Why won't doctors write legibly?
Cassandra's Candid Corner
*A couple of weeks ago, Stabroek News carried a page 2 article about a doctor (actually the head of a renowned Medical Centre in Los Angles) who had organized a novel course to teach doctors to write legibly. I have always considered it to be the epitome of arrogance on the medico's part to shove some scribbled crabfoot into my hands, after I have paid over my hard-earned dollars. Because I paid my money, I have a right not only to be able to read the prescription but to know exactly what each item is for. In so many cases though, the patient - being in awe of the man/woman who has life in his/her hands - is not willing to question the doctor, not lastly for fear of this imperious person belittling the patient or, worse, doing something that might be inimical to the patient's interest. How dare one ask God what his cacography means. I remember once a young doctor on being asked by a quivering old lady what to do with a suppository, shouted that she should swallow it. When she demurred, he then understood that the poor woman probably never held such an object in her hand. That didn't stop him from screaming even louder (for all to hear) that she should shove it up the orifice where the sun don't shine. And believe me, that was not my most obnoxious experience of the God-men in action. But let's get back to these prescriptions. Not only are they often illegible, they are insufficient and even downright misleading. The most prescriptions that pharmacists encounter have the name of the medication, the quantity and how often one should take it. Well, the most common incompleteness is that often it is not defined whether it is a plain tablet or a coated tablet or a capsule that is being proposed. This would be important to a patient that has, say, stomach lesions. Then, comes the quantity. This too is of absolute importance. It is here that an illegible scrawl could lead to serious, even fatal, repercussions. But the most worserous deficiency deals with the directions pertaining to the use of the tablet/capsule/suspension. The pharmacists will tell you that the prescriptions usually have letters explaining how to use the medication e.g. bid, tid, qid, etc., which translates into twice, thrice or four times daily, respectively. Well, I submit that this is disastrously lacking in information and borders on misinformation. One capsule three times daily could be interpreted to mean five o'clock, six o'clock and seven o'clock. That is three times daily. What is meant, of course, is one capsule every 8 hours. Well, dammit, say so. Then how does one use the capsule? Orally? In one's rectum? Does one open the capsule and sprinkle the contents on the wound three times a day? Before meals, with meals, after meals? Why can't the prescription be more explicit? After all, the patient has paid his/her money for that correct information. In America alone, medication error accounts for more than 7000 deaths annually. If inadequately written prescriptions cause even a small fraction of deaths globally and in Guyana, then it is incumbent on the medical practitioner to write the prescription legibly, stating clearly all the data. That is not too much to ask of a professional who has my life in his/her hands. I was once told a joke (well, I hope it was a joke) that relates to the above. A doctor gave a woman, who did not want to have any more pregnancies, a tablet to take home. A few months later, the woman presented her pregnant self to the doctor. She explained that she swallowed the tablet the very day of her first visit, yet she was now with child. "You took it orally?" bellowed the doctor, "I wanted you to place the tablet between your knees and keep it there." Well, so much for faulty information for today. * The Park Hotel bun down! And with it I think I will lose part of my memories. How we used to line up on the promenade separating the two Main Streets just to watch the dignitaries walk across from the hotel to Government House and return slightly inebriated. The ladies with their stockings and lace gloves and thin, funny, inappropriate hats and high-heeled shoes-making them look taller than their husbands. Those were the 'elite' of our society. Some were even black - well, black on the outside but totally white on the inside. Even then, we resented their affluence and exhibited bombast; so it was not difficult to be swayed by B and J who spoke of tearing down these colonials and equating the social strata. We made jokes about their rouge and about the men's three-piece suits which had them most uncomfortable when the 4 o'clock (tea party time) sun stan'up. We tittered, we guffawed. But I think there was a lot of awe and even envy in those crowds. None of us ever thought that one day we could sip cold beer under the cupola of Park Hotel or go to a banquet there. Hell, I know that nothing lasts forever, but too many edifices associated with my past are being destroyed. The Empire Cinema, Queen's College, the Oxford and the Cambridge, and so on. Like Ian, I am confronted with my own mortality and the realisation that some of us are in the 'departure lounge.' Anyway, enough of this self-defeating morbidity. * One person that can always lift my spirits is the goodly Mr. Sharma, erstwhile doctor of mending refrigerators and at present a sit-down comedian sans pareil - the present day George Peetaitai. I have just begun a collection of 'Sharmaisms.' There is no programme that lifts my spirits like Justice for All does. C.N.'s questions and statements are inspiring. A few weeks ago, a beatupee (one who has been beaten up) was complaining how he was pistol-whipped, as he exposed the gash on his cranium. CN's incisive comment: "Yuh get hurt?" Later, he returned to the bus' head matter and asked the guest "weh yuh get hurt?" The man began again to exhibit the skull bruise. "No man, no man," CN admonised, "Ah mean, weh you get hurt? Was in de police station?" Ask CN, he'll confirm the above. In all seriousness though, something has got to be done about some of our TV talk shows. Some of the interviewers speak more than their guests, others badger their guests with the same question, trying to elicit the answer they want, and yet others pose such inane questions that it is clear that they do not understand the subject matter. Christopher Ram's Plain Talk is an exception. The subject matter is obviously well researched and the questions are poignant without being abrasive and embarrassing to the guest. I think that one can safely say that many of the talk show 'hosts' have not been well trained in this art, and therefore have no understanding of the responsibilities attached to such an undertaking. Would you believe that I set out to make some comments on the environment and perhaps to explain why I believe that the world is not aware of the possibilities of global escalation of the Zimbabwe 'model' posited in CCC of 23.4.00. Well, the column fill up and I dun. See you next week.
|