Many years ago, as a junior resident in a large overcrowded public hospital, I chanced upon an elderly man lying in bed looking very pale and ill and surrounded by two younger men looking at their friend(the patient) as if he was in death’s throes. As I breezed past on the way home after a rather tough stint, the younger man stopped me in my tracks and said if we could do something to help the elderly man as they had been told earlier by another doctor that the patient was terminally ill, nothing could be done and that the best thing would be to take him home to spend his last days comfortably in his own bed.
It was already late night but as there was a bit of extra time left before the call-duty was over, I took a brief look at his case-notes and summarised that the working diagnosis was that of advanced cancer of the lungs.
Having promised the patient’s friends that we would take a second look the next morning with the team, I headed off for home.
To cut a long story short, the diagnosis turned out to be a lung infection called aspergillosis and in next to no time, the patient was cured and able to walk home quite well.
I was constantly reminded of this gentleman as he would faithfully turn up once a year outside my office during the main festivity season bringing a celebratory gift. Although he did not speak English, the words, gestures and smile spoke volumes in terms of gratitude. These visits went on for several years till my staff took his visits almost for granted.
One fine day, we all realised that his visit had stopped coming for some time and it wasn’t till much later that word got to us that this fine old man had finally succumbed at home to what was presumably old-age.
This whole episode really got me thinking whether we as doctors do actually determine the fate of fellow human-beings. Much as the Hippocrates Oath or the Geneva Declaration on Health determine our behaviour towards patients, doctors are subjected to various constraints sometimes beyond their control. A missed diagnosis, inadequate review, insufficient resources are some of the factors which may hinder appropriate treatment and consequently lead to a different fate than what God probably intended…