Physician, heal thyself

Omair Ahmad
http://www.thehindubusinessline.com/blink/talk/physician-heal-thyself/article9707122.ece
Patients are not broken toys that need mending. They are humans, in need of compassion as much as the skills of a good doctor
I accompanied my mother to an eye clinic a couple of weeks ago. One of her cousins — a doctor — had recommended it. With a century-old history, a head doctor who is a Padma awardee, and numerous branches, it is supposed to be one of the finest eye centres in the country.
As with all such clinics in India, an appointment time is meant for only the patient. It rarely applies to the physicians. My mother was examined nearly half an hour after I had filled in the forms, and the eye drops to dilate her pupils took effect.
The doctor discovered that other than the developing cataract in her left eye, there was a bigger problem with her right eye, and immediately sent us to see another.
Despite the delay and the stress, the first doctor at least explained the problem. The second doctor did not bother. He sent us running around for tests, and when these were done, told my mother that there was leakage of blood in her retina, and that she was to come back the next day for an injection in the eye. When she tried to ask questions, he dismissed her with a brusque “I have already told your son everything”.
To calm my mother down after the diagnosis, my wife and I took her out for dinner. Despite knowing that my mother has been diabetic for nearly 30 years, the hospital ignored her injection timetables, making us run, and wait, with no idea of what we needed to do, or how long it would take us. In desperation, I called my wife and asked her to take my mother’s injections out from the fridge, and bring them to the hospital, in case we were delayed. We were.
After dinner I called my sister, who lives in the US. She asked me if it was ‘cystoid macular edema’. I hesitated because I had been told nothing of the sort, but on the piece of paper which listed the eye drops, I spotted ‘CME’.
“Yes,” I said.
The macula is a part of the retina, and if there is a swelling — edema — it blurs vision. My sister explained that a few years ago, an injection of Lucentis (ranibizumab) had been approved as a treatment for the condition in the US.
The next day we were at the hospital again. We were asked to sign papers waiving it of any liabilities. In all this time, nothing had been explained. Instead a nurse walked around with a fine liner to mark the patients over the eye that was going to be treated. It was surreal sitting in a room full of elderly people in hospital gowns, with hair askew and vivid green tick marks on the head.
Then the patients were rushed off quickly, quickly, quickly, because time is money, and factory-processing them meant more treatment and more business. Half-an-hour later my mother appeared with a patch over her right eye. The nurse asked her to take a pill, offered tea, and told us to return the next day.
My mother had an anxiety attack that evening. We could not figure out the trigger — the medicine, the fear of being injected in the eye or that of losing sight. The hospital had not prepared us for anything. At 11 in the night we called up an uncle who has overseen my mother’s general health for years. He assured us it was nothing to be too scared about. I slept late and light, unsure of what might happen, and prepared to drive to the emergency ward.
The next morning, one of the doctors breezily informed that the medication, prescribed to lower the pressure in the eye, had caused the attack. A week later, we consulted with the main doctor again. He still chose to ignore my mother — a 73-year-old who has managed her diabetes far longer than most people survive the condition, who has an MSc and gold medals for her studies — and addressed me, saying, “You have to make sure she is calm, a two-minute process took 10 minutes the last time.”
I resisted punching him. My mother has to have more injections in the eye, so I guess it would have been bad form.
I think he is practising medicine his own way, seeing patients as broken toys to be “fixed”. Maybe it would help him, and his patients, if he saw them as humans to be healed.
Omair Ahmad is the South Asia Editor for The Third Pole, reporting on water issues in the Himalayas; @OmairTAhmad 

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