July 1 is celebrated as Doctors’ Day in many countries around the world, when doctors are thanked, felicitated and celebrated for their contribution to humankind. I would like to thank all those wonderful doctors, physicians and surgeons who have treated me over the years and to whom I am deeply indebted.
Unfortunately, I have also had brushes with some who have inspired very little confidence in me and have also caused me grief due to their ineptitude. And no, they were not unqualified or quacks, but highly qualified. In fact I would go as far as to say that they were a tad too qualified – which made them see just that square inch (if not square centimeter) of your body that they had specialised in!
Those were the times when I missed the good old family doctors who were almost part of the family, and who gave you their unbiased and completely honest opinion about your ailment without any ulterior financial motive. It wouldn’t be an exaggeration to say that their compassion helped in speeding up the healing process.
I was heartened to read that the Indian Medical Association (IMA), is trying to revive this great breed, as per this article.
On this World Doctors’ Day, I dedicate this post from my archives to the Family Doctors, who are fast becoming endangered.
When a doctor recommends you take a test or have some surgery, ask whether the doctor would suggest that his or her spouse or children go through such a procedure. Contrary to popular belief, doctors can’t cure everyone. So why cause unnecessary pain with surgery I think music and animal therapy can help more than most doctors imagine.
These are not my words, but those of the oldest living physician Dr. Shigeaki Hinohara of Japan, who at 103 is still working as hard as he did when he started practicing medicine! You can read more about this amazing doctor’s advice to people here.
I am sure he is one of those endearing, friendly and fast vanishing neighbourhood physicians, also known as Family Doctors. This species used to take care of everything that ailed us – from corns in the heels to more serious ailments. These family doctors readily made home visits with their typical medical bag, chatting easily with the patient and family over a cup of tea or coffee. All they gave were a few pills and a foul-smelling and evil tasting ‘carminative mixture’ in a squat glass bottle with a slip of paper indicating the dosages pasted on it. It was based on the simple theory that most routine ailments are caused by a faulty digestive tract. What was more, it worked! Very rarely did they give an injection and even more rarely asked us to go for expensive tests or even X-rays.
When the ailment was serious and warranted specialised diagnosis or care, they referred you to a hospital or a good specialist in the field. Never would they presume to know more than they did and wouldn’t prescribe costly and often unnecessary investigations. Many too, would admonish you to listen to your grandmother and take her home remedies instead of medicines and syrups! They held the basic MBBS degree and no fancy suffixes. Till a quarter century or so earlier, there were RMPs (Registered Medical Practitioners) who did this duty and were a darn sight more efficient and compassionate.
What I liked best about them was their medical bags that contained a plethora of instruments and the way they put you through a ‘physical examination’ that involved touch – actual touch, if you please! He or she would check your pulse; press the stethoscope to your chest and back asking you to ‘take a deep breath and exhale slowly’; check your tonsils by making you say ‘aaaaah’; pull your eye down to check them for telltale redness. Touch, touch, feel, feel……and a large dose of empathy and compassion — that was the mantra.
Today there are hardly any friendly neighbourhood family doctors, at least in the big metros. In fact, when I looked for pictures of one, I found most of them of rural areas! If at all one finds them in metros today, they are found in seedy neighbourhoods with fictitious medical degrees — often a former compounder of a family doctor of yore — merrily dispensing steroid tablets for the common cold and giving injections to gullible and illiterate slum dwellers, sometimes with serious side effects.
For the rest, there are polyclinics, ‘medical centres’ and hospitals where one has to register oneself for a price to get a fancy folder and a card and become a ‘case’. Once you are inside the consulting room, the doctor looks at your folder and shoots off mandatory questions while scribbling furiously a long list of tests and investigations. And all the time he never looks at you directly or cares to get to know the person behind the list of symptoms. You see, all these are necessary before he or she is able to diagnose what is wrong with you, even if it is just a stuffed nose and a heavy head. I remember the time my maid told me that her doctor had asked her to get an MRI when she went to him complaining of a headache. Just like that!
Ah, the touch! Where is the touch? Oh, your BP is measured with a fancy instrument – by the nurse — not the old sphygmomanometer with its rubber balloon that goes ‘phish phish’, where you can peep to see the mercury rising with every phish! (I also miss the mercury thermometer which one had to violently jerk to bring down the level of mercury and which you held up the light to read the temperature in Fahrenheit.) No need to touch the patient, see?
Holistic healing means being there for the patient, listening, seeing, touching and empathizing with her or his problem, healing both the body and mind. We have almost forgotten the phrase ‘bedside manner’ as applied to doctors, for that was when doctors sat by the bed to speak and offer words of comfort along with their treatment to patients. In hospitals good doctors still do it. They leave behind hope and a sense of well-being even if they just greeted you or touched your forehead. It matters – a lot – really.
Not just the doctors from my own childhood, but even the doctors during my children’s childhood were very good. They were the no-nonsense types who gently chided you for panicking and reassured you with their readiness to come on house visits when you needed them. When my older son had been a little kid and was delirious with fever, I was panicky because I was alone at home and it was past 11 pm. We had no phone and one of the kindly neighbours had gone to call our family doctor — a smiling, silver-haired RMP, who lived a few houses away. He had not only come immediately, but also stayed with me to help me sponge the child and reassure both of us with his soothing words and mere presence till the fever came down. No advice to get him admitted to some hospital or nursing home!
And then there was this GP in our Delhi neighbourhood, a wonderful doctor who never over-prescribed potent drugs including antibiotics but gave us gyan in the form of simple home remedies and common sense solutions to many routine health problems. I remember him prescribing an ayurvedic medicine for the younger one’s tonsillitis and advising against surgery. Little wonder that his clinic was never crowded unlike the other one in the vicinity which was posher and the doctor not only advised many investigations but also prescribed costly medicines. Our gentle GP finally had to shut shop much to our regret. We never found another one like him in that big city. Wherever you are, Dr. Ravi Anand, may your tribe increase!
In the days of specialisation doctors have become so specialised that they can only see the specific organ or part of the organ that have specialized in, just as Arjuna had seen just the eye of the bird. While the latter had to only kill the bird, the doctor has to cure the ailment in the particular organ or part of the organ. Unfortunately, our body is a complex machine with interconnected parts and unless one takes the whole organ or even the adjacent ones into consideration while prescribing medicines or lines of treatment, the results can be disastrous. Doctors dismiss these as ‘side effects,’ which can sometimes be serious enough to be fatal.
The other day when I had gone to visit my octogenarian uncle, he talked fondly about his cardiologist. No, he was not the topmost cardiologist of the country, but someone who ‘looks at me while speaking to me and answering my questions without glancing at the reports – for all of five minutes,’ he said with utter satisfaction.
What an indictment of the species of specialists! They of course deserve a separate post 🙂
Related post: Oh, Doctor!