A hi fi patient of political background in a government hospital- met with an apparently minor accident- was lying in a bed allocated for ER staffs doing night duties. Well, the privileged one, I said. He’d already been screened for major injuries (none found) by my subordinate when I arrived, and was surrounded by a couple of ‘well wishers’, and he was talking excitedly to someone on mobile. When I reached to examine him, he gestured like a movie star to wait and let him talk, which would take a while.
I thought ‘what an ass!’ I went away. I came back later to see the patient- after all, its my job, still thinking ‘what an ass’. Now the number of visitors had remarkably increased, who wouldn’t go away despite being asked to make room for examination. I hurriedly did the needful, my mind wondering and wandering over many things, for stimuli- there was plenty. Later, upon cool reflection I realised I could not see and manage the patient as well as I could have, and it was NOT my fault.
A medical doctor such as me writing this article makes it look kind of vain, but all I am trying to do is state the matters of fact.
Society has regarded doctors highly since forever. Part of it comes from the noble cause they work for- saving lives, healing disease and making people feel better, a part for the meticulous hardships of the profession and a part, for the long hours they ungrudgingly work for.
But mostly, it is a mere psychology- a belief and hope of patient that this doctor will look after me better if I am nice to him. Since medical care is not a commodity with a ‘quality control’, one has to believe in what comes out of the head of the medic. Even with thousands tests and charts to make a diagnosis, clinical assessment by a doctor is still the core of management. And this, a doctor does by going through huge database he’s created in his head while in medical school and years of practice. He has to do that within the little time frame allotted for consultation. And make a presumptive diagnosis, suggest some tests and with some lab guidance thereby obtained, prescribe a suitable medicine- again analysing the side effects, adverse reactions and compatibility of the drug with this particular person. All that done, while tending to patient, nodding head to attendants and smiling. So you wouldn’t want to bring negative thoughts into head of a doctor and bother him with that while he’s trying to solve your problem- while he has intricate details to think of.
Treating a patient is like taking exams- patient asks questions with signs and symptoms, and we treat with answers. And like we’d prefer to take exams in a comfortable environment as far as possible, with as little noise and as few things to bother, we like to be thinking only about treating the patient while treating the patient. We are humans too, we get angry at harsh words, arrogance bothers us too. We might not hesitate to mop up a bleeding artery, or dissect a putrefied corpse for autopsy, but an uncomprehending unrelenting mob outside the Emergency room makes us nervous too. Obviously, it is the patient who has to suffer for the whole drama.
Doctor patient relationship is much like being in love. And you can’t force anyone into loving you, you rather sweet talk them to agreement.
Personally I am, all love towards my patients. I work hard, I study so I can help my patients better. I fight with hospital management to improve things in the hospital. And I do understand patients can’t be sugar candy at the time of accidents, troubles, and disease. But it’s a psychological thing, and a smart thing to do- being nice.