Doctors – The Patients Awaiting Ethical Treatment
The opening paragraph of a fairly popular clinical medicine handbook advises the young intern to never forget that his patients have names; their diseases are not their names. Yet, very disappointingly, we see most of them, in the process of eagerly, rather proudly familiarizing themselves with the ward environment; evolve to use the diseases as titles for patients.
Sometimes they tell their colleagues about the ‘awesome’ murmur in a young boy in front of the patient. Even the very good students, the most studious doctors, tend to overlook this sensitive point. After all that’s what their very aspiring seniors do too. It’s not unusual for the consultant to call in, ordering a thing or two about the femur-fracture-patient.
I realize remembering names of 20-60 patients is some task, at least one can depend on bed numbers. Think about it, diseases are named after the accompanying symptoms usually. Will you like yourself, admitted in a hospital, expecting to be taken care of, being referred to as the left sided stroke patient? No it’s very unpleasant, more so for the already depressed patient. In a time like this, when hospital induced psychosis is also a defined health condition, doctors in our region completely take for granted the patients feelings. Some self righteous ones even go to the extent of calling liver failure patients the ‘sharabi’ (alcoholics), be the failure due to viral or toxic insults! Patients with diseases mostly associated with intravenous drug abuse also get their names from the convenient local terms.
Medical ethics is an ignored aspect of our national medical education; the observation gets stronger on ward rounds. The consultant, glowing with foreign earned degrees, at times appropriately flaunting them as well, often score their trainees’ diagnoses and methods with samosas. They, at the patient’s bedside, shamelessly declare a ‘tea for all’ from a particular residents’ side, if their patient’s biopsy reports come out to be consistent with what (s) he was initially suspecting. They never consider for a second it’s the moment of despair for the living being lying right there, its him who’s being diagnosed with a TUMOR, and all the most senior doctors cares about is getting his cup of tea out of it. This is criminal attitude! I wonder if they would be sued for causing psychological stress by their patients had they behaved the same way in the countries they earned their degrees from.
We once had a patient who was mentally under developed, and some pervert had pumped in air up his rectum with a bicycle-tire filling pump, as a result of which he suffered a perforation in his colon. His defect was surgically repaired, air evacuated, and he was recovering in the ward. I saw that big man sob multiple times during those couple of days; he probably was not able to forget the agony of the whole experience. His family also seemed traumatized, but they also were relieved on his quick recovery from the surgery. A senior consultant of the ward, in his next rounds, standing on his bedside with the patients parents sitting there, identified him as the same guy in to whom a man filled gas instead of filling his bicycle. All the juniors accompanying him on the round dutifully roared laughter. Instances like this leave me speechless.
Ignorance is rightly said to be bliss; today, anyone protected from much knowledge to me seems privileged. Working in any easily accessible health care unit, you are forced to face many ugly aspects of our society. Certainly a lot happens here each day, significant amount of which is bad, and depressingly enough, not all of it is accidental.
Mother of a seventeen year old mentally challenged girl told me she had her daughters’ uterus removed surgically two years ago, because she used to wander off in the streets and then recovered back in a few hours, but later found to be pregnant. The same happened a number of times with her before they decided to get the surgery.
One wonders about the shallow mentality of one who impregnates a mentally challenged girl. It is the duty of her parents to take care of her and not let her wander, yet the society has some responsibility.
We are so under developed morally that we behave heartlessly, not caring one bit about the precious feelings, values and ethics. It’s not only the doctors; it’s actually the society in general, which has no morals. They are all ready to give and take lives on religion, but they never want to rectify these small yet very significant behavioral faults. Whatever religion you believe in, even if none, being a human alone brings along some responsibilities, an innate sense of right and wrong. If it was only about the basic needs, then how are we different from animals? We are special; we are superior, because we have brains and cognitive skills. We can think, we can judge, we can anticipate.
I believe the medical council should introduce mandatory courses on ethics in the medical curriculum. The guidelines already provided by it should be enforced and regularly reviewed. In developed countries, students and professionals are tested on these aspects as a part of their training examinations, given different cases and asked to decide what they should do in a certain situation. In our case, we need some more basic conditioning before we get to this aspect of ethics.
We actually need to be trained on very fundamental levels. We need to realize living humans have feelings, more heightened in the cold white corridors of hospitals, and we shall always care about them. We need to believe in, and at all times remember the Hippocratic oath we take at the time of graduating from medical college. In addition to that, on a national level, we shall get our high school / intermediate level syllabi reviewed and civic sciences added as a mandatory course, so that our moral values are enhanced on a wider aspect as a society.
You and I make the society. It is time we think about our deeds, and start bringing small changes in our attitudes.
About the author:
Shazia Faiz is a recent graduate of the Ziauddin University Karachi, Pakistan. She is currently preparing for her postgraduate examinations, and wishes to pursue a career in Internal Medicine. She also happens to be co-author at a medical website and contributes to a social blog. She can be reached at: [email protected]
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