An empathetic doctor, or empathy for a doctor?
My ENT rotation for fourth-year ended last week; the crazy schedule that it saw me dealing with, however, did leave behind a few worthy lessons, like the importance of patience while communicating with patients, and some intelligent understanding at the patients’ end.
Doctors – especially in our part of the world – are also under the constant shadow of suspicion. From the ‘useless’ and ‘unnecessary’ tests that they are accused of prescribing to the truckload of medicines that they weigh you in – the majority of the population will always double-check the doctor’s diagnosis and management plan with a source that they find a bit more reliable – Google.
While it’s good to educate oneself and be aware, it must be noted that Google is a search engine that links you to often inauthentic information. Very few sites – like Medscape – carry up-to-date information and are hence, used by the doctors themselves. Years of hard work and a precious youth spent over amassing all that clinical knowledge cannot contest the incomplete knowledge that one can gather from a few reads of an internet article, without any prior background knowledge of the complex workings of the human body. Every disease has a different prognosis, a different course. Every patient responds to every disease, every drug differently. How so? Because factors like age, gender, biomass index, race, co-morbids (other pre-existing diseases), and personal history matter more than we give them credit for. So yes, every patient certainly is a different story and that is exactly why bedside learning is highly encouraged.
One of the many problems plaguing our society is the unfortunate fact that unless its the pending electricity bill that threatens to cut off the power supply, our people will not pay immediate heed to any problem at hand. The majority will not head over to the doctor unless the disease has progressed to a stage where not much can be done. Be it a recurrent pain in the ear or a suspicious lump in the throat – a visit to the doctor is always the last option. How so, I wonder, can the doctor treat a disease that has already progressed – due to mere negligence on the patient’s part – to a stage where it can only be symptomatically managed and not ‘cured’? Yes, it’s the ‘too late’ scenario here that needs to be considered before harbouring unrealistic expectations from another human who has spent years studying from various resources, training for over thirty hours straight every three days irrespective of birthdays, weddings, festivals.
Similarly, a single medicine can be used to treat multiple signs and symptoms. Often enough, a medicine’s side effects are used to achieve the desired result. For instance, Ventolin (Albuterol) is a drug used commonly to prevent and treat difficulty in breathing, wheezing, shortness of breath, coughing, and chest tightness, caused by diseases such as asthma and chronic obstructive pulmonary disease (diseases affecting the lungs and airways). One of its side effects is hypokalemia, low blood potassium levels. So if the doctor deems it safe, he/she may prescribe a dose of Ventolin inhaler to a patient with high levels of potassium in the blood. In such a situation, a seemingly harmless Google search will only confuse the poor patient or his family simply because of lack of prior knowledge and understanding. It must also be noted that every drug interacts with another and often enough, they work together to achieve the desired result – lesson learnt: it is very important to take the medicine as directed by the physician. As is with antibiotics, leaving a dose as soon as the symptoms disappear only makes matters worse because the drug needs to act on its target for a specified time period for it to completely eradicate the cause and to also prevent recurrence. Failure to do so always results in the patient coming back to the doctor with the same disease – often worse – and almost always holding him/her responsible.
Another important thing to remember – and what many patients and their families have reservations over – is that laboratory or radiology tests are important investigations that help present a clear picture of what really is going on inside the human body to cause the signs and symptoms that the patient can experience; only then, can a definite diagnosis, and hence, an adequate management plan be reached.
While it’s definitely true that the healthcare set-up has become notorious for exploiting patients, that is not always the case. Some basic primary-level science teaches us how complex the intricate, interlinked system of the human body is – so how can ‘fixing’ an abnormality in this complex system be an easy task? The different subjects taught during M.B.B.S. – anatomy, physiology, biochemistry, pathology, pharmacology, behavioural sciences – are all deeply interconnected which is why the modern curriculum is structured around a module based system – the cardiovascular system, the respiratory system, etc – that helps build up a strong understanding of how the human body really works.
If only half the population understood some of the above, it would ease the lines of frustration on many a doctor’s forehead as they try to reason and counsel patients and their families.
So the next time you feel unwell, do not – for your own sake – delay consultation with a good doctor. And when you do consult one, remember that they, too, are humans in need of some empathy!