My initial title of the post was-“Journey so far..”We use the metaphor journey for life, as if life is a linear route on which the subject (ME) is travelling through events and experiences. If that was the case, on looking back, the closest events would be most visible (which is mostly true). The further an event in the past, less visible it should be (which is perhaps not true). 

I feel as if I AM HERE always, at the same spot. Events, interactions happen, adding experiences. Each of those experiences changing the ME, slight indiscernible changes not apparent immediately. They have taken time to get rooted within me, I clearly becoming a different ME from what I was some years back.

When I think something, it’s through all of those acquired experiences; when I make decisions, it’s all those experiences talking to me, telling me my story. Some of those experiences my conscious brain is aware of, many incognito. So the story of ME I am capable of telling is far from a complete truth, its only my conscious memory (known for its deceptiveness anyways) put together.

I was considered a good student, because all I knew and was trained to think was to trust authorities, my teachers and the books and let them educate me. My books didn’t betray my trust and I learnt well. I entered Medical school and the curriculum each year became more complex, teaching more subjective, which I was never trained to doubt. The training took a completely different form when I joined MD in Medicine. We were now in wards, dealing with sick patients in Government Medical Schools. The mentors were seniors and teachers, the gap between books and practical learning kept on increasing. What was completely missing from that training was dealing with patients. The messages conveyed some said and some unsaid were to be logical, rational; to not get too involved or affected by patients. How else would one deal with mortally sick patients in a resource constrained Government medical college. The fancy terms like empathy and compassion were unheard of in all my years of MD training.

Soon enough I was at the receiving end of this cold, rational treatment. Some long dark nights of feeling like drowning in water, struggling to grasp some words of compassion to pull me to surface, changed me. I didn’t know then, but I now know it did. I also realised that medical science was so full of uncertainties, and there is so much we still do not know..

I joined DM Endocrinology fun Endocrinology at SGPGI, Lucknow, the few most defining years of my life. Our first briefing at HOD’s office became my mantra of prioritising work. He said, he would assess us during our three years of doctorate in the following order of priority- First is patient care, there can be no excuse for that, then comes our academic performance and third our research activity. Even a day prior to our exams, we were supposed to take a thorough round of ward patients.

The standards set for our thesis work was also very high, the hormone assay results have to have less than 5% CV for all patients, otherwise the whole batch of results would be nullified. I ended up getting insulin tests thrice for my 100 PCOS patients because each time two reports would be little off the mark. This result taught me lessons which I understood much later.

However, as a student I was naive and we were acquiring so much knowledge in these years, that sitting in a high-backed chair in front of a patient sitting across the table, arrogance creeped in easily. I would dictate treatments because of course I know more! The attitude was”How can the patient who doesn’t understand anything refuse insulin?”

Now I am 10 years wiser to know how little I know and understand. A human mind clouded my biases, handicapped my limited sensory perception and a trickster brain, can see only a part of whole truth. What is the way to know the truth? Scientists have carefully developed methods to keep our biases at bay and reach as close to truth as possible.

I met my HOD few years back at a conference, where I proudly presented to him my diabetes patients’ data. I compared the glucose control of the patients when they first met me and after 3 and 6 months of followup. The results showed that the control was significantly better on their follow up visits. I wanted to publish this data, maybe spread across social media-a very ego satisfying data. My HOD commented- there is a clear bias here. The patients are in my clinic in a big hospital itself suggests that they have come with the “intention” of improving their glucose control. So how would we know that the glucose control improved because they took better care of themselves or because there was anything special in my care? Well I would never know, because I didn’t have a check for this bias in my data.

But now I ask my patients, what brings you here? When I am talking to them I want to share with them what I do know about the treatment and what is not known. Most patients who visit me have chronic diseases with no cure, like diabetes. What we do best is risk management, and sharing facts and data help them understand about their disease and treatment better.

I can put this cumulative experience in a nutshell as “Healing is not just prescribing medications. Listening attentively & empathetically is the first step towards healing. Communicating science in an easy to understand language is the next step to involve patients in their own care.”

To put my experience into practise, I have started a new clinic of mine-DOOR TO CARE. It literally stand for an acronym of the diseases I care for and take care of…D for diabetes, O for obesity, O for osteoporosis, R for reproductive disorders, T for thyroid disorders, and the last O is for Other endocrine disorders.

Metaphorically “door to care” opens up a new dimension in space and time needed for these meaningful conversations.

Knock our door: 138, first floor, Vipul trade centre, Sector 48, Sohna Road, Gurgaon. Call: 9999037144, 9810575167. Email: doortocare@gmail.com.