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Doctors ! Are you here to save or ruin life?

By Tilak S.Fernando in London

“Dear Doctors! Are you here to save or ruin life” ? That is the vital question raised by a Sri Lankan in London, who has had to go through ‘hell’ in the hands of some of the medical men and women attached to the National Health Service in the UK. Mr. X (who wishes to remain anonymous) is in the process of filing a law suite against a GP- Practice and two prominent hospitals in London on the grounds of negligence, incompetence and inefficiency.

In any society doctors stand out as the crème of the elite, and at times regarded as ‘God in human form’ who give life back to ailing patients. A patient goes to a doctor with implicit faith in this so-called curators but what happens if such a ‘godly man or woman’ fails to diagnose the patient’s illness correctly and instead becomes adamant, dictatorial and shows a Nelsonian eye to the beseeches of patient’s and/or his family and brushes a side a request to refer the patient to a specialist for a second opinion? Then the medical man becomes a liability to his dignified profession, breaks the sacred code of medical ethics and above all lets this noble profession stink to high heaven and disrepute. In England by Law, a GP has to refer his patient to a specialist after four consecutive visits to the surgery on the same illness and complaints.

Mr. X visited his lady GP (General Medical Practitioner) complaining of a severe headache with associated neck and shoulder pains. He had been quite a healthy person and had not visited a doctor’s surgery for the past fifteen years immediately prior to this sudden bout of illness. During his first consultation the GP diagnosed wrongly (which was proven quite late) his headaches as being stress related. He was given medication to combat severe migraine and drugs to overcome excessive acidity in his stomach. With regard to the shoulder and neck pains the GP was convinced that it was nothing but due to Osteo-arthrities, yet the patient continued to deteriorate suffering from continuous and severe head and shoulder pains.

When Mr. X started to make frequent visits to the doctor’s surgery a blood test was done, but as far as the medication was concerned it continued with changing from one kind to another aiming all the while at migraine and acidity. When the pain became quite unbearable and constant and Mr. X could not move out of his bed, Mrs. X telephoned the GP several times to be advised that it was a clear cut case of Osteo-arthritis on his neck area which was age related, and had no cure for it, and in the case of head aches it was nothing but migraine.

By now, Mr. X had visited more than four times the doctor’s surgery but to no avail. After the 5th week the patient started vomiting in addition to the headaches, which caused alarm to summon an emergency doctor in the night. Going by the GP’s notes even the emergency doctor treated him for migraine and acidity, and Mrs. X was advised that the vomiting was a side effect of a strong drug that had been prescribed; he changed the drugs once again.

The following mornings Mrs. X confronted the GP, as the patient could not get up or walk up to the surgery, and explained to her about the worsening condition of her husband and made a request that he be referred to a specialist for a second opinion. However, the arrogance on the part of the lady doctor had no limits and Mrs. X’s request ended up being declined with the words: “ There is nothing wrong with your husband’s brain and hospital have long waiting lists for CT scans these days”.

At this stage Mrs.X expressed her willingness to pay out of their pocket (if the NHS was unable to help her husband who had been paying the National Health Insurance contributions for over 30 long years) and for the GP to give a referral to a private hospital to have a CT Scan done on Mr. X. The only response she received was to get a telephone number of a hospital and for Mrs. X to find out the name of a Consultant in order the GP could write the requisite referral! Mrs. X even did all such spade work and finally obtained the letter and received a date from a hospital for a private scan done 20 August 2002, which they thought was too far away considering the gravity of the problem they had in their hands.

However, on 13 August 2002 Mr. X became very ill, started vomiting continually, showed signs of becoming de-hydrated with a new symptom (hiccupping) developing. At this stage the emergency doctor was summoned again, and having seen the sorry situation of the patient he wasted no time in arranging a hospital admission and an ambulance to carry Mr. X immediately.

The ambulance transported Mr. X to the A& E (Accident and Emergency) ward at around 23.10 hours to a near by reputed teaching hospital in South London but was kept un-attended till the following morning while the patient was in pain, vomiting and hiccupping throughout the night!

