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A Dangerous Disease Called ‘Relatives’

A Dangerous Disease Called ‘Relatives’
© Dr. Rajas Deshpande

“What all can happen, doctor?” asked the young lady accompanying her father.

He had had a vertigo for two years, now had developed headaches and had seen best of the specialists. Some of them had advised him an MRI scan, but the daughter who was “in-charge” of her father had decided to wait. They had undergone many treatments simultaneously: allopathic, Ayurvedic, Homeopathic, Herbal, Diet, plus various random suggestions by relatives (almost all patient’s relatives are experts on all medical topics except actually paying bills and donating blood).

The father, a victim of experimentation by a health enthusiast daughter whose profession was law, was visibly anxious and almost shaking.

After examining him, I told them that there were some soft signs, but also that a physical examination may often be inconclusive, hence it was wise to investigate. What must be done must be done. A true Saint, scientist, soldier or doctor will always live by those words. I must stress the need for the right investigations. I told the daughter that he must undergo a scan. © Dr. Rajas Deshpande

That’s when she asked “What are the possibilities?”
Imagine an anxious person sitting in front of you, dead scared of death or illness. He / she is praying God or providence that the doctor does not use and scary words like cancer, heart attack, paralysis, dementia, parkinson’s or early death. No one likes these words, the doctor likes them least. Almost every doctor thinks of the patient’s mental status before choosing the words in such cases. Some patients can even commit suicides if they are too stressed with the fear of long / grave disease.

However, the hyper daughter refused to be subtle.
I told her “You can ask me all the questions you want. But please remember that some answers may scare the patient, Also, I may not have all the answers at this point.’

“Can this be something dangerous? Like cancer? Can this be an emergency? Can it cause death? If so we will do the MRI today itself. Otherwise we will wait.” She said.

To protect the patient from death, suffering and disease is a doctor’s duty, but the law does not allow the doctor to protect the patient from such insensitive relatives. © Dr. Rajas Deshpande

“Madam, there are limitations of physical examination,and we cannot see inside his body. Sometimes we find things wrong inside that can be cured with the correct early treatment. That is the reason we have tests and scans”. I told her patiently.

“But what are the chances of this being a cancer or something life threatening? If at all the scan shows something dangerous, can you guarantee it will be cured?” she asked.

I gave another shot of adrenaline to my patience. © Dr. Rajas Deshpande

“How does that help you?” I asked her, “Even if the chance of a dangerous possibility is low, say 5 %, will you take a chance on your father’s life just to avoid investigations? How can I guarantee the treatment or cure of something we both don’t know yet? By the way, what is your objection to get his scans done?”

“We will do the scan if you say this is urgent” she said.

My patience kissed me a goodbye.

“It is indeed necessary, I cannot say it is urgent. Now I must see another patient.” I replied. Then looking at her anxious father, I reassured him “It is a very low chance that there will be anything dangerous. Please relax. And we have cures for many diseases now, I am with you. Don’t worry”.
“Then can we wait for the MRI?” the daughter was incurable.
“No” I replied, calling in another patient.

I received many messages for next few days from her and her invisible brother asking if the scan was really necessary, where was it done cheapest, etc. I didn’t reply.

They returned after a week. The MRI showed a tumor causing pressure effects on the vital areas of lower brain. This indeed was an urgency, if not emergency. I told the daughter so.

“How come he developed a tumor? He never had it earlier. No one in our family had it ever” she asked angrily, “Is it the side effect of all the medicines he has taken in last two years?”.

I had almost forgotten in which society I was practicing. Education does not always convert into common sense. Money, skimpiness and hatred replace logic here. © Dr. Rajas Deshpande

“In most cases, a brain tumor is not the effect of commonly used medicines. I don’t know the contents of all the medicines you tried upon him. But the delay in doing tests is one definite major factor that your father has suffered so long”. I told her. What must be said must be said!

She changed the topic, a knack every doctor must learn from some lawyers!

The patient has now undergone a surgery by one of the best neurosurgeons, and fortunately the tumor has turned out non cancerous. His headaches and vertigo have gone. However his anxiety and fear will take a long time to go, he is on the medication for that.

