A ‘Poor’ Indian Patient.

© Dr. Rajas Deshpande

Alcohol addiction and heavy drinking for decades. Over 5 packets of Gutkha / tobacco per day for many years. Few accidents due to drunken driving, once head injury after a bike accident, without helmet. Poor diet control. Diabetes, blood pressure, heart disease, obesity. Rich landowner. Came to OPD with a personal attendant to hold his files and medicines, and carry his napkin. 8 rings, gold and platinum, with various precious stones. Thick gold necklace. Costly perfume. Arrogant to the core in behavior, artificially formal language on the verge of threatening. Age 62.

Free consultation and treatment since many years under some government scheme, so has seen almost all senior specialists in town, in different hospitals.

The consultant advised a simple diagnostic test. Patient asked for 30% senior citizen concession for that non-urgent test, which is not sanctioned free by govt. The lady technician said it is not in her authority to sanction concessions. His tone changed: “I can sue you for this.. you are delaying my emergency treatment for money”. His attendant’s face became ferocious, like a dog ready to attack.

“We will do the test now, Sir, but you will have to make the payment and get a receipt. These are hospital rules, I cannot bypass them. This is not an emergency test” the tech explained.
He sat there. “Do the test first, I will pay the money tomorrow when I collect the report. I don’t have any money right now. I will pay tomorrow” he said with a shameless diplomatic smile upon his face, winking at his attendant. The tech did the study after asking the consultant.
Next day he came with two attendants, all white linen, gold studded and sandalwood perfumed. The tech asked him to make the payment before issuing the report.
“You had agreed that I will get senior citizen concession” he said to the tech. She panicked in anger: “I never said that” she retorted. “You did, I heard it” said the doggy attendant.

She didn’t answer. Closing the door, she silently cried in anger.
After waiting a while, they went to the billing, were denied concession as per rules again, got the reports, and went to the doctor, angry at having had to pay.

“You have severe nerve damage related to alcohol and poorly controlled diabetes” the consultant told him.
“It will be completely cured, no?” he asked.
“No. only partial improvement is possible” consultant.
“But I just spent 3000 INR for the test” again six extremely angry eyes stared at the doc.
“That was for confirming the diagnosis and extent of damage” Consultant.
“Ok” said the landlord. “Now give me medicine that will cure this completely”.
“I just told you it cannot be cured completely. These medicines will control and in some cases improve the damage” Consultant.
“Are these medicines costly?” He asked.
“One of these is a little costly. It is your choice whether to take it or not” the consultant still hung on to patience.

“I know doctor.. what these drug companies do for you… TV..Foreign trip.. Hotel… Party..” then he looked at his attendants and winked, touching his nose. “You should think of poor patients like us. In earlier days, doctors always gave cheap medicines, that too without any tests”.

The consultant stood up. Other patients were waiting, and he couldn’t afford to waste time or spoil his mood.The patient didn’t get up. Sitting as comfortably, he read through all the medicines again and asked repeated explanations of the purpose of each medicine. Then, he handed over the paper to his attendant.

“Reduce and stop alcohol and tobacco, and control diabetes well. Also eat carefully as advised” said the consultant, regaining composure.
“Yes. Give me your phone number so I can call you if I need to ask something.”
“Sorry, you can call the hospital helpline, I do not advise on phone” consultant said.
“But I just paid 3000 Rs.”he said.
“That was for the test” consultant.

He got up, and looking at his attendants, commented “All doctors have become thieves now. Hospitals have become shops to loot poor patients”.

After the OPD, the consultant went out for a tea, all mentally drained with humiliation and anger, and burning inside at this hopeless situation all over India. From the cafeteria, he saw the landlord patient boarding his Range Rover, parked next to the doctor’s own Santro.

The consultant’s phone sounded a text alarm.
“Your loan installment is overdue. Please make immediate payment to avoid legal action” it said.
© Dr. Rajas Deshpande.

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