treat that person with whatever resources I have.

How can I advice the patient to go back to his own country for further treatment knowing full well that he might not be able to afford it there as well?

We can't offer to give him a liver transplant either cause the virus is in his blood and it would cost him a fortune to get the operation done anyways. The only thing we can offer to him is medication to reduce the viral load in his body so that we can buy him some time..And that medication costs money, which he cannot afford for long term most likely..

I felt helpless as I chatted with him from the foot of his bed.

I felt like I was just watching him expire in front of me, slowly but surely..

I accept that death is inevitable for everyone, but I just felt sorry for his predicament, and the future of his wife and son.

So, what is my choice, or rather, options? As a human being, I would actually want to start his medication and follow up on him as long as he lives. But as a doctor, I know his time is short lived no matter what I do..

It's a tough call, but someone has got to make a decision for him.

And the clock still ticks on...

"¹²Therefore, as God's chosen people, holy and dearly loved, clothe yourselves with compassion, kindness, humility, gentleness and patience. " Colossians 3:12