Medical advocacy in Goa: A dire necessity

Medical gaslighting has, and still is, an issue that plagues many a patient in Goa and elsewhere. Does the doctor always know it all? Are his degrees a true and valid reflection of his medical mastery?

Often, when you question a doctor and his know-how, you are met with, “Did you slog through these many years of medical schooling?”, “Aah! I see you’ve been consulting Dr Google!” or “Please show me your medical degree.”

And yet, India has seen a shocking number of deaths due to medical negligence. The National Library of Medicine reveals that deaths due to medical negligence in India are around 5.2 million every year.

Medical errors have caused 2.6 million deaths annually in low and middle-income countries, according to a 2019 World Health Organization (WHO) study.

While medical tourism is booming in Goa, driven by prohibitive costs of medical procedures in other countries, the denizens themselves often have a hard time receiving appropriate treatment.

Whether it is just disinterest in the patient’s condition or the inability to assimilate knowledge and make the correct diagnosis and prescribe the related treatment, we cannot condone either, excusing them as rare or unavoidable.

We can lay the blame on the Indian educational system, which promotes rote learning and tests memory rather than lateral and critical thinking. But, that’s more of an excuse.

Only because there do exist the chance doctors who keep up with medical literature and innovations instead of regurgitating information from their old MBBS medical textbooks, which at this point, in many cases, can be considered useless and even detrimental to patient health.

As an adjunct to staying abreast with updated medical processes and knowledge, and an analytical mind, concern for the patient and an absence of avarice is foundational to proper patient care.

If filthy lucre is your main motivation or the prestige that comes with being a medical doctor, you best stay away from the profession.

The gaslighting comes as dismissal of the patient’s symptomatology. In any area of medicine, mainstream or alternate, listening to the patient carefully is of utmost importance to be able to evaluate what exactly is going on with them.

Sometimes patients are not able to articulate what is happening to them. In this case, an experienced, well-informed doctor would be required to guide the person in attempting to explain their symptoms.

A comparison of family history in terms of illnesses to consider the genetic component, clarity on the patient’s own history of illnesses, knowledge of exposure to toxic environments, and the emotional and psychological elements that may have contributed to the present medical predicament must all be weighed in combination with regular medical testing and imaging.

This is probably why alternative medical practitioners trump mainstream doctors in diagnostic abilities. They are known for taking down extensive patient history, detailing every part of the patient’s life.

There have been cases where women have been told, “It’s all in your head,” and nothing was done to help the patient until things were much worse, as it happened with Rachel.

She approached a gynaecologist because of her menorrhagia. The doctor would not consider any of her symptoms and told Rachel she needed yoga and meditation.

Now Rachel also suffered from severe back pain around the same time, which prompted her to visit an orthopaedic doctor. The doctor advised her that her vertebrae were degenerating, and she would need surgery.

So, when Rachel had a second opinion from a different gynaecologist, one that listened to her, she was made to have an ultrasound which showed she had quite a large fibroid in her uterus. Once the fibroid was removed, voila – not only did the bleeding abate, the back pain vanished as well!

In another instance, Mohit was told he had a variety of problems, ranging from arthritis, borderline hypothyroidism, high blood pressure, high cholesterol, rashes, swelling in the feet and hands and so on.

The doctors who were treating him wanted to concentrate entirely on the high cholesterol, negating the other issues, which seemingly made little sense to them.

Lucky for Mohit that he met with a GP who was interested in autoimmune conditions, and after listening to his history, sent him off to do a battery of blood tests, including ANA (Antinuclear Antibody). He came back positive for RNP (Ribonucleoprotein) antibodies.

Through his research, Mohit discovered that it did indeed indicate that he had an autoimmune condition, although he’d been dismissed by an immunologist as not being a serious enough case to receive any treatment.

To seal the deal, Mohit decided to see a homeopathic doctor, who, after reading through all the tests and asking Mohit a million questions, concluded that he had mixed connective tissue disease. This disease was the underlying cause of the other concerns afflicting him.

Despite their extensive education, are all doctors equal? We must conclude differently on the basis of the above examples. And, I’m certain, many of us have our personal horror stories to tell. We must advocate for ourselves and learn to understand our bodies.

Do your research in tandem with your doctor’s advice. Do not blindly accept everything that is said as the absolute truth.

Doctors need to recognise their fallibility and be a little more generous when it comes to acknowledging the possibility that the patient may well be able to understand their illness, not always in the technical context, but to the degree that reflects their ability to be acutely aware of what is happening to their body.