aspirate je la

Usually when people refer me, I don't ask much. I'll just go and see the patient myself. Unless I couldn't be seeing the patient (stuck in OT or other more urgent matters) or wouldn't (phone consult for a TCA).

Today one Medical MO referred me back regarding one patient's neck lump. They're treating as smear negative TB and the only other sample left they haven't got a culture from is the neck lump. My surgeon already saw that patient and he said not to touch the neck yet, USG first. Get sample from her sputum and her ruptured axillary swelling. Both of which came back AFB not seen. 

I told her to aspirate that thing if they really want. Because Radio not granting USG while patient is warded in SARI. We don't do trucut biopsy at the neck and FNAC is just a fancy thing where I bring a lab technician and her stuffs with me while I aspirate things. 

Might as well aspirate that lump (which my surgeon palpated as a cyst) and send whatever it is they want to send. 

"Then I'm referring Surgery to aspirate it."

"You're referring me to aspirate that thing je?" 

I frowned but my tone was even, pressing on the "je". I couldn't believe what I was hearing. They do neck central lines, they tap here and there. But they're referring me just to poke an unchanged swelling with a blue needle.

"Yes. Medical are stupid like that."

I never said that and never thought of that. Woah. This girl degrading herself so much for sarcasm or what? What's her deal. 

At that point I stopped saying anything and just let her talk. Which she then said she'll document this and this as Surgical input, to monitor the progression of the swelling, get USG as outpatient and will refer back if indicated. I told her the USG outpatient was already the plan when my surgeon saw the patient and she can just give the patient TCA SOPD with that USG. 

They started ATT already. What difference does it make now? 

SARI is being handled like COVID. I help prepare the PPEs and our hospital production is 'kais pagi makan pagi, kais petang makan petang' so I know how precious the PPEs are. Dude my fingers hurt from getahkan all those boot covers and long cap so I'm not going to simply go see patients in COVID or SARI ward, don a PPE for a quick non urgent procedure any doctors can do and then ciao. 

Nope.