Doctor, doctor give me the news...

30 Jun 2013

Most of those who read this blog know that I started my professional life running hospitals. Consequently I have a professional curiosity about how different health care delivery systems work. As I have travelled to various places I have observed how doctors run their practices, how pharmacies work, and especially hospitals: Are they clean? Are they well organized? Do they have modern equipment?

Well, this week I have had an up close and personal tour of India’s healthcare system.

Wednesday night, I started to have abdominal discomfort. Not to be too graphic, but I thought I was constipated, which didn’t make any sense to me. If Grandma Whyte had asked, as she is want to do, I would have told her my bowels were fine. Anyway, as I started my day on Thursday, the discomfort was still there despite my morning constitutional. While I was talking with Rae that morning, all of sudden my general discomfort turned into sharp, acute pain over my left kidney. I’m not a doctor, but I did stay at a Holiday Inn Express, so I self-diagnosed kidney stones. Been there, done that. I knew that if it was a small enough stone, all I had to do was drink lots of water and wait for it to pass. If it was too big? Well that would lead to different problems.

When I made it to work, it must have been apparent I was hurting because everyone I met within the first hour asked me what was wrong. It turns out the husband of our Dean is a pharmaceutical rep and the father of our Placement Manger is a doctor. Within another hour I had medicine and three referrals for physicians I could/should go see. Within another 20 minutes I had a nice little buzz but markedly less pain. I tried to work but I really couldn’t focus, so I decided I would work from home the rest of the day. I could drink and, hum, “process” what I drank at will. While I was going home I got a call from Charu, our CEO. She told me I had an appointment with her family physician at 3:00. I had been able to divert everyone else who tried to get me to a doctor but somehow I couldn’t dissuade Charu so I agreed to keep the appointment.

I went to a nearby Apollo Hospital (one of hospitals in a pan-India, multi-hospital system with a great reputation) and began my entry into the Indian healthcare system. The lobby and the waiting room for the physicians looked like train stations during rush hour. In India people rarely go to the doctor or hospital alone. Or with one person. It is more common that it is a family affair so whole crowds of people are there just for moral support. That doesn’t change how quickly one gets into the doctor, but it certainly adds to the congestion. Considering I was being worked into what appeared to be a pretty busy schedule, I waited less than an hour to be seen by Dr. Sikkah (pronounce like, Oh, you’re sick. ah? A good name of a physician but the beauty was probably lost on most patients). Dr. Sikkah did not seem too impressed with my self-diagnosis, and since he probably wouldn’t have gotten the reference I didn’t bother telling him I had stayed in a Holiday Inn Express. He gave me a brief physical exam, asked about my health history, and then said he wanted me to get blood tests, urinalysis, and a CT scan. He would get the results and call me the next day.

If I had to wait an hour to get into Dr. Sikkah, the wait for lab work and the CT scan was miniscule. Again considering that I was a drop in for both, the service was very prompt, efficient, and pain free including the blood draw. I was quite impressed. The only negative, in fact, had to do with the gown they had me change into for the CT scan. I am bigger than the average Indian. The scrub bottoms fit, sort of, but there was no need to worry about tying them because the fit at the waist we just snug. In length they came to about mid-calf. I was pleased to see the top was tight in the shoulders but loose in the waist. I would have been crushed if it had been the other way around.

So all things considered, I was in and out for unscheduled appointments in less than three hours. Now for the fun part: what did all of this cost, you might ask. The total bill - doctor’s visit, comprehensive blood profile, urinalysis, CT scan – less than $300 out the door. That’s total, not my co-pay. For a premier physician and a premier hospital. Pretty tidy I think. Oh, I did have three prescriptions to get filled. Again total cost, not co-pay, less than $5.

Now all was left for me to do was drink like crazy, pee like crazy, take my medicine and wait for the call on Friday. Which didn’t come. Some aspects of healthcare systems seem to be universal. One such aspect is that overworked physicians don’t always call when they say they will. Anyway, I wasn’t particularly concerned because I knew what he was going to say; I knew what the diagnosis and treatment were going to be.

Saturday we had a priesthood leadership training conducted by the District Presidency, followed by lunch. We were in the middle of lunch when I got a call from Dr. Sikkah. He said, “I have your results and things are more complicated than we thought. I have arranged for an urologist to see you this afternoon. How quickly can you be here?” I told him about an hour and a half and he said fine, he would arrange it.

Now my mind is racing. I have to say there are times the distance between India and Portland seems greater than at other times. As I finished the call from Dr. Sikkah, Oregon seemed very far away and although I was in a crowded room I seemed very alone. After lunch we were headed back to the Branch. President Jurial and Brother Arjun rode their motorcycles to the Branch and then we had ridden together to the meeting in my car. On the way back, I asked if they would give me a blessing and then explained the situation. After the blessing I felt more at peace.

If anything, my interaction with Dr. Taneja (the urologist) was more impressive than the first doctor’s appointment. It’s Saturday afternoon; again no appointment; I waited less than 15 minutes. After asking me a few questions (Dr. Taneja was no more impressed with my self-diagnosis skills than Dr. Sikkah had been) and a brief physical examination, he turned to the results of the CT scan. After looking at the scans he told me I have multiple stones and a cyst in my left kidney. The cyst is benign and most of the stones are also not an issue. The trouble maker is the one I’ve been dealing with that is now in the urethra. He then said, I understand you are planning to go back to the US soon. I told him I was leaving Thursday night. He said, not if you don’t pass the stone that’s moved to your urethra. I can’t allow you to fly in that condition. I thought, yeah, like you’re going to stop me. Then, it occurred to me: what would I do if I was in the middle of a 15 hour flight and had an attack?

So at this point, I have a follow up ultrasound scheduled on Tuesday and appointment with Dr. Taneja on Wednesday. In the mean time, I continue to do everything I can to be able to get on that plane Thursday night: taking all my medication, drinking like crazy, and following the biological imperative that follows drinking that much. I am also gladly accepting any and all prayers from others. In that regard, Mehndi told me yesterday as he picked me up at the hospital, “I pray to my God that Mr. Phil gets immediately well.” When he said that, I didn’t feel so alone.

Namaste.