Doctors as a group are good Samaritans. Most of them are in the service of humanity, money of course matters but of many doctors that I have met and know of, are good human beings. My friend Vijay sent me a video in which a physician was speaking about heart ailments. This doctor had a very nice way of putting things across in a humorous way. He was putting his thoughts across that heart ailments can be cured without surgery, angioplasty and invasive procedures in general. Vijay asked me if this is really possible. When he asked me this question the whole kaleidoscope of my interactions with doctors, throughout my life, passed by quickly. This made me think of two things, about doctors in general and about getting well with their help.
My first reaction was that, when doctors treated you as individual doctors they were simply good to superb, as is natural in any group of people. They always cared for you, they would try to give least amount of medicines as possible, and try and allow the nature to take its course; they would intervene only if needed. Over a period I have observed that doctors explain things in details about your ailment. On the flip side I know a doctor who instead of explaining gives you a link to his YouTube presentation about your ailment, which I thought was very impersonal.
The personal attention however changes when you are required to go to hospitals, where you are theoretically in a corporate environment. You would expect quick and efficient actions followed by continuous tracking as would be expected, as patients go to hospitals only when such need arises. I do not know what happens in that environment but things are sometimes at the other extreme. You will see inefficiency galore, delays, late responses, doctors just not being available and so on. (Oh don’t worry the intern will take care of you!) I remember when I was required to take my father to a large hospital due to heart attack. He was admitted under a senior physician. After initial checkups I was promised that the senior physician will shortly come and see my father. After a couple of hours I was coolly told that the doctor will now come the next day as he was now busy in his consulting rooms. For me it was it was simple, if the senior doctor is too busy to see my father then I would rather go to another hospital. When I said this to the junior doctor, he said we should not do that as my father was critical! I said if he is critical then why the senior doctor is not checking him? Within 15 minutes the senior doctor came!
I remember a case of one of our relatives; he was admitted to a major hospital due to stroke. He had diabetes, he was on dialysis, and he had high blood pressure. For two days doctors would just not share details hence I was called to talk to them. Hospital was trying to force a brain surgery on the patient (had put him on ventilator) but as layman I could see that it was meaningless. I took a young doctor to side and asked him his blunt opinion; he said the patients’ brain is 85% damaged and he has no hopes; he gave a sad smile and said well looks like commercial aspects have taken over the case! We managed to remove him from that hospital to another one where we knew the doctors well. Doctors gave the same opinion and advised that he should be allowed to die peacefully! We did!
But I know of a physician who treated a friend of mine for heart ailment; my friend did not have sufficient insurance coverage to have bypass surgery. This doctor explained to my friend how this can be handled without surgery but he needs a drastic life style change. This was 20 years back; my friend and I had coffee last week!
This reminds me of a story told to me by a young doctor. He was working for a small hospital. He checked a patient and felt that no tests were needed. So he let the patient go. When the hospital owner came he asked the details. When he shared details about this patient, the owner said “Is my father going to pay installments for the new test machine?” Our friend simply said “looks like it” and calmly resigned and walked out!
A student hurt himself while playing badminton. His friends took him to a large hospital. When his parents reached the hospital this student was very upset and said “Dad lets go elsewhere”. His father told him to let the doctors handle the basics then they can move. The student said that they took x ray of his ankle and later found out that the doctor had forgotten to put the film in the machine!
The stories can go on and on! But as in life there are good doctors and there are not so good doctors. There will always be some black sheep. But why the basics change in large hospitals is beyond my understanding. Are doctors not good managers? Are good managers incapable of handling intricacies involved in running a hospital? Well hospitals these days have software to handle their administrative work. What a hospital system does is to provide services required by patients. This is very similar to running a hotel or running an automotive workshop. These two also provide services. Did you ever find that garages and hotels took 3 to 4 hours to give you or your vehicle a discharge? Why is that hospitals take so long to discharge a patient? On the other side, I have experienced an extremely efficiently run pathological lab. They are very efficient and at stipulated time you get your reports by email! But the norm is inefficiency.
Coming back to the video, the doctor aptly said that if you want to get well then the patient has to follow ALL things told by the doctor. He gave an example saying that if a tank has 15 holes, how can you fill it up completely? It is obvious that ALL 15 holes need to be blocked to fill up the tank. A patient with liver issues says what is going happen if I take a peg or two of whiskey? Then the patient is asking for trouble. A senior physician once told me that in diabetes, most of the patients keep on having issues as they do not follow the basic discipline of diet, medicine and exercise! He said a very small percentage of patients have really erratic body responses and have a tough time as diabetes remains erratic even after following ALL instructions. He also told me a story of a disciplined patient who in yearly checkups found that he had very high diabetes. But by following the regimen to the last dot on I’s and slash on T’s, in three years’ time the patient has become non diabetic, with medicines!
Friends I wrote this blog to suggest how health issues are handled and need to be handled. These thoughts come to mind probably because I am a senior citizen now!! I will add a few more points. All “Pathys” are as good as the doctor who uses them. Each pathy has its own benefits and down sides plus limitations. When you are having jaundice there is no known cure available in Allopathy! You have to take Liv 52. Similarly other pathys also have limitations. But we should not be very rigid in our thoughts about up & down sides. That Allopathy has certain side effects is a known fact but that does not mean there are no good sides! Allopathy is the best researched pathy and offers cures to many ailments, even the toughest of the ailments. Homeopathy and Ayurved have their own advantages and limitations. What happens is after reading something about side effects of Allopathy, some people tend to just ignore it, to me at least, and it is to their own peril. There are diseases like cancer, dementia and many such tough ones. Very strong Allopathy medicines are also not able overcome such ailments. In such cases people should NOT experiment! I will share with you an anecdote about a patient with blood pressure problems. He went to the doctor and got himself checked. His BP was 200/120! Doctor suggested that he get himself admitted to a hospital or take 100% rest at home for at least four days and then prescribed to him strong medicines. The patient probably did not understand the meaning of 200/120. He asked the doctor, “I am worried about Allopathy side effects. Can you tell me the side effects and try to reduce the dose”. Doctor said, “Let us experiment later, and at this stage let us act fast”. Patient still insisted on knowing about side effects before starting the treatment. Doctor gave him all the details and said, “As against these side effects, if you do not take medicines there is only one side effect”. Patient said “what is it?” Doctor said, “You may die”. Amen!!