Monday, November 26, 2007

The Hypocrisy (Hippocratic) Oath

Why are we loath to put up with any sort of unethical conduct in matters concerning medical health when we openly promulgate such behaviour elsewhere? It is probably only because that we cannot accept that the person who has our life in his/her hands could be unscrupulous to the point that our best interests may have been be compromised. Any medical treatment nowadays is a series of procedures that in trying to eliminate your apprehensions also fills up the hospital’s coffers. It is not uncommon for a succession of treatments and tests to be prescribed for what has been already diagnosed ab-initio, but, we concur with these because it is our health and life that we do not want to risk. But, when the Hippocratic Oath, by which the doctors swear to treat the patients to the best of their ability, is thrown by the wayside for the sake of ready money, it just cannot be accepted anymore.

Dr.Agarwal’s Eye Hospital at 15, Eagle Street, Langford Town, Hosur Road, Bangalore, is supposed to be a renowned eye hospital, though its predecessor in Chennai is the more renowned of the two. My mother badly needed to have a cataract surgery done and we had decided to do it at Nethradhama, Jayanagar, which is the closest eye hospital to my home, until the Nethradhama authorities said that they do not accept the Bajaj-Allianz insurance that I have. So, based purely on geographic distance, we decided to go to Dr.Agarwal’s Eye Hospital on Hosur Road which was the next nearest. As soon as you enter it, you wonder if it was really a hospital. It is run from a house with hardly any staff – two doctors, Dr. Soumya & another whose name I couldn’t get, but, she was addressed as what seemed to me to be Dr. Garima, two nurses, a lab technician and a ward-boy who doubles up as the receptionist. After paying Rs. 300 as the admission fees, we were directed to the waiting room, which was actually the hall of the house. Dr. Sunita Agarwal’s medals are displayed here and so are some newspaper articles of her and her stem cell research. I should have got my first clue then and there itself when all I could see there at 11 a.m was just one more patient, compared to the hustle and bustle of patients that Nethradhama and later Narayana Nethralaya was.

My mother’s eyes were initially tested by what I’m pretty sure was the lab technician and not a doctor – the local slang in the Kannada and Tamil she spoke giving her away. After that we were directed to Dr. Garima who hardly ever spoke and after subjecting my mother to the other various tests, she said that the head nurse would clear our doubts. The head nurse was herself a senior citizen, speaking both Kannada and Tamil with a Malayalam accent and interspersing Malayalam words in both. She told us about how my mother’s eyes were totally dry, painting a grim picture of how harmful dry eyes were and how badly we needed to have a silicon plug installed in each eye at the cost of Rs. 4000 per plug to prevent dryness and no, that wouldn’t be covered under the insurance but it was absolutely necessary! As for the cataract surgery, she said that each eye would cost Rs. 20,000 inclusive of an imported lens, however if we needed a ring to support the lens inside the eye (if the optical muscles were too weak to support the lens), we needed to pay an extra few thousand for the ring and no, it was not covered under insurance. Post, operation, we needed to undergo three sittings of Retinal Diode therapy, once in ten days, the purpose of which was to strengthen the eye muscles, each sitting costing Rs. 2000 each and no, that too was not covered under insurance. She then, told us to wait for Dr. Sunita Agarwal, who was expected at around 1 pm and who would give us the dates for the surgery.

It was during that one hour waiting period, that I realised what a con job Agarwal’s Eye Hospital was pulling off. I talked to the one other patient, an old lady accompanied by her daughter. She had already had the surgery done in one eye about two months ago and had come there for the Diode therapy. Agarwal’s was still not clear about when her other eye would be operated upon. She advised us not to go for the stem cell therapy. Then a young couple came in, with the lady telling the nurse that she had headaches. She was diagnosed with some power after a check-up and then the head nurse started her sermon about Silicon plugs. The young couple were unconvinced and left with only the prescription for the glasses.

