The surgical relative

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 Wersquove learned how to do all of this We know how to handle these aspectsHowever 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 itrsquos 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 Irsquove encountered so fargtgt The Trustor This kind usually has blind faith in a doctor ldquoWe will do whatever you sayrdquo is something they keep repeating They donrsquot argue they donrsquot question they keep nodding They manifest the best result for their patient ldquoDonrsquot worry doctor nothing will happenrdquo 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 rarestgtgt The Projector They take it upon themselves to talk about the patientrsquos complaints irrespective of whether the patient wants to ldquoMr Patel has surgery completely relieved your symptomsrdquo ldquoYes doctor my pain has completely gone and I am able to do everything very comfortablyrdquo The relative ldquoArre but doctor he had a headache two days ago His hands have been shaking a little toordquo Looking at their patient they continue ldquoAlso ask him about that itch near your bum you were talking aboutrdquo Because they stay with the patient and donrsquot want any grumbling or complaining to surface at home they insist that everything be discussed in front of the doctormdashand even invent a few symptoms along the waygtgt The Doubter This is the kind that gets you to dig your palm deep into your eyes ldquoBut what if yoursquore not able to remove the tumour completely What if the disc you fix comes out again What if she doesnrsquot 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 infectionrdquo All valid questions to which answers must begivenmdashbut the doubter asks them on loop after they have been copiously answered and reansweredgtgt The Factchecker ldquoBut last time you said the chance of any complication is one to two per cent and this time yoursquore saying itrsquos about four to five per cent But last time you said surgery will take about three to four hours now yoursquore saying it might take five to six hours Last time you said wersquod be discharged in a week But today yoursquore saying yoursquoll keep him for only five daysrdquo 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 absolutegtgt The Scroller This is completely different from the Googler who has researched every aspect of the patientrsquos 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 donrsquot lift their head up during the entire consultation ldquoTanyahellip Tanyahellip Tanyardquo 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 themgtgt 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 ldquoCan it not be a little lessrdquomdashusually 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 ldquoThatrsquos all Irsquom sure you can help a little extrardquomdashwith the head doing an even more acute tilt You can either smile with serenity or get frustrated because doing this transactionmdashthis part of the conversationmdashis not your job I prefer to smilegtgt 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 ldquoDoctor Irsquom also having some pain in the neck here can you just quickly examine me there and write out some medicines I can takerdquo For this kind I simply grin and do what is asked without grudging them or imagining that I work at a ldquobuy one get onerdquo 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 mostmdashtaking care of peoplegtgt The Ass not really a category more of a oneofakind specimen ldquoDoctor 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 themrdquo said the husband after I finished a thorough checkup 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 ldquoYou have increased your consultation charges by Rs 500 from last yearrdquo he asked with beady eyes I held my head and gently rubbed my forehead Sometimes even the best of us have nothing left to sayThe writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals