Thursday, February 27, 2014

The Oath of Hippocrates

Party conversations.Politics.Corruption.Ethnic violence.Rape.Cricket. And if you are above sixty, state of health, medications, and yes doctors. “And they take the Oath of Hippocrates!” says one vociferous friend, “you may as well call it Oath of Hypocrites,”  Laughs all around, vigorous nodding, sound support. Most of us are eager to quote anecdotes. Time to raise my voice. “Don’t tar everyone with the same brush,” I venture, at the risk of sounding supercilious. “There are kindly souls in the medical fraternity. I have been lucky. My doctors are understanding and compassionate, they don’t exploit us…perhaps I choose such doctors…”my voice trails off as I see eyes popping and brows knitted together in disbelief. “please introduce us to these wonderful doctors, you would be doing us a favour,” I decide to watch them explode. For bottling up angst causes stress, haven’t we been told a million times?

When health has become almost a paranoia for most of us, doctors are part of the package. India ranks second only to China as the diabetic capital of the world. We are living longer, average lifespan has been pushed to 65, and modern technology has made it possible to survive the most difficult of odds, but the pattern of survival has become different. Do we want to linger, suffer, with the quality of life deteriorating, just to prolong our lives in an offspring-supportless environment? The answer lies in locating and staying with doctors and medical services you trust, and people who help you get on in life. For get on you must irrespective of age.

You might choose a doctor because he is eminent, and top of his profession. “Yes we did, and we ended up waiting four hours to see him, and came back with very little satisfaction.” Don’t choose him because he is eminent.  One of the docs described is forbidding looking with a stern visage and strikes fear into the hearts of his patients. They sit before him expecting a death sentence to be pronounced. “Why should they fear me?” he asks, A kindly soul with a heart of gold..the fear barrier has to be broken before realization dawns that he is compassionate. “ I am so overawed that I forget half the things I have to ask him and before I know it I am ushered out.”  

When an appointment is made with a doctor, please put down every single doubt which crosses your mind, before you see him or her. Normally, BP is checked, your heartbeats, your pulse, a cursory glance at your old records, then a prescription given, to you who sits there dumbstruck, then you are out.  Remember your rights as a patient. You need to know why certain medicines are prescribed and what effect they will have. You need to ask if you take them before food or after food. And, since most doctors specialize in illegible writing, you have to ask them to decode it and note it down in your handwriting provided it is not worse than the doctor’s. Ask the doc if the medication has side effect or contraindications. Tell him about any allergy you might have. Write down the list of medications given to you on your last visit and hand over the paper. This registers better than just “getting it off your chest”.

For all my worldly wise advice, I learnt my lesson through a bitter experience. I was prescribed Osteophos70  once a week. With implicit trust, I didn’t go through the accompanying literature, had it first thing in the morning, and started my usual exercises, bending and stretching. I threw up, suffered intense pain in the abdomen and was in bed the whole day! Only a little later, a friend acquainted me of the strictures, , upright position and empty stomach. Stay still for an hour, she suggested. My husband suffered severe reaction after a few weeks of this wonder drug and could not eat for his tongue was blistered. We were told later that this could lead to allergies for some. Moral of the story, read the literature accompanying any drug.
Choose your doctors with care, it really pays to be fastidious. Do enough research, talk to your friends, find out more about them. If you are the restless kind like me, don’t spend hours outside the doctor’s consulting room. You will find someone else just as good, only not so busy. Find a doctor who has more patience than patients, who will listen to you, and will talk to you and explain things in a way you understand. “There is this doctor who is reluctant to see patients, at the same time can’t close shop. He spends exactly five to ten minutes with you. By the time your driver reverses the car, you have one foot outside his consulting room. And he charges a bomb,  though admittedly his treatment works.”

When you have a rough idea of what the doctor’s fees are don’t crib. Come on, hehas  to make a living. And if he is as bad as you make him out to be, just don’t go there! Of course there are malpractices as there are in every profession. The cuts from prescribing expensive diagnostic tests, links with hospitals who expect doctors to advise hospitalization and the ICU. There was this doctor friend who wanted me to co-author a book especially written for his patients, where the malpractices of the medical fraternity was pointed out with candour. Though I admired him for his guts, I pointed  out that he could be sued.. After taking a legal opinion he thought better of it and just as well!

In these days of specialization, it is good to have a family doctor, the kind my father was. He used to visit his patients and most of them were helped by the touch of his hand and saying they were not so ill as they thought. Only in cases where the prognosis was not good would he call in other specialists for an opinion. Our bleeding knees were administered good old iodine and the nurses would blow on the wound when it hurt like hell.  Squeasy stomach, and Carminative mixture was given or Hewletts mixture!  Medicines were compounded to suit your disease. Ah, those were the days.

But when you discover a doctor that you like so much, don’t turn into a hypochondriac and run to him at the drop of a hat, as he too has a job to do, besides placating neurotic patients!!

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