© Dr. Rajas Deshpande
“I want to see the doctor immediately. It is an emergency” the woman outside the OPD chamber was loud enough, and it was for the third time that she had said this. Dr. Rahul was explaining a long prescription to the elderly couple in front of him.He dialed the reception, and asked “What’s all that noise?”. The exasperated receptionist replied : “Sir, this lady has come without an appointment, there are six waiting patients, two on a wheelchair. Other patients are already angry. She is not willing to listen”.
Dr. Rahul apologised to the elderly couple in front of him and opened the door. “What’s the emergency?” he asked the fuming lady.
“I cannot tell here. May I come in after this patient?”
“Sorry mam, there are patients already waiting. If you cannot wait, please go the the emergency department, they will check you immediately”.
To everyone’s surprise, she waited till her number came up. She came in fuming, and muttered a few words to express her anger at having to wait, the ‘F’ words were clear.
In her thirties. From a very affluent and highly educated community. Gold shouting for attention, and a ring with a solitaire so large that it usually speaks of much except love. She had come to Dr. Rahul two years ago for a Neurological problem.
“I have a severe headache since last seven days. last two days I have had chest pain and a feeling of suffocation on and off. Also, I have lost control of urine five days ago. It’s very embarrassing, I cannot leave house. I have had fever before that”.
Naturally, she is worried, thought Dr. Rahul and felt guilty. “I am sorry I couldn’t see you earlier. Why did you wait seven days? You should have come earlier, knowing your neurological diagnosis”.
“My husband was away. He said I should wait. I have a seven year old son, I can’t leave him alone”.
“Why don’t you hire help, knowing your condition?” Dr. Rahul asked.
“I can’t explain, doc. My husband is very skimpy. All he thinks about is more money. Believe me, there’s nothing else he even talks about. I am fed up. He says we don’t need help as I am not working”. She also revealed that she had not seen any doctor as her husband thought it was unnecessary, and kept on suggesting her home remedies based upon his net search. She had stopped her BP medicines a year ago, and had had headaches since a year.
Dr. Rahul asked her to change and asked if she required a nurse attendant. “No” she said, “I am ok”.
The Neurological examination was abnormal, and the Blood pressure was quite high too.
“You need admission, ECG, some blood tests, and an urgent MRI, and we will probably have to use some injections” Dr. Rahul told her.
“Out of question, doc! My husband feels all doctors are out to make more money, he says all my complaints are psychological.” / She said, tearful.
“Then please go to the casualty, we will arrange tests without admission and start treatment. But you will please have to write that you are not willing for admission”. She wrote so, and Dr. Rahul gave her a prescription.
She never went to the casualty.
Next morning at 4 AM she developed chest pain, and was shifted to nearby hospital. When they too suggested an admission, her husband brought her to the hospital where Dr. Rahul worked.
At 5 AM there were frantic calls from her husband. Dr. Rahul went and checked her again. She was stable. Her husband waited outside the ward.
“She is stable” Dr. Rahul told him.
“I am very upset with the hospital. They charged us for the ambulance, and also for the emergency tests. Also, your assistant wrote on her file that she has blood pressure since five years”.
“Yes. She has high BP since five years, we have it in our notes. We must mention only the truth by law, Sir” Dr. Rahul said.
“But we have not told her insurance company about her high BP and her Neurological diagnosis. If they come to know, they will increase the premium and not sanction this bill. Please change that or I will file a complaint”. He raised his voice.
“Complaint about what, Sir? That you did not let her follow up for two years, stopped her BP medicines, endangered her life till she almost had a heart attack, or that you treat her like a a traditional wife-slave?” shouted Dr. Rahul in his mind. A bad start of the day is nothing new for a doctor, but this was too much.
“Please go ahead Sir. We cannot change medical facts for your financial gains” he replied and left.
As the blood, urine and sonography reports came in, she turned out to have a bad urinary infection. Within hours of admission, two super specialists had attended her and explained her diagnosis and treatment plans.
The insurance company declined to sanction her bills, as they had lied. The Medical Director plainly refused to change the facts mentioned on the indoor files.
“We want discharge” the angry couple started shouting at the junior doctor in the ward, a girl who had just passed out her MBBS. When she called Dr. Rahul, she was already crying: “Sir they are using such foul language. What should I do?”
“Please discharge her as per request, mention it on the paper and obtain her signature. Send her file to me for prescription of treatment upon discharge” Dr. Rahul instructed. Standard procedure.
They went home.
Next morning, there were two emails.
The first was a complaint note from the patient’s husband, that mentioned how everyone ill behaved with them. There were also allegations of delays and excess tests done without reason. There was a huge lament about the bills, questioning everything.
The second was from the customer relations cell. The patient had alleged that a male doctor had done her sonography and 2D-Echo tests, and had not obtained her permission to “touch” her.
Next three days, there were legal discussions, explanations, meetings and much writing to furnish the correct answers to everyone concerned. Useless paperwork destroys millions of intellectual human hours. The sonologist and the doctor who had done the 2D Echo categorically explained how every rule was followed, and how the patient’s permission was obtained prior to the tests. Of course the couple was never going to be satisfied, they kept changing stance, threatening a “big revenge” through Press, and adding new allegations. Many patients could not meet Dr. Rahul, busy with this idiotic activity, and the ones who met him found him too upset.
Dr. Rahul wrote to his Medical Director to hand over this case to someone else, he didn’t want to meet that patient again.
To his surprise, the lady came back to the OPD after five days. She was feeling far better. All her complaints had vanished. She behaved as if nothing ever had happened.
Politely, Dr. Rahul told her that he did not want to continue seeing her. She laughed. “Oh you are still upset at the emails, doc? My husband was too upset because the mediclaim was declined. But we have not complained about you”.
Dr. Rahul pointed out that if the patient is admitted under his care, all complaints are directed to him and he is still responsible for everything.
“Look, Doc”, she said with an icy cold tone, “I could have complained anything against you too. I didn’t”.
That was more than what qualified for any compassion or understanding. But there was no time to fight. He stood up, opened the door, and called in the receptionist.
“Please call a female security officer and escort this madam to a female customer care executive” he instructed the receptionist “and she will not follow up with me hereafter”.
“I will make things difficult for you, doc” said the fuming lady.
“Oh, I practice Medicine in India. You cannot make it more difficult for me” he replied, now regaining his smile. A doctor is not allowed revengeful attitude.
But a goodbye smile, he knew by experience, was the best established revenge.
© Dr. Rajas Deshpande
Based upon a real experience.
Please share unedited.