Fate and The Fatal Healthcare Gamble.
© Dr. Rajas Deshpande
In the rush of a local station, a 25 year old man suddenly shouted in a scary way and threw a fit. His eyes rolled up, his body shaked violently, and he fell down. The jerks kept rocking his body and shocked people around him noticed blood stained frothing from his mouth.
Some strong person, too eager to be a hero by the demonstration of gym-built strength, kept his foot on the leg of this patient and pulled his tightened hand to straighten it, till one heard the obvious sound of a bone breaking. Another slapped at the face of this convulsing patient, abusing, and telling the bystanders that the ghost holding this patient must be scared off. © Dr. Rajas Deshpande
Yet another, with the confidence of experience, thrust a dirty leather footwear under his nose. Someone else shouted for an onion or chilli, guaranteeing that it will immediately stop this voodoo. This too was then applied to the nose of this patient who was still convulsing. The patient had a lock-jaw, his teeth were clenched together. A spoon was then forcibly inserted between the teeth, and so strong was the effort that few teeth broke and blood oozed out.
By this time the convulsion had stopped, and everyone who had thus “treated” the patient proudly explained how each of these tricks always worked.
None of them knew that an epileptic attack would automatically stop within a minute and a half, that one should not force open the mouth or straighten the hands or legs, because that will only hurt the patient. The excessive electrical discharge in the brain that causes such fits will not stop by doing anything externally. Within a minute, such activity stops automatically as the brain energy and the currents cannot sustain, and the patient recovers consciousness in most cases. Rarely, such fits go on beyond a minute or two, in which case, only the trained medical practitioners must handle the case, preferably physicians or neurologists. © Dr. Rajas Deshpande
This patient was still unconscious.
An ambulance which had the “contract” for that station arrived, and the “paramedics” got the patient in. Relieved that all was well, people, as always after whatever happens, carried on.
This ambulance then took the patient to a “contract” hospital far away, even when there were many good hospitals on the way, thus wasting the most precious time. The patient had aspirated: his blood and saliva had now blocked his respiration.
By the time he was taken to this hospital, he was almost gasping.
The contract hospital, owned by an organization that had excellent political links, was designed to hide the deficiency of the most important element in good healthcare: well qualified and experienced, genuine specialists. Being the one to provide the lowest cost treatments, it only employed doctors willing to work on the lowest salaries. Poorly qualified, rarely experienced and already fed up with the workload. But in these days of beautiful, colourful signboards and deceptive advertising, declarations of “world class healthcare”, one rarely questions the training, qualification and experience of doctors. © Dr. Rajas Deshpande
The patient was taken into ICU, intubated and ventilated. An orthopedic surgeon attended his manmade fractures.
Legally everything was completed and correct. All forms signed. Critical status explained, understood, accepted. Relatives happy about the charges and the behavior, explanations by the doctors and specially appointed PROs. A qualified Neurologist was called in for a visit, who guided the treatment and went away. He was scarcely in a position to advise the relatives that the basic life support systems require great experience in such cases, and this hospital didn’t have that kind of a team. That would be unethical, plus the hospital had enough connections. That’s what got them the contract in the first place. Also, his calls would stop if he spoke beyond what he was called for.
The patient had suffered damage to the brain due to the delay in starting the treatment. He remained unconscious. Then in a week he developed septicemia: infection from the lungs that spread via blood to all his body. © Dr. Rajas Deshpande
The relatives were explained everything, except the fact that the team was inexperienced, ill qualified to treat. They were broken when the patient passed away., blaming their ill fate
It was indeed the fate of that patient to have a fit just there, just then. A young man who could have come back to normal health in few minutes was killed.
Or was this fate alone?
This death was preventable: a fit generally needs no treatment while it is happening. In this case, people had broken his bones and teeth, forced dirt in his nose, and caused bleeding. The ambulance, due to the obvious “loops”, wasted precious time reaching the “contract” hospital rather than the nearest hospital, the contract hospital took the case in spite of not having well qualified expertise and team to handle the situation, and the relatives did not care much beyond the financial implications. All equally guilty. This was a murder with multiple murderers.
The only thing one can do to help a patient having a fit is to make sure their head does not bang upon a hard surface, remove any sharp objects upon or near the patient, and turn the neck gently to one side, so that the food / tobacco/ anything that the patient has in the mouth comes out and does not block their respiratory pipes. Simultaneously, call an ambulance. © Dr. Rajas Deshpande
Remember the 6×6 feet supermarket that sells everything, in the corner of your lane? Something similar is happening with healthcare now. One wants every specialist in the nearest location, with cheapest competitive rates, and so long as their advertisement is good, people are happy when quality takes a backseat. A specialist is a specialist, so long as he / she has any degree, so long as the govt. approves, and especially if they offer concession, nobody cares about tomorrow.
The extensive training that goes into making of quality doctors is now replaced by many options: some low quality private medical colleges run by those in power, where money buys almost everything and merit/ hard work doesn’t matter, cross pathy and bridge courses, allowing too many unscientific treatments to take center stage in the country’s healthcare, defaming those who try to improve the system , projecting the philosophy that “all healthcare that is cheap is alone good, costly means corruption” etc. © Dr. Rajas Deshpande
Who suffers when inadequately qualified doctors with poor merit, experience and dedication treat the patients? Who suffers when those who have made their career based upon political support or corruption, treat the patients?
The worst gambling in India is in healthcare. People happily stake their lives to save some money.
God save my dear India in this healthcare crisis.
© Dr. Rajas Deshpande