The surgical relative

Representation pic

Medicine is a profession where the patient is considered to be the centre of our universe. We design protocols, tailor surgical approaches, customise therapy, plan treatment, conduct reviews, perform audits, and get feedback to be able to improve our quality of care for our patients. We've learned how to do all of this. We know how to handle these aspects.

However, there is no formal training on how to deal with the relative, that individual who accompanies most patients. Relatives come as solitary figures of one or in contingents of up to five, and they can make the life of a doctor either effortless or exasperating. As it's that time of the year where we sit back and reminisce about the past 12 months, sometimes making lists, I decided to carry out a broad categorisation of the relatives I've encountered so far.

>> The Trustor: This kind usually has blind faith in a doctor. "We will do whatever you say," is something they keep repeating. They don't argue, they don't question; they keep nodding. They manifest the best result for their patient. "Don't worry, doctor, nothing will happen!" they say to bolster you if you show some concern about the difficulty of the case. They wish you good luck before you walk into surgery and they greet you with a broad smile when you come out to tell them how it went. This is the best kind of relative for a doctor to have. Unfortunately, they are also the rarest.

>> The Projector: They take it upon themselves to talk about the patient's complaints irrespective of whether the patient wants to. "Mr Patel, has surgery completely relieved your symptoms?" "Yes, doctor, my pain has completely gone and I am able to do everything very comfortably!" The relative: "Arre, but doctor, he had a headache two days ago. His hands have been shaking a little too." Looking at their patient, they continue, "Also ask him about that itch near your bum you were talking about!" Because they stay with the patient and don't want any grumbling or complaining to surface at home, they insist that everything be discussed in front of the doctor - and even invent a few symptoms along the way.

>> The Doubter: This is the kind that gets you to dig your palm deep into your eyes. "But what if you're not able to remove the tumour completely? What if the disc you fix comes out again? What if she doesn't get better after the operation? What if there is a complication? How many such surgeries have you done before? Will you have someone as a backup in case something goes wrong? What if there is an infection?" All valid questions to which answers must be
given - but the doubter asks them on loop after they have been copiously answered and re-answered.

>> The Fact-checker: "But last time you said the chance of any complication is one to two per cent, and this time you're saying it's about four to five per cent. But last time you said surgery will take about three to four hours; now you're saying it might take five to six hours. Last time you said we'd be discharged in a week. But today you're saying you'll keep him for only five days!" To this kind, you must either surrender or explain to them that the human body is not a constant. These are just numbers. They mean almost nothing. They are provided to give a rough idea about the way things might pan out. Nothing is absolute.

>> The Scroller: This is completely different from the Googler who has researched every aspect of the patient's illness and is prepared with a barrage of questions. The Googler is no more a category because it is almost every patient and relative. The scroller, on the contrary, is usually a teenager or young adult accompanying an elder family member. They can never stop scrolling on their phone and don't lift their head up during the entire consultation. "Tanya… Tanya… Tanya!" I called out thrice after I had taken a full history and examined her grandmom, trying to get her attention to explain what needed to be done further. It really is an addiction. I feel sad for them.

>> The Bargainer: This kind is exclusive to our country and probably even some places in the Middle East. This variety makes you believe that you are practising in a baniya shop instead of the holy grail of a hospital. They ask you what the surgery will cost, you quote an approximate amount, and pat comes a reply: "Can it not be a little less?" - usually with the nod of the head and a shake of a hand that indicates that money is a concern. With the magnanimity of your heart and the ability to prune things a little, depending on the case in front of you, you may be able to quote a slightly lower figure, only to hear, "That's all? I'm sure you can help a little extra!" - with the head doing an even more acute tilt. You can either smile with serenity or get frustrated because doing this transaction - this part of the conversation - is not your job. I prefer to smile.

>> The Freeloader: Once the patient has finished their consultation, things have wound up, and everyone is nearly out the door, the relative suddenly interjects with "Doctor, I'm also having some pain in the neck here, can you just quickly examine me there and write out some medicines I can take?" For this kind, I simply grin and do what is asked without grudging them or imagining that I work at a "buy one, get one" setup. One can even run into a slightly more extreme version of this kind at social gatherings, where they will smoothly lead you to a corner, get you to check them out, and even have you WhatsApp them a prescription over a drink. These too you deal with lovingly, as if this was your calling. After all, this is what we enjoy doing the most - taking care of people.

>> The Ass (not really a category, more of a one-of-a-kind specimen): "Doctor saab, after your operation on my wife, we have travelled the whole world in one year. I thank you greatly for such a miraculous recovery! Now that there are no more places left to see, we are repeating many of them!" said the husband after I finished a thorough check-up to note that everything was okay with his wife. They were directed to pay at the reception, which is usually the practice. He headed there and returned to my clinic while I was in the midst of seeing another patient. "You have increased your consultation charges by Rs 500 from last year?" he asked, with beady eyes. I held my head and gently rubbed my forehead. Sometimes, even the best of us have nothing left to say.

The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals.