Pursuit of TRUST
Posted on: 2018-09-19 10:34:08
Pursuit of Trust: - Srinivasa Raghavan
She was a 15-year-old school kid; came in with multiple episodes of seizures ('epileptic fit' in street language). IV injections controlled her fits; CT scan and MRI painlessly sliced through her brain; millimeter by millimeter searching for a focus; negative. 24-hours later she was stable and ready to be started on long term medicines to prevent recurrences.
He was one of the most respected neurologists of the city, trained in one of India's most prestigious institutes; a nice middle aged man, he had never craved for money and had a good reputation in the locality.
The neurologist started her on a drug called phenytoin sodium; one of the many anti-epileptics indicated for treatment. The parents were so very thankful to the doctor for taking care of their child.
Exactly 72 hours later, when the girl developed extensive rash all over her body, including inside her mouth and eyes; transforming the girl into a horrific creature; did everyone realise that she had developed Steven Johnson Syndrome (SJS); an unusual but life threatening and extremely deforming skin disease. Described first by Dr. Albert Stevens and Frank Johnson in 1922 in a pediatric patient, SJS also known as Toxic Epidermal
Necrolysis (TEN) is a disease that comes after exposure to many drugs including phenytoin. It is an abnormal reaction of the body's immune system, that cannot be predicted. There is no way to predict, prevent foretell or stop a SJS.
The transformation of the cute kid to a monstrous creature, unable to talk, swallow or see made even the tough hospital staff getting visibly emotional.
The parents squarely blamed it on a wrong drug administered by the doctor and labelled the hospital as a worst hospital that spoiled the future of their only child. The doctor tried, in vain, to point out that it was not in fault. The kid was kept alive by IV drip and naso-gastric feed, the blisters healed by scarring. The kid lost most of her vision; her skin
colour turned to a mixture of dark tanned patches. 45 days later she was discharged, on a wheel-chair with a grossly impaired vision. Now for a moment presume that this has happened to your daughter.
Q. Would you -
1. Keep quite and go to sleep?
2. Vow to fight against the doctor and the hospital who spoiled your
3. Ask for a legal help for a hefty compensation from the doctor?
4. Understand that SJS is another disease like epilepsy which cannot be
predicted, or forestalled by doctors. It is easy to pass comments as an
unaffected individual, but as a father I don't know as to how I would have
Lets now presume you are the neurologist.
He studied in a Govt. college on merit scholarship all through. He had done ethical medical practice all his life. He never ran after money. He always kept himself updated.
Q. Would you (as the neurologist)
1.Stop treating kids with epilepsy; knowing that there is no way of predicting which of the kid would be unfortunate enough to get the one-in-a- million episode of SJS?
2. Think it is not worthwhile to spend days inside a wooden box, surrounded by people in back robe, trying to answer questions as to why you did not use a different drug for the kid. (phenytoin is the cheapest drug so you cannot be charged to have 'doc-pharma' nexus)
This is something we want 'non-medical' people to know.
No medical treatment - medicine, intervention, laparoscopy, delivery, surgery, transplant - nothing is risk free. The risks are, no doubt, rare, but when they happen, they are disastrous; and tend to permanently scar the family, the treating doctor and the hospital alike.
The doctor today gets everything listed n get your legal consent signed, before anything is done; but that absolves him of legal issues; nothing else. It doesn't take away the pain, grudge, sense of hatred and revenge that both parties harbour, often for life.
Way out? Both the suffering parties have to join hands to survive with a 'superglue' called trust.
But where do we get it?
I am not sure, but certainly not in a courtroom.
Posted on: 2018-10-03 05:49:57
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