MISUNDERSTANDINGS Mar01

MISUNDERSTANDINGS

As doctors we sit in OPDs and berate patients when they do not follow instructions. Very often we may miss the fact that our solutions are perfect in the ward and useless in the homes of patients An example of this is patients with varicose veins. This is commonly kept for final year MBBS exams. We learnt all the special tests, complications and management. One of the ways to manage varicose veins is compression stockings. As an intern I watched the postgraduates prescribe them and I was confident that I could do at least this during bond. My first case was enough to make me question myself. My patient was a farmer.  I wrote a prescription for stockings and his neighbour brought them from Chennai. The following week he was back again in the OPD with a varicose ulcer and no stockings. I felt that he had clearly not understood my mediocre Tamil. So, I called the nurse to explain. The third time he came the ulcer looked worse and still there was still no stocking. I was at my wits end. I finally asked with exasperation “Why can’t you do something as simple as wearing stockings?” His answer silenced me. He said “Madam, for you doctors stockings are simple. You will wear them and sit in your clinic. For us it is difficult. I live with my wife she and I are old it is difficult to pull on the stockings. Then we do daily work. Our job is to plant paddy and to take the cows to the lake. The stockings get wet and we cannot work. You tell me some treatment that I can do.” His ulcer eventually healed during Pongal when he was sitting instead of standing only to recur...