Storytellers

The Power of Privacy Vijay Gopichandran “Sir,23-year-old man who has come with weakness, tiredness, palpitations for 2 months. I heard some strange sounds on auscultation of the heart. Could you please take a look”, was what my colleague told me when she left a thin built, handsome young man in my room who was accompanied by a tall, overprotective mother. I thought it must be a murmur of some sort. So, I decided I will re-do a history before I examine this young guy. I asked him, “tell me, what is the problem? What brought you to the clinic today?” He did not answer me, gave no response and looked at the side towards his mother. She answered, “Doctor, he is always very weak and tired. He is unable to go to work. He is always complaining of breathing problem and fast heartbeats. He is weak.” She had a very complaining tone. Every time she kept saying “he is very weak doctor” with a frown on her face, I was cringing in my seat. Why is this woman so condescending? She was probabl...

The physician’s agency Vijay Gopichandran An incident that happened in the clinic yesterday made me question whether I had any agency as a physician. In this blog, I am going to describe what I understand by the term ‘agency’ and my reflections on the agency of a physician. In philosophical terms ‘agency’ refers to the capacity of a person to act purely based on their free choice with some amount of awareness of their consequences. So, a person is said to have agency when they are autonomous, can act based on free will and take full responsibility for their choices. The individual agency works on two planes – social and moral. I am said to have social agency when within my work environment, I am able to exercise the free choice of treating my patients based on the resources available, the geographical location of the hospital, the type of patients who visit the clinic, the cultural and social norms and values of the clinic, etc. When the social circumstances grossly restrict ...

Research methodology workshop of a different kind Vijay Gopichandran I was 10 years old and was told by the school health nurse that I needed to check my eyesight for possible distance vision problems. I remember going to the friendly optometrist near our house, having my eye checked and prescribed spectacles to wear with a spherical lens of -1.5 and cylindrical lens of -1.5 in both the eyes. I was told I had ‘power’ in my eyes. I asked my mom, “If I had power in my eyes, why is it that I cannot see the aliens on the moon and all those tiny germs that contaminate my hands when I play in the sand.” I don’t remember what answer she gave, but I vividly remember being shocked when I later understood that ‘power in the eyes’ in the optometry lingo, actually meant ‘powerless eyes’. Those days it took anywhere between 3 days to a week for the spectacles to be ready, especially the complex ones with both spherical and cylindrical power. I remember eagerly waiting for the spectacles. ...

Why I am happy to be a primary care provider? Vijay Gopichandran I have been invited by my mentor to talk to first year MBBS students about the importance of primary care. Her exact words were, “I want more youngsters to be inspired to do primary care”. I feel extremely honoured that my mentor feels that I am worthy of this responsibility. Here is a sketch of what I am planning to say to the students. I am describing why I am happy that I am a primary care provider. 1.       I believe that there is a 10-90 rule in medicine. I believe that of all illnesses the most common 10% of them affect the maximum proportion of 90% of the people. Whereas the remaining 90% of the illnesses are rare and affect only 10% of the population at any point of time. This inference is based on my years of primary care practice but needs to be validated. There are some common illnesses like cough, cold, fever, headache, malaria, tuberculosis, diabetes, hypertension, injurie...

Hierarchies, clans, and fiefdoms Vijay Gopichandran Nowhere else is the strict hierarchy stronger than in the medical fraternity. I have realized this as someone who has been trained in medicine for more than 9 years, practiced medicine for about 20 and worked outside of medicine in areas of writing, journalism, public health, and social work for about 6 years in the middle. The hierarchy in medicine starts from day one of medical school. Fresh from a very forward-thinking and modern CBSE school in Chennai, when I entered the prestigious Madras Medical College, I was shocked to realize that I am not allowed to say “Hi” and wave my hands at a person from my own school who had joined the college the previous year. He was my senior in college and so I was supposed to show reverence and address him as “sir”. I was instantly identified as the rookie spoilt snob from an upper-class school who waves at his seniors and was subject to intense ‘ragging’ for several months. Even tod...