The God Pendulum
© Dr. Rajas Deshpande
Dr. Aman handed over his car to the valet, and went to the rooftop restaurant, his favourite rendezvous. The captain soon brought over his favourite coffee pot and some starters.
‘The look of love’ by Kenny G started playing. It is impossible not to feel inner peace and romance while listening to that piece. Dr. Aman started to think. Yes. He had much in life to sort out.
Sunday late afternoon. The only afternoon to relax if lucky. A moment of peace so precious, that even family duties take a back seat, the mind is so tired of the heavy duty medical practice. Heavy duty because mistakes are not allowed, and seldom forgiven. © Dr. Rajas Deshpande
It is difficult to relax at home too. The society security staff, maids, some ‘sudden’ old friends from god-knows-what-stage-of past will want home consultation, and it is rude for a doctor to say no to any health queries by anyone, anytime, anywhere. Cellphones have become the worst health hazards, more so for the doctors.
He had two patients under his care in the hospital, so he decided not to switch off the cellphone, he was responsible should they have any problem in the hospital.
The phone of course rang.
“Sir, casualty. One GP has referred for you an old lady with convulsions. She is quite bad” the medical CR appeared disturbed.
“On my way” said Dr. Aman, paid his bills, and reached the hospital. On the way he kept on giving intructions to the junior doctor.
The 65 year old lady had had fever for a week, not taken to the doctor, treated by her non-medico daughter and son with home remedies. On the seventh day, yesterday, she had had many vomitings and became unconscious. The local GP gave her some basic treatment, and sent her to the city as she had no facility to treat such a critical case. Since that morning she had also had convulsions.
She was already intubated in the critical care unit when Dr. Aman reached. CT scan of her brain was normal. Her sodium levels turned out to be dangerously low. The management requires skilful vigilance, and it was already started. © Dr. Rajas Deshpande
Her daughter and son were waiting outside the ICU. Dr. Aman updated them about her condition.
The angry son asked “Why is her sodium low? Is it because of the medicines given by the doctor yesterday? I it the side effect of those medicines?”
Dr. Aman had now acquired the skills to tame his anger. He told that it was because of the vomitings, and that they should have taken her to the doctor earlier when she had fever.
The daughter started with an emotional appeal, speaking loudly “Do whatever you want, doctor, please save my mother. You are like God to us. Nothing should happen to her. We are ready to do anything. Please save her”.
“We are trying our best. Let’s hope she recovers” Dr. Aman said the legally correct thing.
“So when will she become normal?” asked the patient’s son.
“It is not predictable, we need to reassess her after convulsions stop and sodium levels are corrected” Dr. Aman replied. © Dr. Rajas Deshpande
“So why don’t you correct her sodium levels right now?” asked the son, as looking at the surrounding relatives as if he was suggesting the obvious that the doctor had missed.
“If sodium is corrected faster than a certain rate, she will develop paralysis, it can also be permanent” Dr. Aman replied, and added “Look, boss, if you do not have trust in our treatment and skills, you can please shift her to any other hospital you wish.”
“No. no doctor. We trust you. You are like God for us. We brought her here because this hospital is big and famous, and has all facilities” said the daughter. The son just kept on looking angrily at the doctors.
On the third day, the lady became conscious. On the fourth day, she was off the ventilator.
“When will she be shifted out?” the daughter asked.
“After a day of observation in the ICU” said the junior doctor.
“Why is it necessary to be in ICU now?” asked the son.
“Because she still has fluctuating oxygen levels, and needs continuous observation” replied Dr. Aman. © Dr. Rajas Deshpande
“Why cannot you observe her in the ward room? The ICU is so costly” the angry son kept muttering.
On the fifth day they requested discharge, as the patient was walking. Her weakness was still fluctuating, and her BP was low. She was discharged on request.
Within an hour, a crowd surrounded Dr. Aman.
“What is this? Is this any bill? Are you doctor or a thief?” the daughter started shouting, to a full audience of the waiting patients.
“Listen. You knew these charges when she was admitted. I do not own this hospital. The rates are standard, and so are the criteria for free or concessional patients. Please speak to the billing department.” Dr. Aman kept his tone low still. He did not want to point at the two costly cellphones that the son flaunted.
They did not qualify for free treatment as per the govt. norms.
“Doctor your fees is also there in the bill. Atleast cut that off. We cannot afford.” The son insisted. The waiting crowd surrounding them stared at the face of Dr. Aman. “Will the doctor be human and help this poor?” was the mob expression.
To save time, Dr. Aman asked the billing clerk to scratch off all his consultation fees. Saved time is more precious than earned money for the doctor.
While leaving, the daughter looked angrily at Dr. Aman and said “We never thought that doctors will be so rude and commercial. Curse upon such doctors who extract money from the poor”.
A doctor must digest all kinds. All patients who had witnessed the scene were doubtful and upset. They knew nothing about the patient and what had actually happened. They had just witnessed the last scene.
Just five days later, the whole family returned in panic. The lady had developed many convulsions as she had stopped the medicines after going home. Now she was unconscious because of the low oxygen that had damaged her brain. This could take a long time. © Dr. Rajas Deshpande
The daughter started “You are God, Doctor, please save her” etc. etc.
Dr. Aman gave instructions about the basic management to the emergency team, then turned to the daughter and said “I am sorry. I am busy with other patients, please take her to another doctor or hospital. I cannot attend her”.
“Can you refuse a patient?” asked the son, as if he had taken a special training from Mr. Ram Jethmalani.
“Yes, I can” said Dr. Aman “No one can expect a doctor to take correct decisions under duress, threats or abuse, and if I think there’s risk to my life or reputation because of ill behaved, hostile relatives, I can even refuse emergencies”.
There was no guilt in his mind when he started the car. He had become a doctor to serve the sick and suffering. Those who did not value him, his work and his profession did not deserve his service. His dignity was as important as his humanity, he would not sacrifice it for those who didn’t deserve it.
© Dr. Rajas Deshpande