Doctor’s Theater 2

The positive feedback I received for my first narration prompted me to seriously consider writing more. Honestly speaking, I was very average (below average, rather) in languages and comprehension, and my teachers had a hard time teaching me grammar and language, so that phobia of language still terrorizes me. Darr ke Aage Jeet Hai, on the other hand, forced me to take up this new hobby. My only idea is to express a doctor’s perspective and experience in day-to-day medical practice. Sometimes, knowingly or unknowingly, people tend to forget that medical professionals are also humans with a heart and soul. We may appear emotionally blunt, but we also have tears in our eyes when we see human suffering, and the worst part is that we can’t overtly express it. If a doctor sobs when seeing a critically ill patient, the patient and family are likely to lose the battle in that moment. And this superhuman ability to control emotions is sometimes wrongly viewed as an emotionless, practical approach.

Back to our title, “The Doctor’s Theater.” Word theater reminds us of a drama with lots of emotions: thrills, joys, and sorrows; heroes and villains. Even a doctor’s theater (the operation theater) is full of it, just like any other theater. However, there are a few remarkable differences. First Doctor’s Theatre is an extempore performance with no option of retakes. No pre-written script exists. God is the director, and Yamdut is the villain. There is no one hero like in a Bollywood movie, but a team of heroes—doctors, nurses, technicians, ward boys, pharmacists, etc. (It’s an injustice to project only the doctor as a life saver and forget the team that contributes equally.) Most importantly, human lives are at stake in a doctor’s office, so there is no room for error. Sometimes, in spite of their best efforts, if the battle is lost, suddenly heroes are portrayed as villains, forgetting the efforts they put in.

There was nothing out of the ordinary about that afternoon, except for a brief lull in OPD. I was just working on a PowerPoint presentation for my talk the next evening on my laptop. There was a knock at my OPD door. A middle-aged man walked in; he must be in his fifties and probably a politician (by attire). He had a different swagger in his posture (we do come across so-called “I am the Lord” types day in and day out these days). Getting comfortable in the chair opposite to me, he started, “I got your reference from one of my friends; I’m Mr. ABC, District President of the XYZ Party.” My brother had a heart attack three days ago, and his angiography was done this morning at WXY hospital. I urged him not to get into this trap, as most doctors fudge reports to maximize profits. The wonder of our democracy is that any Tom, Dick, or Harry can belittle you and your colleagues, and you have to be patient. He continued, “Angiography showed two blockages, which I don’t think are really critical, but that doctor advised earliest coronary angioplasty.” I’m also worried if the findings are manipulated. “I’m here to just see what you say.” Trying to be as calm as possible, I started going through the medical file while the angiography CD was getting uploaded into the system.

It was shocking to see that the patient was 45 years old, and as per reports, he was really in bad shape. He had a major heart attack, which had affected his kidney function as well, and he was on non-invasive ventilatory support for the pulmonary oedema (lung congestion due to a sudden malfunction of the heart). As I went through the angiography, his two major coronary arteries (blood vessels supplying heart muscles) were critically blocked. It was confusing to understand whether Mr. ABC was aware of the severity or if he was just trying to act smart. After going through every minute detail, I started explaining to him the criticality of the clinical scenario. I could tell that he was not much interested in what I was saying and that he had already made up his mind. With a mischievous smile, he started, “See doctor, this has already been told to us by the doctor who did angiography, and we are here to listen to something more pleasing.” He continued, “I heard good things about you and so expected some better advice, but you disappointed me.” At this point I lost my cool, and without using any unprofessional words, I bluntly told him my opinion and also put it on paper. Without any further discussion, he started wrapping up the files and got off the chair. “Doctors are more like businessmen these days” were his last words before walking out.

It was quite disturbing, and the whole day I was feeling irritated. This is not uncommon these days. As a medical practitioner, it’s difficult to understand (as in this case) why people consult a particular doctor if they don’t trust him. Mr. ABC returned to my OPD a few weeks later (probably 8 weeks later). This time he looked much more humble and grounded. I thought he must have gotten his brother for a follow-up consultation but was surprised to know that he had come for his own consultation. I read the details and discovered that he had a heart attack three days ago. I told him about his clinical findings and the need for coronary angiography and further treatment accordingly. He accepted without any further question.

As a doctor, I tried to forget the bitter experience I had dealing with him. His coronary angiography showed one critical blockage, which I explained to him and his accompanying relative. Mr. ABC asked that I treat it in the same manner. I offered him the option of a second opinion if he wanted. But surprisingly, he was not interested in any further opinions. His coronary angioplasty and the rest of the hospital stay were uneventful; however, I was a bit curious as to what brought about this renaissance in his thinking. So while discharging, I thought of asking about his brother. He was probably very much expecting this question. With a tear in his eye, he started, “I lost my brother.” After meeting you, I consulted one more cardiologist, who opined the same. “But unfortunately, we
decided to go for a non-scientific method of treatment, and I lost him.”

Man is a social animal (one of the first antitheses I learned). Inter-individual relationships keep them together. Some relationships, like parents-children and inter-sibling relationships, are congenital, while friends and student-teacher relationships are acquired ones. There used to be one more such relationship, the doctor-patient relationship, which is getting extinct these days. And this is creating a big imbalance. It’s disappointing that some of us have started looking at hospitals like a service center or garage, where they expect complete repairs within a stipulated time frame. Well, if I compare the human heart to a car engine, which drives the human body, there are a few significant differences. First, if you open 100 car engines of the same model, they’ll match each other even at the micro millimeter level. But if you analyze human hearts, no two hearts are similar—not even in monozygotic twins (exactly alike twins). Second, every human body responds differently to different diseases. A common cold may bother Mr. X for seven days but get resolved in two days for Mr. Y. Again, this difference is because of the variations in our bodies.

Medical practice is a combination of art and science; diagnosing a disease is art, and planning a treatment protocol is science. No AI (artificial intelligence) can replace it. The day we all start appreciating the efforts put in instead of the end results, we’ll probably be in a happier world.



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