Dear Editor,
I refer to the editorial captioned, ‘Sent home to die?’ (SN, September 1).
Editor, it is safe to remove the question mark from that editorial title. In view of existing practices, it is no longer a matter of weighing, or speculating, or thinking out aloud in print. This is now accepted (and has been the experience) by many helpless, hapless citizens, and a fact of medical practice and life in this society to a great degree.
I had written about this before right here. The essence of those writings, and some expansion, is worth repeating today. Sufferers, at very traumatic times in their lives, find themselves cast adrift. There is no welcoming medical harbour where they can find sanctuary. They turn up at this or that medical institution seeking relief and comfort; any amount, no matter ho minuscule, would be most appreciated. And the reception is?
Whenever it is determined that the condition of the patient has proceeded beyond a certain point, then it is hands off. In other words: not here! There is neither time nor place for that needy frightened individual, and one usually in great pain. If this sounds harrowing and callous, my own choice of words is gentle and couched. On too many occasions, some practitioners have not bothered with such nuances or niceties, especially when the patient is cash-strapped.
Indeed, it is go home and wait for death. Any sharply Creolese version also would suffice. Crude, uncaring, and boorish are some words that come to mind. This is not limited to any single institution, but is almost (almost) all over the local landscape.
The Hippocratic Oath might as well be some gang initiation rite, for all of its relevance and existence. Money is meaningful, as well as precious space and time. And so do the statistics. This is a large part of the nucleus of the matter.
Many, if not all, of the medical institutions open for business have an unhealthy obsession with (and awareness of) mortality rates, and patients dying under their roof. Go somewhere else and do so, if anywhere else is foolish to commit to allow such to happen on their premises. Whatever might be meaningful and good for institutional comfort, institutional reputation (people don’t die here), and institutional numbers are all hurtful to the welfare of the seriously sick and their already bewildered families. When they need expert assistance the most, it is usually withdrawn.
To be sure, it is understood that some patients are more comfortable at home, and prefer to go to eternity from their own beds, and amidst loved ones. But there are those who want to make a choice, and should be allowed to do so, especially if the financial wherewithal is present, and after the appropriate consultations with family.
Hospitalization, when required and obvious, should not be dumped upon the besieged on a get out of here basis. This might sound rather grim, but it is what has been the experience of too many people. The reports of flinty and unwelcoming personnel and places are too many to ignore or excuse. They are neither accidental nor remote, but part of deliberate unwritten policy. Call them judgment calls.
This hard dispassionate behaviour (focused mainly on statistics) is the equivalent of coldly sentencing people to death without appeal or any recourse whatsoever. It is grotesque; it is also inhuman, if not criminally so.
Such conduct obscures and minimizes the sterling efforts of the handful of medical people dedicated to their craft and who truly care for the well-being of their charges. They hurt, and they hurt when most needed.
Yours faithfully,
GHK Lall
