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Magazine
Spare a thought for the doctor
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While medical practitioners need to spend more time with their patients, the latter need to realise that doctors too are like them and need time for themselves, says DR. SARANYA NARAYAN.
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It is in a patient's best interests that he consults the same doctor.
MY earliest association with the medical profession was a child, when our "family doctor'' would come home with his bag. This bag was brown, seemed to have a host of things inside from apparatus to measure blood pressure, stethoscope, syringes, cotton, spirit, injection vials, prescription pads and so on. There was always a certain smell that I associated with him — a mixture of powder, perfume and spirit. His moods were always good and he seemed to have loads of time to talk to us. He was part of the family and we regarded him as such. He seemed to be able to deal with all our health problems, whether an asthmatic spell or chicken pox or a bad gash on the knee. Not much medication, no tests and in spite of or perhaps because of this, we got better pretty soon.
Several years later, when I was a young idealistic house surgeon we had our postings in the intensive care unit and we had certain "beds'' under our care. Our role as house surgeons was to ensure that these patients were well and were following all the medications prescribed correctly, handle any minor problems they might have and give them their injections.
One day there was this elderly gentleman who was brought into the ICU, in a very critical condition with a cardiac problem. The team of super efficient senior doctors in the ICU, whose only concern was to save his life, brought him around and before they knew it they had the next emergency on their hands. That night I was on duty and so just felt like going and talking to him and was thoroughly floored by this gentleman who was smiling, showed tremendous courage in spite of the narrow escape he had just had and grateful to the team of doctors who were taking care of him.
Thus started a quaint friendship between this very sick "uncle'' as I came to call him and me. I soon came to know his family, and knew just how much he longed for his son, who was out of the country, to come home. On days when he was better, he would not say anything even to his wife, but on some days he would. He never once complained and was a favourite with every single member of the ICU staff. His son did arrive finally and I never saw a more happy person alive. His eyes just shone and that evening, barely eight hours after his son's arrival, he died. This was my first direct experience of death and it left an indelible impression. After his death, his family thanked me for having made his last days more cheerful and I remember feeling surprised. Why were they thanking me? This is what "doctoring'' was all about, wasn't it?
A year later came the time for decision making about our future specialisations and I chose a non-clinical field for various reasons. After I acquired a degree, I started working and am now perhaps in the most enviable situation of being at the hub between the patient and doctor. This has its advantages and disadvantages too — one has to listen to both sides of a story and often I wish there was more communication between the patient and the doctor.
For years, the myth that doctors are money-making machines has been propagated. While there are some to whom this may apply, there are several others who are humane and uphold the highest traditions of the profession. Patients seem to forget that doctors are human beings too, and have no compunctions about calling up their doctors at midnight, to talk about a problem that started the previous day and which the patient's relative believed would get better, until that very minute.
A doctor friend was recounting an incident. She had apparently had a death in her close circle and so had gone to the crematorium. She left explicit instructions at home to tell her patients what needed to be done if it was an urgent situation and that she would be back in a couple of hours. The person, however, chose to call her on her hand phone while she was still at the crematorium. When she said that she would call back a little later, the patient was surprised and showed a total lack of sensitivity. Don't members of the medical profession too have a right to grieve?
Yet one more instance is of a doctor who fell ill rather seriously and was unable to see her patients for close to three weeks. When she realised this, she made alternate arrangements with another doctor to take care of her patients and left instructions at her house and her clinic. But the patient had to call her and, on the pretext of enquiring after her health, decided to have a telephonic consultation. Doctors — or for that matter anyone else — see through this and at times I tend to agree that this profession particularly is a thankless one.
Some doctors become so involved with their profession to the exclusion of all else that their family life takes a beating. Holidays are a thing of the past, so too weekends spent with the family; in short, no quality time is spent with the family. So what happens to this idealistic basically good human being — he/she has got caught in a rut and is unable to extricate himself/herself from. He therefore continues to do what he is most comfortable doing — seeing more patients and making more money.
Let us take a look at the other side too — you do hear of doctors for whom time equals money and it is not surprising therefore that patients feel that some doctors, work with one goal in mind — to pay back the loan taken to get them seats in medical colleges to make them what they now are.
Patients too have now realised that they have rights, but carry this to such an extent that doctors have begun to feel that they "have to" make the patient well at all costs. They know that if the patient does not get well, they may have a case slapped on them for negligence. How do they circumvent this problem — by asking for a wide battery of tests (probably half of which are uncalled for) and over prescribing medication? There are some patients who go "doctor hopping", get totally confused with all the contradicting information and advice that the doctors give, and finally blame it on the doctor. In addition, there is this intelligent patient who is half a doctor, who goes to the doctor armed with the latest information downloaded from the Internet and gently suggests and later insists that the doctor follow instructions. If the doctor is unaware of this information or is wary of trying it out, heaven help him/ her — the doctor, I mean.
No national health policy exists in this country and so the patient has to depend more on the private sector. The insecurities of being a doctor especially in the early days are numerous and when this is viewed along with the enormous population of this country, it is hardly surprising that every doctor is put under tremendous pressure to "deliver" by his/her family, and the patient all the time.
From where I am, I often hear tales of woe from both sides and most times it hurts very badly that the medical profession has come to be regarded in such a fashion. Doctors need to spend more time with each patient and also spend more time with their own families.
Patients for their part need to realise that doctors are like them, they too need to grieve, need to celebrate and cannot give all their time completely to the profession. In the patient's interest, it is preferably if the patient sticks to one doctor. This makes it easier to develop faith in the doctor. The doctor will also realise the extent of the trust reposed in him and do his best for the patient.
The "family doctor" concept needs to be revived very soon, people need to realise that there is only so much any doctor can do and still have faith in this most noble profession.
The writer is with the
Lister Laboratories, Chennai.
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