In the words of Dr Mark Lewis “No one told us in medical school that most of our time in practice would be spent in convincing people of our good intentions”..
People become doctors for various reasons. A straw poll in my first year of medical school revealed that most did so because their parents wanted them to become doctors. But a few did so for the good that they could do, they wanted to “help people”. Not one person said it was because they wanted to “harm” people or “earn money”.
As I was growing up, being a doctor was all I ever wanted to do. I imagined making difficult diagnoses, starting lifesaving medications in the nick of time, snatching the person from the jaws of death and being the saviour! As I grew up, I also watched my father battle with Hodgkin’s’ Lymphoma (a cancer of the lymph nodes) as he underwent surgery, chemotherapy and radiation. It saved his life. I also watched my mother avoid blood pressure medications for fear of side effects and lose her life to a massive heart attack.
The practice of modern medicine relies on tablets, syrups, injections and often surgery and radiation therapy to do its “good”. And we learn how to do this over the long journey that is medical training for a good decade before we apply it to people. We learn in detail the way a drug works, how it affects the body, what are its untoward effects. We study in detail the clinical trials performed in thousands of people to judge the efficacy and safety of these drugs. Therefore, we write medications with confidence with the best of intentions aiming to heal and cure.
The honeymoon phase of medical school ends quite abruptly as we are thrown into the “REAL-WORLD” practice of medicine. It is harrowing and heart breaking. Almost every single day is spent requesting, cajoling, and pleading with people to take their medications so they can live healthy lives. We fear the consequences we know can ensue if that condition is untreated. When a person living with diabetes sits in front of me, I envision worst-case scenarios of faulty hearts and damaged kidneys and I urge the person to take their medications.
I recently saw a 65-year-old man in the clinic. He came in a wheelchair as he had severe pain and weakness in his legs. His kidney was almost completely damaged and working at 10% of its capacity. He had had diabetes for almost 15 years and consulted dozens of naturopaths, homeopaths, and herbal medicine doctors who promised him a” safe cure” for his diabetes without need for “harmful” tablets of modern medicine. His fasting blood sugar was 335 mg/dl and postmeal was 443 mg/dl. The diabetes had ravaged his body but he was still resisting medications because he was afraid of “side-effects”. I cannot express in words the mixture of frustration, anger and helplessness that I experienced as the gentleman kept expounding his theories on the “danger” of modern medicine and the “safety” of alternate cures.
Just after this gentleman, I saw a young lady of 32 who was married with a 5-year-old daughter. She first experienced high blood sugars in pregnancy and did not take any medicines even though her blood sugars were high. She delivered a large baby of 4.5 kgs weight who almost certainly will be overweight and develop diabetes early in life. After her delivery, she continued to experience high blood sugars. Her father also has diabetes with damaged kidneys. She was still not taking medications for her diabetes in spite of 3 years of high blood sugars. Instead, she was being guided by her father for the past 2 years about “home remedies” to take care of her blood sugars. Her blood sugars were to the tune of 300-400 mg/dl.
Every single day is a struggle getting to people to understand the damage that untreated diabetes does, how easy it is to avoid complications of diabetes and live a normal healthy life. The constant negativity about medications is demoralising and exhausts our energy. It seems we are working against the tide, constantly trying to swim upstream. Harming a patient is of no benefit to a doctor. We are like candles fluttering in the wind. Our motivation and energies are at all-time low especially during the COVID pandemic and many of us fear we won’t be able to take any more of this. Burnout is real in medical practice! Not just because of the workload but also the seemingly uphill battle.
Science is responsible for us living longer & healthier. So we need to accept Diabetes and treat it scientifically and well so that we can live a strong and healthy life.