It is often said doctors make the worst patients. What happens when a doctor becomes a patient? In 2008, Columbia University Medical Center psychiatrist Dr. Robert Klitzman explored the question 'if becoming a patient made someone a better doctor,' in his book, 'When Doctors Become Patients.'
In the book, he speaks about his own illness; how depression impacted him after his sister, who worked on the 105th floor of the World Trade Center died on September 11, 2001. Despite being a psychiatrist, he could not bring himself to admit that he was depressed. But once he acknowledged it, he realised what the challenges on the other side looked like as he gained new insight into his own patients' suffering from depression. Klitzman was able to get the physicians to talk bluntly about their experiences, how those experiences changed them, and how they tried to doctor differently as a result.
While doctors spoke about their feelings of kindness and empathy, they also spoke about their frustrations, selfishness, resentment, and anger.
According to a paper published in PubMed by students Mariko Morishita and Hiroshi Nishigori from Kyoto University, a doctor's experiences with his/her illnesses can deeply influence not only their perceptions of illness and roles but also their medical practice.
THE WEEK asked three doctors from different specialties to narrate their own experiences of what it is like to be sitting on the other side of the fence. What is it like to observe the changing dynamics between one's peers and oneself, how difficult is it for one to accept that one has indeed become a patient, what does time on the bed inside the hospital teach doctors about life as a patient and how does the experience of having an illness change how doctors treat patients going forward.
Dr Dhiraj Bhattad, Consultant Internal Medicine, Sir HN Reliance Foundation Hospital
An ancient Chinese proverb goes: “No one can be a good doctor without first having been ill themselves.” True. But like anybody else, even a doctor would dread falling sick. Unfortunately, if the healer himself or herself needs medical care, things are bound to be different. You are treated as a VIP. You can just call up your colleagues and enter their OPD chambers without any formal appointment. You can later on call or message too without turning up physically, unlike other patients when follow-up is needed.
What happens if a doctor needs to be admitted for any illness? On the professional front, if it is an unexpected illness, your whole appointment schedule goes for a toss. If a surgery is needed, you get priority again. With the help of hospital staff who you already know, the admission process is brisk and easy. You may still grouse that so much paper work and formalities are there!
All your colleagues, residents, nurses and management staff, attend you with love and affection, and sometimes out of fear too. If your illness is not bad, you may enjoy the little break you have got from your hectic schedule and the princely treatment you receive. Even the morning sponging then seems like a spa treatment! Nurses are your ‘ messiah’ in this arduous journey. One gets awed by their dedication, much more than that of doctors, with sadly monetary compensation in peanuts.
You also realise the harsh reality of how the resident doctor is ‘just doing his or her job’ and clocking the fixed duty hours without any empathy. If you are a physician like me and know most of the pharmacology, you will start fretting if some medicine is unnecessary or doses are not appropriate. If you repeatedly point out the same, the team may get piqued and hence you end up keeping quiet.
Also, as a doctor, you will experience ‘defensive medicine’. You may have extra investigations to be absolutely sure of your diagnosis. It is like doing DNA test just to make sure that the animal which you are seeing is surely an elephant and nothing else. Extra opinions (or references) are taken just to make sure nothing is going wrong.
You understand what the patients may be undergoing in their illnesses, making you more humane and empathetic.
As a doctor, there are other advantages too, like visit charges not billed by your doctor colleagues, discounts on medicines or the final bill and easy discharge formalities. To summarize, the perk of being a doctor is definitely an advantage when one turns up being a patient. Even research has proven that doctors have better outcomes of their illnesses.
Dr. Balkishan Gupta, Director, Minimal Invasive Bariatric GI and HPB Surgery, Marengo QRG Hospital Faridabad
Last year, I had undergone a critical neck operation in Jaipur. In December 2020, I felt a shoulder pain due to performing excessive laparoscopic surgeries daily a basis. Sometimes the patient load would so severe that I had to forego my lunch and keep on performing surgeries without giving ample rest to my body. I got an MRI done to detect this health issue. Next day, my friend radiologist told me that Parapharyngeal tumor-skull base tumor (3 centimetre in size) had been detected in my neck . I went to Jaipur to consult Dr. Satish Jain, a renowed skull base surgeon. As advised by Dr. Jain, I decided to undergo the surgery there. I was rushed to the OT at 12 Noon and my surgery took place at 3 PM. Dr. Satish operated quickly owing to his expertise in this field. I was discharged the very next day. I had to face a lot of pain while recuperating from the surgery. I had even lost my voice temporarily. I stayed positive and returned to my home. Upon reaching Faridabad where I work, I went to perform an emergency operation in the hospital for 7-8 hours.
On day-4 of my surgery, I underwent frequent speech therapy sessions. I responded well and I obtained my lost voice back. I believe that we should keep ourselves motivated and physically active post surgery. The SOPs mentioned in our medical books say if the patient has a positive attitude and is physically active, positive hormones are secreted, boosting immunity, and I was doing that.
It is advisable to avoid prolonged bed rest as the patient would feel bored. Follow the precautions recommended by the doctor and keep doing their daily routine with a positive attitude. Patients usually tend to delay the diagnosis, which could lead to worsening of the disease.
I had undergone an operation within one week of diagnosis of Parapharyngeal tumor. I knew that it was a critical operation and that I had a high risk of losing my voice. The operation was quite risky as removing such a tumor may cause paralysis of brain nerves. After the operation, one of my vocal cords were paralyzed, but thanks to the speech therapy team, I recovered.
Post-operative care should be given utmost attention in every healthcare setting.
I perform several surgeries a month, but never imagined that I would be on an operation table some day. It was a very tough phase in my life but I convinced myself that it is a human body and it’s a profession. I had not developed any symptoms.
