Does this sound familiar?

Doctors - having been given the gift of being able to help people in distress - should remember the oath they took before they began their careers, says DR. SARANYA NARAYAN.

RECENTLY a friend's (I will call her Deepa) mother had an appointment with a doctor and she decided to accompany her. They went to the hospital, after having confirmed the time, in the afternoon. They were caught up in a traffic jam on the way, but reached the hospital with five minutes to spare. They went in, met the receptionist, and then sat down on some grimy looking chairs. Deepa noticed that the walls needed a coat of paint, and that with so many patients around them coughing and sneezing, her mother's existing problems could get worse. After half an hour, Deepa got up and asked the nurse if she had informed the doctor that they were there. The nurse told them, nonchalantly, that though appointments were given from 7 p.m., the doctor usually turned up at around 9 p.m. as he visited a number of hospitals. Deepa had not told anyone that she was a doctor too, and they decided, that as there was nothing urgent to rush home for, they could wait for a while more. At around 8-30 p.m., both of them had begun feeling hungry and decided that enough was enough and that it was time to get home.

Hearing about this recently, it cast my mind back to another instance almost 14 years ago, when my parents had gone to an orthopaedic surgeon. My mother was the patient. Her cervical spondylosis was so bad that she was unable to lift her arm. However the doctor was unaffected by her plight and told her that as she was a retired person, there was no need to write, read, or for that matter, do anything seriously. Now that she had the time, having "discharged all her duties", she could just read spiritual texts to pass time. I was in the United Kingdom then and looked forward to her letters. When I heard what had happened, I was indignant. All around me I saw healthy people, in their eighties and nineties, who had hip replacements, generally enjoying life. Why was it in our country alone that we still held old fashioned views on the elderly? Why is it that we dismiss anyone over the age of 60 as being "useless"? I honestly cannot blame my mother for wanting to avoid visits to doctors if she can help it. Most people her age feel justifiably, but wrongly, that they are no longer useful.

These days such experiences are so common that one feels ashamed to belong to this once "noble profession" Very often the medical profession seems to exhibit callousness for patients' feelings and time. However in defence of those good doctors in our midst - there are still many - I must also write about a person whom I feel is quite exceptional. Most of our professors practised medicine the way it really ought to be done, and this we expected and accepted. This is however about a young person who is so conscientious that she follows up her patients' cases even after they are cured of their illnesses. She once said something which made a lot of sense to me. "If a patient walks in to see me, he or she has a problem of sufficient importance to them which they feel I may be able to help with. Otherwise why should they go to such trouble."

Patients with access to the internet have become an enlightened lot. This is to such an extent that they go to not one but a handful of specialists. Such perseverance. The end result is that no two doctors can and will have similar views on either the diagnosis or treatment, and the patient is back to where he or she started. Finally those lucky few that have a consensus on the diagnosis, arrive at the laboratory triumphant with their early success in the first half of the battle at least. They come with this battery of tests with acronyms that make them feel that the doctor they consulted was a very learned person indeed.

The following morning - after a good breakfast, that will get them through the day as they do not know how long this visit will take - they arrive at the laboratory of their own choice or one suggested by a friend. Suggestions made by the consultant are usually on several criteria that I do not want to dwell upon right now.

When they arrive they find a queue. While some wait, as they see that the lab is doing its best, not all patients are good-natured and instead want to get preferential treatment. Some see that a system is in operation and try and reason on the labs' behalf. When it is their turn, they find that they are asked questions (that they think are not required) about their diet and medication on that particular day.

Let us take this example - here was this large individual who was used to throwing his weight around. Now he was asked by this midget of a customer support officer the following questions: "May I have your name, sir?" He was rude in his answer. She then asked if he could spell it or write it out on the requisition form that she gave him. He now looked at her like she was an imbecile but anyway humoured her. She then asked him his age, his initials and, before he could get angry, explained to him that it was a precaution taken, just to avoid confusion in the event of two people with the same name being present in the lab at the same time. She then asked him if he had eaten or had a cup of tea or coffee that morning. By this time he had lost patience with her. He told her to get on with the job, the doctor had just asked him to get the tests done, he knew all the instructions he needed to follow and that he was familiar with the pattern as he had been tested several times earlier. She processed his request and after a few minutes more this "gentleman" was called in for testing.

By this time he remembered that he had had a glass of fruit juice before coming to the lab. He dismissed this, as she had not specifically asked him this and decided to forget about it. When his name was called, just as the technical staff were getting ready to draw a blood sample from him, the young man in the lab asked him once more about what he had had to eat.

He decided he confess about the juice and so proffered this bit of information.

The technician immediately said that for the required tests the person had to have "starved" and requested him very politely to come the next day. Our friend was almost about to explode and decided to have one last try.

"So what, you do the tests and then just give allowance for the juice I drank. Can't a lab this big do that?" This most certainly cannot and should not be done. When the technical supervisor and other staff refused to back down, the patient insisted on meeting the doctor in-charge. When the doctor explained the same thing again to this patient, highlighting the fact that it was being done in his own interest, he was appeased. The last straw however was his parting shot. "Your staff should have told me all this initially." Talk of attitudes.

It is not always as bad though, and there are several patients who come with no expectations apart from being treated courteously and efficiently, are happy with the service and do compliment the lab personnel. This makes up, for all that those in the line of fire have to face quite often and gives them the impetus to meet the next patient with the same amount of, if not more, commitment as before.

The points I want to make is that there are good doctors and bad ones, good laboratories and bad ones too, but do not forget that there are some grouches as well as gracious patients too. I do feel strongly that we - as part of the noblest of all professions, who have been given the gift of being able to help people in distress - should remember the oath we all took when we started out as young idealistic doctors.

We need to spend more time with patients (not have group sessions to save time) and treat each patient as our own kith and kin (thankfully we still care for them, and have a rich culture and tradition to answer to). We need to drop the callous attitudes that have slowly infiltrated into the practice of medicine and not arbitrarily dismiss anyone as being a hypochondriac or old and therefore not important enough. The rot that has set in needs to be stopped and fast at that.

There will come a time not too far away, when we too will need help. Let us never forget that.

The writer is Director, Lister Laboratory and Research Centre, Nungambakkam, Chennai.

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