The daughter has changed a lot too. The last time she visited for her own headaches, I told her to get a check scan done, and she showed me the reports the same evening. They were normal, she is happy now!

Many patients suffer for years, develop disability and some die due to such dangerous relatives who experiment upon them, delaying investigations and treatment. The most common purpose is saving money, but there are also whims and illogical, dangerous treatments without the knowledge of the contents and interactions between medicines of different medical and quackery streams. The doctors who try hard to save the damage in the last moments often become victims of criticism. This dangerous disease called “Relatives” who suggest everything but disappear when the patient truly needs them has become rampant in our society!

As for my patience, I had to take it for a long night drive and feed it a lot of icecream that day to agree to return to stay with me again.
© Dr. Rajas Deshpande

(Yes, some doctors take advantage and earn money through tests. This is definitely wrong, but the price of delayed and denied tests is far more. In fact, many relatives make that an excuse to avoid spending for the tests. It is conveniently forgotten that almost all essential tests are available at govt. / charity hospitals at a negligible cost).

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A Statue For Good Health Please

A Statue For Good Health Please
 
© Dr. Rajas Deshpande
 
The 7 year old child with a swollen face and a bandage upon his skull tried to smile through his hazy awareness. He wasn’t feeling good, and his face said so amply. His father who accompanied him sat cross legged, angry and upset, and said “I don’t want him to take lifelong medicine. Suggest something else”.
 
His son was a known case of seizures / epilepsy, and was advised by each one of the three neurologists he had already seen, to continue the anti epileptic medicine. The adamant father not only did not start those medicines, but kept on searching for opinions that suited his convenience and understanding, and treating the kid with unproven herbal therapies and fanatic diets. The poor helpless child, otherwise healthy, had had over three fits in last one week, this time the boy had fallen off stairs during a fit, and sustained a head injury. The father refused to see his own faults, a very common tendency.
 
“The doctor who bandaged him also gave him some injection. Because of its side effects he is so sleepy” the father added, “He told me to admit the child but I don’t think it is necessary. I want your second opinion ”.
 
There are rare days when I let my patience be gagged by my duty, some people really do not get simple, humble and mannerful language.
 
“Sir, you are making a criminal mistake. You are not a health expert, and have no authority to withhold treatment of your dependant, especially a child. It was your mistake to stop the antiepileptic medicine. The child must be seen by a pediatric epilepsy specialist immediately. He is sleepy because of the fit and the head injury. He needs in-hospital care and urgent restarting of epilepsy medicines” I started to notice I was raising my voice. Realising that the child’s well being was more important than correcting his father’s mistake, I toned down and explained to the father that there was no choice, and more fits could risk the kid’s life.
 
“Can you give hundred percent guarantee that your medicine will cure him?” asked the cunning father.
 
“No doctor in the world can give any guarantees, and should not too. It is my duty to tell you what is necessary for the health and life of the patient”. I so much wished I had the authority to have the father arrested, and so helpless a situation it was, that there was no agency in India to report this to.
 
“It is a huge task for us to take father to hospital, you know” said a millionaire recently to me, because him and his four brothers who lived in the palatial mansion built by the same father did not find enough time to accompany him to the doctor.
 
Thousands of children suffer and even die because their adamant parents refuse to treat them in time, or even refuse to continue the advised treatment. The same fate is meted out to many dependent elderly. The romance of poverty and politics makes it easy to shift all the blame on the govt. / private practitioners who see the patient last, when it is too late.
 
The IMA, which just correctly advised doctors not to drink alcohol or go to parties, should also draft a proposal of “Criminal Child and Elderly Health Abuse” and pursue it with the PMO. All children and elderly must be taken to the doctor immediately when sick, and following the doctor’s advice must be made a legal binding upon them. Then alone this health crime will stop.
 
The same quasi-intelligent people who advise doctors to “Keep calm and communicate properly with the drunken, aggressive relatives of terminally brought patients” should also use the same halfwit to advise the community to treat their dependents in time.
 
This is my sincere, heartfelt request to our kind Prime Minister / Health minister: save our children and elderly who need proper medical care, but are denied the same in time. We need this more than any gardens and decorations, more than statues and memorials, more than any other development. May all the treatment of all the kids below the age of 15 be free all over India, may every kid and elderly be insured for health.
 
