A middle aged women came to the Emergency Department at 1 am in the morning, 2 days after she was hit by a reversing car. She was at the passenger site, not wearing the seatbelt, couldn’t really describe how she got hit but the impact was quite bad as her car was badly damaged.
She did not go to the hospital after the impact, instead went back home and tried traditional massage. She explained that her husband suggested it and she need not seek urgent medical attention at that moment as her pain was bearable. But tonight, she came to me with pain all over the body, excruciating muscle spasm and blood sugar level of 21.8 mmol/L.
Pre-morbidly, she explained that she had a history ‘stroke’ 20 years back, diagnosed by the homeopathy doctor based on the severe back pain and reduced mobility of her left leg. She told me that she had to crawl just to move around because of the pain. For her diabetic control, she took the medications on PRN basis (basically when she feels like it). Her symptoms of severe back pain and reduced mobility were not really suggestive of stroke but I decided not to decipher anything more of that history and focus on her current presentation.
However, as she further explains her illnesses, I got agitated because indirectly, it reflects on how oblivious she is of her own well-being. She dutifully agreed to her husband’s suggestion of homeopathy and traditional medications despite the pain. I kept on wondering how could she have dealt and cope with the terrible pain, waited for 2 days before she decided to get some help. Was she coming to the hospital out of her own choice or after endless persuasion by her family members, seeing that 4 of her children and daughter in law came together in the treatment room?
I tried to rationalise with myself that every patient/person has their own right and preferences upon deciding their treatment options, which includes alternative medicine like homeopathy, Ayurveda etc. We as doctors can only suggest but it is up to you to decide. Patient adhering to the treatment plan indicates that our counselling/advise given is working BUT it is actually more than that. It means, YOU as the patient understands what is going on with your body and what needs to be done in order to keep yourself healthy as well as avoid future complications.
Unfortunately I have seen younger patients, who are less than 50 years old, came in because of fluid overload, heart attack, uncontrolled sugar level and infected diabetic foot ulcer because they did not take a good care of themselves. They skipped their medications, defaulted their appointments and will opt for alternatives medicine beforehand. They will usually come to the hospital when the infection has gotten worse or when the damage is irreversible.
I can’t quite comprehend this way of thinking and continue asking myself;
One. Does being married subjects you to obediently follow your husband/wife’s decision even if it costs you your health, well-being and self-esteem/self-worth?
Second. Does being in pain is worth the risk, as long as it keeps you from seeking or submitting yourself to modern medicine and proves that homeopathy/traditional medicine heal it all?
Third. Is 45 and above becomes the new acceptable ‘normal’ age for people to start having chronic diseases and forget about being healthy or active?
Fourth. Is it really a diligent act, for sons and daughters agreeing to parents not wanting to go to hospital or take their medications despite how serious their condition is?
Fifth. Have we not explain and made information viral enough for the public to know the complications of chronic illness like diabetes and hypertension, where prevention is much better than cure?
I apologized to her before and after my counselling. My words were sharp and I did not hold back. I explained and nagged about the risks and complications she might succumb to if she continues with the way she lives and handles her health issues.
I told her, if being obedient means you risk your health and self-esteem for the love of your life then it’s not love. If risking yourself with pain and dragged your whole family with you at 1 am in the morning to the emergency department then it’s not love. If you become burdened taking care of your family member due to the complications of their illness, out of yours and their ignorance then it’s not love.
She was my mother’s age and my mother was denied a lot of other things in her life except health as compared to this lady. And I, for sure will not allow my mother to be in pain just because the other parent has his own rigid principle of not believing modern medicine.
There is only so much a doctor can help you with. But if you don’t take charge of your health, then why the paradoxical reactions of anger and disappointment towards us when we deliver you the bad news? So take charge of your health. Start today!
Dr. Anis Nabillah is a medical officer working in Johor and also an editor for The Malaysian Medical Gazette.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]