As a successful doctor, you not only need to keep yourself updated with the latest medical guidelines while simultaneously retaining that which you learnt in medical school aeons ago, but you also need to be equipped with the presence of mind to deal with crises of all sorts – attendants who are angry and possibly violent, in a state of denial, uncooperative, and even threatening.
The first reaction to a loved one’s death is almost always that of shock, followed by denial of the unfortunate event before being proceeded by grief. What the doctor needs to remember, however, is that the deceased was not the grieving family’s patient, but a very, very important part of their life. Patience, empathy, and compassion are the only tools that can help a doctor communicate to the attendants – as clearly as possible – the reasons leading to the patient’s demise. Words like ‘cerebral infarction’, ‘non-ST elevated myocardial infarction’ – are Greek to them. Using simple language and an easy-to-understand analogy along with a gentle explanation of what the term ‘palliative’ care entails, can help avoid unpleasant incidents where the deceased’s family may unfairly blame the doctors, inadvertently creating a ruckus in the hospital.
A very important – and yet, easily forgotten – clause of the Hippocratic Oath entails: ‘I recognise the special value of human life, but I also know that prolonging life is not the only aim of healthcare.’
What a lot of patients and their families also do not understand, is the fact that often – especially in our set up – they head to the hospital once the disease has progressed to a stage beyond that of a quick recovery, or when there are a few asymptomatic comorbids. In such a scenario, there’s not much a doctor can do except choosing between ‘management’ and ‘treatment’, and often, ‘symptomatic treatment’. Unfortunately, a lot of home remedies that are often the first option chosen by quite a few patients tend to aggravate the situation, further complicating the doctors’ job. All these factors combined – doctors are always treading on a fine thread that asks them to make quick, one-minute moral decisions pertaining to patient health, patient and hospital safety, and sometimes, even cost-benefit analysis. But the important question, again, is whether to save a life – no matter how physically or emotionally compromised – or the quality of that life. What would you want? A few more years of bed-ridden breaths haunted by persistent nausea and weight loss as a result of the chemotherapy needed to cure cancer, or, a relatively easy, pain-free few more days spent reminiscing with your family?
Another important clause that is forgotten amidst the glory of doctors, is this: ‘I will promote fair use of health resources and try to influence positively those whose policies harm public health’.
How many doctors – out of sheer goodwill – do not charge their patients on rounds in hospital wards if all that they do is having to check the lab reports, a task that the medical officer has already performed? How many doctors weigh their patient’s financial situation before helping them decide the best course of treatment? Or how many doctors in power stand up to the unfair health practices and extortion of money that some private hospitals shamelessly engage in? How many stand up to the varying prices of diagnostic tests? These are questions that quite a few healthcare professionals and policymakers have yet to answer.
All in all, human negligence is very much possible and doctors are also humans, hence, remaining vigilant during your care is not only a good idea but extremely necessary. But let us also remember that human life is pretty fickle, its fragility is a truth as ancient as the human civilisation itself, and there’s not much that we fallible beings can do with our limited intelligence in the face of good, ol’ mother nature.