The Importance of Being Honest

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.