Is learning medicine enough to be a doctor?
2023; Medknow; Volume: 71; Issue: 7 Linguagem: Inglês
10.4103/ijo.ijo_930_23
ISSN1998-3689
Autores Tópico(s)Ethics and Legal Issues in Pediatric Healthcare
Resumo"There is a little kid who I see sitting in the sprawling gardens of our campus every evening with his father. Sitting in the lap, he points out to the flowers in the parterre and enthusiastically calls out their names that his Papa seems to have taught him. Today, I saw him at the temple. His father, lifted him to the height of the giant bell. The boy hurriedly, with the strength of his tiny hands, rang it in feeble excitement. He then, imitating his father, bowed his forehead to touch the feet of the Goddess Durga statue. With folded hands and a peeping eye, he waited till his father was done with the prayers and then rushed for the Prasad. There was something intriguing about this child. Maybe it was the way he made the little things in life look like a celebration. Or maybe it was the sparkle in his eye that refuses to go despite the chemo mask on his face." This incident goes back to the beginning of my ophthalmology residency when I was posted in the retinoblastoma ward. It was the first time I came face to face, realizing what a secure and privileged world I resided in. It was beyond my comprehension then, and still is, how life could be so unfair to people who least deserve it. Over time, I witnessed the strength displayed by my patients and the grace with which they handled difficult circumstances. Like the forty-year-old with a subconjunctival hemorrhage who eventually revealed that she was a victim of domestic violence and had finally gathered the courage to file a case against the husband, making sure her son grew up with better values. The widower with one eye lost to glaucoma, living alone, but his zeal for life being so infectious, nonetheless. The 82-year-old gentleman always taught me a lesson or two about life in his own subtle way, without being overtly preachy. Sometimes, I feel my patients help me almost as much as I help them. When I completed masters in ophthalmology, my mind followed a bookish approach to disease: etiology, pathogenesis, symptoms, signs, treatment, and prognosis. I genuinely believed it was the medicine and its mastery as a science is what cured the malady. However, in the last few years, through humbling experiences, I gradually realized there was no single formula of healing that was universally applicable to all patients. Patients with the same diagnosis and presenting symptoms are uniquely different as individuals. Furthermore, their response to medication or the physician's interaction with those patients is also distinctive. There are still some anomalies for which mainstream medicine has no answer. Often, we have patients with unspoken anxiety, who want the reassurance that they are not alone in their struggle to get well. For instance, this elderly lady who visited me for watery eyes and diminished vision. Her eye examination and other investigations were unremarkable. It was impossible to reach a diagnosis, until over subsequent visits, I came to know that she was a retired professor and a widow. Her only daughter passed away twelve years back due to a prolonged illness and she had since been living alone with her caretaker and a young driver. I decided to approach her in a different manner this time. I gave her a few extra minutes and continued to listen even though I knew her problems could not be solved by my prescription. Then, almost like magic, her demeanor softened. She did not ask many questions after that. Holding her hand, I wished her good health. This time, after all those half-convinced, half-hearted, tepid consultations, I noticed that she left my chamber with a hint of a smile. Most definitely, there is something beyond prescribed chemical compositions that help the healing and recovery process. I believe that this nontangible aspect of patient care is the most fascinating part of our profession. Practicing ophthalmology is not just about diagnosing diseases and performing surgery. It also gives insight into human psyche. For example, this middle-aged lady who underwent uneventful cataract surgery was very dissatisfied and restless. "I am forbidden from offering prayers. They don't even let me watch television for half an hour, saying it will damage my eyes", she complained, pointing to her son and almost in tears. I could instantly connect the dots. Her body was working perfectly fine. Having been deprived of her busy work schedule and day-to-day activities had suddenly made her feel lost and purposeless. The unhappy mind with its negative thoughts caused the physical body to develop symptoms (what we call somatic symptoms in medical science), when in reality, there was almost no physical morbidity! I relaxed a few postsurgery restrictions and asked her to gradually go back to regular chores. A week later she called me up, asking when we could plan surgery for her other eye. I smiled, knowing the "treatment" had worked. These are things we did not learn in medical school. Then, there are patients on whom your treatment works so impeccably that they lift you up to a demigod status. That patient with a light perception cataract who was bedridden, who can now go for an evening walk independently. Or that patient with a corneal ulcer who finally slept through the night after weeks of incapacitating pain. It is gratifying to serve society in this capacity, where our reward is filling someone's life with light again – the difference people think we have made in their lives. These are the patients who shower you with unconditional love – even more than your family could give. This is an art, and that is why, one "practices" Medicine; something we learn and get better at along the way. I am a mere speck in the vast ocean of doctors brimming with knowledge, wisdom, intellect, and vision. Moreover, it has been an enriching experience so far. I am grateful to all the patients who gave me the opportunity to serve them and learn about the human body and disease the way no book ever could. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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