In the Dark

It's the human nature everywhere, including the medical profession, to learn the know-how by habits.

We practice medicine by copying what our predecessors do, though we're unwilling to admit this. After a while, it's second nature and we keep our routine doggedly. And if a bold student comes to ask why, there comes the dismissive reply, "Simply because we've been told to do so."

This morning, I went to see a patient whose large blood vessel developed a tear and began to rip. There is a good chance that my patient can die if the blood pressure are left unchecked. High blood pressure can weaken the wall of that broken vessel, further tearing the outer wall. His team doctor had started him a drug labetalol intravenously. I thought I'd do the same, too. But I was stupefied to see a "naked" tubing infusing the medication. By naked, I mean the tubing was not covered like how we wrap a candy.

"How come? We should have wrapped it to protect the drug from light," my resident shared with my view and shook his head. "We've been taught to do so since graduation from school."

We started to worry that naked tubing could have exposed the drug to excessive light, making it ineffective. It would appear that I should pull evidence to show the nurses why they should cover the tubing. What stunned me even more was that I could not find any evidence to prove them wrong. Not a bit of it. And then the pharmacist confirmed that it's perfectly fine not to keep the drug in the dark.

I gave a vague smile but could think of nothing to say. If I am candid, I'm among the ones kept in the dark.