Saturday, December 22, 2012


    I have been  a physician  for longer time than I have been not a physician . I have noticed several things about physicians . These are only my observations and may not be validated by others. We physicians are the only people who can neglect our family , who can neglect their health , and will be considered 'great ' physician . "HE IS SO GOOD THAT HE DOES NOT CARE IF HE HIMSELF IS SICK OR IT IS A HOLIDAY ETC " are the statements that we here and 'feel ' good . Son it is not a surprise that many a times diagnosis of illness is delayed  and we pay dearly for it . It may also have to do the facts that since we know the medicine , we are 'afraid ' of the diagnosis and , so avoid doing the tests that could make the diagnosis earlier . Let me give some examples .
    I was standing in a doctor's lounge , trying to eat before I had to go to the office . I had may be 5 minutes at most .In past and even today I sometimes eat in the car , while going to office and have stains of ketchup to prove it . But this time I was eating in the room and was with couple of female doctors . I saw a male surgeon walk in the lounge . I had called him for a consult few weeks ago and was told by the covering physician that he had open heart surgery --a coronary bypass . So I was happy to see him back . I told the other 2 female MD . and asked them if they knew that he had a bypass surgery .They had heard that he was 'out ' but did not know exactly as to why . They asked me if had problem with the heart before . I told them I did not know . How come he did not know that he had heart problem , they asked . I said , "two reasons , one he is a doctor and second is that he a male doctor . "When the surgeon came towards me I asked him about his health. As predicted , he never had any testing done . nor had he gone to physician for routine check up . (He is 67 yrs old .)
     The second story is that of a another friend of mine . He was a gastroenterologist . One day he called me asking me if I knew any good surgeon . I was surprised as he was himself a physician. He told me that he had hernia and needed a surgeon that operated in the hospital, that not too many people knew him .I told him couple of names and asked him as to what was the problem . He told me that he had vague belly pain and he thought that it was due to the hernia that he had . He did get an appointment with a surgeon , but did routine blood tests before going to him . To his surprise , his liver tests (blood enzymes )were not normal . So he did ultrasound of liver and then CT scan . HIS LIVER WAS FULL OF CANCER . Further investigation showed that he had cancer of the stomach . He died in less than 6 months after the diagnosis. His belly pain and weight loss was due to cancer and not due to hernia . (and I am sure he might have suspected it , but never thought of working it up like any good doctor would do ---like himself  and paid price for it )
    Just add a personal story , I had a hernia and I knew about it for at least 3 years before I decided to get operated . .(The size was such that at times I had to reduce it in public , making sure no one was watching.)I was scheduled for the surgery on Wednesday before Thanks Giving .I completed my "hospital rounds ". Then at one pm checked myself in , had surgery at 3 pm and went home at 6 pm . I was back to work on Monday . ( If I was allowed to start the work on Saturday by my wife I would have done that too )
    The next story is that of a young cardiologist. He had a dizzy spell and then passed out . The family called 911 and he was taken to a ER . CT scan of brain was done and it showed that he had bleeding in the brain . He had no medical history . He was transferred to other hospital , but he was gone . He was brain dead and family decided to stop everything . He was not even 50. I was talking to a ward secretary ,few days after this incidence . She told me a story which shocked me . One day this cardiologist was making round and this ward secretary asked him she could help him . (by getting charts or labs or calling RN etc . ) He said that if she wanted to help him she could get some ibuprofen as he had headache  . She gave him 400mg of Advil (which is usual dose ). He said , he needed 800mg to 1200mgs to relieve 'his' headache. She did give the dose . In retrospect if a patient came to me with a complaint of headache that needed such a large dose , I would have sent him for STAT CT scan of brain . My suspicion is that he had an aneurysm , that ruptured and he died of the bleed . COULD WE HAVE SAVED HIM IF THE CT SCAN WAS DONE EARLIER ?DID HE NEGLECT HIS OWN HEALTH ?----YOU DECIDE .

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