There is a general perception among people that doctors do not fall ill. As a doctor, I understood my illness and got treatment without any delay. I obtained positive outcomes of early detection of the disease and effective treatment on time.
Doctors should have a sympathetic attitude to patients. If the patients want to meet, doctors should reply in a very polite manner. Doctors should also be informed about any kind of complications patients are suffering from.
We always inform the patients about scars left by the surgery. As patients, we should accept all that and try to modify our lifestyle. Sometimes counseling the patients takes more time. Patients need to understand that health is very important in life and look for the best doctor in case of a disease.
Hospitals should also be equipped with state of the art technologies. As patients, you should focus on early detection of the disease. They should also trust their doctors as this may help them feel confident to communicate symptoms, helping diagnosis and future care. Patients need to follow the prescription and cooperate with the doctor and maintain a positive attitude post surgery as well.
All my colleagues took care of me very well. They stayed with me even during my visit to Jaipur for the operation. They extended a great helping hand to me after joining the hospital.
As surgeons, we perform many surgeries daily and take it casually but as a patient, I realized the importance of this painful journey. Before going to the operation theatre, I informed my elder brother as it was a major surgery and was scared of mishaps on the table. The whole procedure was discussed with the family. I realized that patients need moral support during a major surgery. Doctors should be more caring and patients should respect doctors equally.
Opting for the right surgeon and anesthesiologist doctor too is important. Today, patients gather a lot of information from various sources, but the call to choose the treatment should be taken by the doctor. Patients should take second opinions before undergoing any treatment.
Dr Trupti Gilada, Infectious Disease specialist, Masina Hospital
When my husband once showed me a cartoon of what the brains of pregnant ladies looked like, I just smirked. The cartoon had a colouful brain graphic with just four areas, one each for cute babies, emotions, forgetfulness, and cupcakes!
Little did I know that I was going to experience the same soon.
My baby bump at 25 weeks was showing very well and a few people commented on how it looked more than that. It could have been so because I was eating almost thrice my normal diet to combat constant nausea and hunger.
Between weeks 24-28, a test to diagnose gestational diabetes is done with a fasting and post-glucose blood sugar. Now, this may sound like routine, but for a perpetually hungry me, the thought of 'fasting' itself seemed Herculean. But it had to be done. I did pretty well on avoiding the urge to enter the kitchen all night.
When the phlebotomist called at 8am that she was running 15 minutes late. Avoiding the hunger pangs was now irresistible. As a doctor, I 'knew' that a glass of plain milk wasn't going to show up 15 minutes later. And so I sheepishly gulped it down before she arrived.
The day continued like any other until 5pm. At 5pm, I received a call which culminated into something very stressful. My obstetrician called to let me know that I had developed gestational diabetes and would need to start insulin. And this, while I was eating the last few crumbs of the most delicious cupcake ever.
As soon as I hung up, tears rolled down my eyes. I felt guilty for every dessert I had had over the last few weeks and began to worry how each of those may have harmed the baby. I began to think about daily insulin injections, the risk of me developing permanent diabetes, and all the dietary restrictions this would entail. Every complication of gestational diabetes, however rare it might be, seemed so close.
In the mix of all those emotions, I did think about so many of my patients who braved even worse diagnosis. I began to comprehend the depth and truth in the phrase 'ignorance is bliss'. I wished I wasn't a doctor at that moment.
Even worse was verbalizing all these worries over frantic phone calls to my husband and parents. This continued for another few hours until something struck me.
I rechecked my blood reports. The blood sugar value which was deranged was the fasting one. The postprandial glucose values looked fine. My pregnancy brain finally woke up to remind me about that glass of cheat milk before the test.
The anxiety of diabetes for the past few hours now suddenly changed into the embarrassment of confessing how silly I was to give a fasting sample after gulping down a glass of milk. I wasn't probably diabetic at all.
Although my obstetrician laughed it off without making any judgment, my family still continues to mock me every time I need to do a blood test.
This one little incident taught me several lessons. In retrospect, and especially as a doctor, the diagnosis seemed not so significant. But it reminded me that being at the receiving end is never easy. Now I understand every tear shed in my consulting room and give a patient ear to every worry and fear.
The incident also reminded me that you can never know it all even if you are a doctor. Most importantly, pregnancy brains are not a myth, they are indeed made up of cute babies, emotional roller coaster, forgetfulness and cupcakes. A lot of them!
Dr Sanjith Saseedharan, Consultant & Head Critical Care, SL Raheja Hospital, Mahim
During Covid-19, we, as doctors, were at the forefront of the pandemic. I was responsible for one of Mumbai's busiest intensive care units, and it was quite a challenge. As I had to prioritise the wellness of my patients, this period provided me with immense learnings on how I could tackle issues both within my personal and professional lives.
Even though Covid-19 continues to be a challenge, the first and second wave was one of the most difficult periods of my career. Despite contracting the disease, I worked tirelessly to support and aid my patients through social media and telephonic conversations. During this time, I even sought the advice of my colleagues and seniors on how to treat my infection since I realized that even a doctor would require medical expertise from others.
However, my entire team was very supportive. They kept me motivated throughout the whole duration, and I truly valued the suggestions and input shared by my consulting doctor as they helped me recover faster.
Throughout my entire experience, I learned that trusting the inputs and suggestions of the concerned doctor was very important as they play a critical role in helping patients recover. I was hospitalized, and my electrolyte was imbalanced with varying sugar levels. After the treatment, I recovered and returned home healthy and, importantly, to treat many more. All this was due to the efforts of the doctors who treated me, who ensured that I remained in the hospital until I was fully recovered.
