Patients’ attitudes influence the doctors’ response

Adoctor’s life is perhaps the only one that provides the widest range of emotional travails every single day: from profuse gratitude and joy on one end to deep frustration and sorrow on the other, and to the recently increasing one of blame and accusation that disturbs most.

CATEGORY 1

When a young girl brought her elderly mother to me last week from the other end of the city, my obvious question was what made her travel so far when there were good hospitals in her neighborhood. Her simple answer was, “I had brought my father to you last year, and you cured him of the stone stuck in his bile duct. We have full confidence in only you”.

This is the commonest: satisfied grateful warm people that make us go all out to help them.

CATEGORY 2

Sad and frustrating times are not infrequent in our lives. I remember a young man who had brought his elderly ailing mother to me with a severe attack of pancreatitis. After 3 weeks in the ICU and on ventilator, and with much money spent, she had finally succumbed despite all our efforts. The family was devastated.

I remember cancelling a dinner invite that evening as my heart cried silently in resonance with the bereaved family.

CATEGORY 3

A 65-year-old businessman visits me for liver cirrhosis brought on by years of excess alcohol consumption. He had required hospitalization for managing the water that had accumulated in his abdomen and lungs, from where we had helped him recover. But despite our forbidding him to touch alcohol, he was back to the bottle very soon.

Our efforts to make him stop alcohol has not worked: my verbal and written warnings, medications that help reduce alcohol craving, counselling by de-addiction experts, emotional pressure from family members.

This is the perfect setting for the “blame game”, family members accusing us for not being able to stop him while we feeling the family has no time for him, and I getting “frustrated” and apprehending what is coming!

CATEGORY 4

A media director accompanied by a lawyer friend walks in and starts the consultation by switching on the cellphone recorder. He thrusts a fat file of investigation reports at me, most of which show no abnormality. I can see that he is angry, suspicious and “depressed” and, I learn subsequently that his family is breaking apart and his son, a dropout, is on therapy for addiction and depression.

His demeanor was rude and accusing. His comments about the ten doctors he had consulted before coming to me were derogatory. I realized I would be the next on his list.

I chose to be strictly professional, answering all his questions with technical information, but holding back any surge of empathy for his unfortunate state, or from offering well-intentioned advice on how he could possibly mend his life and feel happier, lest I be misunderstood.

I suggested he sees another senior doctor if my medicines do not help him (I could almost tell that they would not!)

Patient-doctor relationship is not a consumer-seller one, like walking into a shop and buying a toothbrush. It is a personalized human relationship in which the patient’s attitude also matters.