Doctors aren’t killers, but… | Pakistan Today

Doctors aren’t killers, but…

…their negligence is a cultural attitude

No rhetoric about an entire workforce must be believed at face value; but there may well be something worth complaining about.

Doctors are vested in enormous respect in our culture. It is one of the few fields in the country where the gender barrier has been broken, at least in a superficial sense. Family values, tradition, and mardana/zanana partition is all well and good; until one’s daughter barges into the ER with an unrelenting pain in her flank, and the only specialist on call is a 38-year old male. Regrettably, the ‘leaky pipeline’ phenomenon applies, where women continue to drop out of the field as they ascend through the ranks, until men at the top outnumber the women.

Medical practitioners are respected not simply because medicine is considered a field that pays well (doctors’ earnings are frequently overestimated, unless they work privately), and because they deal with something that’s regarded sacred across all cultures, ethnicities, and religions.

I have no doubt that complaints against doctors have always existed, but the general image of doctors is on an obvious decline; to the point where, I suspect, we’ll be satirizing doctors the same way we satirize politicians. Where does a vampire learn to suck blood? Law school, clearly, but the answer may well be ‘medical college’ within a few years.

There are a few reasons for the healthcare industry’s declining popularity. The Young Doctors’ Association (YDA) and its supporting organization may blame it on government propaganda, particularly of the government of Punjab, as a response to the movement for better pay structure that peaked more than a year ago. The movement was infamously marked by industrial action taken by doctors, who walked out of their duty, with the exception of the emergency shifts. Several doctors were arrested and brutalized, and incendiary remarks were made by officials against protesting medical officers.

The protests in Pakistan are being loosely compared to the ongoing movement by junior doctors in the United Kingdom. The situation is complicated, but the basics are familiar.  There is outrage over work structure, where junior doctors feel overworked and underpaid. Protesting healthcare officers have walked out of their duties, without closing down the emergency departments. Consequently, the public has suffered.

Like in Pakistan, deaths have been reported that have been attributed to ‘killer doctors’, but the British response towards doctors has been far more sympathetic. After all, would you like to be operated on by a surgical officer who hasn’t slept in 30 hours? If he makes a potentially fatal error, how much of it may be blamed on his incompetence alone, without questioning the authorities that have been working him like a mule?

In a Facebook post that went viral recently, a 51 year old woman whose daughter died allegedly as a result of the chaos surrounding doctors’ strike, lambasted Jeremy Hunt for using the death as a statistic against hardworking doctors:
“Jeremy Hunt. How dare you! My darling daughter passed away at 9pm Wednesday evening in Wythenshawe hospital at the end of the two day strike by the young doctors whom I fully support. She did not die due to this strike and I will NOT accept her name included in any statistics saying it was.”

The idea was clear: doctors, like everyone else, demand fair pay for their service. One could theoretically hold the Hippocratic Oath against a doctor’s head like a firearm, and demand constant service for the sick and the wounded; but the doctor has his own set of rights to fight for. In these circumstances, however, it is clearly in the interest of the authorities to malign doctors and use public pressure to force them into dropping their signs and placards, and returning to their hospitals in defeat.

This does not explain the entire length and breadth of the issue. If doctors are falling from grace, badmouthing by government officials may not be the only factor. Indeed, the patient has lost confidence in his doctor.

Contrary to what the pessimists and doomsayers may suggest, Pakistan is growing smarter; and the patient today is more aware of his rights now than he ever was. The addition of Behavioral Sciences to the curriculum taught in medical schools has gone a long way in bridging the communication gap between the doctor and the patient, but there’s much left to be desired.

Many doctors continue to see patients as complacent pin cushions who ought not express their disapproval of a jittery house officer jabbing a patient’s elbow crease without drawing blood, four times in a row. Poor conditions and hectic working hours probably don’t help, but doctors are poorly trained to perceive a patient as a person in deep stress whose discomfort may be causing him to behave inappropriately, and instead seeing him more as disease itself. This attitude is reflected in the very language doctor’s use in wards:  “renal failure wala”. “pancreatitis wala”.

Doctors aren’t ‘killers’, but there is a culture of elitism and neglect that is being fuelled by both a relative deficiency of medical experts, and the fact that an average patient is uneducated enough to not notice the violation of ethics.

As a doctor, I believe that charity begins at home.

Faraz Talat

Faraz Talat is a medical doctor from Rawalpindi and an ardent traveller who writes frequently about science, social politics and international relations.