This is a good article Klaus wrote  for the Diospi Suyana website about call at the hospital. It is so hard at times to be patient and show kindness in the middle of the night when someone comes in for an abdominal pain that they have had for a week. You want to ask why didn’t you wait 4 more hours until the morning or come yesterday during the day. But I try to remind myself that we are doctors not just to try and heal disease, but to also give comfort. And comfort is almost always psychological. As I start this night on call it is good for me to remember this.

During the night in the emergency department

“Mrs Doctor, it hurts!”

Sunday evening in the Hospital Diospi Suyana. Two emergency patients are lying on stretchers.  In order to get a clear picture Dr Martina John obtains the medical history.  In both cases the pain-symptoms have been there for a couple of days.  Both patients could have come during the morning hours or yesterday: why do they come exactly at this time?

Doctors around the globe have come across this interesting phenomenon.  Many patients delay going to hospital until nightfall.  Only then do they get their act together and go.  There are several reasons for this behaviour: throughout the day the sick person is distracted by what is happening around him/her. (S)he hopes that (s)he will get better and encourages her-/himself through her/his own words and thoughts. But once it gets late, night falls over the town and the streets and the houses fall silent the attention of the patient focuses automatically on her/his own situation, which suddenly becomes very threatening.  The light of morning is an age away: not a pleasant thought.

At some point they can stand it no more and their tolerance threshold has been crossed: “Get me at once to hospital, I need a doctor!”  It is harder to endure pain at night than during the day.