During a discussion about a surgery of a 91-year-old gentleman, a question was raised, how will his body handle this surgery? His physician was confident and his surgeon, a urinary expert, said he will perform laser surgery. The surgery was performed and a couple of days later the gentleman is recovering well. His surgery team also included an anesthetist. The surgery was nothing complex and for a younger person it would have been a routine surgery. Due to age the situation was a little more complex. But this team apparently was good, confident and more importantly must have handled such complications due to age, before. This last factor is very important.
Our body is a complex organism, on top of that, every individuals body behaves differently, reacts differently. When this surgery was discussed during a conversation with someone else, not from Pune, that person asked a question. Why with similar issues a person from their family was not being operated upon? This is a very valid question, but it also depends on the team of doctors who look after the patient. Such laser surgeries are performed in various cities now. This is not about competence of the team but there is a possibility that this team has never performed such surgeries on old patients. This other person is 80 plus and is suffering from the same issue. The surgeon may be confident, but physician may have different views. But the question is why this option is not even discussed about this patient. Performing or not performing any procedure will depend on different parameters but the most important is specific experience of the team of doctors in that area.
Another person I know about has been having heart issues since last several years. Recently when the person had major health crisis, the person was taken to a large hospital. Looking at the criticality, the experts decided to perform angioplasty as a last resort. This plasty improved the patient’s health many folds. The question arises why this procedure was not done several years back; this problem has been existing for years, but doctors in those times took a decision that angioplasty can not be done. Again, it boils down to the experience of the team to perform such procedures or it is about their opinion and decision not to perform angioplasty in that situation.
A friend of ours has been having health issues, she is same age as me. She was taking treatment from a physician. Once the friend said that she wanted to get herself checked by our physician. Checking was done, all tests were performed. Body parameters from previous tests and current tests were similar. But her previous physician had told her that everything was hunky dory though it was not. The results were so obviously out of range, even a non-medical guy could understand that she needed more control on her parameters. Why did this happen? I am sure that the previous doctor also had his views or may be his treatment is different. So, treatment again depends on the knowledge, experience of the doctors who treat you.
My father died in the year 1980 of a massive heart attack. My nephew Atul, who is a well-known physician in Pune, was a medical student at that time. Sometime recently, we were discussing about my father’s death. Atul said, “Mama, in those times the doctor’s knowledge was limited. Testing methods were also limited. So, the doctors could not judge the seriousness of his problems. I distinctly remember that he had back pain and was quite uneasy for 4/5 days before the attack.” Similar was the case of my father in law. He died a couple of years earlier than my father. He had a heart attack, was hospitalized and came home after 10 days. A few weeks after that, he was told during the follow up visit, that he was now hail and hearty and could now lead normal life. Next day early morning he died of a massive heart attack. Heart attacks are notorious for their behaviour but sometimes it also depends the doctor who is treating, his experience in handling specific cases. Was it a case of wrong judgment by the doctor?
Does it mean that our treatment and our health is based on luck? No definitely not. Doctors have good knowledge. But an individual patient may have some variant of a disease. If the treating doctor has never come across such variants, things can become complex and tricky. Most of the time, we may not take an opportunity for second opinion, even if the disease lingers on. It is sometimes good idea to take second opinion. By doing this we are just dividing the risk.
Honestly speaking, I also do not know how to handle situations discussed. Whenever required go to a good doctor. But one way will be go by the doctor’s reputation. I know of a friend who decided to go take treatment from a certain doctor because he was near their home. There are far superior doctors available in Pune. Once you find a good doctor who could be a physician, stick to him and go back to the concept of “family doctor”, like we used to have GP’s in olden days. He or she will be your regular doctor, will know about your health in details. Any other health issue from different areas, should be treated through him by different specialists. They will work in tandem and chances of you getting superior treatment improve. Of course, the best doctor is NO doctor! But this can be only in our wish list!