Here is the two versions of a discussion by a cardiologist to his patient , on the day of his discharge from a state of the art trans national heart health service in southern India.
An alluring cardiologist .
- I have implanted the world’s best drug eluting stent to your block .
- The block has vanished without a trace .
- You will be free from pain here after .
- You can enjoy a new lease of life .
- You can go for holidays , you can cherish , you can do whatever you want .
- Forget about complications it is negligible .
- But please take all the drugs regularly .
A Bitter cardiologist
- This stent is a temporary solution to your problem .
- Do not think you are cured of your illness .
- Atherosclerosis can never been cured completely.
- You have to be careful .
- Avoid very strenuous activity .
- It can re occlude at any time even if you skip the tablets for few days .
- After all, it takes only 6 minutes to form a blood clot .
- You may require CABG in future as most stents get blocked by 5 -10 years .
- Further , the drug you are taking may develop resistance and you may recur the same old problem .
So , the art of medicine is to hide some of the unpleasant outcomes from the patient and project only positive aspects to our patients *
* This is often a controversial issue . Scientifically advanced health care system do not agree with this . But I would believe , that is one of the major reasons they are suffering from huge health care crisis !
I do not agree with the concept of empowering patients with bitter truths . This need not be vigorously practiced. Disclosure of all potential complication to our patients , by itself a trigger such events by meager anxiety .