Heroic Medicine


“Heroic medicine is just too central to our culture, a culture where economists like me have far less authority than doctors.”

“His memory infused me, at a younger age than most, with a sense of my own mortality. The knowledge that I too could die young drove me to try to drain the most out of every moment of my life.”-Bill Clinton, My Life.

It is ironic for a libertarian blog to quote a politician, but this is close to an accurate expression of how I have felt for years. I have always feared that I would die earlier than my detractors. When I used to say, “Have they ever had a good night’s sleep?”, someone used to tell me: “They sleep more than you.”Some of them had come under my essay on the development model of Kerala to damn me. I know the dude behind it, but I will save the story of Magazine editors who leak drafts, take orders and “suffer kicks in the tonneau of their pantaloons” for another day.

If not taken too literally, what I said in the essay was not too unlike what Robin Hanson has been long hollering about:

“Heroic medicine is just too central to our culture, a culture where economists like me have far less authority than doctors.”

Last month, I experienced it first-hand. One day, I was feeling very cold, and dizzy, and I took an auto, asking me to drop me near a hospital nearby. The auto driver dropped me in a place where there were many government hospitals next to each other. No auto driver knew any private hospital nearby. But, someone took me to a private hospital somewhere in that lane. It looked bad enough.

I went into a doctor’s room, and asked a woman who looked like a nurse: “Can I see the doctor?” She went on to measure my body temperature without answering me. I asked nearly a dozen times whether she is a doctor, but there was no answer. After a while, a doctor came in. He was very casual in his approach. I asked him: “Are you a doctor?” He looked at me, puzzled.

When another doctor came in, I asked him, “Is he a doctor? I do not think he takes his job seriously.” He said, “You have high-grade fever. It is dengue. We will have to admit you. When you are fit, you should also get yourself psychologically treated.” When I said, “I asked the nurse ten times whether she is a doctor and there was no reply. Is this a hospital? If you would psychologically treat someone who loses his temper, what would you do to someone who doesn’t? ”, he calmed down, turned to the nurse and asked smiling, “Aapne is malayali bacche ko pareshaan kar diya?”

The next day, an uncle of mine who lives in Gurgaon took me to a hospital. They tested me for every disease, and the results were negative. After a while, I noticed a doctor who was seated near my bed in a chair saying, “It is a very rare condition. But, he is very young. I do not know how such a young person developed this condition.” When I asked “What?” he whispered: “Bone marrow, leukemia”, and then added smiling, “No. This is nothing serious. It is food-borne.” as if he was trying to help me feel better.

The next day I was moved to a larger hospital in Gurgaon. The day after, a doctor said, “The functioning of your kidney is damaged. We will have to do a dialysis.” I was hospitalized for nearly fifteen days.

In the ICU, there was an elderly man who was expected to die the next day. I saw one nurse going near his bed and saying with a smile, “We will discharge you tomorrow.” Nurses often went near the bed of a Nigerian patient Ossito, saying, “Ossito, Ossito”. When his wife and sister came to see him, they felt that Michael Ossito was treated like an animal in the zoo.  

The nurses were really bitter. One of them told me: “The MD of this hospital is a big shot. The hospital gets many concessions from the Government. But, do they pay us well? No. They charge International patients a lot more. But, do those patients survive? Of course not! I just heard that one more patient died.” Then she looked at the floor, with a sad expression on her face.

They did dialysis around three times. They tested me for every conceivable disease, and the results were negative. In between, the nurse asked me to sign the consent document for the test for HIV. I looked at her with a frightened expression on my face. I was once pricked by a doctor recommended by the soul-mate of a detractor. She said, “Do not worry. We have already done it. The results are negative.”

I was suffering from the after effects of a bladder infection for nearly 6 months. Doctors often said: “It is just an infection. It can last for months, and is nothing serious. More than anything you are psychologically down.” But, I felt that there was something wrong. I felt that my days are counted, and did not resist when my parents packed my luggage back home. In between, I asked the doctor, “What are my chances of survival?”, to which he replied, “There is every chance that you will survive.”

When I reached back home, a doctor in my hometown said: “It was enteric fever. Enteric fever might affect the intestines, though it normally doesn’t. It happens. If you feel that the after-effects of the infection are gone after the dialysis, that is good. But, it is improbable that the kidney dysfunction has anything to do with the infection you had.”

It was only when I went through the Discharge report that I noticed that it was enteric fever (typhoid), and that I did not have bone marrow disease, or leukemia as the doctor said. He was joking. No one told me that, in all those days.

PS: I do not know why I am thinking of this passage:

“One night, Barbara called Rand’s apartment from a pay phone, choking with anxiety and pleading to come over for a little while. She had been walking for hours in a state of panic, an image that brings to mind the haunting scene in which James Taggart’s young wife, Cheryl, commits suicide after wandering the streets. She needed their help, Barbara told Nathaniel. In a rage, Rand took the phone and railed, “Do you think only of yourself? Am I completely invisible to you?” The older woman refused to let her join them, pointing out that no one had helped her in her times of trouble. “Why should I be victimized for Barbara’s problems?” she said to Branden afterward, who though horrified and worried stayed with Rand, an indication of the loyalty and fear she had already commanded in him. Amazingly, not until much later did either of the Brandens connect Barbara’s increasingly painful anxiety to the affair.”-Ayn Rand And The World She Made, Anne. C. Heller

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