The common doctor's cabin, except the ones who are attached to five-star hospitals, like Hinduja or Leelavati, is a thoroughfare, anybody having access any time. In India, a patient is always accompanied by at least 3 to 4 relatives who literally throng the cabin as if owning it. And rather than the patient they are the ones who are overly eager to furnish the history necessary for coming to the diagnosis. In such situations I literally have to shut them up and ask the concerned one, the patient to furnish the details, an approach abhorred by many from the tribe. They are not guardians but the custodians who decide everything for the well being of the patient though the affected party may be well past 40, having school going children and 20 years service in his/her kitty. If the patient is a female, may god save her, she is not allowed to speak even a word. The height is, not only she is not bothered but when prodded directly by me, looks at her male counterpart, maybe a husband or a son, for him to carry the conversation further. I then have to interfere and say, "They are not the doctors, tell me, I am the one you have come to for your ailment." Sheepishly then she would venture to give out a few details which amount to like finding a needle in a haystack.
It so happens many a time that something bad/ sinister comes out of the entire examination, investigation routine. As soon as I am about to declare it, the antennas of these custodians are upped in no time and they start gesticulating to convey their displeasure about revealing it to the patient. 'Don't tell him/her, it will affect him/her. he/she won't be able to take it, it may be a big psychological jolt you know! So far we haven't told him.' etc. etc.
I never ever understood this stance. The normal human mind is extremely resilient and can absorb many a shock with dignity. Those who can't, are already weak psychologically and are not going to cope up with the situation anyway! WHO has accepted it as a human right to know about oneself, one's body. These so-called custodians are depriving the patient of this right, under the guile of ' How much we care for you !' A total pseudo mask, that comes off immediately when I try to explain further.
'He is suffering from a cardiac problem [ or any such life-threatening disease], if HE doesn't know, he is going to run to catch a missing bus and going to fall dead when you are not going to be there for him for 24 hrs. Forget about catching a bus even if he strains while passing the motions he may pass out in the loo itself. Are you going to accompany him to loo every time? If HE knows he will take care of himself. And there is nobody in the world who could take better care than one himself !' Unfortunately many a time it falls on the deaf ears and the army of well-wishers wins in the end.
After receiving prompt treatment for Acute Myocardial infarction within the right frame of time, one of my female patients recovered completely with a total reversal of ECG. Husband arrived from outstation next morning insisting on discharge as the patient did not have any complaint by then. I cajoled, insisted, tried to explain, requested him to take her to another hospital of his community/choice if he was not happy with our treatment but all went down the drain. In the end, I had to discharge her against medical advice within 24 hours of admission [ For Acute Myocardial Infarction]. Point to be noted is, 'In the entire scenario the patient/ wife did not have any say !' As expected, unfortunately, she died at home within 4 to 6 hrs of discharge. Now, who should be held responsible? Naturally, the Hospital refused to issue a death certificate and asked for Post mortem. No sooner word PM was uttered he vamoosed in the thin air without leaving a trace.
Again a female patient running 104* F fever was forcibly taken home, on the insistence of distant father in law, uncle of husband, to look after the kids as there was no extra female helping hand at the home !.
RTI,[Right To Information] has governmental air about it. So that's out but every person must have the right to know about him, his body, his ailment, how he takes it, should be his problem. The doctor in the picture is an expert in the field and for this very expertise, the patient comes to him, to know, where he stands. The sugar-coated pill is a thing of past, if the pill is going to be bitter there should not be any hesitance on part of the doctor to dispense it, it's patient's problem whether to swallow it or not! That's right to know. So if one knows, he/she can plan out his/her life as per one's own wishes. Least, as well-wishers, we can do !
It so happens many a time that something bad/ sinister comes out of the entire examination, investigation routine. As soon as I am about to declare it, the antennas of these custodians are upped in no time and they start gesticulating to convey their displeasure about revealing it to the patient. 'Don't tell him/her, it will affect him/her. he/she won't be able to take it, it may be a big psychological jolt you know! So far we haven't told him.' etc. etc.
I never ever understood this stance. The normal human mind is extremely resilient and can absorb many a shock with dignity. Those who can't, are already weak psychologically and are not going to cope up with the situation anyway! WHO has accepted it as a human right to know about oneself, one's body. These so-called custodians are depriving the patient of this right, under the guile of ' How much we care for you !' A total pseudo mask, that comes off immediately when I try to explain further.
'He is suffering from a cardiac problem [ or any such life-threatening disease], if HE doesn't know, he is going to run to catch a missing bus and going to fall dead when you are not going to be there for him for 24 hrs. Forget about catching a bus even if he strains while passing the motions he may pass out in the loo itself. Are you going to accompany him to loo every time? If HE knows he will take care of himself. And there is nobody in the world who could take better care than one himself !' Unfortunately many a time it falls on the deaf ears and the army of well-wishers wins in the end.
After receiving prompt treatment for Acute Myocardial infarction within the right frame of time, one of my female patients recovered completely with a total reversal of ECG. Husband arrived from outstation next morning insisting on discharge as the patient did not have any complaint by then. I cajoled, insisted, tried to explain, requested him to take her to another hospital of his community/choice if he was not happy with our treatment but all went down the drain. In the end, I had to discharge her against medical advice within 24 hours of admission [ For Acute Myocardial Infarction]. Point to be noted is, 'In the entire scenario the patient/ wife did not have any say !' As expected, unfortunately, she died at home within 4 to 6 hrs of discharge. Now, who should be held responsible? Naturally, the Hospital refused to issue a death certificate and asked for Post mortem. No sooner word PM was uttered he vamoosed in the thin air without leaving a trace.
Again a female patient running 104* F fever was forcibly taken home, on the insistence of distant father in law, uncle of husband, to look after the kids as there was no extra female helping hand at the home !.
RTI,[Right To Information] has governmental air about it. So that's out but every person must have the right to know about him, his body, his ailment, how he takes it, should be his problem. The doctor in the picture is an expert in the field and for this very expertise, the patient comes to him, to know, where he stands. The sugar-coated pill is a thing of past, if the pill is going to be bitter there should not be any hesitance on part of the doctor to dispense it, it's patient's problem whether to swallow it or not! That's right to know. So if one knows, he/she can plan out his/her life as per one's own wishes. Least, as well-wishers, we can do !
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