I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Sunday, December 22, 2013

What Money Cannot Buy

Affluence sometimes serves as a double edged sword, getting you and your loved one access to high quality medical care in 5-starred hospitals, but at times buying you heaps of misery and suffering as well.

Mr Gupta’s 40 year old son, who looks after the family’s thriving businessis unable to come to terms that his father cannot be saved despite any amount that he is ready to spend.

Mr VK Gupta (name changed), 87 had ben diagnosed with liver cirrhosis and has been ailing since then with weakness and swelling of his feet and abdomen. Last month he had slipped into liver coma and respiartory failure. The affluent business family, wanting the best treatment for their father, had air-lifted him to a very modern ICU in a posh tertiary care hospital in the capital for care.

My encounter with the family was during ICU rounds. While an excellent team of doctors took as good care of him at par with the best hospitals of the world, he continued to sink. They monitored his his blood counts, creatinine, electrolytes, albumin, ventilator pararmeters, urine output, pro-calcitonin levels, SOFA scores and so on but he reamined ventilator dependent and unresponsive. An equally excellent team of young nurses performed 290 nursing tasks every day for him – from cleaning his back and airways, checking his IV lines and catheters, ensuring the right kind and amount of tube feed went into his body, provided eye and mouth toilet and an endless list of things that kept him technically alive with his heart still beating although hooked on to machines and tubes. It had cost the family Rs 50,000 every day for a month, but they were prepared to go on as long as required.

During my daily ritual of counseling I learnt that they had spent around Rs 20 lac already.  What was frustration to the family however was that the money was not getting their father anywhere near cure. They were prepared to spend another Rs 50 lac for a liver transplant if only the doctors would try!

They found it difficult to accept that their father was too old to undergo a major surgery at 87, and that how, for the 1st time in this condition was too frail to even give it a try. For the 1st time in their lives, they were confronted with a situation where money in any amount seemed to prove inadequate to solve their problem.

Mr Gupta had started his business 50 years ago that had brought him and the family to prosperity. The thought that they could shying away from any expense his treatment required, filled them with guilt.

While the old man’s soul seemed locked for weeks in an old, frail, diseased body, perhaps aspiring for release, the family’s wealth ensured that his pain was indefinitely prolonged.

I thought of all the poor villagers around Mohanlalganj who came to government hospitals, had much less means but more clarity of thinking to accept the inevitable.

As published in HT City ( Hindustan Times) dated 5th August, 2012.

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