Showing posts with label doctor. Show all posts

Expectations of a Cataract Surgery Patient

Aging brings loss of vision due to loss of transparency in the crystalline lens of the eye and the condition is known as Cataract. No medicine can cure it, so surgery to remove the opaque lens and replace it with an artificial lens is the only remedy.

With the advent of microscopes and phaco machines, cataract surgery has become a miracle bringing great visual results.

But surgery has its own challenges. Here, we as surgeons are afraid of infection leading to endophthalmitis and the second is intraoperative drownings of the crystalline lens in the vitreous chamber. Either of the two complications can lead to visual damage and phthisis - softening of the eyeball to the shrunken small eye. So though results are the best most of the time, it cannot be so each and every time and complications can occur.

What are the expectations of a cataract patient going for surgery?

Though this may sound to be a simple question, the answer is a bit complicated. I will start from the expectations. one by one from the maximum to the minimum.

  1. I should have the best possible visual outcome at the earliest without any pain, redness, or swelling.
  2. I will tolerate some pain and redness, but I should gain vision to some extent if not the best.
  3. Cosmetic: By chance, if something goes wrong during surgery for reasons beyond the control of the surgeon despite the best care, my eyeball should remain in shape and I should not have a deep shrunken eye.
  4. Painful blind eye: At least, I should not have an eye causing constant trouble like pain, watering, and irritation. I may tolerate small eyes (phthisis).
  5. Life-threatening complications: As time passes, I will accept ocular complications as my bad luck, but I should not die in the operation theatre due to a reaction to any injected drug or cardiac arrest. At least I should go home alive.

These are the thoughts I had myself while my cataract surgery was going on.

We, the eye surgeons operating thousands of patients during our lifetime and having complications at least a few times are not happy passing through such events. Being sensitive, we may become stressed and sometimes lose sleep for many nights.

Maybe we see this thought cycle of a patient and learn about the other side of the story - the patient.

Dr Bhaharchandra M. Desai
M.S (Oph)

Doctor Patient Relationship

An individual professionally trained to treat an ill and suffering person (patient) is a doctor. And their natural relationship is a bilateral one.

When a doctor is sincere, focused, patient, persistent with ethical conduct, a continuous learner, and doing keen observation – it is certain that doctor–patient relationship is the most enduring and satisfying relationship where the doctor learns to hear and see with heart and mind. This healthy and strong relationship will survive forever. (A)

Doctors and patients are the two sides of the same coin fighting their common enemy: disease. In fact, medicine is not a mere profession, it is a calling, a mission, or perhaps even devotion. (C)

During sickness, the patient and his entire family look up to only one person after God and that is the doctor. In the old days, when doctors relied more on their clinical skills than on investigation, patients trusted them with full faith. In those old days doctor was a healthcare giver, philosopher, guide, and teacher – a member of the family while considering this complicated doctor–patient relationship we will have to consider the factors related to their relationship.

Machines: Modern-day medical practice is full of technology bringing modern machines – diagnosing the disease with pathological, radiological, and other aids. They are meant to augment Doctor’s ability to diagnose and not replace them totally. The “S” singularity of machines tries to replace a doctor but that is not possible. (E)

The corporatization of medical treatment has given all the seriousness under one roof with all the modern medical instruments and highly trained doctors. But sadly it took away the human touch. Compassion became a victim of greed on one side (doctor) and unfulfillable demands of the patient on the other. Ultimately strange bitterness invaded the holy patient-doctor duo. (F)

Media: Print, electronic and social media also played a hoax. In hunger for sensationalization and increasing viewership, the media failed to paint the true picture: “especially from the doctor’s point of view” leading to doubt and low regard for the humble profession of doctors. (G)

Google: Huge influence of knowledge given via youtube – Wikipedia – WhatsApp group – made patients think, “they know everything”. They understand the disease and treatment. In fact, details on Google are neither right nor authentic. Patients trust all they read there, putting doctors on backfoot. (H)
Doctors are not God, but merely an instrument of God. Not everyone can and will be cured. (I)
Complications are bound to happen in the best of hands with almost care. Doctors should seek another colleague's opinion to seek support and involve as many other doctors as possible.

