Saturday, November 27, 2010

Hippocratic Oath and Doctors

This evening the Asianet News had aired their investigation on doctors’ private practice. The doctors of various Medical Colleges in Kerala are engaged in private practice even though they are banned from it. While watching the news two incidents came to mind. One was a bitter experience and the other a good one.

The first incident was that my mother had to undergo. My Mum used to get severe stomach pains. She was under the treatment of a doctor in a private hospital. Every time she suffered from pain she would be admitted and be there for a week. She would be discharged and the next month she gets admitted again. Once she got a very bad pain that she had to be rushed to the hospital in the late hours at night. Her doctor was not there and it was a junior doctor who attended her at the casualty. She was a very young doctor. She examined Mum and said,

“Ammakku hernia aanu. Oru surgery vendi varum.” [“Mother, you are suffering from hernia. You need a surgery”]

For so many months mum wasn’t told what she was suffering from and we were kept ignorant of that fact. I advised mum to seek a second opinion from some other doctor before she decided on surgery.

Mum went to Medical College in Trivandrum and she met a doctor there. As my mum is suffering from rheumatoid arthritis she always uses a walking stick. The doctor told mum that she needed a surgery and she had to get admitted the next time she got a pain. Then he wanted to know if her children were in the US as she was carrying a walking stick (as though nobody else carries one?????).

After two weeks again she had another bout of pain and she was admitted to the Medical College Hospital casualty. The condition of the casualty was deplorable. The cot on which she was lying was ”physically handicapped”. Above that she had to share her bed with another patient. (My Mum’s “cleanliness” was all gone in no time.)I could see the sign of irritation and disgust on mum's face. I spent a sleepless night sitting on a chair with mosquito bites and screams and wails of patients and by standers. Next morning I managed to get a room for her in the deluxe pay ward. Her doctor came, examined her and told her that she needed the surgery as soon as possible. She had to get herself scanned. After all the results the doctor never came back. It was the house surgeons who came to examine her. She was there for over two weeks. One sweeper informed us that we had to pay a bribe and only then Mum would be operated upon.

I asked her how much should I pay and her reply was,

“Athu oru 20 roopa enkilum kodukanam.” (You will have to pay at least Rs 20).

Here Rs. 20 meant Rs. 20,000. It seems we should go to the doctor’s house and give him the money. She also added that only if we gave the money would he come and examine her again.

I asked mum what was her opinion was. She totally disagreed and told me that I had to inform the vigilance if I was intending to pay him the bribe. Believe me, for one month she lay in the hospital without a surgery. Finally she was operated upon without paying a bribe. She was the last patient to be operated that day.

After the operation she was in the post operative ward. The post operative ward was filthy. There were two buckets under mum’s bed with some kind of dirt. A cat and its kittens freely roamed around the post operative ward. I can understand why people get infection in the government hospitals. It is best not to talk about the toilets there. Every time I wanted to use the toilet I would go to our room.

Two days later another we realized that her hernia was still there. A house surgeon gave me a pathetic look when I informed him about that. Anyway mum was discharged from the hospital after 42 days’ stay. My first reaction was to sue the doctor for his irresponsibility. Then I thought he would operate her again and her life would be at risk. A year later she had to undergo another surgery for hernia and two other surgeries in another hospital and had to shell out more than a hundred thousand of rupees.

The next incident….. My father was admitted to Medical College Hospital for an emergency surgery. He was suffering from ulcer which went undiagnosed for years. His health was already failing and the surgery was an urgent one. His diabetes was very high and he couldn’t be operated upon. Dad is a person who cannot control his diet. Even during his stay in the hospital he would go out to the hotels to eat without the hospital staff seeing him. As his operation was delaying my aunt (Dad’s sister) told mum that the doctors were delaying the operation on purpose for bribe. Mum believing her went with some money to the doctor’s house. The doctor fired Mum. He said that there was no use in paying him a bribe because he wouldn’t operate a patient when he was not fit for it. Mum said that she was ashamed at the way the doctor scolded her. Anyway she learnt a lesson that doctors were not to be bribed. Guess that is why she did not want to pay a bribe for her own operation!!!

These two incidents came to mind. There are a very few good doctors with ethics while a vast majority of them are unethical. The doctors take the Hippocratic oath

“I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:
To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.
I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
But I will preserve the purity of my life and my arts.
I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.
In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.
All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.” [Coutesy Wikipedia ]
How many doctors truly follow the oath they have taken at the time of convocation??? A good doctor is a person who has a true passion for his profession. When money and other worldly goods becomes their top priority, it is quite natural for them to forget their ethics. Haven’t we come across doctors who prescribe medicines of certain companies????? Haven’t we heard about doctors who send their patients for scans and other tests unnecessarily????? If that doctor who operated mum had the slightest ethic he couldn’t have cut open mum’s stomach if he did not have any intention of removing her hernia. I know hernia recurs even if it is operated upon but recurrence in a couple of days is strange!!! My mum could afford to pay the bribe but can all the people who goes to the hospital afford to pay a big sum like this????? I have seen the rudeness meted out to patients by this hospital at their maternity wards. I beg you doctors to be more humane with your patients. Money is not the ultimate end. The love shown by patients, the respect that they give and the gratitude that they show you brings much more happiness than what money can buy!!!!

