Patient's Progress

In my last article, 'Mind over Matter - Part 4', I explained my tendency to mentally classify medical practitioners into 'Healers' or 'Doctors'. The latter being those, who look at their patients very superficially and treat the most obvious symptoms, and not caring enough to go to the root cause of the affliction. My maternal uncle, a very popular General Physician was the first 'healer' I knew as a child. By the grace of God, all the GPs our family has had till the current one have all been healers. I have a theory, that every healer is a potential novelist. For it's the healer, who knows all the sub-texts of a patient's disease: the relationships and equations he has with himself, his family and the rest of the world. His dreams and his desires, his inner pining and the ghosts that haunt him! For a healer, his patient is an open book - a novel waiting to be written. It is therefore not surprising, that some great doctors have also been great writers, poets and novelists. The names that readily came to my mind, as my favorite novelists are Somerset Maugham and A.J. Cronin. But just one glance at 'Physician Writers' in Wikipedia shows a mind boggling list - right from antiquity to the 20th century. Oliver Goldsmith (18th century): I studied him in school, but never knew that he was a doctor. Then how about the creator of the legendary Sherlock Holmes - Sir Arthur Conan Doyle! Apart from these my favorite-doctor novelist was one, George Sava.

George Sava was a Romanian plastic surgeon, living in exile in London. He was intrigued as to why his patients wanted some detail of their face or the entire face changed. Each patient of his became a protagonist of his novel, real identities being duly fictionalized. I wonder how he managed to balance his life as a busy and popular surgeon and an equally popular novelist. Novel after novel just tumbled out! Among all the writers I have read, he was the most awarded and internationally honored person: as a surgeon, a novelist and a political activist! Sadly his autobiography, 'The Healing Knife - A Surgeon's Destiny' is out of print. In this book, he also narrates what expectations a patient has vis-à-vis his doctor, his family, friends and colleagues. The fulfillments of these expectations are as important for the patient's recovery, as the treatment the doctor prescribes. He has traced these cultural attributes, right from the different tribes all over in the world to today's developed societies. And the differences are most revealing - once again, it's all about 'mind' over' matter!

In India, at least in the milieu in which I grew up, even if you were in the pink of health, the only way to show that somebody cared, was for that person to say 'What is that small swelling under your right eye (where none existed'). Come I'll give it a rub!" When I would be fast asleep and had my right hand over my forehead, my mother-in-law had to wake me up and say 'You have a headache. I will rub Tiger Balm over your forehead and then you can sleep well'. The balm duly rubbed never sent me to sleep again. But that was the done thing! Every summer, when I was sent to vacation with my paternal grandmother, all my paternal aunts used to fuss around me. 'See, how much weight poor Suman has lost! He has become dark. Don't worry Suman, we'll right away cook all your favorite goodies, and give you an oil massage every day and send you back in good health. When after a month I was brought back to my maternal grandmother, Granny and all the maternal aunts played the same spiel, all over again! Really, very cute!

Having lived and worked in Italy, I found that both Indians and Italians have more or less the same attitudes about the idea of being taken 'care' of. A lot of fuss has to be made around you, even if you are perfectly fine. And not only by your immediate family, but also by your friends and colleagues! As a child, I remember when my mother was hospitalized for typhoid, a whole convoy of bullock carts carrying people from our village arrived, just to be around! They were neither our friends nor family members, but just fellow villagers - and that mattered a lot to my mother! It was also a great matter of moral support and pride for the rest of the family. So, in the social context of India and Italians, though the 'healing effect' of the doctor is an important factor, the fuss and the number of people who make this fuss is equally, it not even more important. A lot of telephoning and cross-telephoning about the patient's 'welfare' is mandatory - even if the person answering these calls has no respite and parrot-like keeps repeating the latest 'health bulletin'!

In Germany it is quite different. Germans are great believers in keeping shipshape all things they possess, be it their body, their refrigerator or their car. Unlike others, they pride themselves not in the fact that they have the latest Mercedes, but the in the fact that they have devoted better part of their weekends in keeping their grandfather's old Mercedes, still on the road. The worst thing that can happen to a German is to be seen by a friend or a colleague, stuck with a stalled car on the highway! 'How could such a thing happen, when I take such meticulous care?' Same is the case with them in health matters. A German will seldom want to discuss or make any thing public, if something is amiss health wise about him or his family. On the other hand, we Indians would make such a song and dance about it, to any one who may care to listen. Once, I came to know that a daughter of a very close German friend of mine was undergoing radiation therapy for a lung affliction. Wanting to show my concern, I made some discrete enquiries and he was red in the face and very sternly told me, 'Thank you, we can manage it ourselves'!

Once, while in Germany, an Indian colleague had to be hospitalized for a heart condition. His wife and I were on a 24-hour vigil taking turns. While we did not spot any one around for the other local patients! My colleague was sharing a room with a local German. During the visiting hours in the evening, the room was swarmed with Indian friends and colleagues, who had to be gently and repeatedly reminded by the nurse, that the visiting hours were over and they had better leave. The German patient sharing the room was quite surprised at this 'unnecessary' display of concern, by the relatives and the local Indian community. While his wife and son were very much in town, all he received were 'get well' cards from them and his colleagues. Only once, I saw his wife visit him but briefly. She brought a card, exchanged a few words, gave him a peck on both his cheek and went back. A German friend who had lived in India for over two decades, explained to me that generally the Germans still (and this may be outdated by now) had a very mechanistic 'weltanschauung' . Like the car, the body was also a machine. If your car rattled or huffed or puffed a bit, you handed it to a garage you trusted. No body hangs around the garage and wants to know the latest hourly 'health bulletin' of the car. When the car is back to normalcy and in the pink of health, then the garage itself will call you up, to come pick it up. Same goes for the human body. Once you have handed it over to specialists who know their job, one need not worry. Each society has found its own solutions, which may not work for others, but do work for them.

Soon, my wife will also be hospitalized for a knee replacement procedure. Judging by the numerous anxious telephone calls, offers of help and arrivals by flights (if not by bullock carts, of my childhood days), I am sure everything will turn out all right. After all, it's 'Mind' over 'Matter' that counts!