Doctors and Patients

This was my response to one post in a discussion forum.

Can you pls give your response to this?
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A DATABASE of patients' symptoms is welcome; such databases exist, in various text books, and in the internet. To be accepted by qualified doctors, they should be prepared by recognized experts after adequate research. Modern medicine has evolved over the centuries, that symptoms alone can't bring out any conclusions. One has to look for various features (examination) and do the necessary investigations.

These databases may not survive the knowledge explosion we face now. It has to and will evolve, as knowledge is accrued. Sometimes a whole 'diagnosis' is replaced by new terminology and explanations. So 'symptoms' become superfluous. If a doctor of the 50s were to come back to practice, he would find himself quite out of place. The 'explanations' for many 'illnesses' have changed, new 'illnesses' have appeared and so are the investigations and treatment modalities.

We continue to acquire more knowledge after coming out of medical schools by various means. Old explanations or treatment modalities are changed, challenged, or dropped. Treatment has shifted from herbs through potions to tablets or injections given directly into blood stream.

Nobody understood 'sepsis' before we discovered bacteria. Before Leeuwenhoek invented microscope, nobody knew about micro-organisms. Now where are we? We have 'seen' the smallest (?) micro organisms called viruses and know they infect even bacteria. What I mean to say is science and technology is evolving and consequently modern medicine too is advancing.

If patients are not getting enough help, is it that doctors are not helping or their help is not reaching them? Can it be a communication failure between the doctors and patients? One must keep in mind a reality; that in some situations, no help exist. In certain situations getting back a normal life is ...

"Why must the patient do all the work?": Is it to say that enough work / research is not done by the doctor? It should be understood that the ANSWERS are evolving while, at the same time, new questions appear on the horizon.

You said > "Can you think of any other industry where you have a problem, request a professionals help, and have to pay though the exact condition still exists?"

Ans: Do you mean the pharmaceutical industry? Health-care as I understand is not an industry, though the 'industrious' survive better. True, technology has brought in various gadgets and hence there is an industry there. But imagine, where else a human being has to spend his prime years in universities burning the midnight oil, attending night calls and emergencies, facing people who, for being sick, are angry at the doctor.

There are a lot of things the doctor or specialist of now a days know more than his colleague 50 yr back, but there is a great lot he is yet to know. We have reached the moon, and are eying the Mars, but the large universe is far beyond. We know about the various organs of human body, and the cells that make it up, and the various chemicals which go into the structure of the same and how they function. But do we know enough? That is why medicine is more of an art than science, and we still don't have all the answers.


It is difficult to find a perfect doctor, and that is because doctors too are human beings.

If only we had angels to qualify as doctors ! :-)


Thomas Antony

Life is like that..

Today afternoon I had to attend a call from the hospital. As ambulance passed through the marine drive – we have a road alongside beach, can I not name it that way? - I saw the beach was crowded. It was expected, as they were all still enjoying Eid holidays, tomorrow they have to start work. Many of them are visitors from north. The driver stopped to collect a GP who had got down there while coming, to buy soda. It was then I noticed raised hands and fists, and shouts from the crowd. Now, that was something unusual. I have spent five years here and I found Yemenis a peace-loving docile people. You can’t see them without a disarming smile. They talk politely and with respect.

As he climbed in I asked the doctor what it was about. He told me there was some amount of wrestling or beating up between two. A local had photographed a Somali woman in his camera-phone. Her husband didn’t approve it, and fight started.

There are quite a few Somalis here, who have come to work. There are a few illegal immigrants. It is only about 25 km to cross by sea. Some of the women beggars one sees are said to be Somalis. You have to guess, as their faces are covered.

We don’t use our cameras if there are Arab women around. In shopping malls, we are careful that there is no Arab woman in the background. If she is a friend of yours, and she permits, you may photograph her. They walk about with their abaya (long black gown with full sleeves and reaching down to cover the ankles – as they don’t get exposed to sun, they are prone for hypocalcaemia and osteoporosis, laments our orthopaedic surgeon) and a cover for the head (to cover the hair) and sometimes a ‘makrama’ to cover the face below eyes. Some may wear a veil above this as well. We try to recognize a co-worker by her size and shape, and the way she walks. If she is too well-known to you, you can ‘read’ the eyes provided they are exposed. And if she greets you, there is help from the ‘voice-recognition-software’ you have in your brain. But many times we may have to ask “min?” (who). Sometimes they surprise you and the passers-by by lifting the veil to show her face.

When they come as patients into the clinic, it is another story. My nurse asks her to remove the veil, and she obeys (Some ask, is it necessary?). Again, if it is a male nurse, while she removes the veil, he moves to a place behind the patient, so that he doesn’t see her face. He is back in his chair near me only after she has covered her face. I am able to examine her nose and mouth. What about neck, and ears? (That curtain also has to be removed. This exercise takes away precious time in the outpatient, but one gets used to it.) Elsewhere you can get sued for missing a finding or sometimes not even completing the required exam. If it is earache, some of them lift that part of the ‘veil-system’ for me to get a peek; that means you never see who you are examining.

I stick to my strict routine of examining ‘whole head & neck’, otherwise I record “patient not co-operating for exam” in the patient’s card, and refuse treatment. The nurse tells her to meet some lady doctor; we have female GPs. During my first few days, once I wondered aloud angrily what if they had male gynaecologists.

And the two gynecologists in the hospital were male.