Access

Three years ago, a dear secondary school teacher of mine was struggling with his worn-out heart valve. A normal heart valve is a smooth, glistening, pliable surface that seals off and then opens to the chambers of the heart with every beat. Blood glides over the normal valve. My teacher's heart valve roughened with age, and became a kind of stiff squeaky door stuck with faulty handle. Over time, blood could hardly go through the door. Every time his blood squeezed through the narrow thoroughfare, I could hear the unpleasant screeching sound.

After a while I began to realize that he could hardly survive without getting the squeaky valve fixed. Yet, to state the obvious, it's not as simple as fixing a door handle when we're referring to a door inside an eighty-something-year-old heart. It was a truly challenging operation, coinciding with our cutting non-emergency services to meet the demand from patients infected with the coronavirus. Improbable as it would have seemed to almost anyone else, we tackled his faulty heart valve by inserting an artificial one to widen the opening. All because of our talented cardiologists with state-of-the-art everything.

In effect, the artificial valve acts like a slip coupling for a leaking pipe. The more congruent, the stronger and more secure the case.

It was a big temptation to brag about the success, and sometimes I did. But after less than a year my teacher had a fall at home during a fever spell. Little did I know at the time how sinister that fever was. He didn't text me, as what he usually did in the event of serious medical problem. By the time he found me - after his getting delirious at another hospital - I knew it was something serious. So I took him back to my hospital without second thought, drawing blood myself on the way. Within two days, the blood came back to show sticky bacteria attacking his heart valve; he passed away three days later. "Why didn't he call me earlier?" I kept asking myself.

The situation with my courteous teacher isn't unique in that many patients of us don't want to bother the doctor too much. It's easier for our patients to get hold of our telephone number or email address - and maybe that of our secretary's, for that matter. I know what you're thinking. Who is this doctor kidding? Hear me out. I am not advocating doctors to dole out personal contact number like business card in a party. But sometimes it is worth the effort. Anyway, what's wrong with being accessible when most of our patients are reasonable? One of my patients could not come back from Liverpool in time, and had emailed to reschedule the appointment. After coming back to Hong Kong, he had bad cough and chest pain, but didn't find me again until his rescheduled appointment this Saturday morning. By the time I saw him, he was in such a bad shape I had to quickly get him into hospital, put a tube down into his windpipe and sent him to the intensive care unit for his pneumonia. "Why didn't he call me earlier?" I asked myself.