“I weep for you,” the Walrus said:
“I deeply sympathize.”
With sobs and tears he sorted out
Those of the largest size,
Holding his pocket-handkerchief
Before his streaming eyes.

“O Oysters,” said the Carpenter,
“You’ve had a pleasant run!
Shall we be trotting home again?’
But answer came there none–
And this was scarcely odd, because
They’d eaten every one.

The Walrus and The Carpenter
Lewis Carroll

Doctors are good, god-like and like everyone else, get angry when criticized. But they must be held accountable. Not merely for negligent practice but for being indifferent to the queries of patients and their families. In our countries, medicos often do not bother to explain prognoses, medication proper living-style changes to the common person. They think the latter to be too ignorant in things scientific to be able to understand what is going wrong medically. Of course, there are good, humane doctors who are genuinely interested in the welfare of their patients. For example, there is Dr. Sukumar Mukherjee against whom a case is pending for gross medical negligence of the wife of his NRI student, Dr. Kunal Saha. Dr.Saha has accused his teacher of deliberately giving steroid in higher doses to the late Mrs. Saha. But this writer has met patients touched by the healing hands of Dr. Mukherjee and found that they think of him as a veritable deity. I found that without Dr. Mukherjee’s help patients suffering from auto-immune diseases like SLE and rheumatoid arthritis would have degenerated long ago. One patient from Dhaka told me that when her SLE made all her vital signs to drop, Dr. Mukherjee was at her bedside for over five hours till she showed signs of improvement. The doctor sees patients till two am in the night. One veritably doubts whether such a man can ever deliberately kill a patient. But this is an example of a good man practicing medicine. Unfortunately too many doctors have made a business of their professions and also there is working a sinister nexus between pharmaceutical companies and doctors. Pathological laboratories are known to pay up to 30% to doctors for prescribing high-cost tests. While investigating for this report I have come across large chain hospitals in Kolkata setting targets for surgeons to achieve. A famous, resort like hospital off the Eastern Metropolitan Bypass, Kolkata, has set certain benchmarks for appraising the performance of doctors in its pay. One is aghast to know that a doctor’s acceptability to the hospital increases only if say, a spinal surgeon fulfils a certain quota of surgeries. Other staff has told me on conditions of anonymity that in such a situation doctors have to force patients undergo dangerous surgeries for trivial reasons. Otherwise their jobs are at risk. A curious fact has come to light; patients undergoing routine and sometimes urgently recommended angiographies to check for heart-blocks are suddenly declared in the gravest of dangers. The cardiologist in charge will suddenly declare that if the patient is not given stents right at the moment then the patient might not live; the blocks are so disastrous. The patients’ families are then charged anything from a few thousands to lakhs, depending on the economic strata of the patient, for those stents. Doctors receive very handsome commissions on stents costing over a lakh each, sometimes to the tune of 25% of the billed price. There are indeed cases where doctors do have to perform angioplasties urgently but the greater malpractices erode our trusts in honest doctors.

Three horrendous cases have come to my notice. I have the prescription of one of them with me. A lady in her late twenties visits famous, busy rheumatologists. She complains of knee pains and joint pains. The doctor who boasts of a tight schedule cursorily looks at her and prescribes her the deadly (when not necessary) methotrexate and diagnoses her as having progressive degenerative rheumatoid arthritis. He advises the starting of the medication without key tests. When the patient’s family asks him whether tests are necessary, he bursts into a diatribe about the idiocy of the patient-party and reluctantly insists that some very expensive tests be done from specific laboratories, though there are known better laboratories in the city. It was later found, on second opinion, that the said lady had only a minor sprain and suffered from exercise related transient injuries. A general physician has last week told a family that their patient has throat cancer. It is the truth. Then the doctor has delicately put forward the proposal that he be taken with the family to Mumbai where he will be so kind to arrange everything for the patient at the relevant hospitals. One just has to pay his for his flights, his residence there and also his days missed at work in Kolkata. When the patient’s family refused, the doctor had first thrown a tantrum and then refuses to set eyes on them ever more. This is as far as I can write of doctors here. A medical representative recently ran up a bill of more than Rs 55,000 for a dinner for three at the Taj, Kolkata. There was a doctor-couple and himself. He was mandated by his pharmaceutical company to hard-sell ginseng capsules to the docs. Incidentally, ginseng has been reported to reduce long term immunity by some researchers. His company also manufactures atorvastatin. He suppresses to the doctors that this cholesterol lowering drug often has serious motor-neuron side effects which may possibly be reduced with CoQ10, an enzyme. Neither are the doctors too interested to know the nitty gritties of the medicines. They have just been offered an all-paid trip to Switzerland.

What can the layman do in such circumstances? I have put up a post here about how to deal with medicos. But then, nothing is foolproof.