Patient changes medical history, medical student sends legal notice.

Some patients may even fake or exaggerate their symptoms.

Mumbai: In an incident which has sent shock waves across the medical fraternity, a final year MBBS students has sent a legal notice to a patient and demanded monetary compensation for mental and emotional distress, after the patient had changed his medical history in front of the professor.

It is a well known fact that every doctor in his educative year always goes through this scenario where he takes a detailed history taking for the case presentation during clinics ‘in the patient’s language’, but the patient gives a completely different history when the professor starts the case presentation, making the medical student a butt of all jokes in front of his fellow batch mates.

In an exclusive interview with us, the Dean of Quackdoses Multispeciality Hospital Dr. K’abhi Mat’bann™ said, "Gone are the days when we used to teach our students - Listen to the patient, he's telling you the diagnosis. Now days, that can backfire on you into a legal suit. Patients offer explanations for their symptoms that are bizarre or illogical, and often start their medical history with what they had eaten a week back. Some patient's description of their main problem is so creative or vague that it's unintentionally funny, like a patient saying that she has been swallowing the laxative suppository since 3 days but it is not relieving her constipation, or that a husband giving history that his wife doesn’t have chills or rigors but she was hot in bed last night. When you ask patients if they have any past medical history or co-morbidities, they'll refuse. But when you ask them if they're taking any medicines, they'll show at least 10 strips of different medicines. Even when a situation is funny, it's difficult to hold back the laughter and remain professional.”

Unconfirmed sources have claimed that the patient’s husband has also decided to legally pursue the matter, and after obtaining a copy of the patient files has pointed out many glaring mistakes in the budding doctor’s notes including the one which stated – ‘The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.’

Emergency Medicine – My Love, my passion & everything in between my Vows.

They say, “You have to be crazy to be a goalkeeper”. I say, “You have to be crazier to be an Emergency Physician!”

My interest in Emergency Medicine started very early, in the 2nd year of MBBS itself to be precise. The EMS & the Trauma centre at Sion hospital, Mumbai where it all started is among the best in the country, dealing with the entire spectrum of medical and surgical emergencies.

I still distinctly remember and smile, thinking about the time spent as a medical student / intern putting hundreds of IV lines, collecting blood samples, inserting Ryle’s tubes, Foley’s catheters, collecting ABGs, taking ECGs, accompanying trauma patients to CT scans, counseling patients, etc. Whenever I was free after daily lectures or while taking a break from the library, I would hang around in the EMS. I would look forward to the ‘Emerg-Double Emerg-and Triple Emerg’ where the unit in which you were posted had the call day for the weekend and the following weekday/s and you would end up continuously working 56-60 hours at a stretch in the EMS.

No matter how busy it got, the Doctors, nurses, the mamas and maushis, security continued to do their best – day after day.

Over time, I realized that being a government hospital, with the limited resources and the financial capability of most patients presenting there in the EMS, they were not being offered the best modality of treatment, nor was the treatment protocol based– Eg. There was no PAMI for an acute STEMI or thrombolysis for an Acute Stroke, no management of trauma patients as per ATLS protocol, procedural sedation, drug assisted intubation, etc.

At the same time, there was lack of communication skills, compassion, empathy & sympathy towards patients and their relatives by the resident doctors.

There were many instances during treatment by my peers which shook me and had a huge subconscious impact – seeing amputation of the hand being done under local anaesthesia with the patient howling in pain, pneumothorax while doing blind central lines, breaking multiple teeth while intubation, intubating awake patients with just a shot of Midazolam, patients requiring emergency surgery spending hours for an OT slot, etc to just name a few.

I had kind of made my mind then and there - the people deserve good Emergency care, which does not include only the medical aspect, but of the overall patient experience, satisfaction and quality in terms of ethical and affordable treatment, protocol based, supported by the latest equipment and cutting edge technology. I had vowed to practice ethically, not being money oriented, for the best interest of the people and provide them with the highest level of care. Not even once did I ever think of working abroad where it is possible to earn 4-5 times more money than in India, just because people here too deserve good emergency care.

Over the last 15 years, I have worked exclusively in the Emergency Departments of the top hospitals in the country, commissioned 4 Emergency Departments so far (seen them evolve over time into Centres of Excellence, and 2 of them receiving the coveted NABH Emergency certification), being actively involved in the teaching and training of young doctors, nurses and healthcare professionals. And the journey has been satisfying. More so because I have seen myself grow and learn, everyday.

Even to this day, I remain excited and enthusiastic about going to work. I look forward to the patients I would be seeing in my department. A well managed resuscitation, a smooth intubation, emergency procedures, STEMI, strokes, and everything in the Emergency – THE DRAMA, THE TRAGEDY, THE WORK PRESSURE, THE STRESS & THE URGENCY still excites me like it used to 19 years ago and keeps me going.