Sunita Agarwal ambled in around that time and I swear she reeked of cigarette smell. She hurriedly saw our reports, spoke to the two doctors and wrote a few more points on the report and left, leaving us to speak to the head nurse again. Post her lunch, Dr. Garima, did a few more checks and she had garlic and masala stench on her breath and her hands. She told us that my mother had a slight squint in her eyes (after 57 years of nobody discovering it!) and it could be corrected with treatment and no, it was not covered under insurance. The old nurse came to us again and said that Sunita Agarwal had prescribed us Stem cell injections and it would cost us Rs. 40,000 but it was very good for an early recovery and no, it was not covered under insurance. After we expressed out reservations about it, and after I cut short her sermon about stem cells saying that I knew what they were and that they were unethical, she agreed that it was something Sunita Agarwal prescribed to all patients and very few actually had them. She told us to come the very next day for the surgery. I reminded her that my mother was diabetic, but, she said that it was a minor operation and a sugar check was not needed. She told us that a BP check would be done the next day prior to the surgery and that was enough. When we asked for the file containing the reports, she refused to give them to us. I asked her if the doctors don’t speak to the patients, she mumbled something about language issues when I clearly had heard Dr. Soumya talking in Kannada on her mobile phone. I asked her about the recovery time after surgery, she said that if we wanted, we could have both eyes operated at the same time, when I knew that this was wrong.

Back home, I searched on the net and consulted my friend who is a doctor (but not an ophthalmologist). I found that Diode therapy was something done for damaged eyes and silicon plugs were totally optional and my doctor friend warned me against having the surgery done at Dr.Agarwal’s Eye Hospital, saying that all they did was daylight robbery. I called up my insurance company the next day and got the approval for my mother’s surgery at Dr.Agarwal’s Eye Hospital cancelled. My mother had her surgery done at Narayana Nethralaya, Rajajinagar and she’s had no problems ever since and I have the satisfaction of not having been conned.

I find it difficult to blame Dr.Agarwal’s Eye Hospital. They have their business to run but it sure is difficult to digest the fact that they were playing around with the life and health of someone close to me. Medical ethics are supposed to be of utmost importance to a doctor but I think Sunita Agarwal must have bunked that class in her medical school.

Wednesday, November 7, 2007

The Other Side of the Coin

I’m certainly not a right-winged Hindu fundamentalist but, I have no sympathy for the late Rizwanur Rahman. It is just that I cannot pity anyone who gets ensnared in any sort of a complicated situation brought about by that silly notion called “Love”. The media and the ideological youth have, needless to say, made a martyr of someone who didn’t do anything to deserve the accolades he’s getting after his death.

I’ve always wondered why we have such a fascination and anticipation for love triumphing against all odds. Maybe it is the effect of watching too many Bollywood movies glorifying “love”. Why can’t we accept that the odds can even out once in a while and the universal “bad guys’, the parents who disagree with their children’s love, also have their own point of view that may have an iota of prudence to it. “He has sacrificed his life for love and country. Its our turn to show it was not futile” – says the first post of a web site dedicated to Rizwanur. Would Rizwanur have sacrificed his life willingly for his love even if he had a prior inkling of the fame he has since achieved? Why do we then keep at it that he sacrificed his life for his love? I also fail to understand the connection between welfare of the country and his death. Do they mean to say that Rizwanur’s death is the next Jalianwala Bagh in the freedom struggle for love? Why does love require a sacrifice to establish its stamp of greatness and why does love make an educated man or woman lose their marbles so that they can’t take in the good from the bad or make judgements that may prove fatal?

The whole matter being sub-judice, it would be iniquitous to brand Ashok Todi as a murderer. It would also be totally unfair to completely ignore his side of the story. Any man wouldn’t want to see his daughter marry below his social standing and for a man said to be worth in excess of Rs.200 crores, who surely must have brought up his daughter in a comfortable if not lavish lifestyle, the mere idea of her marrying a socially insignificant person like Rizwanur would have been sacrilegious to say the least and he did try to wean him away from her with promises and threats. Why blame Todi, for I’m certain that all these “soldiers of love” crying for Rizwanur today, would do the same if they are in Todi’s position tomorrow. Rizwanur knew about the influence his father-in-law had in the corridors of power, but still went ahead with the marriage which makes it hard to believe that he was not just a gold-digger. Had Rizwanur had the sense to listen to his mind over his heart, he would have lived. Should I blame the person who knowingly & willingly put his hand into a snake-pit or should I blame the snake for biting him?

If Rizwanur had been just beaten up, or if Todi had been a Bengali this incident would have been relegated to some obscure column of the newspaper. Had Rizwanur not been from the minority community, would this episode have been politicised? Rizwanur had agreed to convert to Hinduism. Then, why is he hailed as a hero and a champion of the minority community who stood up for what he believed? Is this incident just a sad reminder of the generation gap between parents and their offspring? There are too many hypothetical questions. But, there is one thing I’m glad about - for obvious reasons - that, this incident did not happen in Gujarat.