Storytellers

Let’s humanize medicine Vijay Gopichandran I did two deeds today, both of which I am ashamed of. Writing about them is the only way for me to get tuned to the reality that all doctors and teachers are humans and all of us are error-prone. While there is no room for error in medicine and there should be zero tolerance, such a high level of accuracy can only be expected from the system as a whole and not from individuals practicing medicine. An elderly man walked into my clinic today. He had a very slow and unsteady gait. He was holding a big branch of a tree as a support as he walked into my room. He said that his main complaint is severe pain in his left hip, thigh, knee, and feet. He was unable to bear the weight of his body on the left leg. So, he needed the big stick as additional support for walking. He said he usually comes to our clinic and has been seeing other doctors. He has been prescribed several medicines and pain-killer injections. All these medicines help temp...

Rising temperatures, seething anger… Vijay Gopichandran Yesterday during the weekly rural clinic, I almost lost my temper. I am reflecting on my experience in this blog. This experience taught me that balanced emotional expression is one of the most important skills of a good doctor. It was a routine Sunday morning. Traveling in the train along with two very interesting gentlemen, who happen to be students in the college where I teach, we had some involved conversations. One of the students, speaking about the other, who is the class representative and leader, said, “Sir, this guy loses his temper a lot. A good leader should never lose his temper.” The discussion then revolved around anger, anger management and how a person in public service cannot afford to express his or her anger in a crude manner. As this discussion was happening, I was thinking to myself, I don’t have this problem. I seldom lose my temper and I am a cool person. The clinic was a busy one as...

Who is a good doctor? Vijay Gopichandran I am writing this blog following three days of intense discussions and deliberations on medical ethics. The annual meeting of the working editors of the Indian Journal of Medical Ethics just got over. This year, just before the annual meeting of working editors, the Forum for Medical Ethics Society had organized a one-day intensive workshop on Indian Philosophical traditions. One message during that workshop, by the facilitator Prof. Meera Baindur, was particularly impressive to me. She discussed the difference between doing good things versus being a good person. While the former is an aspect of ‘karma’ of a person, the latter is the ‘dharma’ that a person follows. I am going to use this karma-dharma difference to analyze medical ethics. The question that I will address is “Who is a good doctor?” The first point I want to address is, whether a good doctor is one who does what is good for his/her patients. This is largely true...

Often the patient tells you the diagnosis Vijay Gopichandran “Listen to the patient carefully, she is often telling you her diagnosis when she is talking to you”, my teacher Dr. K.P. Misra used to say. When we were in his clinic and undergoing our medical education outside of our medical schools, Sir, as all of us used to lovingly call him, used to drop these pearls of wisdom in the passing. All of us picked up those pearls and strung them together into our lives. Today, most of us are decent clinicians because of him and what he taught us during the 101 (the room number in Apollo Hospital, where Sir practiced cardiology) days. I am narrating two instances where the patient told me the diagnosis during the process of careful and attentive history taking. One of these events happened today and led to this blog and as I was preparing to write this one, I remembered the other incident that happened a few months ago. Today, towards the close of the clinic, a middle-aged woman i...

Can I cry in front of my patients? Vijay Gopichandran A small but strong army of bloggers is forming in our institution and these bloggers are inspiring me to write more. Yesterday, one of our student bloggers wrote an emotional and reflective piece on the various instances when she was moved to tears by the pain, distress, and anguish of her patients. Read the blog here . When I read her reflective piece, I started wondering what I did during the moments I was moved to tears. I was also reflecting on various discussions I have had with batches of students on this topic. In fact, another student of our college did a study on Emotional Intelligence and published it. I am going to write briefly on what I have done when I have been emotionally affected by a clinical situation and its influence on the way the patient related and responded to me. I was pursuing my MD in Community Medicine at that time and had just lost my grandmother to a very severe form of pneumonia. I was ve...

Domestic violence – a social impediment to health These are stories of three women who came to my clinic over the past 10 years. They came to the clinic at different points in time, one almost 8 years ago, one who is visiting regularly since the past 5-6 years and one whom I saw today. Each has a very different story but linked by one common determinant, domestic violence. Sarasu, a 60-year-old lady who I saw today in the clinic, brought back memories of Roja and Amudha from the past. The violence that they experience in their lives reflected on their health and brought them in contact with me. From a fresh MD graduate ten years ago, who was naïve to the issue of domestic violence in the lives of women, to the primary care practitioner, who suspects domestic violence in my patients very frequently now, I have come a long way. I am narrating the stories of these three women who taught me to be aware of how much violence a woman must face in order to even exist in an oppressive an...

Nowadays who sees caste? I understand I am treading on a politically sensitive topic in this blog. I am using some words in this blog which may sound objectionable to some people, so I start by declaring that I mean no malice while using any of these words, and I am using them only because they stung my auditory sensitivities and I want to transfer that sting to you through these writings. “Doctor, I am guessing you are a brahmin”, said a patient as a closing remark during a conversation today. The words stung quite harshly. Read alone, there is nothing hurtful about the words that were uttered. Being someone born in a privileged community, being referred to by the caste name, should usually not incite this kind of response. But it did. To understand why I would like to narrate the incidents that led to this statement. It was a routine clinic day. However, the clinic was not too busy. After finishing the clinic early, my colleagues and I came to the doctor’s resting room to ...