Saturday, November 20, 2010

Deshadaanakikkal Karayarilla

A few weeks back I watched an old Malayalam movie, “Deshadaanakikkal Karayarilla.” [The translation in English….”Migratory birds never cry”…..I hope it is not like salt mango tree].

The story is about two girls, Sally and Nimmy, fed up with the strict rules of their boarding school and a teacher of theirs. The teacher accompanies them for a trip and these two girls run away at the end of the trip. They live in a different town disguised and finally commit suicide. In the movie Shari played the role of Sally. She is a very bold and naughty girl. Nimmy is played by Karthika who is naughty but a bit timid.

This movie took me back to my schooldays where I was thoroughly fed up with the strict school rules. I would compare myself with Sally. I could not tolerate any injustice meted out at me. There was one particular instance where I planned to run away from school. I was always harassed in school. For mistakes I did, for mistakes I didn’t do, for mistakes other people did I was punished. This is no exaggeration. It was the plain truth and it was very disturbing.

I will never say that I was angelic….no…not even good according to my Principal, teachers and my boarding mistress. I agree that I was naughty…. but was I all that bad as my teachers thought???? No, I never was.

I was tall and big for my age. I had a look of arrogance (which is no fault of mine…Blame it on my genes). My Mum taught to keep my head erect and to look into people’s eyes. I made sure that I followed that teaching of Mum. When ever I spoke to someone or when someone spoke to me I made sure that I kept eye contact. People mistook it for boldness… especially my teachers. They always felt that I walked with my nose up in the air (again blame it on my genes).

The only fault that I can find with myself is that I pull up a “big” face if someone tells me what I don’t like. Then I can back answer them. I always try to prove myself, if I am right.

Now coming to that particular instance….

We always had two assemblies every day. One was in the morning and another in the afternoon. The afternoon assembly was a boring affair. Students had to assemble at the playground sing a hymn, say a short prayer and then disperse. We had to form lines and go to class in silence. That particular day a friend of mine, Meera was talking to me while we were going to classes. There were school reps who would stand at regular intervals to “mind” us.
Suddenly one of the reps shouted,
“Meera, stand out.”
“I am sextemly sorry yaar,” Meera giggled
The rep was fuming.
“She is sextremly sorry,” I gave a broad grin at the rep.
“You two girls come out,” screamed the rep.

We were taken to the staff room. We were charged with using abusive language at the rep. Though it was Meera who started it she was absolved of the crime (as she looking down like a poor soul!!!). I was punished (for looking straight into the eyes of the teacher). I was made to stand in front of the office room. I cannot tell you the humiliation I went through. The Principal wanted to throw me out of the school. That nun told me that she was going to inform my parents. She did not want me in school.

“This girl has that ‘phoren” influence in her,” barked that nun and she continued, “you will spoil the other girls also.”

I stood there like a pillar. I felt insulted. The girl who started it was in class while I was standing there like a criminal. My ego wouldn’t let me cry. Though I was weeping inside, my posture was that of arrogance. Informing my parents was something that I just didn’t want. I did not want to humiliate them and that too for a word that was not there in the dictionary. The only solution was to run away from school. Then there was another option…to commit suicide. It was not easy to commit suicide in a boarding full of students everywhere. I cried the whole night under my bed sheet. I wanted to run away. All that I had was around Rs.200. I decided to take two or three dresses in my school bag. I would wear my uniform and go out of the boarding. Then I would change my dress once I am out of the gate. I was not sure as to where to go.

Suddenly I thought of my parents and my friend. What would they do without me??? I was in dire straits. Finally I decided that I was going to face it all by myself. Worse come worst I would be dismissed. I was ready for it.

Next morning I went to school and was made to stand again in front of the office. That nun was saying a whole lot of things and I was standing there like a deaf criminal. Finally I was allowed to sit in class. The nun must have known that it was not easy to punish a boarder like that.

I think of this incident quite often. What was the mistake I did??? Why did the Principal and teachers make so much fuss over a word that was not there even in an encyclopedia? Did the word “sex” make them fume???? Why is that I alone was punished when there was Meera too?????

May be that is how I developed a hatred toward the nuns and priests. They are in an ‘Utopian’ world and they are the people with the seven deadly sins…. wrath, greed, sloth, pride, lust, envy and gluttony!!!!!