Doctor Death

AUGUST 2001 - What quality of health care would you expect in Pakistan where a royal sum of one percent is allocated from the government every year? Citizens agree that given the mindset and priorities of those who have ruined us – sorry ruled us ever since we gained independence, even one percent is a surprise. It could so easily have been half a percent. Education, that other great national cause, about which the number of speeches and commitments made must run into millions, gets two percent and that’s a whopping sum, which the country’s educated billions acknowledge most gratefully. Bangla Desh spends eleven percent on education. Obviously they are mad. While our former wing spends almost the same on defence, we spend thrice as much and given the chance, would spend all 100 percent on it. The logic is that without defence there is no country and therefore everything else is really quite irrelevant.

Of course the rich have a pretty good time when they need medical assistance. Legislators have been known to proceed abroad for a swollen knee. Likewise, many officers of the (very) armed forces have had themselves transported to the world’s finest clinics and hospitals. Here, they received five star service from some of the best names in the profession and returned home hale and hearty. The poor, the bulk of the country, who in any event really have no right to live, simply sighed and died because there was nothing else to do. In this scenario, with consciences as pure as the driven snow, have emerged the nation’s doctors and along with them, clinics and hospitals, whose main purpose clearly is to deprive the rich and the not so rich, of whatever they have and make themselves pots of money.

As a business objective, it is laudable but what is even more remarkable is how these men and women have made this their burning mission in life. While ostensibly moved by the pain of the human condition, these professionals lead dedicated lives, working well into the late hours, making money, money and more money. Now and then, they might save lives, but generally they don’t. A friend of mine always refers to his cousin doctor as ‘Doctor Death,’ and not without reason. Neither are they burdened with such outdated and irrelevant notions as reaching out and helping without skinning their patients. Such ethics and commerce don’t blend too well, so very conveniently, principles are left at their palatial homes from where they emerge to hit the stock market. The only difference being that they deal with human beings and life and death. It is of course the same thing and only some of us might be confused and claim that they are not, but we don’t count and that’s that.

Every now and then, the nation is startled when horror stories break into the media where people lose lives for virtually no reason at all. Patients who walk in for a minor operation are wheeled out a few days later, scented with cheap rose water and placed six feet under. They are unable to complain being rather dead and the family or relatives might occasionally kick up a storm, but since life is one inevitable downer here, most simply suffer and go back to their lives. Platitudes such as the way of things, fate, kismet and the will of the Almighty are used as soothing balms and life stumbles on. Most people you meet will have one or more horror stories to tell. The callousness of the medics, the indifference and downright negligence of the staff and the exorbitant sums of money extracted are common themes. Now and then, alas too rarely, there will be a silver lining and a heart warming tale to cheer anyone up. In such stories, the hospital, the doctor, the nurse or the attendant acted like a human being and not a mechanically driven money-grabbing mutant. It is therefore not surprising that in Pakistan people are terrified of going to the hospitals, most rightly believing that they will not emerge from the experience and live to tell the tale.

Last week, someone who shall remain nameless had the kind of experience that leaves you tottering. The parents of a young boy took their son to a child specialist since the child was complaining of a pain in his stomach. Six hundred rupees later, they were on their way to the hospital where the doctor ordered various tests. A few thousand rupees later, the tests were in and were negative. In other words, there was nothing wrong. However, the surgeon, armed with a pathology report declared an emergency claiming that serious blood infection indicated immediate surgery and removal of the appendix. The ‘serious infection’ turned out to be minor, but the parents didn’t find that out till much later, choosing to trust the surgeon. More money changed hands and the surgeon, acting in what he described as an emergency situation, set about the operation. As anyone knows, by this time, money is flowing faster than the Samnabad gutter and deposits, advances and the like literally require having your bank manager by the bedside. The forty five minutes operation took considerably longer and eventually the child was wheeled back, all stitched up. That, they turned septic is another story, but not unusual at all. The room, which had no provision for anyone else to sleep – the mother slept on the bare floor, was a mere Rs 1500 per day. The IC unit where the child was detained for six hours, was also Rs 1500 except that there was no one on duty. The charges for the operating theatre were Rs 1500 as were the sutures – Rs 1500 for a inch long thread? Apparently the hospital had standardized most charges at the happy sum of Rs 1500.The medicines cost Rs 8,000, the hospital pocketed Rs 10,000, the surgeon Rs 10,500, the anesthetist, Rs 2500 and the doc charged Rs 500 each time he appeared for a flash visit and was gone before you could say, ‘doc.’ In all, the happy sum of Rs 38,000 was forked out by the parents in a two day stay.

It was only after they left hospital that they realized they had been taken for a ride, since none of the reports recommended removal of the appendix. In fact, there was absolutely nothing wrong with the appendix and there was absolutely no need for surgery. Once other doctors confirmed this, the angry couple stormed the hospital and threatened them with legal action. After the usual stonewalling at which we are so brilliant, the main players knew the gig was up, so they said sorry etc and offered to refund ten percent back. Thereafter it was a haggling session and eventually, the hospital refunded a little more than half the sum. They had no explanation of what had happened and used the familiar ploy of passing the buck to someone else. This is one of the city’s most prestigious outfits. Elsewhere, the stories are even more hair raising. The parents in this case were lucky. They suffered no major mishap but many others have not been so fortunate. In a sense of course, one can neither blame the doctors or the organizations where they peddle their craft, because common decency and respect for the lives and values of others, is long dead. The doctors are like the other vultures that feed off the carcasses of our dead and decaying values. Life has no meaning here and certainly no value. Have a nice day.