Glimpses of the year ahead and a look at the things that make practicing medicine worthwhile
Months before our first copy of Forbes India hit the stands, our rigorous editorial team was slicing through my sample columns. We all felt that we could make it work, but a regular column by a doctor in a journal where the most popular punctuation is a comma found in the middle of long rows of numbers was not obvious. For me it was a familiar unlike position. I was the engineer in medicine, the doctor who built a software company, and the pathologist running a hospital for pain relief.
I tried too hard at first. My piece on neuroeconomics in which I studied John Stuart Mill and concepts such as hyperbolic discounting did not work. The piece on electronic cigarettes would not appeal to enough of our readers. That was good news. Ultimately the invisible editorial hand guided me to pick up on a passing notion in one of my trial stories. A study on behavioural economics showed that the cuddle hormone, oxytocin, induced trust between strangers. It clicked. We called my first column “The Doctor Will Hug You Now”.
The sad truth is that few doctors do hug you now. We want to change that. This coming year we are going to add more pieces that give glimpses of that special doctor-patient relationship, or how it should be. The stories will be my own or of contributing physicians out there.
Here is the first instalment, an excerpt of a true story by my father, a maverick neurosurgeon:
Mommy, don’t cry. I will be fine,” she said ever so sweetly. “Where I am going there are no needles, no hurt. It is so pretty out there. Father John told me that. I will have so many games to play and my friends will come and play with me.”
It was not easy to keep oneself composed hearing this precious six-year-old overflow with love and innocence.
Two years ago this beautiful child with golden hair fell while running. At an emergency room the doctors discovered an innocuous looking lump in her belly. The lab results came as somewhat abnormal but her mom didn’t think much of the incident and went about her routine. It was when Sarah said, “Mom, I feel hot and like I am going to throw up,” that her mother Mary became alarmed.
“I could technically treat her, but for Sarah I want to do the best,” Sarah’s pediatrician told Mary when the diagnosis of a neuroblastoma was confirmed. “Go to my colleague in Philadelphia. This is a rare and tough tumour to treat and I will frankly feel uncomfortable to treat her here.”
“Mark, honey I am calling from Dr. Trey’s office. I think we have a serious problem with Sarah. He has suggested we take her over to a pediatric oncologist in Philadelphia. He wants to meet both of us at 8 a.m. tomorrow.”
There was silence on the other end. Thirty seconds that felt to Mary like eternity.
“OK, honey, I will rearrange my office and will come with you tomorrow. Drive carefully, the roads are a bit wet, love you.”
That night the Evans had a quiet family dinner. “Mommy, what did the doctor say? Did my tests come out all right?”
“Darling we are doing fine. Your dad and I will see Doc Trey tomorrow to go over some of the test results.” Mary was trying to keep a stiff upper lip.
At the hospital in Philadelphia the nurse changed Sarah into bright polka dot pajamas. Dr. Peters rubbed her hands till warm and started to feel Sarah’s belly. “There, does that hurt?” she asked while running her hand over the abdominal lump. “Just a little, but it tickles”, giggled Sarah.
Over the next fifteen minutes, the doctor did a complete examination of this little girl who had kept such a brave front, yet deep below knew something was not right.
Mary turned around so her darling daughter couldn’t see her tears. “Oh mommy, I love it here already. I will be fine. Dad, you take Mom out to have a Philly steak, OK?” The non-verbal communication of the family had a peculiar intensity to it.
“I am Dr. Vijay Kumar and I am the senior resident assigned to your case. I work closely with Dr. Peters and will look at every medical issue that you may have. You may call me Vijay.” I spoke to the owner of those brilliant, exploring eyes. “Yeah, we will be friends. I see a ring on you. Are you married?” I blushed, “Sarah, this is my school ring. No, I am not married. I am available to make friends with you.” I carried on small talk with this child who had two out of three chances of not pulling through.
Over the coming days we brought in one of the top surgeons to attempt to remove her
tumour. We were not successful. Sarah declined rapidly, but she never lost her spark.
Three weeks after our first meeting, we had our last conversation.
“Doc Vijay, you look after my Mom. I don’t know why she wants to cry. You are my boyfriend, right? So when I go, you look after my Mommy. You become her boyfriend too, OK?”
I turned away for a few moments but quickly recomposed myself and faced her, successfully containing the film enveloping my eyes. I left that night humbled by the strength in this little girl.
The next morning I went first to her ward but did not see her name on the board. One of the nurses told me that Sarah had passed away into the night.
Over my 40 years the bright eyes of Sarah have guided me to give all of myself to my patients. It is to serve patients like Sarah that makes medicine so meaningful.
-Contributing author: Dr. Vijay Sheel Kumar.
Dr.Vikram Sheel Kumar , and our health team, can be contacted at firstname.lastname@example.org