Mob Violence: Unending patients’, expectations and politically supported gangs who exploit doctors lead to mob violence. Arrogant, ill-behaved, and threatening relatives do violence leading to physical assault on doctors, damaging hospital premises, and destroying precious instruments. Though few patients are troublemakers, all are not. They make doctors monsters from demigods. Mob violence makes doctors feel timed, gutless, and easily terrified. Doctors become zero from heroes. 75% of doctors in India have faced violence once or more times. (Y)

Medicine is not mathematics and so no single formula can be applied to one and all. Every patient is different and multiple factors play a role in the end result. But without understanding all these details, a judge with little knowledge of medicine and overcharging exploiting lawyers decides the amount of compensation. With the fear of this law, doctors give defensive treatment, advise detailed investigation and refer the patient to a higher center for treatment.

So, present day, three requirements are medically trained judges, legal media restrictions, and appropriate remuneration to doctors.

The remuneration of doctors is always expected to be low telling it to be the profession of human service. Everyone expects discounts when it comes to the payment for health. Medicine is a noble profession, but it is still a business and so doctors need to be paid fairly for their talent. This expectation of low charges, generous, and charity doers can not be satisfied, because expenses for medical education, hospital premises & staff salaries, modern-day costly instruments, and government taxes demand a big amount of money.

The life of a doctor is worth studying before discussing anything. Doctors never refuse a call from the patient. Sleep deprivation and stress are the killing factors leading to five to six years less life for a doctor than the general public. All are allowed to fail, but doctors do not have that luxury. When complications arise, doctors become sleepless, tense, stressed, and has the feeling of anger, shame, and humiliation. Remember, doctors, too, are human and doctors too are only human. Doctors miss numerous family dinners, birthdays, marriage and even visiting their dying relations. They have no family life and sometimes face failed marital relations leading to divorce. Female doctors have more problems because they have to look after domestic work settings, husbands- children, elderly, and sometimes they have to cook in addition to days work of medical practice.

So medicine is an art of healing. Doctors can cure the patient with empathy, meaningful conversation, and sometimes with just a reassuring smile. If a doctor can communicate effectively with the patient and his family and take time to explain the disease, its prognoses, limitations of the doctor himself, and probable charges of the bill, the patients are ready to accept even the most.

Black sheep: However for every failing guilty doctor, thousands are honest, treat countless patients tirelessly and make their life better.

Similarly, for every inconsiderate patient, thousands are grateful and make the doctor's life journey worthwhile.

Corruption and greediness are related to society in general and are reflected in both doctors and patients.

I will summarise the long story short telling a few more things.

Healing touch: Some doctors have a healing touch that works wonders and transforms the patient’s life.

Faith: 100% faith is a must. 1% fear with faith means fraud! Faith infuses positive thoughts, expectations, and communication in the patient.

Law of attraction: Here one says that you can attract whatever you wish.

Law of acceptance: Death is inevitable. Doctors can only do their best to postpone it. Doctors can treat, but can not decide the outcome (end result).

Be non-judgemental: Sometimes there is an end of life. It is time for people to go and they do. The doctor must never feel that he can confer immortality to any patient.

Spirituality is an individual's search for the ultimate meaning of life mixed with humanism, rationalism, and naturalism. It plays a major role in healing. Spiritual dimension showing prayer with great faith in God, chanting mantras repeatedly and meditation do have a great role in healing. Cultivating optimism and positive emotions can counter depression and make healing faster.

