Sounding Off: A bitter pill to swallow

Once upon a time, an illness was sure to be cured by a concotion created by the local doctor's compounder. But, today...

In the India of old, long before the public became aware of the law of torts and their privilege to sue for a new phenomenon called malpractice, doctors had their own compounders equipped with a mortar and pestle, and several bottles of colourful fluids. They'd pulverise something, blend it with a bit of the liquid and tell you to down a dose or two, at specified intervals, of what had all the characteristics of an emetic. By the time the bottle joined the empties on the shelf, you'd be fit as the proverbial fiddle.

You didn't know the composition of what you'd been guzzling, and you'd never thought of asking, because,

a) that would have been like casting a questioning glance at the MBBS certificate adorning the clinic wall,

b) it would mean small talk when the doc had other patients to attend to, and,

c) anyway, what good would it be to know the chemical formula of the potion meant to cure the malady (which also would have an unpronounceable name) you were suffering from; all that mattered was that you were getting value for money.

Now, patients visit a doctor only after countless friends and colleagues vouch that as far as they know he can recite the Hippocratic oath by heart and that his practice has not resulted in any unwarranted casualty; then you have to call for an appointment, whereas earlier you would call on him when you felt a need, well, felt a pain.

The scenario is like this: you say, 'hello, I've got to see the doctor ASAP'. The receptionist responds: 'Yes, what's your name... do you spell it with a 'i' as in ibuprofen or a 'e' as in adenectomy... are you registered with us... what's your registration number... what your P.O. box... what's your daytime number... what, no mobile... what's that? you are beginning to suffer from terminal frustration? Don't worry our specialist is specialised in ending all terminal syndromes.'

The outcome is: the doctor's schedule permits him to examine you next Sunday, and, in the meanwhile, if the terminal-whatever pain increases, take a paracetomol.

Indeed, things have changed. When you eventually meet the doctor, you get the welcome generally reserved for an unidentifiable microrganism that has escaped from some Petri dish and the feeling that if you stay a bit longer than required, you will witness an apoplectic seizure. Back home, your GP would have you update him with your family history before he'd let you open your mouth and stick out your tongue to say 'aahh'. The routine would end with an intuitive diagnosis, and the prescription would go to the compounder.

If, earlier, you didn't know what you were suffering from either because you thought it impertinent to ask your doctor or because you trusted him completely, now even if you want to know, you get only a vague outline... 'it could be this, but... or it could that, but... hmmn! We need to conduct a few more tests before we rule out...'

The profession seems to have lost the intuitive ability. Or is it that the poor guys feel there's the Sword of Malpractice hanging over their heads and are afraid to hazard a decision? Finally, when the reports come in, he tells you, 'We'll try this course of action'. Try? Aesculapius, do you hear that?

So, you have to put inane questions to him to ensure that he has arrived at as close a proper diagnosis as possible; you ask him about all the side-effects and after-effects and non-effects that you would, or would not, have to suffer just in case you intended to follow his prescription. And then, just to ensure that you are getting full value for money, you ask whether vitamin B complex would be good for your condition (a hearty yes), whether cod liver oil is necessary (hmmm, yes), whether gingko biloba would help (perhaps it could), whether he would recommend spirulina (no harm in trying), whether a soup of rapidly-boiled cabbage...

Then you go home and scour the Net and your medical reference book, and you decide to go for a second opinion. You can't afford this luxury, but...

The upshot is, you are feeling worse than before.

Arthur Miller wrote something about the death of salesmen. Likewise, I've not seen compounders for a long time. But, I know there are hundreds of real good doctors out there, so I will refrain from saying, 'Physician, heal thyself'.