Year : 2013 | Volume
: 4 | Issue : 1 | Page : 45-
What I wish every doctor knew: A patient perspective
Founder, V Care Foundation, Mumbai, India
A-102, Om Residency, Opp. Bhoiwada Court, Parel (East) Mumbai - 400012
|How to cite this article:|
Gupta V. What I wish every doctor knew: A patient perspective.Perspect Clin Res 2013;4:45-45
|How to cite this URL:|
Gupta V. What I wish every doctor knew: A patient perspective. Perspect Clin Res [serial online] 2013 [cited 2020 Jul 3 ];4:45-45
Available from: http://www.picronline.org/text.asp?2013/4/1/45/106377
Laxman Rao sits hopefully next to his wife Savitri Devi's bed in the general ward of state of the art government hospital in Mumbai. Savitri was recently diagnosed with breast cancer in stage IV, and Laxman has travelled from interior Maharashtra in the hope of saving his wife. While her local doctor said it was too late and the cancer had spread, the doctor at the regional cancer center gives her hope. He informs her of a new medicine that can extend her life. She signs some forms and is glad that she will get the medicine for free. Holding on to every hope and word that can save his wife, Laxman Rao concurs.
This illiterate couple doesn't know what a clinical trial is. All the husband understands is that it can 'save' his wife, one of the breadwinners in the family. Savitri is one of the several hundred patients that a doctors checks. The overflowing general wards, the serpentine queues, and the endless hours of waiting to see a doctor leave little time for explanations to patients. Her illiteracy, lack of awareness, and unquestionable faith in the doctor leave no doubt in her mind. Her husband may or may not know of his rights or for that matter care about them as long as it can make his wife live.
But, Savitri is also concerned about the physical change in her body. Will she be ostracized by her husband? Will her in-laws accept her? She believes that the new medicine may answer these queries but has no one to ask. Considering the patient loads, the doctor spent a short time, explaining her condition using medical terms - a language that neither Savitri nor her husband understood.
A late-stage cancer, a new drug, and acceptance by her husband are the concerns currently plaguing Savitri's mind. Cost of treatment, health of his wife, and her return to normalcy are prime concerns of Laxman Rao. Considering the harsh conditions they live in, they are just relieved that the doctor has visited them.
The lack of infrastructure, medical personnel, and lack of awareness/education make the Indian healthcare system very vulnerable. A doctor who understands Savitri's physical, emotional, and social challenges and educates her about her options is just as critical as giving her the option of an innovative molecule. A conversation on potential side-effects will help Savitri better manage their disease. A chat with the husband will give the doctor insights into how he is managing his wife's condition and guide him to a counselor if needed.
A doctor-patient relationship is complicated by the patient's suffering. A culture where a doctor is equated to God makes it difficult for patients to openly share or discuss their concerns for fear of offending them. The doctors should engage patients in medical decision-making, irrespective of their awareness, acknowledge the stress that patient undergoes and respect their preferences, beliefs, and values.
As Savitri Devi begins her trial for the new molecule, that has the potential to save several lives, her future, from an emotional and social perspective, still stays uncertain. From a patient's perspective, the doctor's endeavor to reach out to her and respect her ability to comprehend the complex situation can change this reality.
Vandana Gupta, is a cancer survivor and is the founder of V Care Foundation, an emotional support group for cancer patients.