Not On Oath!

This is literally, a tale of two cities with a twist. More correctly, these are two tales from two cities with two twists. And, this is not fiction. Let’s find out.

A family, known to us, shifted to another city as the elder son joined his new job there. The senior, the boy's father, had just retired and was looking forward to some relaxed time with his wife and family in the new city.

The junior was feeling good about his company as they had purchased a health insurance plan for his entire family including his parents, and as a starter, even offered a comprehensive health check for them. The senior couple had always been in good health so far. The boy asked his father to visit a certain corporate hospital for the check up, and on the decided day left him in care of the staff there, assuring that he would pick him up on his way back home from his job. The hospital was sparkling clean and the staff was polite and pleasant. The doctors also behaved with dignity to the gentleman who, it was obvious to them, was new to their city. The senior liked what he saw and experienced.

As the check up proceeded per its set protocol, the gentleman's electrocardiograph was taken out and it showed some "doubts" about a likely coronary problem. He was advised coronory angiography just to ascertain that the coronary arteries were not blocked to any "significant degree".

A day or so later, and after much discussion, the father and son decided to go ahead and get the angio done, so that, at the very least a source of anxiety was ruled out. At the hour decided, they walked up to the cath lab and got the angio done.

The cardiologist was soon done and he came out with a serious expression on his face, leading the son to the TV monitor to show him his dad’s angio. He showed him the 96% block in two coronary arteries and a 78% block in the third. He told him it was serious and that his dad needed an immediate by-pass surgery. As if on some cue, the cardiac surgeon walked in and explained the surgery and asked them to get admitted and be ready for surgery in the next available slot, the next day.

The father-son duo got perplexed. The senior thought about it and then decided to have a second opinion. He came back to his home town and consulted his cardiologist with the reports and the CD containing the film of the angio.

To their pleasant surprise this cardiologist told them that whatever reports and films they were showing him were as normal as one could get.

What was going on here?

The corporate hospital’s cardiologist had most probably shown them a previously recorded angio of some other patient who must have had a significant disease. But when asked to put that on paper for the purpose of a second opinion, to save his skin, he mentioned what was actually evident on the senior’s study.

Remember, this cardiologist at the corporate hospital was as much obliged to act in the patient’s interest under the Hippocratic Oath as the cardiologist giving the second opinion was. The corporate cardiologist acted upon the oath, so to say, in letter and not in its spirit.  Sad.

Now, the second tale.

A Cardiologist classmate of mine met me at a reunion. He was limping and my curiosity led me to tease him as to how he managed to put the wrong foot forward.

What he told me left me wondering about that other cardiologist’s behavior.

This friend was on a trip to Madrid with his wife and during a freak accident both of them got injured. The wife sustained a fracture that warranted a surgery while my friend had a badly sprained ankle*. A series of xray films, bandaging and other treatments followed with a strong suggestion from the treating doctors that the couple postpone their return to India till the surgery was done. The patients decided that they would get done whatever surgery was necessary only after reaching their hometown. As they left the hospital, they asked to settle their bills.

Imagine their surprise when they were informed that not only the treating doctor had waived his fees but the hospital, with its considerable inputs toward both of them, had also followed suit. Doctors are under moral obligation to treat members of their fraternity without any profit motive, but not so the hospitals! A European doctor, perhaps because of his proximity to home of the legendary Hippocrates of Athens, is more likely to abide by the oath named after him.

*All details till this point in this incident have been changed to protect privacy.