Some of our unlettered, but wise, villagers live up to 100 years without any medical check-up
Doctors and their patients are alike in all respects: except their attitude towards modern medical interventions. While 90%of dying patients in America get their last rites while still alive in the intensive care units (ICUs), a meagre 5% doctors ask for those futile terminal rites. Why this wide variation? Doctors don’t want to die: they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain and dying alone. They’ve talked of this with their families. And they want to be sure, when the time comes, that no ‘heroic’ measures will happen; that they will never experience—during their last moments on earth—someone breaking their ribs in an attempt to revive them with cardiopulmonary resuscitation (CPR) (that’s what happens if CPR is done right), writes Ken Murray, a retired family physician, who himself has written his ‘living will’.
The hapless patients and their relatives are told that without ICU admission they have very little hope to live. Patients believe that doctors are capable of pulling out the dying even from the ‘jaws of death’. The relatives feel guilty if they do not agree. So the business goes on; over 90% of hospitals’ profits come from keeping dying patients in the ICUs. Time was when most patients who went to the hospital went to the grave. Have we not come back to the same state again with all our hi-tech stuff?
The other area where doctors and their patients are treated differently is in the area of regular check-ups. A few decades ago, there was a study in the US of doctors’ families and the general public’s incidence of screening. While everyone was asked to have these check-ups for their good, doctors and their near and dear ones were hardly screened! The screening industry is another big money spinner for the good of the profession but certainly not for patients. Some doctors had not had a check-up all their lives!
What surprised me is the story of a doctor who went to a cardiologist and asked for an angiogram as he had reached 60 years and would have coronary blocks; and, if they were there, they need to be bypassed. Of course, even children will have those intra-luminal blocks which are just band-aid processes. This brilliant doctor got his bypass done, thinking that it will cure coronary artery disease. And he also thinks that bypass surgery is the best preventive. Both beliefs are not based on scientific facts. The reality is that some of our unlettered, but wise, villagers live to be hundred without having had any check-up.
When doctors fall ill, they want the best and compassionate physician to look after them. Patients feel the pinch of the enormous cost of medicines and investigations while the sick doctor gets away with free consultation, free medicines and even free laboratory tests! Therefore, doctors do not realise the pharmaco-economic burden on their patients while prescribing drugs and surgery for their own benefit and that of their benefactors—the drug and device lobbies. In conclusion, one soon realises that doctors are on a different pedestal when it comes illnesses. Dr Ken Murray, referred to earlier, had done a survey that showed that most doctors do not want to die in a hospital’s hostile ICU while they send every patient in an emergency to the ICU with some silly excuse. Do these ICUs save extra lives? That is a million dollar question—million dollar benefit for the hospitals and doctors.
God save mankind!
(
Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)