Ralph Waldo Emerson said:
The purpose of life is not to be happy, it is to be useful, to be compassionate, and to make some difference that “you have lived and lived well.”
Take home message:
Despite longanimity of life, eradication of many diseases by vaccines and cure by transplanting vital organs, nobody is going to live a healthy life forever. So doctor’s help in curing physical illness is a must and doctors have voluntarily chosen to be a healer by profession. Thus doctor – patients relationship is compulsory.
Present-day society: “full of stress, hurry, corruption, infighting and having suspicion all around” has to be accepted as a reality. Few of the doctors and patients may not be honest and well behaved respectively. Both have to rationalize the relationship. Patients should find out a reasonably clever – honest and compassionate doctor around. Afterward, the patient should trust the doctor, have full faith, and tell him the details of illness and addictions. Doctors should be cautious regarding treatment, charges, and their own safety against violence.

Dear People, with Love and Care, Your Doctors
  • Book Title: Dear People, with Love and Care, Your Doctors: Heartfelt Stories about Doctor-Patient Relationship
  • Author: Debraj Shome and Aparna Govil Bhaskar
  • Book Review: by Dr. Bharat Desai, Date: 07-Dec-2022
  • Price: ₹ 389
  • Pages: 298+22
  • Publisher: Bloomsbury, New Delhi (2019)

My 2018 Accounts (On Life)

Over time, I have learnt and practised being accountable and better-organised in day to day life. That makes me disciplined and presentable with honour – any time and every time. I maintain day to day diary for the last seven years recording all the events and emotions. Reading the contents of the 2018 year diary inspired me to write the statement of account presenting activities of 365 days of the year.

Daily Routine
  • I consider my day starting at night, 9.30 PM, when I go to bed. I get up around 2:00 to 3:00 AM. That’s when I do my reading and writing work until I fall asleep again. That gives me more than 2 to 3 hours of study every night.
  • I do clinical practice as an ophthalmologist between 9.30 AM to 1:00 PM in the morning and 4.30 to 7:00 PM in the evening. Yes, after lunch, between 1.30 to 4:00 PM there is a compulsory sleep, the classic after siesta, for about two hours.
  • Morning hours, between 7:00 to 9.30 AM are “no work” time, spent in getting ready, reading newspapers and having tea-breakfast. How much time should one give for newspapers, I often wonder.
  • I spend 7:00 to 9:30 PM in front of the television – watching entertainment serials and news.