In the morning a junior House Officer saw the patient, his blood pressure was taken and a sample of blood was sent to the laboratory for a test. Mr. X was asked to eat breakfast, despite constant hiccupping and when the blood results came he was discharged at around 11.30 a.m. certified as fit to go home!

Mr. X telephoned home and conveyed the message and Mrs. X and her sister came back to hospital to take Mr. X home in their car to find the patient was missing! When enquired the ward staff was unable to account for Mr.X.

This was when this teaching hospital managed to bring the whole hornet’s nest upon their shoulders. The patient’s family having searched for Mr. X all over the corridors of the hospital finally spotted him inside a toilet being sick and vomiting. The patient’s family demanded to see the doctor who discharged him to have an explanation as to how and why he was discharged in that condition but in his absence a Senior Registrar who was responsible and accountable for the Ward’s activities immediately rushed to the scene apologising for the comedy of errors that had been taking place since the previous night.

Realising the gravity of the problem the Senior Registrar did several tests instantaneously on Mr. X in the presence of his family and a CT Scan was arranged immediately. The results of the Scan showed that the patient was bleeding from both sides of his head, inside the brain, medically termed as Subdural Haematoma . Immediately arrangements were made by the Registrar himself for the patient to be transferred to one of the leading hospitals reputed for neurology. Mr. X under went brain surgery the following after noon.

Within a week after the operation, however, Mr. X. developed the identical head and shoulder pains and was rushed back to the teaching hospital for the second time where he experienced trauma and drama initially. Mr. X was scanned again to find that the bleeding from both sides of the brain had re-occurred ! and which naturally sent alarm bells to his family. He was once again being prepared to transfer back to the hospital where he was operated on initially. To make things worse for Mr. X another junior House Office was seen struggling to find a nerve in Mr. X’ s hand to introduce an intravenous drip. Mr. X with a mixture of pain, irritation and anger at the way he was being pierced from place to place had to ask once the young medical officer politely whether he needed assistance from a senior officer! However, after many an attempt, the needle was inserted, a drip line was fixed and the hand was bandaged.

It was a stoke of fortune and the presence of mind on the part of Mr. X that he wondered why air bubbles were forming all along the saline tube rather than a dripping! When he summoned a nurse and brought this to her attention, the horrified nurse pulled the needle out immediately and found a nerve and re-inserted the line into Mr.X’s nerve. It was unfortunate that the young doctor at the teaching hospital had not been able to find a nerve after all these attempts but had pierced Mr. X’s hand on several places and to make things worse had administered saline into the tissues of Mr. X’ s hand, which later became infected and swollen.

A serious mistake done by the reputed (Neurology) hospital staff was that when Mr. X was taken into the operating theatre for the second time his next of kin (wife) had not been informed despite pledges by the patient! This is regarded in England as a serious violation of medical rules and ethics. Everyone wonders why this was done as Mr.X was not in a ‘ now or never’ situation to operate on!

Mr. X says he is thankful to his good stars and of course the senior surgeons who saved his life after such trauma and drama that he had to undergo. He is now recuperating gradually but with an added misery of his left arm swollen and in bandage due to the damage done by the second junior House Officer at the Teaching Hospital.

This is a clear-cut case where incompetence, negligence and arrogance were evident on the part the General Medical Practitioner initially and two hospital authorities later. Mr. X thinks there is enough grounds to sue them all ! In the meanwhile it remains to be seen what action will the Teaching Hospital take on the doctor on duty who discharged Mr. X with a wrong diagnosis, the second House Officer who introduced fluid to Mr. X’s tissues and infected his hand and also what action will the other reputed hospital take against the staff who failed to observe an important code of practice of informing the next of kin before a patient was taken into the operating theatre . How much and to what extent the reputation of these two hospitals has been damaged out of this melodrama ? And who said our Sri Lankan hospitals and our Sri Lankan doctors are bad !

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