In the world of medicine there are broadly two types of people, the care giver and the cared for. For those of us who are care givers, being humans we occasionally are forced to do a role shift and be among the cared for. We have to submit to our medical colleagues and allow them to take control of our lives. For me, this occasional switch in identity has given me the opportunity to view medical science from both perspectives and this is often very revealing. On those days I try to take an outsider view and I watch as doctors and nurses go about their work controlling our lives when we are most vulnerable. The revelations in those moments are often troubling.
One such day was this weekend when my wife had a mild inflammation of the right lower eyelid. To me it seemed that it could be a developing stye. Not willing to take the risk of a misdiagnosis for an eye condition we went to see the ophthalmologist at a nearby clinic. Standing in the long queue for patient registration, I look around and see that the waiting and hoping crowd isn't really smaller on a Sunday morning. We move to the next floor where a short walk from the elevator is the waiting area for the ophthalmologist's patients. As we settled into our not so comfortable seats, we realized that we were surrounded by numerous cases of what looked to me as the seasonal conjunctivitis and of course other unpleasant looking eye diseases. We wait our turn trying not to touch any surfaces in case we go back home with the virus. After about 40 minutes, the nurse informs us we are next in line and that we can move into the short corridor from where the door to the doctor's room is visible. Another few minutes and she signals us to enter the room. As we open the door, we see that he is only finishing up with the last patient. Or this is what we gathered on seeing the boy's mother rising up from her seat while the doctor has his gloved hand on the eyelids. Embarrassed that the doctor may have found us intrusive, we quickly shut the door and wait. Soon the boy and his mother walk out and we slip in as quickly. My wife seats herself on the examination chair. And I sit across the table with ears wide open hoping to hear that this is nothing but a simple stye and would require nothing more than a few days of medication and hot fomentation. The gloved hands make a thorough examination of her eyelids and convinced of the diagnosis the doctor starts his explanation of the condition and the simple treatment measures for the stye. Happily we walk out of the room satisfied and then onto the street. As I enter my car, it suddenly dawned upon me that this doctor had not changed his gloves before examining my wife. It was hardly ten seconds between his gloves on the other patient and then on my wife’s. Recalling memories from clinical practice days, I thought to myself that this doctor like so many other doctors would not change their gloves nor even wash their hands between patients. The results are alarming as is evidenced from the thousands of cases of hospital acquired infections reported every year. These infections are often deadly with many such avoidable deaths routinely occurring in hospitals around the world. I do not for a moment believe that this is because they want to deliberately transmit disease. Instead I think it is because they have all the weakness of being human. They can be lazy, forgetful arrogant and everything else that humans can be. And I am not trying to justify this but I am trying to think from the other end, the patients, the victims of this humanity. But this is what patients don’t expect their doctors to be, they do not expect their doctors to be affected by human weaknesses. Thus in their world of make belief, patients are blind to the real problem of what we have nicely termed ‘iatrogenic’ infections. Much effort has gone into hospital campaigns to make physicians wash their hands when they have to but unfortunately the problem persists. As a result, patients continue to wait in the registration queues for care not knowing that once past the queue they may actually be the unlucky ones to catch a disease courtesy of the doctor, the one gloved ophthalmologist
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