Reading and Writing
  • My only hobby – I can boast of – is reading and writing. I keep on reading the books, make short notes and then present the book-review as an article on my blog. Learning to Say No, India Vs Pakistan – Why Are We Not Friends, Morarji Desai, History of Jammu and Kashmir, Lord Shiva, Parvati, Karthikey and Ganapati, are some of the well-received book reviews.
  • I do study and analysis by myself to publish research results - Status of Senior Citizens and Accidental Marriage of a Daughter are such presentations.
  • I have written tour diary following a visit to Kankaria Festival, Ahmedabad and visit to the Taj Mahal, Agra.
  • I was felicitated as an achiever at Centenary Celebration of my high school, D.C.O., Killa Pardi – the article following that event describes my high school life 50 years back.
  • I have written 215 articles so far and my son Rahul presented them with pictures at “” More than 300,000 visitors all over the world have read them and a few of them sent responses. One of my readers, Nirali Desai from Ahmedabad, was inspired to prepare an illustrative work on Anavils, after reading my blog article on the subject. This year 15 such articles were published.
  • In addition to being a life patron at J. B. Petit Library, Bilimora and Sayaji Vaibhav Library, Navsari, I have my own treasure of books. When I decide to buy a book, my son Rahul orders it online and purchases the said book.
  • During 2018, I have read and re-read books on Mahabharat, Bhagavad-Gita and Ramayana. I have prepared a summary of them to be published for eager readers.
The Book I Like (ભારત વિ. પાકિસ્તાન: આપણે મિત્રો કેમ નથી?)
  • Guzder Library, Gandevi team comprising of Prin. Ashvinbhai Patel, President Thakorbhai Naik, Secretary Jayantibhai Mistry and Vice President Jyotiben Desai have been organizing lectures on the book-review every month on second Saturday at 4.30 PM for the last 52 months. I have joined them for more than two years by now. Dr Pravinbhai Gilitwala, Dr Naliniben Gilitwala, Piyushbhai Dharaiya and I have formed a four-person team. We attended six meetings last year. The orator speaks on one book for about an hour and later there is discussion. I enjoy these events. I write my feedback to them. This has given me friends like Jay Vashi, Dipak Desai, Chhayaben, Jasubhai Naik and Hetalben. The 50th episode of this series was unique - Desai Musical Orchestra presented their book review with film songs.
  • The residential society we stay at is 30+ years old and nearly 70 families have been staying from the beginning. We meet nine nights during Navratri and Dussehra is celebrated with dinner of the 150-170 residents, more than 70 participate regularly. This year also we had 10 days gathering at early night with Ras-Garba. We come to learn more and more about one another every year.
  • In the North-West corner of Jalnagar Society, 11 eleven houses and ~40 residents have made a unique family, meeting regularly on our terrace. Either we eat Khichdi-Kadhi, Ubadiya-Jalebi, Ragada-Patties, Pav-Bhaji or anything like that prepared by ourselves. Ketan-Kamal and Mehul are the key members volunteering their services and managing the whole show.
  • This year, three of our members passed away and we were together with their family all throughout, till the last rites are performed. While making them feel comfortable and eat, we eat together and stay with them - a rarely seen togetherness is seen here.
  • We celebrated 90th birthday of Sharda-Ba on 27-Jul-2018. Our family also gathered to say good-bye to Shiv Vashi going to Canada for higher education. We blessed him on 03-Aug-2018.
Medical Meetings
  • I have attended a dozen of clinical meetings organized by Indian Medical Association (IMA) Bilimora. During such meetings, I get the fellowship of the friends around and increase in the general medical knowledge. I just do not go for the dinner offered. We also have the South Gujarat Ophthalmic Association and Valsad Area Eye Surgeon Group. I had four-to-five occasions to attend them.
Senior Citizens’ Club
  • Being of 60+ age, I have joined Bilimora Senior Citizens’ Club and was selected as Vice President. I take an active part in their deliberations. I have organised lectures of Sureshbhai Desai, Navsari on old-age and Dr Radha Mehta, Navsari on psychological problems of old-age. I have attended six general meetings and seven board meetings.
  • I have been active in South Gujarat Senior Citizen Society too. I attended their quarterly meeting at Navsari with Dr Bhavana. I was the key person in holding their Bilimora meeting.
  • Old-age people behave differently compared to young-age and children. I find a nice time with new friends.
  • Dr Bhavana and I have watched 21 movies in the cinema house this year! It felt like having seen one movie a week, but I was wrong.
  • We have a group of nine people, Dr Gilitwala couple, Dr Vijaybhai Desai couple, Anilbhai Desai couple and we two making eight with Prof Minu Desai, the ninth. Dr Bhavana usually contacts all of them and I bring tickets from advance booking.
  • Bilimora has only one cinema house (multiplex) and two screens showing two movies simultaneously. The audience is a big problem. Many times, even 10 patrons do not come and the show has to be cancelled. We do not face this problem nowadays because of our own group.
  • We saw many Gujarati movies as well this year, including Chal Man Jitva Jayaye, Chitkar, Reva, Shu Thayu, Swayamwar and Sharat Lagu. Nowadays they are comparable or even better than Hindi ones. On Bhavana’s birthday, we invited 14 people to see Sharato Lagu Gujarati movie and it was a great, unusual birthday celebration.
  • Every movie we go for many not be good! Actually, the pleasure and enjoyment gained during the movie depend on one’s own mood and company. I take the liberty to sleep off and on during the movie. All in all, this is one of our important pass-time activities.