If ever I feel low, there are 2 feedbacks that reverberate in my ears. One was by my security guard who after seeing the many post CPR ROSCs said, “Sir, aap toh murda ko bhi zinda kar dete ho” and the other by another hospital staff, “Sir, God forbid, kabhi mujhe ya mere kisi family wale ko kuch ho gaya, I wish you are present on duty in the emergency”.

My current focus is on developing Emergency Medicine as a specialization, providing world class-quality care to my patients and to train healthcare professionals of tomorrow – of integrity, passion, honesty and discipline.

I now have confidence in my Emergency department, our current protocols and policies, the excellent team of Consultants and staff at our hospital, that in a life and death situation, if we can’t save a life, nobody else can!

Road to Success - Always Under Construction

A young 20 year old male patient was brought to our emergency with complaints of sudden onset chest pain, profuse sweating, hypotension (low BP), Hypoxia (low Oxygen concentration). ECG was suggestive of Sinus Tachycardia (a fast heart rate).

Based on his clinical evaluation, a quick bed side clinical diagnosis of a massive Pulmonary Embolism was made. Though I have only seen only 4 such cases in the last more than a decade of my practice in Emergency, I was 99 % sure that I would not be wrong, and did not write any other provisional / differential diagnosis on his emergency notes.

Knowing that Pulmonary Embolism is a life threatening Emergency where a patient can suddenly go into cardiac arrest and die, we needed to make quick clinical decisions and interventions.

The family was counselled regarding the seriousness and fatality of the illness, if not treated in time. His father and mother both started crying inconsolably; the patient was counselled regarding the possible diagnosis and he too started crying looking at his parents, with that feeling of impending doom of whether he will survive or not.

A quick CT Pulmonary Angiography was done, which confirmed the diagnosis of a Pulmonary Embolism. With our Emergency team which worked with clockwork precision, we were able to give him the definitive treatment in the Emergency itself, within 38 minutes of arrival, and by the time the medication infusion was over in 2 hours, he had stabilised completely - Chest pain gone, BP picked up, Oxygen levels up and he was much more comfortable.

His father stood by the bedside throughout the life-saving medication infusion. At the end of it, with tears in his eyes, the patient said, “Thank you doctor…” which made me emotional.

Hearing this, the father told him, “Ha doctor dev manus aahe, kahitar honar nahi tumhala (This doctor is God present in the form of a human, nothing will happen to you)…” and I was left speechless.

A reason why I wanted to write & document about this case was because it was one of the most well managed cases of my career, and highly satisfying considering the lifesaving interventions done in a timely manner.

The Head of the radiology department and the cardiologist (under whom the patient was admitted) were all praise for the quick diagnosis and treatment in the emergency, moments which make you feel good to be a part of a Team where we celebrate each other’s success. Also, it reminded me that I still get the same adrenaline rush and kick by saving someone’s life in emergency, like I used to since 2006 when I was a 2nd year medical student and first exposed to the EMS at Sion Hospital.

Over the last few weeks, we’ve had some really interesting and exciting cases wheeled in to our Emergency Department, and as a Head / Team leader, I really feel proud of the phenomenal work that my team is able to accomplish, and we’re growing together.

PCA staff spot diagnoses patient, wins employee of the month.

Mumbai : In an incident which has become a beacon of hope for many of the patient care assistants (PCA) working in hospitals, an emergency department PCA at the famous Quackdoses Multispeciality Hospital was awarded the employee of the month after spot diagnosing a patient with Status Dramaticus.

It is a well known fact that apart from the emergency ‘bread and butter’ cases like chest pains, abdominal pains, fevers, injuries, etc, most Indian hospital emergencies also cater to a large population of young women working in corporate companies who regularly visit emergencies to sort out their domestic personal problems and relationship issues.

In an exclusive interview, the now famous PCA Sachin Helpkar said, ”I quickly ran with a stretcher when a ‘bus’ full of office employees with a young unconscious female sitting on the front seat stopped at our emergency ramp. As soon as I saw that she was continuously blinking her closed eyes and had tears in her eyes, I knew it was a clear case of Status Dramaticus. Similar to how 100s of people stop their vehicles on a busy road to help a ‘Papa ki pari or didi’ on a stalled scooty, 10s of office employees regularly swarm our emergency to check on such female colleague as if it’s their official field trip. Usually the symptoms subside when the worried boyfriend or the husband comes running and apologizes, otherwise 99% of such patients always respond to stuffed gauze full of ether or spirit on their nose – the other 1% being actual Status Epilepticus.”

Unconfirmed sources have claimed that the PCA Helpkar has been invited to contribute a chapter on Status Dramaticus in the upcoming 22nd edition of the Harrison's Principles of Internal Medicine.

Food from OT tiffins goes missing, surgeons under the scanner.

