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Doctor Diaries- How do I handle the bias?

preethi shanbhagLeave a comment

There are people whom we like and then there are those we do not. Knowing somebody up close and personal sometimes magnifies their faults and personality quirks. Now, when we handle such issues in our personal life, there is not much of a problem. There are thousands of quotes on the social media which advice us to stay away from negative influences, so that we can be sunny and positive always. Just stay away and your problems vanish. Clap, clap!

But when you are a doctor, and a psychiatrist at that, a lot of people coming to you are not only distressed but also not “nice”, to put it mildly. Within the first few visits, we know their personalities, their decision making skills and their life choices very closely. As a matter of rule, we need to be at our non judgmental best in our counseling. Allow the person to make his/her own life decisions. At best, we can steer them towards a choice, but that too, very unobtrusively.

Unfortunately, this seems utopian on paper, not reality. How can one remain unaffected when he/she hears of a man boasting of knowing how to keep his unruly wife in place by resorting to violent means? How do you react when a lady comes depressed because she is worried about her daughter in law being snubbed by her own daughters? Such a concerned woman, you think. The concern emerges from the fact that the girl’s father has paid a fat dowry and is asking uncomfortable questions about the same! How do you console a father when he cries, that we should convince his daughter to go back to her alcoholic husband’s home, because they have already depleted their life savings on the marriage? How do you convince an utterly melancholic woman (melancholic because, her parents had no male progeny, and hence died uncared for and now the daughter in law has produced two healthy bonny girl babies), who obviously will leave her uncared for too?

These are situations which arise frequently. On a particular level, I understand that these are people who have a different value system and a way of thinking alien to mine. They may have a genuinely good side to them and maybe just discussing their miseries. Atleast they are honestly bad! But these are also times which make me want to quit my “non judgmental” high horse and tick them off like a very strict school marm.

I keep squirming in my seat trying to calm the feminist in me. Most times, I am successful. Occasionally, my unobtrusive push becomes slightly more forceful. And rarely, I do scold. I do fervently hope, that  this happens to anyone who handles human emotions as a part of their profession.

We do not understand the decisions that others make and their reasons for it. Over the years and with some maturity comes the discovery that we cannot change the world so easily. Change is for most part slow, a lot of hard work and painstaking. Once the abusive husband, after 6 months of counseling, finally stops abusing his wife physically (though a wee bit of verbal abuse remains), I should consider it my victory!

Unfortunately, this victory is not all sweet! There is an itch to do something more, push a little more and dream a little. And go back to listening all over again. Maybe, this is more like the bevu bella (an offering of neem and sugar eaten during ugadi, the traditional new year), which symbolically signifies that you should swallow the good and the bad with equanimity. Probably, I should start everyday with a small bite of the same:)

Does this happen to you?

Doctor Diaries.

preethi shanbhagLeave a comment

There are certain life experiences which come to us, courtesy our professions. Some of them make good dinner table conversations, some put a smile on our face years after they occur and some make us feel a deep pain inside. As doctors,  we see many incidents which have the power to move us beyond what we thought was possible. And such incidents make us richer, wiser and sometimes more cautious. I have always wanted to share a few of my experiences as a doctor first, a psychiatrist next, about how we see the good, the bad, the ugly and the hilarious as a part of our everyday life in the hospital. Hence ,the doctor diaries.

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Of when my idealism died.

Off late, medical professionals  have been viewed more with suspicion and wariness than respect and love. We often hear stories about how doctor so and so ripped off a poor patient, or performed an unnecessary surgery or followed some unethical practice.

As much as I know of most people in our profession, they seem hard working to such an extent that they have no time to even defend themselves in times of crisis. In a day and age, where most media bytes  go to a person who voices the highest decibel levels, we seem to have missed the bus by a mile. A lot of us are excellent clinicians, but poor communicators. Mostly, not our fault. We were never taught that our practice, would one day, turn out to be a war zone with land mines, which we had to gingerly tread through. Do not get me wrong. It is not everyday that we go to work like scared rabbits. We enjoy what we do, and how we do it. But on occasion, fear does seep into our bones. This was one such time.

It was a sleepy Sunday afternoon broken by an earth shattering cry, that would have woken the dead. All of us in the surrounding vicinity came out on the roads to see what had happened. What we saw was not a pretty sight. There were two people who had accidentally got electrocuted, lying on the road literally fuming at the mouth. There was this huge crowd gathered around. The stench of burnt flesh was overpowering. I live just across from the hospital that I work in. By the time I made my way through the crowd, I saw that two of our hospital staff had already lifted the victims bodily,and put them into an auto rickshaw.They drove on to a tertiary care center five minutes away for ICU care. The whole episode must have taken around five to seven minutes at most. I was impressed by the immediate action taken by our orderlies and was on my way to praise them, when I was in for a rude shock.

One of the people from the crowd asked us why we had not taken care of the patient. They started accusing us of poor first aid. We appeared confused at first. They must have taken it as a sign of weakness or guilt.

The cause for our confusion, was the fact that, apart from having a time machine to do the needful, we had been as fast as we humanly could. Two of our staff had rushed to find autos on a deserted road to ferry the patients, while two others had helped them into the vehicle and gone to the hospital with them. According to us, we had done all we could and more.Apparently not.

According to the leader of the mob, we needed to check the pulse of the patient before we put him into the auto. The other claimed that we should have done first aid inside our hospital premises before shifting him to an ICU.

We tried reasoning out that time was of utmost importance. That there was no need to check the pulse when the patient looked alive and was breathing. And we shifted him to a tertiary care center only because we did not, as a facility catering to mental illness, have an ICU facility and ventilator support.

Seemingly, all our explanations fell on deaf ears. The crowd kept chanting that we should have checked the pulse. On one level, I knew that they were just out to create a scene. Maybe the shock of seeing a person burn was too much to take. Maybe, they had no idea what to do in case of such a situation.

But on another level, we were scared. Upset that our good intentions were being slandered unnecessarily. Scared that they may abuse us physically.Are really really worried as to why understanding such a simple explanation seemed impossible to them.

Anyway, after a while, for lack of any other logical form of argument apart from the “pulse”, the crowd dispersed. But the hurt remained. That we, (especially our hospital staff who courageously helped the victims without a thought that they may have got electrocuted themselves too) were considered villains even after selflessly doing our best.

It did not matter that half the crowd was totally drunk, and had not moved a muscle to help all through the episode.What did matter, was that a scene was created. And that we looked like the bad people.

In the pat two years, in the small city that I live in, I have seen at least  four hospitals getting ransacked and damaged for some alleged negligence on the part of a doctor, which has later on been disproved. I have participated in rallies held to protect the rights of doctors. The district administration has given us a list of laws and provisions to help us protect ourselves. We now have cctv’s in our hospitals.Despite all of these, the sense of disillusionment remains.

Sort of like, when you have actually done your homework, but forgotten the book at home. The teacher does not believe you, but you want to be believed oh so badly. Standing in front of the class looking like the culprit pains you bad. The pain, that neither your teacher or your friends had the good sense to believe you.Submitting the homework book next day does not really ease your pain. The damage has been done!

And so also in this case.Life  moved on. Work resumed the next day. But every time I pass by the place on the road, I feel a physical pain deep inside me. One for the victim, who was a young man with small children. Two, for my idealism, which died a more cruel death that day.