Corporate physicians have replaced that extinct, warm-hearted tribe known as family doctors for whom healing was a scientific but compassionate calling
We routinely place our lives in the hands of corporatised doctors, young and ambitious professionals who go by lab reports rather than their own instincts. Illustration by C Y Gopinath using Midjourney
Anup received his death sentence in March 2019. The eminent oncologist from a major private hospital took one look at the ultrasound report, the bloodwork and the tumour clearly visible in the CT scan, and pronounced his diagnosis: “I can say with 99.5 per cent certainty that you have pancreatic cancer. You have about three months left if we don’t take it out.”
Already diabetic, Anup first realised something was amiss when his urine remained consistently dark yellow. His total bilirubin count was 20.2 mg/dl, against a normal between 0.1 and 1.2 mg/dl.
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The oncologist recommended the Whipple procedure, a complicated, rare and high-risk surgery for removing pancreatic tumours. Because the pancreas is buried behind several other organs, the Whipple procedure involves first removing the gallbladder, then parts of the small intestine, the bile duct and a portion of the stomach to finally reach and remove the tumour.
The procedure is rife with risk, and life afterwards is usually wretched, full of cautions, precautions and restrictions.
In Anup’s case, to get the bile moving again, they first put in a biliary stent using a non-invasive endoscopic procedure. While at it, they took five samples from near the tumour for biopsy.
The results were a surprise—they could find no cancer. The oncologist, brushing aside the results as sloppy, began calling Anup’s wife, pressing her to convince her husband to go in for the Whipple procedure.
“That struck me as unusual,” says Anup. “Doctors don’t usually call patients.”
He began to suspect that the oncologist was more interested in performing the Whipple procedure than in curing him. Pancreatic cancer is one of the rarer cancers, ranking 14th in incidence and 7th in mortality worldwide. In India, it ranks 24th among cancers, with 10,860 new cases in 2018, and 18th in mortality. The cancer’s incidence is about 81 cases for every crore Indians.
Over the next three months, the lab performed biopsies on five more samples, and then five yet again, for a total of 15. There was still no sign that Anup had pancreatic cancer. Meanwhile, the tumour began to shrink on its own, eventually disappearing entirely.
The oncologist, clearly disappointed that there was no cancer to cure, pronounced Anup a lucky man and changed the diagnosis to “chronic pancreatitis”.
Anup is indeed lucky. He’s still alive five years later because he survived a close encounter with a corporate doctor.
In the age of privatised medicine, we routinely place our lives in the hands of corporatised doctors, young and ambitious professionals who go by lab reports rather than their own instincts. Highly trained and clinically cold, they have replaced that extinct, warm-hearted tribe known as family doctors, for whom healing was a scientific but compassionate calling. Their eyes, ears and fingers told them more about the patient than lab reports. These were the healers immortalised in Bollywood film dialogues with lines such as: Aap doctor nahin, aap bhagwan hain.
Today, those gods have gone. For the majority of today’s physicians, employed in private hospitals, saving lives is a corporate goal to be achieved through a battery of high-tech, often costly, laboratory tests. In this new world, patients are warm bodies, anatomically identical. Medical expertise is standardised and interchangeable, and one doctor is just as good as any other. After all, if medicine is a science, any practitioner should reach the same diagnosis and prescriptions based on the lab test reports. Right?
Wrong.
My life has been saved over and over not by high technology but by sensitive, caring doctors who combined science and wisdom with intuition, believing that their job was to help their patients live well and eventually die well.
The following tips for recognising such a doctor may one day save your life.
1. Don’t be subservient. Today’s doctors are neither gods nor your body’s overseers. Google the diagnosis thoroughly. Upload your lab reports to an AI like ChatGPT and ask it to re-interpret the results in plain language.
2. Be shameless. Get a second and even a third opinion, because different doctors have different opinions.
3. Listen to your body. Even experts can make mistakes and errors in judgement. My long-time doctor, a brilliant, sensitive and caring healer, did some tests on my heart and told me an angiogram was unnecessary. But my body thought it did, so I insisted. The resulting angiogram found two 90 per cent blockages.
4. Put your faith in the doctor who occasionally tells you to let your body heal itself rather than rush to prescribe pills.
5. Don’t let technology awe you. A private hospital wanted to replace my frozen shoulder rotator cuff with titanium. A Chinese chiropractor used acupressure to restore me fully in a one-hour session.
Above all, remember it’s your body and your risk. When my father needed spinal surgery and the doctor told him, “You’re an old man, I can’t take the risk”, he called him out.
“What risk are you taking, sir?” my father asked him. “You’re worried about risking your reputation. But it’s my life, not yours. I will decide what risks to take.”
You can reach C Y Gopinath at cygopi@gmail.com
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The views expressed in this column are the individual’s and don’t represent those of the paper
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