Disclaimer: A work of fiction or based on true events, I will leave it for the reader to decide.
Scenario – A 70 plus elderly gentleman is brought to the Accident & Emergency Department of a hospital in an unconscious, unresponsive state with no recordable pulse, blood pressure and spontaneous respiration, by an auto rickshaw driver.
No identity of the patient known, No past medical and surgical history available, no mobile phone available (to contact family), no wallet or identity card with the patient.
History - Patient was driving somewhere (alone), felt uncomfortable, stopped his car by the roadside to ask for help, collapsed on stepping out of the car, 3-4 by standers rushed to help, an auto rickshaw driver stopped and volunteered to take the patient to the hospital, none of the bystanders accompanied the patient, patient is drowsy in the auto but manages to tell auto driver to rush patient to the emergency department, becomes unresponsive en route to hospital.
Once the patient reaches the emergency department, the entire team of doctors and nurses sprung into action and all life saving measures were initiated. CPR is started immediately, all life saving drugs were given as per ACLS protocol, patients was intubated, but no ROSC (return of spontaneous circulation) was achieved even after 30 minutes of intense efforts. Code was called off and patient was declared dead on arrival.
A pouch is later found in the patient’s belongings with a pass books and few thousand rupees which he probably would have withdrawn from a bank. On the passbook is a landline number through which the doctor is able to contact his old wife (after multiple attempts of getting in touch), takes the number of his son who was in office from her, calls him too and asks them both to rush to the emergency department. No update regarding the patient’s condition is given to the family members on the phone.
Medico-legal case formalities were initiated and since the cause of death was not known, the police was informed.
Anything wrong or atypical in this scenario? I’m sure many doctors would have come across such events at some point in their career.
Shockers (after the family was told of the turn of events and that the patient was dead):
1) The doctor is questioned by the son that why does he have to pay the bill if the patient was declared ‘dead on arrival’ and if the hospital was not issuing the death certificate.
2) The doctor is threatened by the son, “What if I refuse to pay the bill?”
3) The auto rickshaw driver is questioned that the patient’s phone was missing.
My questions to the readers and the society in general:
1. Why is there so much mistrust against the medical fraternity? Why can’t people think that doctors and nurses try to do their best to save someone’s life, they too are humans, and have emotions, and that it takes much more than courage to see life and death everyday!!
2. Should the doctors and the nurses not even try saving an unaccompanied patient’s life brought to the emergency and directly taken a flat line ECG instead?
3. Why should a hospital write off the entire bill of an affording patient for providing life or limb saving emergency services, when the treatment was initiated without caring for the patient’s ability to pay or not and there was no deficiency of services?
4. Would the son have reacted the same way and questioned the efforts put by the medical team, had the father miraculously survived and managed to reach the ICU even with a guarded prognosis?
5. If educated & English speaking people can indirectly threaten the doctor of putting false allegations that the body of the deceased is forcefully being kept by the hospital for non-payment of dues, what can the medical fraternity expect from the lower socioeconomic people?
6. If an uneducated auto rickshaw driver can offer to help (without caring about any legal hassles), why can’t other bystanders and onlookers come forward?
Conclusion - After 4 hours, the bill was finally cleared by the son who showed no remorse for his actions of questioning the credibility of the doctor and the medical team.
The phone was left by the patient at home, later discovered by the wife.
I really wonder what will change the perception of the society in general that all doctors are heartless cheats, and a hospital is only a money making business enterprise. The future of healthcare and humanity surely doesn’t seem bright!!
