Have you heard of “Kitchen Nightmares”, the show hosted by the infamous, foul-mouthed Gordon Ramsey? I watched some of it the other day, thanks to my obnoxious roommate who had inadvertedly tempted me away from my studies by blasting the show from his phone at full volume. I mean, Gordon Ramsey cursing away at the top of his lungs isn’t exactly going to help you concentrate in studying, would it now?
Anyway, I made an observation while watching it. So, most of the time, these restaurants that were failing had one thing in common: their refusal to change.
Take the infamous Amy’s Baking Company which was featured in the aforementioned show, for example. Not only was the husband, the manager, a thieving and self-centered bastard of a man, but Amy, the chef, was also always in constant denial about the condition of her food. No matter what Gordon Ramsey said about her food, she would refuse to listen and either ignore him completely or interrupt him to adamantly defend her cooking. This prompted the devilishly stubborn Chef Gordon to do something he has never done before: walk away.
I feel in one way or another, the medical world is the same. I have heard of many horror stories about patients who were mistreated in hospitals and doctors who abuse their privilege. One such story that stuck in my mind was the story of a doctor who, in order to satisfy his ego and prove his superiority, purposely gave wrong diagnoses and even subjected the patient to unnecessary procedures.
It all started when my senior, a medical student in his medicine posting, was monitoring this one patient who was a lady in her fifties. She complained of pain in the epigastric region and it was initially suspected to be peptic ulcer, gastric carcinoma, or something of that sort. But, the pain was mild and didn’t worsen after the woman was hospitalized for some weeks. The drugs that were given had little or no effect and the condition seemed to be non-life threatening.
So, he confronted the house officer in charge about his observation and suggested that it could have been a parasitic infection instead. The house officer was unresponsive and didn’t take further action, so he decided to do further observation and find more concrete proof to support his statement. While he was observing the patient one day, a doctor came up to him and in a rude manner, asked him what he wanted. My senior, who was quite knowledgeable in these things, told the doctor what he suspected and faced a dead end.
“So, is there an increase in the antibody count in the blood?” The doctor asked, irritably.
“No,” he replied.
“Then, it’s not a parasitic infection. What’s more to know?”
My senior, reading the atmosphere and the doctor’s tone, knew the doctor was out to get him and decided to keep mum. It should be noted that there are some cases of parasitic infection where the antibody count don’t increase. “Where’s your tie,” the doctor asked.
My senior tried explaining that he wasn’t used to wearing a tie in his last posting and attempted to appease the doctor by saying he would wear it the next time. But, alas, he only got scolded and had to go back to get the tie.
The patient was subjected to laparoscopy and endoscopy, only to come up with nothing. More infuriatingly, the doctor later added new diagnoses that didn’t make sense, i.e. liver abscess and even herpes. Imagine the look in the patient’s eyes as the doctor asks her whether she has had risky sexual behaviour. She’s a lady in her fifties, with two children, for goodness sake!
In the end, the problem wasn’t resolved as the doctor refused to consider my senior’s suggestion and the patient was released with only some painkillers.
In my opinion, the egoistic doctor who refused to accept other people’s opinion was like Amy from Kitchen Nightmares, unable to put down their pride. And who can blame them? Doctors have been revered since the 1900s and they are used to it. Surely, no snot-nosed brat can walk into their hospital and tell them what to do, right?
Well, that’s the problem. Many doctors prescribe antibiotics left and right like it’s nobody’s business, and when asked about it, refuse to answer. Prescribing vancomysin for a common flu is too much, don’t you think? And yet, many of them do it, and proudly.
Medicine and the culinary arts are not rigid, unlike what most people think. There’s no such thing as an unchangeable procedure or a definite diagnosis. If anything else, procedures serve only to guide the doctor, not determine all that he or she does.
Great chefs do not achieve what they achieved by memorizing cook books, but rather understanding what each and every one of the ingredients contribute to the dish. Cinnamon and black pepper isn’t strewn on the meat for no purpose, and the same goes for antimicrobial drugs like carbapenems and macrolides.
You don’t just memorize the medical knowledge, word for word, but rather understand the mechanisms. Knowing the pathophysiology of malaria is going to help you understand and remember the symptoms and treatments for malaria. Understanding the mechanisms of beta-lactams and beta-lactamase is going to help you remember its uses and functions.
I am a firm believer in the flexible mind, even in doctors and those in the medical profession. Are you?