Mumbai : In an incident which has sent shockwaves in hospitals across the country, the mystery of missing food from tiffins kept outside the Operation Theatres (OT) has deepened further with OT staff now accusing surgeons of randomly picking tiffins and emptying them.

It is a well known fact that unlike in the West where most surgeons prefer to take a heavy breakfast before beginning long surgeries, in order to maximize their daily number of cases (and the money), apart from the patients being NBM (Nil by mouth) for 6-8 hours, most Indian surgeons also show up NBM to the OTs.

In an exclusive interview, Dr. Kutting Dey, the Head of GI surgeries at the Quackdoses hospital said, “The five rules for survival in the surgical world are - eat when you can, eat whatever you can, sleep when you can, drain pus and don't mess with the pancreas. This is part of our basic training from residency, and pretty much like how our non surgical friends are groomed to borrow pens from the nurses and never give them back. During surgeries, it is frustrating to see the anesthesiologist sipping coffee and chilling, while we are trying our best to avoid the vital structures while dissecting, it's bleeding now and then, and there's fluctuation in blood pressure – a prolonged stress which increases our cortisol levels, increases appetite and cravings. OT staff who are complaining should understand that the benefit of a successful surgical procedure outweighs the risk of assisting a starving surgeon. On the bright side, we tend not to be choosy if there is any tiffin kept on the common area table.”

An official statement issued by the Hungry Surgeon’s Association of India, has rubbished the statement by Dr. Dey calling them his personal views, and 'like for everything', has blamed the anaesthsiologists for the missing OT food.

Patient undergoes Robotic Circumcision, refuses to pay surgeon.

MUMBAI: In an incident which has sent shock waves in the surgical community, a patient admitted at the Quackdoses Multispeciality Hospital refused to pay the surgeon’s fee after undergoing a robotic circumcision.

Robotic surgeries, although facing stiff resistance from the insurance companies, is now slowly becoming the preferred choice for most surgical procedures. With the advent of the fast-growing AI based technologies and robotics, surgeons are already scared that they might soon become an extinct species in the coming decade.

In an exclusive interview with the Quackdoses, patient Dis’Kount Dey said, “The surgeon had offered me 3 methods of circumcision – by open method, laparoscopically or by minimal access through the testicles, and by robotic surgery. He counselled me that robotic surgery offered the fastest recovery, hence at the insistence of my wife, I opted for it. During the surgery, I was shit scared that the robot might cut off more than what I had consented for. To my dismay, I was shocked when I realized that ‘Robodoc’ ⟨™⟩ did my complete surgery, while the surgeon was busy playing some video game on his hi-tech gaming console. What should I pay the surgeon for, for playing on his joystick while ‘Robodoc’ dangerously played with mine? ”

Furthermore, rubbing salt on the surgeon’s wound, the patient gave 5 star rating on Google reviews to ‘Robodoc’ instead, with a special mention about the elderly assistant nurse who let him see the excised foreskin after surgery and politely asking him, “Sir-come-see-son.”

Unconfirmed sources have claimed that after knowing that the patient only paid for the consumables, OT charges and for the anesthesiologist’s coffee, the disgruntled surgeon has refused to do the patient’s follow up dressings.

OPD footfalls decline, Doctors announce Chintan Shivir.

Mumbai : Taking cue from the ‘expected & predicted’ Chintan Shivir of the Congress party after their poll debacle in the upcoming Delhi Elections next month, the Quackdoctors Association of India (QAI) have announced a three-day brainstorming Chintan Shivir in Mumbai of their own.

The shadow of dwindling OPD footfalls in-spite of the end of the vacation time / New Year fever, and ‘healthy months’ lasting more than they should, has made the medical fraternity worried. Around 400 quacks are expected to attend the Chintan Shivir.

In an exclusive interview with the Quackdoses, Dr. K’abhi Matbann, president of the QAI said, “Medical profession is no longer a white collar job. Charted Accountants have GST work all round the year apart from ITR filings, lawyers are busy with litigations perennially, but doctors are now out of work most months of the year, except the monsoons. Also, the government’s strict action on the pharmaceutical company which took 30 doctors to Paris and Monaco for improving their ‘knowledge’ recently, and subsequent action on those doctors for professional misconduct needs to be contemplated upon. The association will introspect in the next three days how to embark on a new direction by confronting various challenges to pave the way for our bright future, and of the future generation of Quacks. If needed, like the visionary leader Rahul Gandhi (pun intended), we will also undertake a nationwide ‘Kashmir to Kanyakumari Patient Jodo’ yatra to revive the connection with our trusting consumers.”

Unconfirmed sources have claimed that similar to the standard ‘Please correlate clinically’ written on radiology reports, as a solution to the low footfall problems, QAI has communicated to all its members via various Whatsapp groups to write ‘Please Visit Again’ on their prescriptions and prominently display it in their clinics too.