Indian Journal of Surgery Medknow Publications on behalf of Association of Surgeons of India ISSN: 0972-2068 Vol. 65, Num. 2, 2003, pp. 200

Indian Journal of Surgery, Vol. 65, No. 2, March-April, 2003, pp. 200

Letter to Editor

Attacks on surgical establishments in rural and urban areas

B. D. Kabra

S. R. K. M. Nursing Home, Station Road, Sikar 332001, E-mail: bdkabra2001@yahoo.co.in

Paper Received: January 2003, Paper Accepted: January 2003. Source of Support: Nil

Code Number: is03042

Sir,

Attacks on doctors and medical set-ups, in both rural and urban areas, have now become common and in fact may be on the rise. The problem is more acute for single surgical set-ups where help is not readily available. We have to delve deep into this problem to find answers for it. Is it more work or lack of it? Is it the "care for none" attitude of the younger generation? Is it the lack of satisfactory care of our patients? Is it the lack of compassion? Or is it a more materialistic attitude? Have we lost the art of effective communication with our patients and their relations? Have we lost sight of our commitment to the patients? Are we learning from our mistakes? So many questions come to the mind for which answers are difficult to find. Care, compassion, commitment,¹ communication and consistency are moral aspects that we learn from our elders in the profession. We seem to have lost the art of effective communication. It is one of the major aspects that need to be looked into and the art has to be mastered just like any other skill. Communication with oneself (introspection), communication with colleagues and communication with patients and their relatives is what we lack today. I would like to share what I have learnt over the years from my seniors and hope that those who care shall carry it forward to future generations.

1. Lend an ear. Ensure that you really listen and are not in haste. You have all the time in the world. Nothing is more meaningful than trying to soothe an overwrought friend, relation or patient with an assurance that "you are not alone".
2. Do not lose your cool when you see someone in stress. Stress arises in a state of ignorance. It believes that everything is an emergency. Whenever you are called to see a patient just go ahead and attend to him / her. It will soothe the patient and the relatives. A soothing assurance helps greatly.
3. A sharp tongue can bite its own throat. Remember the famous couplets of Rahim Khan Khana which roughly translate into English as "tongue, you are silly and say many irrelevant things, after saying these things you just go in and it's the head that gets all the beating".
4. Silence is golden when you cannot think of a good answer.
5. Never take things for granted. Assumptions are the termites of relationships. Always communicate to confirm. Patients' relatives need to be informed regularly after the rounds regarding the condition of the patient and the prognosis.
6. Don't be afraid of criticism. If you are never criticized, you may not be doing much.
7. How do you as a doctor face a loss? A missed diagnosis may result in death and a situation such as this calls for deeper understanding and revaluation of what you have done. Your pain should be visible on your face when you communicate with the relatives, especially when you have known the patient for long. Your final treatment is to heal the family, have the courage to face them in their grief and anger and to explain the loss with sympathy.

Look to someone in the community who can control potentially inflammable situations. Keep contact with them for help in an emergency. If we are vigilant, the risks will diminish.² Get your establishment including the visiting doctors and nursing staff a comprehensive insurance cover for such eventualities. This should be over and above the indemnity insurance of individual doctors.

B. D. Kabra

S. R. K. M. Nursing Home, Station Road, Sikar 332001,
E-mail: bdkabra2001@yahoo.co.in

REFERENCES

1. Chakrabortii SC. New horizons, new hopes. J Indian Med Assoc 2002;100:590.
2. Kabra BD. Rural surgery. Indian J Surg 2002;64:467-8.

Copyright 2003 - Indian Journal of Surgery. Also available online at http://www.indianjsurg.com