In the service of my beloved motherland.
 
Jai Hind!
 
Narendra Modi PMO (India)
 
© Dr. Rajas Deshpande
 
PS: Modified story to mask identity.
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A ‘Poor’ Indian Patient.

Alcohol addiction and heavy drinking for decades. Over 5 packets of Gutkha / tobacco per day for many years. Few accidents due to drunken driving, once head injury after a bike accident, without helmet. Poor diet control. Diabetes, blood pressure, heart disease, obesity. Rich landowner. Came to OPD with a personal attendant to hold his files and medicines, and carry his napkin. 8 rings, gold and platinum, with various precious stones. Thick gold necklace. Costly perfume. Arrogant to the core in behavior, artificially formal language on the verge of threatening. Age 62.

Free consultation and treatment since many years under some government scheme, so has seen almost all senior specialists in town, in different hospitals.

The consultant advised a simple diagnostic test. Patient asked for 30% senior citizen concession for that non-urgent test, which is not sanctioned free by govt. The lady technician said it is not in her authority to sanction concessions. His tone changed: “I can sue you for this.. you are delaying my emergency treatment for money”. His attendant’s face became ferocious, like a dog ready to attack.

“We will do the test now, Sir, but you will have to make the payment and get a receipt. These are hospital rules, I cannot bypass them. This is not an emergency test” the tech explained.
He sat there. “Do the test first, I will pay the money tomorrow when I collect the report. I don’t have any money right now. I will pay tomorrow” he said with a shameless diplomatic smile upon his face, winking at his attendant. The tech did the study after asking the consultant.
Next day he came with two attendants, all white linen, gold studded and sandalwood perfumed. The tech asked him to make the payment before issuing the report.
“You had agreed that I will get senior citizen concession” he said to the tech. She panicked in anger: “I never said that” she retorted. “You did, I heard it” said the doggy attendant.

She didn’t answer. Closing the door, she silently cried in anger.
After waiting a while, they went to the billing, were denied concession as per rules again, got the reports, and went to the doctor, angry at having had to pay.

“You have severe nerve damage related to alcohol and poorly controlled diabetes” the consultant told him.
“It will be completely cured, no?” he asked.
“No. only partial improvement is possible” consultant.
“But I just spent 3000 INR for the test” again six extremely angry eyes stared at the doc.
“That was for confirming the diagnosis and extent of damage” Consultant.
“Ok” said the landlord. “Now give me medicine that will cure this completely”.
“I just told you it cannot be cured completely. These medicines will control and in some cases improve the damage” Consultant.
“Are these medicines costly?” He asked.
“One of these is a little costly. It is your choice whether to take it or not” the consultant still hung on to patience.

“I know doctor.. what these drug companies do for you… TV..Foreign trip.. Hotel… Party..” then he looked at his attendants and winked, touching his nose. “You should think of poor patients like us. In earlier days, doctors always gave cheap medicines, that too without any tests”.

The consultant stood up. Other patients were waiting, and he couldn’t afford to waste time or spoil his mood.The patient didn’t get up. Sitting as comfortably, he read through all the medicines again and asked repeated explanations of the purpose of each medicine. Then, he handed over the paper to his attendant.

“Reduce and stop alcohol and tobacco, and control diabetes well. Also eat carefully as advised” said the consultant, regaining composure.
“Yes. Give me your phone number so I can call you if I need to ask something.”
“Sorry, you can call the hospital helpline, I do not advise on phone” consultant said.
“But I just paid 3000 Rs.”he said.
“That was for the test” consultant.

He got up, and looking at his attendants, commented “All doctors have become thieves now. Hospitals have become shops to loot poor patients”.

After the OPD, the consultant went out for a tea, all mentally drained with humiliation and anger, and burning inside at this hopeless situation all over India. From the cafeteria, he saw the landlord patient boarding his Range Rover, parked next to the doctor’s own Santro.

The consultant’s phone sounded a text alarm.
“Your loan installment is overdue. Please make immediate payment to avoid legal action” it said.
© Dr. Rajas Deshpande.