The Side Effects of Education

© Dr. Rajas Deshpande

“Doc we have come for a second opinion. We think the earlier specialist was wrong.” said the patient’s daughter in law. Complicated case of Parkinsonism. 82 years old.

“But the earlier Doctor (a senior bigwig) has in fact written the probable diagnosis here, and started correct line of treatment.” I said.
“Yes, but he advised some costly tests, so we first read about it on the net. We also discussed it on a health blog. We thought that was not a correct diagnosis, as all his complaints and behavior does not fit in into that”. D.I.L.
“Do you think that your net search will replace 15 years of complicated medical training required to be able to diagnose difficult brain conditions correctly?” We do have a common medical ego!
“That is why we want second opinion”. She said.

My hidden tiny personal ego was pleased: a patient seen prior by a senior bigwig specialist had come to me!
I opened the file. Mine was eighth opinion. The poor tiny personal ego died after a hysterical fit of anger.

After an hour of discussion (every question had the word “exact” in it) and my cross examination that will put the cruelest (that is approx. 97%) medical examiners to shame, they left with a comment “If we remember anything, we will email you”.
In a few minutes I heard their arguments with the receptionist about the 1000 rupees fees, they wanted a receipt in some other hospital’s name (where I worked) to be able to reimburse.
© Dr. Rajas Deshpande

When I was about 15, my 12 year old sister was prescribed some antibiotic eye drops by our beloved family physician. She reacted badly within hours: the eye was all swollen and red, and we rushed to him. He gave her an injection, two medicines, and asked her to not use that eye medicine again. “It will take two-three days to improve.” he said. She improved. I once reacted to a common painkiller prescribed by him. My face was all swollen. We went to him again. Improved. There was never a thought about suspicion, mistake or anger. We never questioned his integrity or wisdom.

Now, even the best done by a doctor is scrutinized with legal glasses of suspected mal-intention or negligence.
“Doctor, is this rash because of the medicines I was given by Dr. X?” a young lady.
“Most likely. This medicine is known to cause rashes”. Doctor.
“Then why did he use it?” patient.
“You had convulsions, you were admitted in an unconscious state, it is an emergency, so the doctor must have used whatever anticonvulsant was available immediately. Many anticonvulsants cause rashes”.
“But he did not explain that to us before giving the medicine” said the husband.
“During a convulsion, brain may be damaged in three minutes. The emergency doctor did what was essential to save her brain”. I tried to explain.
“Can’t they use medicines without side effects? The world has advanced so much, and the hospitals charge so heavily.. “. The anger was disproportionate.
“Sorry Sir, there are no medicines without side effects. No one can predict which medicine will cause allergic reaction or side effect, or even what side effect, in any patient taking some medicine for the first time”. I said.
There was no relief on his angry face.

“By the way, why had she stopped the anticonvulsant medicines prescribed a year ago?” I asked.
“Oh I found a herbal medicine sold on the internet, that has no side effects. We had started that”. He said without guilt.

In a faithless society where education has come to mean “ability to find mistakes and sue others” and healthcare awareness begins with a prejudice against an entire profession, almost every doctor works today under a thousand loaded guns to his / her head. And sadly, many patients end up pulling triggers upon their own health.
© Dr. Rajas Deshpande

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