Last month, there was an incident in the hospital I work in. A young girl, not more than 5 years old, accompanied by her parents came to our hospital with an apparent injury to her eye. There was obvious internal bleeding localised to a section of her eye, suggestive of an incident of trauma, though her parents denied any injurious event. As an anaesthetist, my role was to elicit any significant history from the local guardians and inform them of the anaesthesia I would be providing as the child was not likely to sit still during the procedure.

While asking her parents the routine questions, I was getting the usual 'nothing wrong' answer from her parents and was pretty much just ticking boxes on the form. When I asked them if their child had been admitted previously in any hospital for any other illness, the parents promptly said no and I looked down to tick the relevant box out of habit. As I looked up, I noticed the child looking at her parents and pointing towards her knee. The parents motioned for her to keep quiet. 9 out of 10 times, I would not have even looked up from the sheet I was filling. 99 out of a 100 times, it would have probably not even registered on my radar. But this time, it did. And doing so saved us all - the parents, the child and the hospital - from a catastrophe.

Having noted the child's action and their reaction, I stuck with the question. After two denials, they made a casual reference of how she occasionally used to go to the hospital in the past because she's clumsy and falls down, hurting her leg. A little more persuasion finally revealed what they were trying to hide for so long - that when she falls and scrapes her knees, the bleeding tends NOT TO STOP. She needs hospital admissions and a 'few bottles of blood' - nothing significant, her parents assured me. A quick blood test confirmed my worst fears - the girl suffered from a severe form of a bleeding disorder. Once the bleeding starts, it would require huge blood transfusions and other blood products to control and stop it.

The hospital, set in what still constitutes rural India, was not equipped to deal with such cases and didn't have the blood products necessary to handle the case. The girl needed specialised care in a tertiary hospital with state of the art facilities. Had we pricked the eye without knowing this history, there would have been no way to control the bleeding. You would probably have seen us in newspapers as 'the doctors who killed a girl without knowing her illness.' A simple observation saved her.

The gratitude ? Well, the parents were truly angry and enraged that we asked them to go to a tertiary hospital as it would disrupt their plans for a cousins wedding due the following week. Trying to explain to them that we neither had the facilities nor adequate blood products to control the bleeding once it began fell on deaf ears. The fact that they deliberately hid their child's illness and nearly killed her was irrelevant, for some reason. Our inconveniencing their family wedding plans over 'such a minor thing' was the foremost issue on their mind.

We did follow up on the child though from our side. She eventually reached a tertiary hospital 'a few days later' and the surgeon there informed us of how the surgery was eventually done after providing a huge amount of blood products pre-operatively to prevent the bleeding. There too, the parents had chosen not to reveal the child's illness and the anaesthetist had found out only because we had noted it in our letter to him. Had we gone ahead with the surgery that day, the child would have bled to death inside the theatre and the parents would have no qualms about getting people to come over and beat us all to a pulp besides smashing the hospital to the ground. At the age of 5 years, they were already tired of the illness their child had. The burden she bears as she grows up... I would rather not speculate. 

If a doctor asks you about your medical history, please don't actively choose to lie to us. Depending on your mindset, it may seem irrelevant to you or you may fear that we are out to make a quick buck with 'routine tests'. The truth is for every seven out of ten tests which come out normal, three show a significant finding which has an effect on your treatment. 
I know visiting a doctor is no joyride. We can be an annoying bunch at the best of times. But we are trying our best. We are doing our best to save lives. Help us by just being honest with us.

Author's note :
The above article was featured in Tamarind Rice's inaugural issue, where I will be hosting my own column "An appletini a day...". The inaugural issue includes articles by author Yashodhra Lal, children rights activist and cine-star Amole Gupte alongside many familiar bloggers including Lavanya Mohan, Dr Rohan Mathew, Saumya Kulshreshtha and Vyshnavi SV. You can read the inaugural issue directly online from here itself or choose to subscribe here and get monthly issues in your email directly.


Rohit said…
Well said ! Quite a few medical catastrophes could be avoided if only the patients give us a proper medical history !
Illeen said…
I understand the feeling. Patients at times don't understand their own responsibilities.

And congrats on the features and publications.. great going Roshan :)
Wow! I wonder what would have been the parents mentality, if it was a boy they had instead of the girl?
Rohan said…
I have seen such people in the clinic. We have to ask them repeatedly to know the history. . They seem to know the treatment plan but fail to give the right history. As you said if anything goes wrong due to lack of a proper history it is the doctor's fault.
And thanks for the mention. . :)
Nisha said…
Hmm.. Being a victim of this problem of 'not revealing to the world' .. I don't know what to say. It creates a terrible dent in the child's mind and you can see the type of issues we face as grown ups.
Having said that.. I think parents try to do their best with their limited knowledge. Lying to a doctor is not the best thing to do though. I'm surprised this particular family went to thatt extent.
Deepa said…
Thank you for highlighting the issue Roshan. I have always believed that lying to anybody else can be corrected (not good, but still can be fixed) except doctors. After all, everything to do with your body - who knows what else downstream can happen, and all for what? It's just not worth it! Doctors are the one species who should never be lied to!
Am seeing quite a few cases recently... its scary because some of the history omitted ( as in this case ) are literally fatal. We could have been massacred had we taken it in and the patient died.
Thanks Illeen.. I really just wish the parents would be more responsible.
I'd rather not think of what happens in the future to her... but going by what I saw, it is not a good fate awaiting her.
In this case, if we had not unearthed that history, I can assure you we would have all landed in the morning papers... and not in the good sense either.
At times, it really is a thankless job.
Many times parents do try their best based on their beliefs and it may work out well.. but even the things done with the best of intentions can be harmful sometimes.
Even after we explained to this family the gravity of the situation, they still chose to hide it from the next doctor... that was scary to me.
if only we could get the rest of the people to think that.. so many cases have come up recently where the patient intentionally chooses to avoid giving valuable information till its nearly too late.

