“ Treat the patient not the diagnosis “ a little something I’ve heard so many times. It isn’t that I didn’t understand what it meant, but what meaning do quotes hold anyway if there isn’t a life experience to throw light on it.
So here’s a little something which made those words ever so clear.
As always, it was any other day of the week. 5 of us sat in a small cabin, the junior resident seeing patients one by one, the senior doctor looking over this, and me, the intern, invisible to the world (interns would know) doing the meagre job of writing down patients names in a register whilst observing the proceedings of the OPD.
A young female patient is wheeled in, she seems to be in distress, complains of pain in the right knee. A series of questions were asked and she was then asked to lie down on a bed in order for her knee to be examined.
The junior resident proceeded to examine the patients knee methodically, prodding at strategic spots around the joint and at one point a particularly tender one. Without warning the patient started to cry in pain. Not knowing what to do I awkwardly went back to my seat while the resident consoled the patient for a minute or two before the patient was helped back into her wheelchair.
The patient was given some painkillers and advised to come back when her pain had subsided. Sniffing, she was wheeled out of the cabin.
I continued scrolling social media on my phone when I heard the Senior Doctor-
“So, what went wrong there?”
“The patient cried”, I heard the junior resident remark.
He smiled and nodded, “Yeah“.
And then there was silence, or maybe I zoned out but I didn’t really understand.
So what if the patient cried? It wasn’t intentional and more importantly, the test that had hurt her was the one which gave us the most probable diagnosis. So what’s a little pain eh ?
Then, as if he’d examined the thoughts in my head, he explained.
‘Never make the patient cry, if you’ve hurt the patient during your examination, then you’ve failed as a doctor right then and there. What good is it ? To get a diagnosis after afflicting pain upon the patient. You can always rid the patient of their pain first, the diagnosis can come later, which more often than not, is a personal agenda.
Cue angels singing
Treat the patient not the diagnosis.
I was Netflix and chilling (alone) with a tv show- Diagnosis. Great show! Anyhow, it’s about people with really rare symptoms that have been left undiagnosed and untreated, the premise is that they use crowdsourcing to help find a diagnosis. Weirdly, in most of the episodes there was never a diagnosis or, there might have been, but there was no Eureka this is what you have, and now you will be cured. What I’m getting at is the diagnosis never really mattered if there was no treatment.
And it dawned upon me that after the great deal of investigations and questioning , the illness gets a name and the patient becomes anonymous. Not to mention, to the patient or most of them, it hardly matters to them if we tell them what their illness is. They seek doctors to alleviate their pain, or to restore functionality of a certain body part and if we can diagnose them whilst tending to their pain then yay brownie points. But may it never be the primary aim
Physicians, heal thy patient first