Spelling it out

You know what I realise…. we don’t explain things well enough.

By we, I mean bruneians in general.

And by we, I also encompass the various government and private sectors that exists in Brunei.

I dont really want to name anything specific but I’m sure people have gone through it before anyway. An example would be concerning the information given by health professionals. I have had people asking me of what a diagnosis given to them means, what the prognosis is, what can they do to help/cure/manage. Even worrying is having a discharge letter from an oncology patient detailing CT scans and further management and people asking what the letter is saying. Firstly, I’m not gonna bash the healthcare professionals because I’ve been there. I know how it feels like to have so little time and having to rush to see the next patient. If I can, I would love to explain everything in detail. Even when doing baby checks, I wish I can encourage mums a little bit more on breastfeeding, going more in detail on colostrum etc etc, but I can’t. I’m a service provider and I need to get on with the next baby check, seeyoulaterthanksbye.

There could be other reasons too. Maybe there is still some subservient nature, where the authority thinks it’s ok not to explain everything. I dont think its because they dont care but it didnt occur to them that we expect more. Society is changing though. As people are more educated and knowledgable, we want to know more. We question more. So what is the condition really? What does it mean for me? What’s the prognosis? Why does it happen? What’s the management? These are all legit questions. Simply telling me the diagnosis and giving me antibiotics does not
do anymore.

In fact, in today’s practice of googling everything, it’s even more harmful. People could go to dodgy websites suggesting alternative treatments, or make them
even more hypochondriac than they are (omg please do not WebMd it – looks at Big Bro 3). Or they could speak to their neighbour who said ‘oh so and so have that too and died the next year.’ Oh yeah, thanks.

And I’m not talking about just medicine here. I have heard plenty of stories regarding how we are not transparent enough. For example, someone might not be granted something and it may very well be a justified decision but tell
us why the person didnt get it. Spell it out to us. SPELL IT.

Also, there are countless events where I wish they could just tell me more. Ok, there’s a charity run – what charity is it for? Are all proceeds going to them? And there would be posters telling me about it but no websites or anything where I could read more about it.

Maybe I’ve just gotten used to having everything spelled out to me here. Like kalau mau ada manual macamana beranak, one day they probably would have it. When I had caesarean section, there were countless pamphlets from ‘having c section’ (what to expect) to ‘exercises after c section’ and then in second pregnancy ‘vaginal birth after c section: risks and benefits’. I smirk because it sounds like kana baby kan,
but that’s because I know it. To those not in the know, it may very well be information much welcomed!

In terms of medicine, I really do understand the limited time per patient, the time pressures. What we need to remember is that the time spent on good
communication and explanation actually is cost beneficial – patients understand more, will be more compliant with medication/management, less chance
of readmission or attending A&E, and overall increased trust to the healthcare system.

Perhaps we should have more DETAILED pamphlets on everything under the sun that is common and make it readable and in different languages (aka malay and english). Here I may not find the suitable pamphlet but I can direct them to websites, so at least I know theyre reading respectable websites and has good knowledge from it.* Sometimes if I have more time, I’d print the pamphlets from those websites if the hospital I work in doesnt have them. I’m not sure of any malay language medical websites to recommend.
I know there is a website where people can ask malaysian drs medical questions (forgot the name of website) but not one where you can read on different conditions.

Also to those who are and will be patients or families of patients, ask. Just ask. Don’t go out of that clinic/hospital unless you understand fully. If they explain and you still dont get it, ask again. ASK. I used to work for a surgical consultant who is super scary (banar
menggigil lutut kalau ya bad mood. tiap kali ward round, macam
kan tekamih rasanya – haha kira berijap banar tah sudah tu) and he would be giving instructions in a mumble and super quick way. I couldnt hear him
most of the time and I’d turn to my colleague – ‘what did he say??’ He shrugged ‘You’re the one closest to him!’ Alamak macamana ni, kalau salah ku buat, makin tia marah karang. And I would ask and ask until he probably thinks I’m the most doofus house officer that existed. But at least I got the job done! The point is – it’s scary to ask and you might be worried to sound like a fool but it’s better asking then! That dr saw you, saw the blood test/x ray results, made a conclusion and he/she should very well give the explanation of why they diagnosed you with so-and-so.

Anyway, wherever you work in, please take time to explain. Spell it out for me if you can.

Many thanks,

*Ps. The websites that I recommend are:

For medical conditions – http://www.patient.co.uk
For paediatrics – Great ormond street hospital website. It has really good explanation on conditions that I read it to learn and make sense myself of paediatric conditions and management! I used this website to practice on communication station for exam!

PPS. I havent used the healthcare system for a long time so I may very well be wrong and these are isolated individual cases. Please don’t shoot me.

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