I find happiness in planning an event and executing it as a key person or maybe the only person.
  1. Lecture from Dr Pradip Patel, Spandan, Chikhli at Vansada on diabetes with free diabetes check-up was the first event. Lions Club Bilimora Yugma and President Ln. Shankarbhai Patel decided for this and the lecture was organized on 07-Jan-2018.
  2. Lunch Event at Old-age Home, Gandevi: on 03-Apr-2018 we organised a lunch at old-age home with gifting each resident a set of bed sheets, pillow cover and blanket, a donation on the demise of mother-in-law Dr Indumati K Desai. My wife Bhavana, her sister Sandhyaben and elder brother Rohitbhai arranged this. About 60 people including the family members, old-age home residents and friends were present.
  3. Eye Camp in Jun-2018: Dr Darshana Naik and I organised an eye camp for three days on 15, 16 and 17-Jun-2018. The patients were examined at my hospital in the morning and Jyoti Care in the evening. The income was saved for social activity.
  4. Orphanage Event on 17-Aug-2018: The principal of the orphanage informed us that the students were not interested in the study. So, to motivate them, we arranged a lecture – dialogue with Jay Vashi. As per the students’ wish, we arranged to serve pizza for dinner. The orphan children, ladies there, staff and Lions Club members made a total of 100 to enjoy the event with. Prerana Group of Chikhli with Dr Sharad Patel, Jayesh Desai and Dharmesh Kapadia helped there. We gifted a Spherehot geyser (Rs. 16000) for the use of the people at the orphanage. Dr Darshana and I contributed for the dinner.
  5. Aspee Kanya Vidyalaya, Antalia: A) Lecture from Dr Ami Yagnik, Surat on ‘Reusable Sanitary Pads and Female Genital Trac’ (on 20-Sep-2018). B) Lecture from Dr Ami Yagnik, Surat on ‘Basic Life Support and Life Skills’. Above two events gave very useful information to nearly 1200 girls on their genital functions and how to help during person-in-emergency. Our friend, Campus Director Prin. Jayshree Desai was ready to help. C) Story Telling competition on 06-Dec-2018.
  6. No to Crackers Movement on 03-Nov-2018: I wanted to do some social work and ‘noise pollution due to firecrackers during Diwali’ was the project. I prepared a leaflet to be placed in the newspapers, an information chart in the news handbills and advertised this information via Facebook and WhatsApp.
Second Life
  • I had faced a major car accident on 06-Apr-2018 at Kailas Road, Valsad. I was alone in the car and the accident caused the car to turn upside down with breaking of glasses and complete damage of the car-body including the roof. The damage was so bad that the entire body had to be replaced and the car had to be practically rebuilt. I had no injury whatsoever, because of the seatbelt I had applied. Anything could have happened, but then I believe ‘God is Great’! I had faced a similar accident in 1999 at Bharuch Golden Bridge, so is it a second life or third? I wonder.
Weddings and Yagnopavit
  • During this year, of all the invitations I received, we could attend fourteen events,
  • Yagnopavit of Devansh (my nephew Deval’s son) at Abrama, Jash (Biren’s son) at Maganwadi, Kadodara and grandson of Prin. Kishor Desai at Anavil Wadi, Gandevi were enjoyable. The wedding celebration of Ronak Ajaybhai also made a great memory to cherish.
  • Every event costs a lot of money and hard work – any debate about their worthlessness are only academic! People go on organizing them and others do not miss to enjoy them.
  • Eating too much is out of the question, but I do enjoy a variety of nice foods. DJ and high-volume orchestra are torturous, but we do see good ones also.
  • Eight birthday celebrations we attended also have the same tale. I do not like cake cutting and playing with cream-paste, but that is my problem.
Death and Condolence
  • 2018 was a year causing the death of six closed ones. The started with the sudden demise of our neighbour Rameshbhai Raval on 18-Jan-2018, later Harendramama passed away on 15-Jul-2018 to be followed by Tarunimami’s death on 13-Sep-2018. Sharda-ba and Mukeshbhai passed away on 05-Sep-2018 and 22-Oct-2018 respectively. Two deaths in the same house in a short period made us feel sorry. Our relative Janak Balvantrai Naik, Kachholi passed away on 06-Aug-2018 of heart problem. We mourned their departure for thirteen days and thereafter we are feeling their absence and loss.
  • I skip attending death funerals, condolence meetings and other rituals of not so close relatives and friends.
Tours and Travel
  • 01-Jan-2018 (Ahmedabad): The year began with a surprise visit to Ahmedabad because our friend Anilbhai Desai repeatedly invited (insisted) us to visit Ahmedabad for Kankaria Festival. The two-day tour had pleasant hospitality by Darshan-Shalu and we had a great time with them. We visited Kankaria Festival and Flower Show at Sabarmati River Front.
  • 22-Feb-2018 (Five days Agra Mathura Tour): Alliance Club International had installation ceremony at Agra. Seven members from Bilimora attended this event. Bhavana wanted to experience the journey by Rajdhani Train travel. She wanted to experience water, tea, breakfast, dinner and ice cream served. Earlier, it used to be offered to all. Nowadays you have to pay extra for this facility. We visited Fatehpur Sikri’s 174 ft. high “Buland Darvaja” – fort and palace inside, then we saw the Taj Mahal - the wonder of the world and lastly, we visited Mathura Temple with Gokul and Vrindavan. We stayed at Clarks Shiraz, one of the most premium and luxury hotels in Agra.
  • 07-Apr-2018 (Poicha - Rajpipla Tour): 17 tourists, mostly senior citizens, excluding Nidhi and Aarna visited Poicha for a night stay. There is a big temple on the riverbank of Narmada. We saw a big garden with multiple presentations of Ramayana – Mahabharat, a big statue of Lord Krishna, Mirror Museum and what not. There is a big temple, Kuber Bhandari, 100+ steps high on the other side of the river Narmada. Many visit this templet every last day of the Hindu calendar month to be rich! We did see Rajpipla with temple and palaces.
  • 18 to 22-Sep-2018 (Goa): Bhavana and six ladies went to Goa for the four-day ladies-only tour.
  • Pune – Mumbai: Our permanent tourist destinations are Pune and Mumbai because RahulShivani and Vaishali stay there.

