Counselling the patients and relatives 2

 Our psyche is stuck between two opposite ends. One end of the spectrum is the old-fashioned way, where the doctor used to diagnose any ailment by checking the pulse and giving a medicine out of his/her box. Other end of the spectrum is the present ‘state of the art’ diagnostic tools, instruments, medicines, and various specialists.

Back then, Allopathic treatment was a miracle. It cured so many diseases that were not amenable to indigenous methods. An injection was considered as an ultimate treatment. Operations or general anesthesia means near death experience. Surgeons used to have extreme reverence in the medical field and in the society. Cost of the treatment was also not much.

This naturally led people to flock to allopathic medicine and subsequent developments. Compared to 50 years ago, allopathic medicine has advanced tremendously in all aspects. We are able to cure many diseases, increase the life expectancy, reduced the infant & maternal mortality, reduce the surgical complications & mortality considerably and make surgeries less painful.

Along with the improvements the populations expectations have increased. They are expecting 100% success in all the situations and not able to accept any failure during the treatment process. Some people are naïve (or arrogant enough) to ask, “Our patient came to hospital alive; how can he/she die?”

As mentioned in the previous posts, modern healthcare costs money. Some people think, costly treatment means success is guaranteed! It is not so. As we witnessed several times, the (so called) best doctors and hospitals across the world are not able to save the most influential and wealthy people.

Instead of understanding and accepting the mortal nature of our body, this again has increased the anxiety and search for even better doctors and hospitals! This and the inherent nature of human mind seeking betterment all the time, healthcare industry is coming up with more equipment, medicines, and treatment methods in pursuit of immortality. (Read as more costly methods and treatments!)

Our psyche wants the best of medical treatment, guaranteed success with little cost. It is not possible. No one can guarantee a successful outcome. All that the doctors and hospitals can do is to give treatment to the best of their abilities and hope that the patient’s body mends with the treatment given. Following is a statement from one of the revered surgical textbooks: Faced by a patient who has lost the power to heal, the most famous surgeons are reduced to impotence!

If the doctor is honest and tells the facts as it is, people do not like it. From the doctor they want to hear the words “I will take care of everything, you/your patient is going to be fine”. Doctors are not able to give such statements these days as that statement is not correct in the first place, secondly if things do not go as planned, he/she will not have an explanation and it does not sit well with the modern ethos of keeping the patient informed and making a part of the decision process.

When people are out of touch with reality, it becomes rather difficult to counsel them about the treatment options, costs and the possible outcomes. This often happens when the patient is stuck in the ICU and is not improving. As there is no improvement, they start having doubts about the treating doctors and the treatment process. They start seeking multiple opinions and keep cross examining the treating doctors.

There is nothing wrong in seeking a second opinion. However, there is no point in cross examining the treating doctor and educating him/her with the knowledge & wisdom gained from internet, friends and family. This will only increase the frustration of the treating doctor and is a waste of time. It is not uncommon for the doctor to be overly cautious while counselling the relatives and treading extremely carefully so as not to have trouble later.

The doctors’ time and energy could be better utilized if they can be open with the relatives, giving the facts as it is and thinking about the patient’s condition, rather than trying to defend the cross examination of the relatives. People must do their due diligence before deciding upon the doctor and hospital. But once decided, have faith in them.