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( Tale 6 of healers suffering themselves )
Healthcare services in developing countries, like India ,are strange. They are strange because every time you visit a healthcare provider , you find a stranger in him. There are no fixed SOP's, mostly. Qualified doctors in their pathy's usually do follow standard text books but those who become doctors by back doors ( read qualify in one type of pathy and practice another , grab a RMP or experience label , at times even degrees through various reservations - ranging from caste ,creed ,politics to money ) have their characteristic ways of practicing medicine. Hit and trial is their best bet. Copying prescriptions of those ,who are big names in their fields ,is the route for hitting highways for such gentlemen. This also happens with qualified ones at times , specially when they have no time to refresh their knowledge. I am reminded of an ophthalmologist prescribing a certain tube with a suffix " pox" , to a Herpes Zoster ( a sequel of chicken pox of childhood ,in later years of life ) patient. When questioned by a well wisher , he quoted a prescription of a senior dermatologist and said ," I thought it must be for viral ( pox) infections being named Dermapox". The well wisher (me) informed him that it was a steroid and is rather contraindicated. Goes without saying ,how his figure was cut to apologetic levels. Period.
It is in this background that I have to tell a tale of an
RMP, Dr. So and so . He had a roaring practice in a border town of Amritsar. He was Jack of all trades and master of none , literally. His Jackalness , however proved to remove his outer coatings. Remember that Panchtantra story of " ranga siyar "- ( folk tale of strange blue colored king ) a jackal after falling in a blue colored tub of a washerman starts scaring Jungle animals because of his strange color. He started thinking himself to be the king of the jungle , a lion. One day , when rain falls , his color runs away and friends call, his reality becomes obvious. The real kings tear away the virtual king , the Jackal. This Jack of medical profession also lost his masque , once he got exposed to an HIV patient's blood while carelessly stitching his wounds after a road accident. He ignored the exposure and resultant was expected. Once tested positive , he reached me with all relevant tests done. That was the time of two drugs regimen to treat HIV. He was put on Zidovudine and Lamivudine combination ,by me. The doctor was regular in his visits to me initially ,but for once. When I tried to contact him to remind his due medicines etc , he politely and firmly told me not to contact him on phone as his patients may come to know of his status.. He feared the impact of his HIV status on his professional status and personal medical practice. His orders were followed. The doctor patient ,however ,did not follow me. Suddenly ,one day after many years ,he was brought back to me , by his Medico sons ( who were by now in third and final years of MBBS). He was failing clinically, immunologically and virologically. This was obvious too. The whole world by then had learnt to treat HIV with three drugs but Doctor sahib was still on two drug regimen ,which started failing. Loads of counseling, switching to the right combination was my duty which I did once again. Before seeing him off, I shot a natural query" doctor sahib, how many patients of HIV are you treating now a days and with what medicines??".
Sheepishly he admitted ten to twelve and all on the same combination of two drugs ,which he was taking ,on my advise ,some years ago. I saw quackery raising its head instantly. I bowed my head to him for his confession and at the same time felt like banging my head, to the nearest wall of medical system in this country. Once again ,the doctor so and so , is lost in the jungle of " lost in follow up" cases , but what I have found is that the healthcare system needs much more attention by those who are in authority and matter. Else the situation is like बाड़ ही खेत को खाने लगे ( boundaries start eroding the field ) or we can say what if those who are meant to save our lives ,themselves become life takers.
It's a sad ,sad and sad tale indeed.
Rakesh Bharti
( Tale 6 of healers suffering themselves )
Healthcare services in developing countries, like India ,are strange. They are strange because every time you visit a healthcare provider , you find a stranger in him. There are no fixed SOP's, mostly. Qualified doctors in their pathy's usually do follow standard text books but those who become doctors by back doors ( read qualify in one type of pathy and practice another , grab a RMP or experience label , at times even degrees through various reservations - ranging from caste ,creed ,politics to money ) have their characteristic ways of practicing medicine. Hit and trial is their best bet. Copying prescriptions of those ,who are big names in their fields ,is the route for hitting highways for such gentlemen. This also happens with qualified ones at times , specially when they have no time to refresh their knowledge. I am reminded of an ophthalmologist prescribing a certain tube with a suffix " pox" , to a Herpes Zoster ( a sequel of chicken pox of childhood ,in later years of life ) patient. When questioned by a well wisher , he quoted a prescription of a senior dermatologist and said ," I thought it must be for viral ( pox) infections being named Dermapox". The well wisher (me) informed him that it was a steroid and is rather contraindicated. Goes without saying ,how his figure was cut to apologetic levels. Period.
It is in this background that I have to tell a tale of an
RMP, Dr. So and so . He had a roaring practice in a border town of Amritsar. He was Jack of all trades and master of none , literally. His Jackalness , however proved to remove his outer coatings. Remember that Panchtantra story of " ranga siyar "- ( folk tale of strange blue colored king ) a jackal after falling in a blue colored tub of a washerman starts scaring Jungle animals because of his strange color. He started thinking himself to be the king of the jungle , a lion. One day , when rain falls , his color runs away and friends call, his reality becomes obvious. The real kings tear away the virtual king , the Jackal. This Jack of medical profession also lost his masque , once he got exposed to an HIV patient's blood while carelessly stitching his wounds after a road accident. He ignored the exposure and resultant was expected. Once tested positive , he reached me with all relevant tests done. That was the time of two drugs regimen to treat HIV. He was put on Zidovudine and Lamivudine combination ,by me. The doctor was regular in his visits to me initially ,but for once. When I tried to contact him to remind his due medicines etc , he politely and firmly told me not to contact him on phone as his patients may come to know of his status.. He feared the impact of his HIV status on his professional status and personal medical practice. His orders were followed. The doctor patient ,however ,did not follow me. Suddenly ,one day after many years ,he was brought back to me , by his Medico sons ( who were by now in third and final years of MBBS). He was failing clinically, immunologically and virologically. This was obvious too. The whole world by then had learnt to treat HIV with three drugs but Doctor sahib was still on two drug regimen ,which started failing. Loads of counseling, switching to the right combination was my duty which I did once again. Before seeing him off, I shot a natural query" doctor sahib, how many patients of HIV are you treating now a days and with what medicines??".
Sheepishly he admitted ten to twelve and all on the same combination of two drugs ,which he was taking ,on my advise ,some years ago. I saw quackery raising its head instantly. I bowed my head to him for his confession and at the same time felt like banging my head, to the nearest wall of medical system in this country. Once again ,the doctor so and so , is lost in the jungle of " lost in follow up" cases , but what I have found is that the healthcare system needs much more attention by those who are in authority and matter. Else the situation is like बाड़ ही खेत को खाने लगे ( boundaries start eroding the field ) or we can say what if those who are meant to save our lives ,themselves become life takers.
It's a sad ,sad and sad tale indeed.
Rakesh Bharti
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