Tuesday, May 18, 2010

The Healing Hands

Almost 3 months ago, I posted an article about a suicide attempt near my office. That post had a happy ending in that the man did not die. A visitor to this blog, Sarah, commented that she was "glad it didn't have a gruesome ending...". I replied by asking, "When someone is bent on taking his own life, can we really stop him from doing so?"

Well, the poor chap was reportedly sent to the mental hospital but was eventually discharged after a couple of weeks. Not long after that, he was found dead at home. He finally achieved what he set out to do by hanging himself.

But I don't want to dwell on his story—I'm done living through that afternoon. At least one person had told me that she was hopelessly unable to control herself from laughing so hard until she had tears in her eyes when reading my article. I admit that I wrote the article in an amusing way, but I didn't expect that some people found it that funny!

What I really want to say here now is that during the drama, when several hands stuck out of the window to grab the man, it was later revealed that a pair of hands were actually those of a driver who worked in a nearby building. He had no business to be there for the rescue, but he was there anyway, trying to help. There was a short mention of him in the papers the next day.

But one has to wonder what would have happened if they had failed to save the man that day. I suspect it would have been possible that the busy body might have been blamed even. He's not trained for rescue work, yet he tried to be smart! Fortunately, however, the man was saved, and the good samaritan received a pat on his back.

A couple of days ago, I was running together with Dr Peter in Likas Park, and we got to talk about professional responsibility. He told me that the standard of care expected of doctors is very high. That is of course not surprising considering that they're dealing with human lives. A careless mistake can result in the loss of life.

After I reached home that evening, I started thinking about life being a doctor. It is difficult for me to imagine, of course, but I was trying to picture myself seeing a dying man in the street—how would I react?

I think long before becoming a doctor, I would have made up my mind that I wanted to help sick people. There has to be a passion to save lives. In many cases, doctors end up becoming rich people too, but I'm inclined to think that rich or poor, the priority is always about saving lives; that the money comes as a side-effect of being a doctor. Therefore, if I were a doctor, upon seeing a dying man in the street, my first reaction should reasonably be to act within the best of my knowledge and ability to save his life. As to whether that man can afford my fees or not, that is a secondary matter.

Nevertheless, in reality I have the feeling that most, but hopefully not all, doctors these days would refrain from doing all that they can to save the life of the dying man. And we ask ourselves, why? Are they not trained to save lives? Are they not morally and ethically obliged to save lives?

We have come a very long way from the original spirit of those people bestowed with the gift of the healing hands. It is unfortunate that the law had also come a very long way to the extent that doctors who obey their inclinations to save lives may end up getting into big trouble if things go wrong—they may get sued and found liable for huge compensations. And the effect does not end there too. Their reputation may be damaged beyond remedy, and it is possible that that can be the end of their career too!

Therefore, I think when a doctor sees a seemingly hopeless case of which success is very remote, he would rather refrain from trying to help. Instead, it's a safer bet to just direct the patient to other doctors who're willing to try their luck! And then those other doctors would also push the patient to yet other doctors.

I think that's why several clinics turned this baby away. That's the reality in the real world, but some people may not understand it.


Scho said...

Sometimes we think we know. Actually we do not know. Try for once. We imagine we are this person. We imagine what we go through like this person. Then may be we can understand why he comes to this decision.They say laughter is a medicine and probably and assumably that girl laughed. To be a real good doctor takes a lot of commitment and patience. It is not easy for the sick to seek a strong figure to hold on to and to find solace.

Cornelius said...


Thanks for your comment. However, it's a bit unclear what's your position in this matter. You said:

"To be a real good doctor takes a lot of commitment and patience."

I did not suggest otherwise. I think moral and ethics can be very tricky issues.

There is the tendency to look at the matter from the surface and then condemn the doctors for having no ethics or commitment and patience, thus pushing the baby away. Yes, that is one way of looking at the matter.

The other way of looking at the matter is when seeing a patient that is terminally ill and perhaps requires the support of competent staff such as fully-trained nurses and high-tech equipment which are unavailable in the small clinics. Would it be ethical for the doctors to accept patients whom they know fully well require much more than what they can handle? And in the event that those patients die, would these doctors be blamed for undertaking tasks which they know they're not qualified (on virtue of ill-equipped facilities) to handle?

Anonymous said...

Tragedy does become comical when there is the happy ending, unfortunately your story has taken a sad twist, no longer much fun anymore.

I think doctors need safety nets because of the nature of the field they are in. They need to have the confidence and ability to believe every life is worth saving, and when someone dies in their care, really good malpractice insurance so they are not scared away from the basic nature of the field they are working in. People will die in their care, it is inevotable, especially if one truly is agood doctor and turns noone away, no matter how sick. Saving lives should not be about ego or about fear of retribution. In America there are strong laws protecting professionals in the caretaking industry, I hope this is so in Malaysia also

Anonymous said...

Forgive my spelling errors, I am commenting from my husband's IPhone.

Cornelius said...

Now, I'm really hungry, Sarah, and I really need food! But I just wanna make a quick reply about that malpractice insurance you talked about.

Being a professional myself, we do take up indemnity insurance to safeguard ourselves in the event of negligence.

But the truth is that if ever we do get sued, that is most likely the end of our careers. Because reputation is almost everything, you see. Once you are found to be negligent in your work, it is very, very difficult to win back people's trust.

Likewise, when a doctor undertakes the task of trying to revive a dying patient when he knows very well that he is not well-equipped for it, he may just get into big trouble when and if the patient dies. Yes, the insurance can help to pay the damages awarded by the courts. But his reputation will be affected forever.

Anonymous said...

Yes but there is a difference between negligence and inevitable death. Doctors should not be turning patients away because they are afraid a patient may die! That is negligence! (I am speaking of dr's working within their specialty, not outside of it).

Cornelius said...

This thing about being in the "noble" professions - lawyers are supposed to fight for justice; doctors are supposed to save lives; teachers are supposed to impart knowledge etc - I sometimes wonder, how "noble" are these professions in reality?

Well, I honestly believe that these people really want to help others, at least during the earlier part of their careers. But when all's said and done, no matter how much they want to help others, they still want to help or safeguard their own interests first.

A lawyer has the right to take a case, or reject it if he deems the case not winnable. Of course we can say that win or lose, it doesn't matter, the point is, he should try to win?

I'm of the opinion that doctors should also be given the right to reject a case if he feels that there is little chance of success, especially if they haven't the necessary supporting staff and or medical equipment in their clinics. I thought the John Q story is a good example of what's happening in most developed nations, where the first thing they ask you when you arrive at the hospital is for your insurance policy numbers.

We should be very careful to impose a standard where doctors are forced to accept all patients coming their way. That may just result in some people shying away from this profession.