Monday, February 6, 2012

Living In The Fast Lane

[ musings of Shaykh Hakim Achuletta ]

Shaykh Hakim Achuletta is a different 'animal' from myself.
He practises 'holistic' medicine stemmed from  his background of hemeopathy.
He 'lives', figuratively' from my perspective, in the 'slow lane'. He can intellectualize and has the luxury of time and his practice is sedate.

My speciality is  usually  in the slow lane but oftentimes in the  'fast lane', ocasionaly too fast for my  own 'mental health' : you get to see someone's bp on the floor while 'operating' on him on the  table and you have exactly one minute, not more, to react  and bring it back to some respectable level otherwise things will get catastrophic: his rthym will fast degenerate to ventricular  tachycardia and very soon after, ventricular fibrillation. All hell will break lose thereafter.

In interventional cardiological parlance, 'time is muscle'. We do not have the luxury of time to 'stand and stare'. More time spent in indecision means more  heart muscle death, more subsequent heart failure, translated subsequently to more early premature death.

When our ER team sees a young chap brought in  'technically' dead with a 'sudden cardiac death ' syndrome [ cardiac arrest ]. They have  exactly  30 seconds  or so to 'defibrillate' [ electric shock to the heart ] him to bring his rthym back to normal and your team need to intubate him fast to takeover his breathing etc etc and lane needing fast action and decision.  Failure to do so mean the young man may either go home in a coffin via the mortuary  in the basement floor of the hospital, or worse still, his young wife may need to take care of a 'vegetable for weeks or months with very slim chance of recovery.

Than, a quick discussion to be made with family members with respect to triage to active 'endoluminal' [ ptca/ptcsa] intervention, mean a fast transfer to the cath lab for an urgent angioplasty/coronary stenting , or , a chemical lysis of the occluding blood clot, ie a quick transfer to the CCU for intravenous bolus metalyse infusion in the case when family members are rather slow to make up their mind. In such situation time is of the essense, and to me  just 15 minutes  of hesitation is too long. 

" Madam do I take your husband on plan A or plan B ....please decide ! "
"Doc, I have to check with my insurance..........". 
They have to check with an insurance clerk somewhere based in a Kl office who cannot comprehend the urgency of my problem. That is what it usually boils down to nowadays !
A clerk to decide a life and death situation. Can be frustrating on my end.

That is usually my perspective...... Always on the balls.
Medicine is multifaceted though. Some, like psychiatry, sedate and slow. Orthopaedics despite the fractures and all usually can wait for tomorrow. While others are fast and oftentimes gory and bloody, never as sedate as homeopathy. 

But  someone has to do the 'dirty' work on 'man' in his quest with respect to time, his modern activities [ fast cars, fast lives and fast women all thrown in ] and  the vagaries of aging. 

Having said all that however,  in many ways, I do share  a lot  commonalities with Shaykh Hakim's views on life as a whole.  

Lucky him, sedate, full of wisdom and very intellectual . Do listen to him,

Related articles in the blog :
Elixier of youth,
Mixing the profane and the sublime,
Longevity: a Muslim's perspective,
Unto Him Is The Journeying,

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