A Matter of Faith (12)



The post-war period was a period of physical privation but the intensity of human relationship and the consideration and caring for others was at its best, probably because of the hardship which was shared by all during the war. The porters would wait for hours after duty time to shift the patient to the ward if the operation took longer than scheduled. And yet, when a young colleague visited a hospital in the recently, there was a strike by the union and the patients lay on the operation table for an hour or more after the surgery, not because of shortage of porters, but because the union would not permit even the doctors and nurses to move the patients themselves because it would be undermining the union rules. A far wealthier but, in many ways, a far sadder country, for the yardstick of civilisation had shifted from the consideration that the society had for those who are less fortunate, to the accumulation of material goods and wealth.

The other extreme was experienced when I was conversing with a middle aged middle-class woman seated next to me when I was travelling by motor coach in the U.S. from Colorado Springs to Denver. Her opinion of the medical profession was that it was "a necessary evil". Her husband had just died after suffering for two years from a chronic neurological illness for which there was evidently no cure. This had not only wiped out their life savings but she was about to sell her house for final settlement of the professional and hospital bills even though their medical insurance had paid a substantial part of the total expense.

Unfortunately, there is an increasing disenchantment with our own medical services especially by the urban middle class. Bombarded by medical high-tech propaganda and its availability in the expensive private hospitals, they now have to decide between providing the best for their beloved ones and its cost which would prove to be an economic disaster for the entire family. While the rich can afford this dubious luxury, little do they realise the dangers of excessive and unnecessary investigations medical treatment and surgery and the very high rate of secondary iatrogenic (doctor/man-made) diseases these produce. The poor have to be content with the ubiquitous injection and now the intravenous glucose drip from the private practitioner to which they have been hooked.

There are only three major injections that can be ethically given outside a hospital, viz. immunization, penicillin and streptomycin for tuberculosis because almost all the rest of the drugs can be given orally. And yet these are the least commonly used. The family physician who must be the basic pillar of health care is no more produced as there is not a single general practitioner in our medical colleges to train the students. They have been replaced by an increasing variety of specialists with their penchant for the latest western technology, regardless of appropriateness to their patients or the nation's needs. Like the injection for the poor, the better off are hooked on to specialists, whom they seek as the primary contact, even for minor ailments.

Compilation of professional reminiscences of specialists - edited by M.V.Kamath and Dr.Rekha Karmarkar.