There is a certain amount of faith required which is badly missing in the present doctor-patient scenario.
I read this on Tamarind Rice already.

You are right about this. Always be honest to your doctor and the lawyer, is what I've heard. And I dont know what can be achieved by lying about one's health :-/
Ankita Ghosh said…
My goodness!!!

This article not only talks about not ignoring the little things, but also raises a very serious concern about parenting, about responsibilities, attitude and mentality - about whether the biologically grown ups are also actually matured enough to rear a tender young soul!
Meety said…
What kind of parents would hide such a serious problem from doctors??? Its appalling.. and nice to know you have another feather your cap... I wonder if there's enough space for all of them (including the upcoming one's).. Why don't you just restructure it?? ;-)
Aathira Nair said…
I am surprised that the parents did not think excessive bleeding as a major issue, but just a minor gripe. Sad state of matters.
Kshipra said…
Hello Roshan Sir,
Thankyou for sharing this anecdote with us. I guess as a doctor, you do save a lot of lives by just being earnest, considerate and sincere towards your patients.
It is sad that even though parents are supposed to be extra considerate about their child's needs, they prefer to shy away from their responsibility even if it means facing extra hardships in this case.
And congratulations on getting published again. :)
Saru Singhal said…
I somehow don't blame the parents completely. I have seen cases where a female had surgery for kidney stones and the news spread like wildfire and parents had problems marrying her. When people hear that your child is sick, they multiply the gravity to such an extent that others think she is terminally ill. Lack of education, pressure from society are the reasons why we behave like this. Yes, they shouldn't lie to doctors.
Their main aim was to get the surgery done somehow or the other and get discharged before the wedding...
unfortunately theres no way to license that, is there.. whether a parent is 'a fit caretaker' is a whole other debate. Believe me, if I narrated stories which I've seen with my own two eyes... sigh.
You'd be surprised- lots of parents do hide it. They weigh the risks for themselves ( in this case, a delay in operation vs chicken biryani at a family wedding... tough choice as you can see ). Truth be told, that kid saved herself more than anyone else by choosing to point at her knee.
As for the colourful feathers for my cap, well - I'm going to GulfGate and gonna get them stitched onto my head - that way I can show off 24/7
sad state.. but then they honestly seemed least interested in the kids welfare. And i hate to say it, but this isnt the first time I'm coming across patients like this.
Thanks Kshipra... its one thing to become a father/mother... its quite another to be a responsible parent, I'm afraid.
Shocking really...especially because kidney stones does not imply anything for the value of a person... its equal to say a tonsillectomy or appendicectomy.

Lack of awareness is the key here... and I dont see things getting better anytime soon.
jaish_vats said…
Very true Roshan. There is a saying that one should never lie to doctors and lawyers!
Rachna said…
Why would parents do that? So ridiculous really.
Superb article. Hit the nail right on the head. It really is a thankless job. People don't realise that most of us are actually trying our level best to save the patients all the time. And the few times we might not be able to, the blame also lies with those people who chose to give us a false history. But, the mindset is so radical among people nowadays that they expect us to be God and find illnesses all by ourselves and when sometimes we do not, because of false information given by these people themselves, they really don't hesitate in screwing the hell out of us. Double edged sword. And btw, well done sir. Your keen observation saved her life, your career perhaps and the entire hospital. Very Inspirational.
Alka Gurha said…
That is very stupid on the parents part. They should be thankful that you had the patience to find the truth and act accordingly. Congrats for your column doc.
Anonymous said…
It is like a car slamming into a pedestrian. It is always the car driver at fault. It doesn't matter if the pedestrian was dancing in the middle of the road.
I wish people come out of their preconceived notions.
Silly question, but is there no social services agency you can report these less than qualified parents to? Perhaps the child shouldn't be in the care of such folks.
if only people remembered that.. especially as a doctor, I can assure you lying can literally be fatal.
They just wanted the operation done and discharged so they could attend their family event. Believe me, every doc has seen patients like this. Its sadly not a 'once in a blue moon' event.
They have the knowledge to get local people to come around and threaten should something go wrong... at that time noone will be bothered to listen to whether they tell a lie or not.
Definitely agree - the implications of what would have happened had I not persisted are pretty bad.
Forget gratitude, they were pretty pissed at me for 'my act'. Sadly, this is another part of life as a doc.
true.. it is pretty much the same thing. When will the country ever learn what is right and what is wrong, i dont know
Anand, this doesnt even come close to qualifying for social service, if there is any. The very fact that she has parents is considered enough - the system is very different in India. Cruelty, neglect.. none of these matter. Besides, they can always say they did take her to the hospital, right ?

Whether she should be in the care of such parents is out of our hand..
Chithira Menon said…
It's quite sad that the parents fail to recognize the gravity of the situation. And it's quite good that you looked up, at the correct time.. :)
Jyoti Mishra said…
your post reminded me of famous line of Dr Gregory House- Everybody lies..I don't ask why patients lie, I just assume they all do :P

Well I never really understood the fact that why people lie specially in situations like this.. thanks to your alertness otherwise things would have gone so ugly n sad.
pure fluke.. trust me on that.
House couldnt have said it better... his 'patient observations' may seem rude but more often than not, they are bang on target. ask any doc :)

Invisible said…
good work :)
Thanks.. cool name.
Gymnast said…
This sounds like an episode out of grey's anatomy ? Wonder which character you would be !!
Binu Thomas said…
They say, never lie to Doctors and Lawyers! How true!