analogy of a critically-ill patient

many would have argued, with their facts and numbers, justifications and qualifications, experiences and exposures, belief and principles that the core of management of a department is completely different from management of a patient.

but, i beg to differ. i beg from a lowly position that i held, without any power, respect or jurisdiction. management of patient is a life and death affair, but management of department is just about life and death of the corporate body - no blood, no gore, no people dying. But if that people in the department is involved in management of patients, by compounding factors, there's more gore, more blood and more... I will stop the list here

here's the analogy...

beep... beep... beep...
the machine of the ICU beeping to the heart rate of the ill mother, who had labored for many hours and managed to survived a postpartum haemorrhage. On the verge of going into the nightmare of disseminated intravascular coagulopathy, her condition continues to slide.

2 obstetricians stood by her. maybe more. both agreed - the patient need blood. the blood bank was contacted earlier. very very much earlier. the blood bank agreed to supply 4 pints of whole blood. whether or not the promised quantity is sufficient is still questionable, but to the very least, it will alleviate the condition, possibly to a great extend.

1 obstetrician waited patiently, while the patient continued to filled up her drainage tubes with small crimson tide. he called back to blood bank and "on the way" was the standard reply, even after few hours. he continued to wait - patiently, in spite of news that the assigned blood was channeled to other patients, for reasons only known to the blood bank who couldn't really comprehend the clinical side of matters.

another obstetrician, at a slightly lower hierarchal position, suggested that someone should go to the blood bank to get those essential life-saving human products. his polite recommendation seemed to have fallen into deaf ears. as patient deteriorated further, his motion escalated into a stern proposition. he was seen as impatient, harsh, pushy, less civilized from the approach, though his intention was noble, timely and appropriate.

the remaining hemoglobins of the patient is fighting their best war in keeping the patient alive. the patient wished she could stand up and march to the blood bank to keep herself alive.
the patient hopes and trusts that she's in the good hand of obstetricians.
and the only thing that she needed badly is still "on the way".

on the way...
on the way...
on the way...

and soon, the patient will be on the way to heaven...

no, this is neither an open assault on the blood bankers, the obstetricians or the intensivists, but a grim reminder of the negative repercussion of the refined gentle courteous practice of a manager.

expectant management must be used with extreme caution and extreme flexibility and fluidity in managing development in the case scenario, or else, be prepared to bear the extreme liability due to delay in responding to the arised complications.