You can’t find patients’ fear, anxiety and pain in any lab report

April 6, 2019 0 By FM

As a medical teacher who had his initial medical training in the early 1960s, and then taught post- and post-postgraduate medical students throughout his teaching career, I have seen implausible advances in imaging technologies, electrophysiological studies, investigative and therapeutic tools and the entry of molecular and genetic engineering in medicine.

In the bargain, good old clinical medicine with a stethoscope, a knee hammer, a tuning fork and pins and needles has gradually withered away. But the rituals of using these instruments are continued, to pretend that clinical medicine methods are still practiced. In many large hospitals, the medical history of patients is taken by the junior-most doctors or the nurses who are overburdened by their routine work. They stick to the protocols of history-taking given in each specialty.

The patients are in awe of these protocols and they forget to tell their problems. The youngsters have forgotten the usefulness and the palliative nature of haptics as no one now teaches how to touch or feel the patients. Nor do they realize that a compassionate hearing can have a curative effect and that a kind touch can alleviate pain.

For them, after all, clinical medicine is dead already.

Is it really so?

In the final count, medicine is, as it always was, a deep transaction narrowed down to two – the patient and the doctor: One trying to comfort and heal, and the other seeking the same. The plethora of lab results, imaging reports and histopathological studies mean very little to the patient who sits across the table of the doctor or lies down on the hospital bed diseased, desolate and depressed. His fears, anxiety, anger and sadness are not reflected in any of the reports which his doctor received from his labs. He is not really bothered whether his brain tumour is glioblastoma multiforme or a glioma grade 2.

He prays and expects his doctor would tell him that he would recover soon. Soothing words could be placebos as well.

These days, it is mandatory that all relevant investigations are prescribed, and new treatment technologies used, to treat ailments. They certainly help to arrive at correct conclusions and definite diagnoses. But patients should never be told about their ailments and the treatment planned in a rough manner. After all, like placebos which please the people, there are nocebos too (which bring pain, distress and anguish) both in drugs and dialogues.

Why can’t we at least show some humaneness and empathy even if the patient has a fatal illness?

The doctors too will become patients one day or the other, and then only, will they know the anxiety, the fear of mortality and the terrible unpleasantness of the pills given, cuttings done and inexorable bills they accrue for the diseases.