It is not uncommon to have patients pretending to be unwell in order to gain a medical certificate from physicians. It would then be shown to their bosses to excuse their absence. In the outpatient section, we had a regular.
He is a foreign worker who is well-built and speaks a little English. The physicians first took him seriously and even referred him to numerous other specialities for evaluation. Blood tests, scanning, and imaging, among other things, were performed. But they couldn’t detect anything physically wrong with him.
I was moonlighting at the outpatient department one day when they were short on physicians. And then I met him.
The time was 11 a.m. He couldn’t go to work since he was in pain all over his body. I informed him that I would not be issuing him an MC. He began to sob.
I looked over the pages of his lengthy medical history. He has never seen a psychiatrist. And, on one of his latest appointments, the doctor noted that he felt like dying.
When I asked him whether he ever considered suicide, he said,’sometimes,’ especially when he couldn’t stand the ‘pain.’
I dialled my boss’s number, Dr. Juswan the psychiatrist.
“Suicidal ideation. Prepare him for ECT, post meridiem.”, came the reply on the phone.
The next thing he knew, he was told not to eat lunch, he needed to go empty stomach. He was changed into a hospital gown. ECG performed, CXR done, all normal. It was good to go.
By 2 p.m., he was already laying on his back on the chilly hospital bed in the operation theatre. IV drip set, Foley’s in, consent form signed. He was still asking everyone around him what was going on and what was going to happen while his limbs were shackled.
“We will make you feel better,” I assured him.
Dr Juswan arrived. “Everything okay?” On the trolley, he examined the ancient-looking wooden box that resembled an antique radio with a plethora of dials.
“Boss, we are good to go,” I said.
It was not necessary for him to go through the file again. I was from the ER. How could anything go wrong with a doctor who deals with life and death on a daily basis?
He gave the anaesthetist a nod.
The patient attempted to speak. Dr Juswan lifted up his index finger to his lips. The patient remained silent.
The anaesthetist placed the mask over his face, he was instructed to count to ten.
Instead of counting, he was trying to turn his face from side to side like a newborn avoiding a nipple. However, his neck muscles were too weak in comparison to the powerful arms of the theatre assistants. He attempted to open his eyes wide, to defy, and then to beg with puppy eyes near the end, his end. But he was quickly overcome by the great weight of his eyelids.
Intubation done. Suxamethonium given. Vitals normal.
“He is under,” the anaesthetist declared.
“Gel. Pad. 50 volts. 5 seconds.” Dr Juswan gave the order.
An assistant adjusted the dials on the ancient box before placing the two electrodes on the patient’s temple. One on each side. The electrodes were spherical foam pads that had been saturated with conductive gel. They have minor greenish discolouration here and there, most likely from moss growing on them when they were stored in a museum somewhere.
His body tensed up, his back arched, limbs straightened, fist and toes clenched and curled. It had to be the most intense orgasm he’d ever had. Too bad he was unconscious.
It was followed by an episode of convulsion. I didn’t even know what he was trying to fuck, or with which part of his body. Every muscle on his body was trying to fuck something.
It had finally ended. He eventually calmed down. There was still some sluggish muscular twitching here and there.
I exhaled a sigh.
“Repeat!” Dr Juswan said.
There we go again. Another orgasm.
The pee bag contained some urine, but no seminal fluid was found. With the Foley in place, perhaps he ejaculated retrogradely?
“Again!”
God-damn! It sounded like someone was deflating a balloon. The stink was filling up the theatre.
“You didn’t give him an enema?” Dr Juswan inquired.
“Sorry about that, boss. But I have instructed him to BO.” I responded.
“We are done. Clean it up. OMG! I just had my lunch!”
In the recovering area, he gradually regained consciousness. “What happened? I feel like I have been beaten up…”
“By Chuck Norris?” I responded.
“Who is Chuck Norris?” he asked.
“Nevermind. Jackie Chan?” I suggested.
“Yes. Yes. Jackie Chan! What happened? Very painful everywhere! I can’t remember anything! Where is my clothes?” Nothing came to his mind.
“Don’t worry. How are you feeling?” I asked him.
“I want to go home.” He started to cry.
“Sure thing. Here is your MC. One week. If you want MC again, come look for me the next time.”
We haven’t heard from him eversince.
I am still quite proud of myself for being able to heal my patient of an undiscovered chronic condition and allow him to return to work with sincerity.
Ganbate! Jia-you! Jia-you!