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Thursday, May 24, 2012

Doctors

Long ago i was walking in trivandrum during the night and the street lights were off . Very few vehicles and no other people on the road . Suddenly a motorbike which had just passed me with two six foot men turned around after a few metres and approached me . I was a little scared considering that it was a place in trivandrum known for gangsters . I looked at them and both of them were smiling at me : two complete strangers .  Apparently one of them was admitted at the ward where i was the medical student and they just wanted to say hello .I was very happy  .  Thinking back ,  i  can only  think  about  very few professions which gets this respect from total strangers .
                                                                                    To this moment i strongly believe a doctors profession is one of the noblest professions . But due to the tremendous changes in the society in last two decades i feel its one of the most "challenging " professions to be in these days . (and i dont mean in a positive sense )  . Its most challenging for the people at the frontline of medicine  --paediatricians ,gynaecologists etc .  Whenever a person  dies unless he is very old and "expected to die "  it is the onus of the doctor to prove that the death is not caused due to his neglect .  I have observed on numerous hospitals that the skill of the doctor is more in predicting death than saving the life .  And if by misfortune any medication has been given in the preceding 30 minutes before his death its a case of wrong medicine injected (concluded by the public)  .
                                                                         Recently i had a discussion with a few radiology  postgraduate students  about the trends in specialty choice last few years . It has been radiology ,radiology,radiology  for the top rank holders . There are many reasons for this choice but one of the reason is this specialty offers more rewards than the frontline specialties of medicine .  I still believe that the unique reward of intense patient contact is missing in radiology . But still this speciality also safeguards to a large extent from the intense contact with the public many of whom are arrogant , ignorant and even physically abusive to frontline doctors these days . These young postgraduate students were telling that when they were doing housesurgeoncy an infant death or maternal death means sure physical abuse . Now they are all happy that those days are behind them .
 Paradoxically thanks to modern medicine  the maternal mortality and infant mortality has reduced almost ten times in the last 50 years . And 50 years ago when numerous women and infants used to die  the doctors were respected not abused .

  Even in the primitive tribes the witch-doctor was one of the most respected person in the community along with the village chieftain inspite of many of his patients dying .  Probably the expectations of modern man with his dreams of 100 % survival till 100 years is not being fulfilled by present day doctors  . Or the vast technological strides has made us so egoistic that we think we can control death and disease fully . Coming to think of it in natural disasters like tsunami there is no use of blaming anyone while in any hospital death (people still die in hospitals ) they need to vent their anger at someone for the "failure " . I think even the anger felt towards doctors is a time for deep introspection about us on what we expect out of our unpredicatable life (medicine just reflects that unpredictability even this day ) .
                           
                                                                            Though there are blacksheep among doctors like all other professions, overall i feel they do  a much better job considering the society in which they operates .  And its high time they are given their respect due or as i fear its not long before the best students do not opt for this noble profession and patients are left in the mercy of doctors who are as ignorant as them ...





                                                   
                                                                       
                                                                                   
                                                                       

4 comments:

  1. Haroon, I agree that medical profession is a very noble profession. But what is equally true is that the doctors are mostly very arrogant. They think that the non-doctor patients are dimwits incapable of understanding physiology or medicine even if it is explained to them. They never tell them what is wrong with their body after examining the patients. Even if the patients ask about it, they reply in a vague way. Many of the common people I see around me say that the doctor told them to eat these tabs or drink these meds but do not know what is wrong with them that made it necessary to eat/drink the meds. I've heard that in western countries it is the the right of the patients to know what is happening to their body and they can complain if the doctors did some treatment without informing them. what is wrong with Indian medical service??

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  2. sorry for late reply ..
    though seemingly simple this is a little complicated issue .
    I fully agree that an educated patient should be explained and these days many doctors do it and if they dont its time to change your doctor .
    This is however not practical in government hospitals where average time per patient could be as little as 3-5 minutes ( reasons for poor healthcare infrastructure is a very loaded social topic which touches on economy , our corruption etc etc ..)
    Lastly a small incident i will narrate based on my experience ..

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  3. i used to work in the land of thacholi othenan the famous martial arts hero in northern kerala --badagara part-time . Overall it was a good time for my reports on ultrasound were respected but there was just one single incident where i had a small problem . It was not a medical mistake but the very point you had pointed out . Unfortunately i had to tell the patient that the result of the ultrasound was not good for her baby . Unfortunate but the truth cannot be hidden . I still remember she asking me whether all things were ok . And since the babies brain was replaced by fluid i had to tell her things were not ok .
    In the evening her brothers and husband came and asked me why i told her things were not ok ? Apparently according to them i shouldnt have told that there is a problem. I was saved that i didnt explain the problem to her of fluid completely replacing brain of baby .
    It would be good if you imagine yourself in my position and what explanation you will give the pregnant mother ...

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  4. According to American College of Radiology guidelines it is appropriate to communicate the result of the examination if the patient enquires and i had communicated . But the relatives of the patient had not read the ACR guideline ..
    Also had i given a detailed explanation(of her delivering a congenitally deformed baby ) i dont know what would have happened that day ..

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