Before I write this piece, I must take the opportunity to state that I am not against doctors or medicine in any way. My General Physician in Mumbai is very good and we have two very capable and thorough doctors in my own family, who we consult whenever in doubt and they’ve always guided us through the best course of treatment. So, I hope this is not seen as an attack against all doctors, but as a request. A request to some doctors to be a little careful with us, their patients.
My last ultrasound, two weeks ago, felt like I was participating in a race. I was asked to get one because my doctor feared my PCOD had returned. I was miraculously declared okay as per the ultrasound, though the pain and the problems still persist.
I, however, was a little uneasy after experiencing what transpired behind the closed doors of a well-known diagnostic centre in Delhi. Sitting in the examination room, bursting from all the water I’d drunk, I could only observe silently how the doctor, the nurse and the assistant went about their work. And, there was a lot of work.
As the clock struck 4, there was tension in the air, a kind of impatient buzz in the room and things started moving really fast. The woman before me was hurriedly ushered behind the curtain, scanned and sent on her way in a jiffy, the doctor shouting uterine dimensions for the assistant to log into her computer. The girl, however, was too busy gossiping with the nurse over an unmarried patient who was sexually active and the doctor’s instructions were blatantly ignored. As they poured over the patient’s history, my name was called out and I was immediately bundled behind the curtain, even before the previous patient had had a chance to fully dress herself. I was told to quickly get on the bed, shoes or no shoes and my stomach lathered with gel. The doctor’s irritation at having to work longer that the stipulated hours was visible. The story has a few more embarrassing quirks that I’ll spare the reader. Even before the examination began, it was over and I was hurried off the bed again and shoved outside before I’d wiped myself clean, struggling with my clothes. I was not surprised. This was the third time I’d experienced problems during an ultrasound. Obviously, nothing had been detected.
This is not an isolated event. A question I posted online about cases of medical neglect – simple or life-threatening – that people may have experienced, led to my inbox blowing up with messages, from India and abroad and I knew it wasn’t just all in my head.
Last year, a psychologist friend went through hell when her mother was diagnosed with a severe chest infection. Their doctor, who knew she was pre-diabetic, went onto to prescribe cough syrups with sugar, causing her sugar levels to hit 608 and a stroke. Ignoring the source, the madness continued when she was hospitalised and the doctor wanted to put her mother on Parkinson’s medicines because he connected her case with that of her distant uncle’s, knowing full well that she had none of the symptoms of Parkinson’s. My friend, even with a degree in Psychology, was ignored when she asked them to first concentrate on lowering her mother’s sugar levels. The events resulted in her mother going into a 40-hour delirium, untreated because it was the weekend and later restricted to a wheel chair for months. In another case, a colleague’s baby was diagnosed with Erb’s palsy after a mishap while giving birth. Her gynaecologist, who forgot to note the baby’s weight during her last ultrasound, assumed he would be 3-3.5 kilos, enough for a normal pregnancy. When the mother found it difficult to push the baby out, the doctor used forceps, yanking the baby out of the womb and as a result, damaging her son’s arm nerves. The baby was 4.7 kilos at birth. Another friend in Sweden was allowed to go 12 days over her pregnancy due date because the hospital was understaffed during the holiday season. In some cases, the doctors have admitted their mistakes, while in some others, they’ve shrugged it off as ‘medical expertise’.
There have also been examples where patients have been refused treatment, based on judgements passed by doctors or nurses on their weight, marital status and lifestyle. In 2006, when Jaymie Vaz was a college student in Mumbai, she began experiencing back-breaking periods which lasted a month or two at a time. She approached several gynaecologists for a solution and was always turned away because they insisted it was because of her weight and college stress. Later, after exercising, following a rigid diet and losing weight, she was ignored by gynaecologists again because they refused to believe she had made any effort in fixing her weight problem. It was only in 2012, in Bahrain, that she was finally taken seriously and diagnosed with PCOD which had gotten worse from lack of treatment. Another friend from Belgrade whose hand broke in an accident at home and rushed himself to the ER was refused urgent treatment and put through a series of drug tests because the doctor was convinced he’d hurt his hand in a drunken scuffle.
The list of stories is endless.
My mother used to say, ‘Tell your doctor everything’; and while that is the best way forward, there are still several hoops a patient jumps before their illness is diagnosed and a conclusion drawn. I obeyed her rule sincerely till I went to a doctor complaining of severe pain in the abdomen, who went into a long interrogation of my life and my choices before declaring it was because of my lifestyle that I was in pain and sent me on my way. She refused to examine me, not even a physical examination but was quick to offer an easy solution to my weight in the form of weight loss pills. Luckily, for me, my pain was from an injury while exercising. Small mercies.
So, I ask, why? Why does this happen? I am fully aware that doctors are burdened with massive responsibilities and have to face the repercussions of any harm that comes to the patients. What I do not understand is these tiny oversights, the small mistakes they make with their patients that could cause serious damage to the person or even death. Relying less on physical examinations and more on scans and tests from diagnostic centers, I have, at times, been asked to take multiple blood tests for the same problem because the doctor wants it done at a specific lab or via someone in-house, rather than rely on the results from another lab. This is a waste of money and time, all of which is irrelevant and let’s not forget the PAIN and bruising from needle jabs!
Most of the time, especially with patients from poorer backgrounds, the family doesn’t even know what questions to ask the doctors and just accept everything that is told to them. When my father was going through chemotherapy for throat cancer, we weren’t even told about the health precautions one has to take when the patient is back home. Everyone was eager to get the job done, but no one bothered with the details. Is it because most people self-diagnose by googling their symptoms that it is assumed we will figure out the details ourselves? Why should my marital status determine whether or not I have cysts in my uterus? These are the questions that often go unanswered because after a tragedy has occurred, it’s too exhausting to go back to the start.
And so, dear doctor, this is a plea. A plea to help us get better. A plea to tell us everything. A plea to consider our lives more worthy than you already do. A plea to factor in the details. Because, tomorrow, if you’ve overlooked something tiny and life-altering, you may administer the best treatment, but it will already be too late.
We promise to trust you. Now, please promise to respect us.