THE DISGRUNTLED PATIENT
Every story usually begins with “A long time ago” and ends with “Lived happily ever after”. Well, that’s not the case with our profession. Careers rise and fall, not because of who you are but who you are portrayed to be. Long gone are those times when a patient came to you, seeking help to get rid of their pain, whether physical or emotional but since the social media became a source of spreading hatred and false news, things have not been the same.
I wanted to be Doctor who was respected for the work that was done, to feel a sense of satisfaction when a patient smiles after a phase of pain, to make sure every life that could be retrieved from the hands of the grim reaper was saved. I realize that I have become a doctor who is like a guy at a bunk shop who gives what one asks for. The guy at the grocery store you are familiar with, who just seems to give you the best of his stock so that you can come back to him every single time. Every medico (Atleast the Lot of us) studies medicine to become doctors and save lives, for the respect that we demand, for the positions we hold in a community and for the dearest feeling of happiness after treating a patient for their illnesses. This might just be my opinion (Debates are welcome), but I truly believe that we have lost all those feelings the world that has constantly changed. I understand that there are certain times that a doctor might not be able to help with the scenario and has to forego every emotion of theirs to let that patient go. We build a cemetery inside ourselves and mourn for the loss of every patient that we couldn’t help save. I remember spending hours with patients just to keep them from shutting down.
She was a mother of two small children, a husband who loved her so much and a family who kept her in their prayers. Stage 4 Colonic Carcinoma and on palliative care. She could smile through her pain with the hope that a miracle would change her life and that all of this would go away. Spending long nights tending to her needs beside that bed and making sure that she kept breathing. One dismal morning in the ICU I tried to wake her up, but in vain. I tried everything I could. I called out her name loud enough to have the nurses rush into my aid from their station. I had tears rolling down my eyes when I continued giving CPR. I didn’t want to let her go. The feeling of not having to see her opened eyes rattled my mind and my heart. I didn’t want to let her go because she wanted to see both her children go to school and come back to her in the evening so she could spend time and play with them. We tried so much and her heart wouldn’t show signs of living on. I asked the intern who was beside me to inform the attenders that she was critical and that we were doing everything in our ability. Twenty five minutes of CPR and she didn’t come back. I could not believe that she was no more. I walked out to her family in tears and broke the bad news. I can still feel her husband’s hug when he cried at her loss. We had to let her go. Moments before the ambulance could depart, he came up to me, wiped his tears, smiled and thanked me. I had no words to ease his grief but he managed to ease mine. She was at the hospital under our care for fourteen days and all that we could do was give them the confidence that we were doing everything in our capability to keep her alive. We couldn’t.
In this age and time when Google becomes the go to physician for people and the mass media seem to cover the losses of patients rather than how many we have saved. Negligence is condemnable, agreed. I know most of us must have read this line somewhere in forwards or whatsapp statuses or facebook stories. “People only remember the ones that the goalkeeper failed to save”. This saying concurs with us as well. No one wants to know about the hours you spent reading or the number of times we skipped lunch or dinner to collect blood reports, the times when your sleep was disturbed to attend to a patient or the few minutes you felt bad for not answering your viva well. They don’t understand the hardships we go through to make sure the patient is monitored at correct intervals and given the right medicine at the given time. They don’t want to believe us when we explain in detail about the effects of the treatment and the risks involved on both sides. They don’t recall the doctor risking his livelihood when he tends to operate on a serology positive patient for any of the conditions they suffer from or the moment he shed tears when he could not keep that heart beating. People want to trust the media who have pushed them into a genjustu that doctors only care about themselves. They have been strewn away by false accusations made by others who don’t take responsibility for their ill actions. Doctors in the country have been arrested or charged for crimes they haven’t committed. Dr. Khafeel Khan, who was arrested for his so called negligence causing deaths of children at BRD medical college is a good example of such events that cause unrest in our minds.
Many years and scores of patients later, a man in his late thirties was brought to the Emergency room with an injury to the head. The exact details were unknown but his GCS was low. He was under the influence of alcohol and was drowsy, which made the assessment of the GCS much more challenging. The CT revealed an extra-dural haemorrhage at the right temporal region that was causing a midline shift (Go Figure). The haemorrhage had to be decompressed immediately and so we began explaining the condition of the patient to his attenders. I made sure I mentioned that he was in grave danger and neurosurgical intervention would help his survival. Being surrounded by 4 of his beefy relatives and a worried old lady, I began to pray that the patient survive the journey to the nearest tertiary center that offered Neurosurgical intervention. One of the patient’s attenders paused and stared, waiting for me to finish giving my advice. “There is a chance of him dying even if the surgery is done. Right Doctor?” he asked. I had to respond to that question in the calmest demeanor. “Without the Surgery, he’d die. The bleed is in the brain and not the leg.” I replied. Baffled and still puzzled, he began to discuss with his party of men. I started churning the inside of my head, trying to find out a plausible reason for that question to pop up in his head. Was he thinking that medicine is so advanced to treat brain bleeds medically? Did he try to inquisitively find if I was doing my job right? I cannot forget the look on his face when that question was asked. We were unable to follow upon that patient due to several reasons and I fail to tell you what happened to him later on. Let’s just hope that he is healthy, well and breathing.
Those were the days when patients would just say “Save him doctor” and let go of their strife. Those were the times our minds and senses felt the weight of their worry, rest completely on our shoulders. We wanted to be competent enough to save a life and be obligated towards their wellbeing. I guess my dream has been turned into a career that I must pursue to make sure my ends meet. I pray that one day people realize that we care. I pray that one day every doctor would work for their patient and not their master. Now that’s a happy ending.
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