Not too long ago, I had to transfer a teenaged girl with major bleeding after a complicated surgery for pancreatic cancer for an investigation called angiography, to a nearby hospital, as the interventional radiologist was unavailable in the hospital I worked in, back then. As is not uncommon, the investigation failed to diagnose the source of bleed. While wheeling the patent back to the ambulance to take her back, her father, in a fit of rage pushed me against the wall of the deserted corridor in an entirely strange place by placing his forearm across my neck. ‘What next, doctor’ he growled. ‘Let’s see’ was all I could mumble. Providentially, he let go off me, stepping back. This is the closest I’ve come to be physically ambushed by a patient’s relative, besides numerous occasions of being liberally showered with expressions of extreme emotion verbally, as patients fail to improve to well-meant care and treatment modalities.
Recently, an orthopedic resident in Government Medical College in Dhule, Maharashtra was mercilessly beaten up by the family of a patient with head injury whom he asked to be shifted to a centre where a neurosurgeon was available. The doctor lost vision of his eye in the attack.
Attacks by irate attendants of patients are on the rise in India, nor is it new. In January 2001, an extremely ethical and mild-mannered Dr. Vasant jaykar was murdered in Knar, Mumbai, because a patient ailing with terminal liver cirrhosis died under his care. In medieval times, the treating physician was buried alongside the royal deceased. A similar practice prevailed in certain European kingdoms until a few hundred years ago. That the doctor is held responsible for every adverse outcome or death is assaulted in India even today, in the 21st century is preposterous.
Doctors these days work in trying situations and conditions. Those in tertiary referral hospitals need to treat complicated diseases in patients already sporting numerous co-morbidities, an exorbitantly expensive undertaking. Those in government hospitals need to treat patients in multiples of hundred in thoroughly under-staffed and ill-equipped facilities. How did doctors, once equated to God lose people’s goodwill? They have only themselves to blame. Mushrooming of Private medical ‘Colleges’ that churn out ‘doctors’ of questionable quality and attitude, unholy nexuses viz: doctor-pharmaceutical , doctor-laboratory and doctor-pharmacist, and shameful irregularities indulged in, in the name of ‘private practice’ especially by doctors of the immediate past generation (there was a time when paying the Unit Heads at home won a patient languishing on the hospital floor, not only a bed, but also a place in the next operating list, and situations where duty doctors shamelessly indulged in skirmishes openly in Emergency Departments over filling up CT Scans forms, eager to pocket the ‘cut’ offered by CT Centers), over-corporatization of the science of healing, which has been made a business of, exorbitant cost of modern-day treatment modalities, besides many are the reasons for this unfortunate fallout of the sacrosanct doctor-patient relationship, such that the present generation of doctors are at the receiving end of ire, anger and disillusionment of the sick and their families.
The argument of doctors that politicians, advocates and contractors need to be pulled up like they are, holds no water, as none of them deals with life directly as doctors do. Time has not run out to make amends. All is not lost yet. If the present generation of doctors swears to function by the Hippocratic Oath in letter and spirit, lost goodwill can be regained. Doctors need to treat with their hearts rather than their brain. If doctors return to the times when their sole intention was to restore health to the ailing, and nothing else, the public will turn around to at least understand that doctors deal with life and it’s restoration, which cannot be always ‘guaranteed’, thanks to the uncertainties of the response of the human body to diseases and well-meant treatment modalities adopted to treat them.