Spare me, my dear doctor!!
Ram Sahib was my neighbour in Bombay some 35 years ago. He was 60 years old, retired from the railway service and about 30 years my senior. He joined a private company to work as some kind of a consultant. After working for many years in the Railways in a very senior capacity, working for a private company was not very easy for him. He was a very upright personality and did not bother to feather his own nest while in service and therefore when he retired, he had hardly any savings other than the pension from the Govt., Provident fund etc. which amounted to little in those days. That is the reason he chose to work for the private company after his retirement.
One night Ram Sahib felt some uneasiness in the chest and he was taken to the hospital for a check up. After a series of tests the doctor told Ram Sahib’s wife that her husband must undergo a heart bypass operation immediately. The poor lady was all upset to hear this because her husband was hale and hearty until a few hours ago, and he had no past history of any illness.
When Ram Sahib heard the verdict of the doctor he said nothing doing, he did not want any operation performed on him. He and his wife had a long chat about it and consulted their son who was working in Calcutta. His son flew down from Calcutta and tried to persuade Ram Sahib for the operation. Ram Sahib would not budge and said he felt perfectly all right and wanted to be discharged from the hospital. Though the doctors said that he his arteries were in a very bad condition and could burst any moment Ram Sahib would not listen saying that it would be preferable to die suddenly than be a heart patient ever after and insisted on being discharged. Later he told me privately that he and his wife debated the issue and arrived at the decision against the operation because he could ill afford the hospital bills, though his son would not have had any difficulty to meet all the expenses. He said he had lived for 62 years and his children are all settled well in life and his wife could easily live a comfortable life for many years with his small savings and the pension she would receive until her death. This operation would break him financially and he would ever be dependent on his two sons. That was too much for him.
Later it proved that he had made the right decision because he lived a very active life for another 22 years without any health problem. At the age of 84 he complained of chest pain and during examination in the hospital he suffered a massive heart attack and died on the examination table itself!! That was one great man!!
Another friend of mine had a similar experience about 15 years ago. He had various problems like Hypertension, Diabetes, obesity, rheumatism etc. and on one of his routine check ups he was told by the heart specialist (after angiography examination) that he had a 95% blockage of the arteries and advised immediate heart bypass operation. In fact the doctor gave him not more than a month before he died, if he did not undergo the operation immediately! Like Ram Sahib he also opted against surgery. Now after 15 years (he is now 75) he is still living, with Hypertension, diabetes and all!!
Five years ago I felt some discomfort in the chest, during normal activities like walking or carrying weight etc. Immediately I went to my General Physician who told me that I had high blood pressure, probably caused by thickening of arteries etc. due to advancing age and a lot of other causes. He told me that I could consult a heart specialist for proper guidance. However, I told the GP that if I could avoid visiting the specialist I would prefer that. I told him that he could watch my situation for a couple of days or a week or so before I went to a specialist. The GP gave some medicines for the Hypertension and advised me to take Sorbitrate 10 mg tablets if I felt any pain or discomfort in the chest and keep in touch with him on a daily basis. Within a few days my Blood pressure was under control and the pain in the chest during normal activities also disappeared. The GP then told me that when I feel well I should take a Treadmill test also and then decide on further course of action.
However on the insistence of my close relatives I agreed to be taken to a heart specialist who asked me to take all the tests including the Treadmill test. Though I was not at all willing to take the TMT, my sisters and Brothers-in-law advised me to take all the tests and after getting expert opinion I could decide. I told them that I knew exactly what the specialist would say and that is the reason why I do not want to submit myself to all the tests! I was not in a fit condition but on their insistence I agreed for the TMT. After the test the specialist told me that I should undergo angio-graph test before a decision could be taken. I refused to take any such test and went back to my GP, who told me that since the specialist has advised angio-graph I must go for that. I refused to do so and told him that he can give me medication for my condition and see later if any other tests or treatment was necessary.
I have been taking medication to keep BP under control and regular exercise by way of about 40 minutes of walking for the past 5 years. I also do breathing exercise and now the dosage of medicine for high BP has also been reduced. I have not had any chest pain after that first time more than five years ago, and I think it was a good decision not to go for any invasive tests. If I were 20 years younger probably I would have gone for the angio-graph and the works but at 67 I feel a kind of peace when faced with death. I have a fairly comfortable life and do not wish to experience greater and greater joys of life anymore.
These days, specialists are subjecting patients to a series of expensive tests for any kind of illness. They say such tests are required to make sure that the treatment prescribed is correct. But the general feeling among the public is that these tests are prescribed either to make use of the machines and instruments already installed or for kick backs from the labs where the doctor advise you to go! Dear doctor I say it is immoral to subject a sick person to such expensive treatments without sufficient justification.
