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The one about Grandpa
Many things in life incite different forms of emotions, as we grow we learn to react to different events with a dynamic set of emotions. We do not need to learn how to feel happy or when to feel sad. When another kid snatches your ball away, you do not need anyone to tell you, “You should be angry now”, it comes naturally and even if you do not know what being angry means, it doesn’t stop you from feeling so.Then again there are events in life, which, no matter how many times it happens, you never learn to deal with it in the right way. A set of events defying all pre-established norms. An anomaly on the unblemished surface of our emotional resume.Old age and death is a natural transition interweaving between our lives, a common trait you share with the stranger beside you on the train. Often times, it is with the benefit of hindsight that you come to realize how big an impact someone has been on your development. You start to wonder how you might have turned out without their guidance or advice. Would you be better of, or would your path become skewed. The reason for this post is my Grandfather. He is 87 this year, no longer the authoritative figure we have grown up with, no longer able to shuttle between Singapore and Indonesia on his own and no longer able to chase me around trying to knock my head with his knuckles. Instead he now requires an aide to hold onto him as he makes his daily commute from his room into the living room or the kitchen. The aide my mom hired for him is Indonesian, the only other language my Grandfather is proficient in, and her job is to watch over him and attend to his needs at all times of the day.But no matter how careful you are with an elderly person, accidents can always happen. Last Tuesday, while on his way to the Kitchen, the Aide turned away for a few seconds and my Grandfather fell. He apparently fell forward hitting the right side of his head on the bedpost causing a large bruise over the surrounding area. Seeing that he was conscious and able to walk back to his bed, my family decided to let the matter rest.The next day, when I came home from work, my mom told me of the accident. I asked her how he is doing now and my auntie, who had been listening, replied that he hadn’t gotten out of bed the whole day. I decided to investigate the matter seeing that a reduced sate of consciousness is not a good sign as it may indicate other complications such as head injury or a concussion. When I went to see him, I saw a big swollen area over his right eye, and noticed that the right was tearing. I looked around the head for any other signs of bruising when I saw a patch of purplish bruises behind his right ear. I looked at the other ear and noticed the same bruising.I knew immediately these were Battle’s Signs. Named after William Henry Battle, Battle's sign, also known as mastoid ecchymosis in medical terminolgy, is an indication of a fracture of the base of the posterior portion of the skull and may suggest underlying brain trauma. It consists of bruising immediately behind the ears. Another common bruising sign of a skull injury is raccoon eyes, the purplish discoloration around the eyes following fracture of the frontal portion of the skull base. But since my Grandfather suffered blunt force trauma to the region around his eye, I ruled the bruising under his eye to the immediate effects of the trauma.I notified my family of this discovery and alerted them to the seriousness of the matter at hand now. I explained to them the complications that could arise from a brain injury stressing on words such as Brain Death and Aneurysm. I told them I have seen such signs before on patients of Road Traffic Accidents and other cases where major head trauma was sustained. I advised them it was definitely a good idea to at least have the injury checked out while highlighting the bruises behind his ears.My Grandfather was taken to Mount Elizabeth hospital on Wednesday night for an X-Ray. A decision, which I protested. Private Hospitals do not have doctors on standby in their A&Es thus not being able to provide emergency care for my Grandfather. The family however, were against the idea of sending him to a government hospital citing long waiting periods, poor ward conditions and since Grandpa was an Indonesian citizen, he wouldn’t receive any government subsidy anyway. Even after explaining that the Ambulance service (which I am VERY familiar with) will send Grandpa directly into the A&E immediately handing over the case to the doctors (no waiting time), they were still adamant on their decision.Auntie 1: Wah must call Ambulance ahAuntie 2: Wah dowan lah later Police also will comeMe: The Police come for what?Auntie 1: Not so serious lah no need ambulance lahMe: Ah Kong’s condition is seriousAuntie 2: Choy! Don’t anyhow say!After much argument I could only bite back tears as I watched my Grandpa being wheeled into the A&E of Mt Elizabeth Hospital. As my aunties were with him I was asked to return home to await news since I had to study for an exam on Friday. Part of me wanted to scream at my aunties while the other part forced me to control my emotions. I knew full well the futility of my argument. After all who did I think I was, I was only a Medic during NS, all the medical knowledge and experience I had gathered were only from my 6 months of intensive lectures and 1 and a half-year of public service. I did not have the right to diagnose my Grandfather.I went back with dread in my heart, the kind of dread that restricts you from doing anything else. I sit in XM’s living room trying my best to study but the words in front of me continued to make no sense. My mind was flustered, eagerly awaiting news from my aunties. Images of Grandpa sitting me down and making me repeat his sentences in Malay, and of him showing me the right way of eating rice with my hands, how he would knock my head if I used the wrong hand flashed through my mind like sadistic picture cards.My phone rang at 1am, my mum informed me that the X-ray results turned out ok and Grandpa was on his way home. I was relieved at my own misdiagnosis and glad that everything turned out well.The next day, the family had a meeting at my place, seeing that Grandpa’s condition hasn’t changed much, they decided to bring him to another specialist at Mt. Elizabeth Hospital. This time a CT Scan was to be performed, which will prominently display any irregularities associated with the injury. My diagnosis from the previous day came back to haunt me, I realized that an X-ray will not be sufficient to show any anomalies in the head. For a head injury to be confirmed a CT Scan needs to be performed.The results were released the very same day. Just as I had thought Grandpa did sustain injury to his brain thereby causing the Battle Signs to appear. There was bleeding in his brain, and the some of the blood had coagulated forming a major blood clot in his skull. At his age the doctors advised against open brain surgery, a procedure that is risky even when performed on a healthy teenager. Statistics wise, the doctor had quoted a 30% chance of survival from the procedure. There was nothing much the doctors could do.An emergency family meeting was held, filled with tears and regrets. I wanted to say out loud, “I told you so!” but restrained myself. I don’t see any point adding insult to injury besides even if we had sent him to the A&E of Changi General immediately, there was doubt that anything could have been done. The only thing to do now was to stay with my family throughout these difficult times. It was decided that Grandpa should be discharged letting him spend his final days with loved ones. Even though he is in a coma now a part of us thinks he knows we are beside him, holding his hands.
posted by Ken The Man at
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