Indian Medic

Being a doctor means shouldering many fold responsibilities - to your patients, to the community, to your family and to yourself. What happens if a doctor falls sick? It is a tenet in medicine that doctors make the worst patients. Is it because they know too much and know what questions to ask the treating physician? Because they know too much and consequentially are more scared? Or maybe because they know too much and are well aware that the best of doctors can make mistakes? The bottom line is that doctors make poor patients because they know too much.

When does a doctor seek medical help (from someone else)? How much is too much? All doctors practice some form of self-medication or the other. The degree they hold gives them the right to. But what differs is the scale in which they prescribe to themselves. That I assume, depends on their level of specialization and experience. For instance, being a non-specialized plain MBBS doctor my self-medication spectrum ranges from paracetamol to Cetrizine to simple broad spectrum antibiotics. No anxiolytics, no sedatives or such other drugs. Luckily enough I have ever needed more than that. But I know a few peers who do prescribe stronger stuff like Tramadol and Alprazolam to themselves when needed.

And as far as seeking outside medical help is concerned, mostly doctors approach others only when they have extinguished their quiver of arrows. Or when the symptoms are dramatic enough to warrant it. But if it can be avoided doctors tend to avoid it. This is speaking from experience.

As a kid, I never had any major health issues, except for chickenpox and the occasional cut needing stitches. A couple of years into medical college, which was in a place that faces extremes of all climates, I developed Allergic rhinitis. Allergic tendencies run in my family, my grandma is an asthmatic. But considering that I had never been sick before, I was overwhelmed with this simple but taxing affliction. I used to sneeze, I used to sneeze, and I used to sneeze all day long. The first thing I did on waking up was sneeze uncontrollably 20-30 times. My eyes would go red, my head would start aching and it would feel like my nose was on fire. It was like having a cold forever. The slightest of temperature changes or breezes or dust could bring on a massive paroxysm of sneezing. A senior med student gave me some Antihistaminics, which did help but also made me rather drowsy. I spent the whole of six months in this manner, and if I was a nuisance to my friends and roommates, they sure didn’t say anything.

Then one day my nose started hurting. The lightest of touches would send searing shots of pain into my head. I took all manner of over the counter analgesics but to no avail. The sneezing only escalated in frequency and it seemed like my perpetual cold was getting worse from not being able to smell anything. After a fortnight of suffering, I visited the ENT department. It was not just the pain that pushed me to do so, I was scared. We were studying ENT that semester, and I was scared that I would develop Atrophic rhinitis. It’s a condition where all the nasal mucosa and turbinates shrink and undergo atrophy, leaving a very roomy nasal cavity with permanent loss of smell. The treatment was a procedure called Young’s operation; it consisted of closing away one or both nostrils with skin flaps I admit, it seems like classic Medical student syndrome (a form of hypochondriasis) but the pain was for real.

That’s when I was officially diagnosed with allergic rhinitis, and the nose pain was from vestibulitis, an infection of the outer and lower part of the nose. A course of antibiotics and some serious nasal douching later I was back to normal in a week. You would have thought that I learnt my lesson with that. Nay….

Later that very year, I came down with a serious case of tonsillitis. It went off, only to return in a month’s time. Summers are excruciating in that part of the country and we were heavily into chilled drinks and ice creams to keep cool. Even though it is a myth that drinking or eating cold foodstuff causes cold, URI (upper respiratory tract infection) is aggravated by cold foodstuff, because they lower the temperature in the oral cavity allowing the bacteria to thrive. So my tonsillitis returned with a vengeance every time I went on an ice-cream binge. The odynophagia (pain during swallowing) it caused however was something that was amenable to NSAIDs and I ploughed on.

When I came home for the holidays that year my mom made me visit an ENT specialist, who tagged me with the diagnosis of Chronic follicular tonsillitis. Though she didn’t suggest that I get my tonsils removed, she did advise that I steer clear of cold stuff, something my mom made me swear to do.

Now that I am a registered medical practitioner, I know how to handle my idiosyncratic afflictions. Though occasionally I do indulge myself with some ice cream, I manage to have not more than four attacks of Acute on chronic tonsillitis in a year, as that then would become an indicator for tonsillectomy. My mom, though, keeps haranguing me to get it done.
But tonsillectomy, with General anesthesia, with the ET tube down my nose…no way… I can’t even begin to count all the things that could possibly go wrong there. So as a doctor if I am a poor patient that’s because I know what to be scared of.

My ‘illness’ is a very simple matter, I chose to write about it because I can be subjective and truthful about it. But I do know of a few colleagues who in spite of having a lot of dangerous symptoms didn’t seek help till it was too late.

One of them had abnormal menstrual cycles with occasional abdominal pains which kept getting worse. One day she collapsed during rounds and was diagnosed with twisted ovarian cyst. She had to go under the knife for that one.

Another friends had been passing blood in stools for a while. He thought he had piles and was embarrassed to get help, but turns out it was a fissure, which had progressed to a stage where it had to be excised.

Agreed, the above two conditions are about potentially embarrassing situations. My friend in Med school had occasional shooting pains in her right arm for a really long time. We kept telling her to get it seen. She was in the habit of writing out stuff to memorize it, she over did herself before our second year exams. She could hardly hold her pen straight on the first paper because of the pain. An x ray taken that evening revealed a cervical rib. Luckily enough she managed to scrape through in that paper and did not have to lose six months.

I have a few more of such examples, but the gist has been given. Most doctors are narcissistic, they have super egos, but they are still human. Physically they are as vulnerable as everyone else is. But does having first hand knowledge of the ways of the human body and the millions of things that could go wrong with it, in a way hinder their willingness to seek medical help for themselves?