All said and done, how do I see the year 2018?
Of 365 days I had, I have done enough clinical practice, reading and writing plus socialising in weddings, birthdays and tours. I want to plan the year that follows in a way, I can do more clinical social services.
I am happy the year passed gave me multiple occasions to do the activity that pleases me or, let us say, makes me happy - be it a tour, attending any event or a meeting.
I know, I am what I am because of my wife Dr Bhavana, family members Vaishali, Rahul and Shivani, friends around and last but not the least Jalnagarians!

Diabetes Awareness Session (Free Entry)

Did you know, diabetes is a leading cause of blindness in adults?

Inviting residents in and around Bilimora town, to an awareness session on diabetes.

Event details:
  1. Know and understand diabetes
  2. Diet for those having diabetes
  3. Exercises recommended
Speaker: Dr. Pradeepbhai Patel & Diabetes Team (Spandan Hospital, Chikhali)

Entry fees: FREE

Complications - When Doctor Commits Mistakes

When a new doctor is learning for the first time or when a senior doctor is learning or not learning a new technique, who suffers? Naturally, a patient. When we visit a doctor with a physical problem as a patient, we expect perfection. But it is not easy to get. So, we have to understand how the doctors may make mistakes.

We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, all enterprise of constantly changing knowledge, uncertain information and fallible individuals. It is not only science but also habit, intuition and plain guessing. This article is about dealing with mistakes made by doctors and their remedy.

When Should A Doctor Retire?

When should a doctor retire?

Your reply is a must...

ICU (Intensive Care Unit)

ICU (Intensive Care Unit). It is the most alert and up-to-date department in a hospital.

Minimum expectations of the patient admitted here are would be:
  1. There is a doctor present all the time (round-o-clock) to treat the patient and attend to any emergencies.
  2. The present doctor must be having technical skills and know-how in the management of critical care. He/she may be a Physician/Anaesthetist/Critical care treatment specialist.
  3. Necessary gadgets like a cardiac monitor, ventilator, pacemaker, cardiac defibrillator and such others are present in working condition.
  4. Emergency Medicines, Oxygen, continuous electric power and assisting staff on duty.