Friday, May 14, 2010

Diagnosis, treatment and .. guesswork.

When I was in school, I remember we all went through a period of "crazy for books by Eric Segal". I can't remember which was the first one, but I remember that Doctors was devoured by the whole circle of friends, the tattered copy getting passed around, after much covering and recovering with brown paper. In hindsight, the novel seems a rather cheesy, but apart from the improved vocabulary, it left one lingering affect - a strong belief, that the practice of medicine, is more guesswork that knowledge.

I think the lines were these - "Gentlemen, I urge you to engrave this on the template of your memories: there are thousands of diseases in this world, but medical science only has an empirical cure for 26 of them. The rest is ....guess work."

That number might or might not be true, or it might have changed, or perhaps it wasn't meant to be anything other than fiction. However the years showed, how hard diagnosis always was, how little we really understand our bodies, and even less our minds. The past few years were specially revealing, as we reached an age, when one after the other, parents of friends and cousins, rapidly declined in health. As the stories emerged of malpractice, extortion, incompetence, carelessness, I was reminded again and again, of the word guesswork. Not everyone is equally talented at guessing, and the faster you guess, or the better you use the tools to help you validate your guesses - the better you can be as a doctor. There are many things that can help with your guessing, experiance, knowing the patient, updated knowledge, etc etc etc. But at the end of the day - its finally all about guessing.

I was reminded of that today as I trawled through the net for the umpteenth time, looking for answers, and  finding numerous reports with numbers, which look suspect to say the least. And mental ailments seem so much more of guesswork than the physical ones. Its a depressing scenario every way you look at it. But then such is life.


Veena said...

Yes guess work it is. however what i find outraged about his how doctors use patients as guinea pigs for experimenting their ideas. The patient's interest needs to come first and interest of medical science much later

Tess said...

sigh, I don't find it that outrageous... sometimes sad, sometimes not. I guess it depends on the situation..

Anonymous said...

Hope everything is fine.

Guess we all need a Dr. Gregory House.

~ sonia

Tess said...

hmm things are the usual. sometimes fine, sometimes not.

as for House, yes we do need him, but then he's just one mythical character, and there are too many of us on this planet!!

Guru Kini said...

If you haven't been to a Medical school hospital - you ain't seen nothing yet :). It is both amusing and scary to see a bunch of young masked nerds giggling around you with scalpels in their hands. It is straight out of a Robin Cook mediscare novel.
Guesswork, of course it is. But thank God for doctors and surgeons anyway. I am too faint-hearted to do what they do.

Tess said...

he he, I don't want to go to a med school to see that. I saw a version of it at NIMHANS last time I went there.

At the end of the day, their profession , just like ours, is an understaffed area with no shortage of people ill adapted to what they are doing. Plus, even if they are the best people, they have to learn on the job, there is just no escaping it.

If I didn't have a little more sympathy for the fact that human life at stake or not, finally they are just human beings, I'd probably be a lot madder. But I guess its ok, such is life!