Sunday, February 24, 2013

Getting Sick in the US vs. Getting Sick in India

I've been home 9 months and just contracted my first viral infection. It's no fun and I'm still a miserable sick person. It's brought some reminders for me about how things worked when I was in India. I don't feel angry right now and haven't through this entire ordeal. That is a huge difference for me because while in India, I experienced an extreme anger while I was sick.

I wrote many times about being sick while I was there. The pain I felt every time I got sick and how intense the symptoms were. I'm not having any of that here. But, I've noticed that when I'm sleeping, my family doesn't wake me up to check on me. That was one thing I never understood while I was in India. I would feel like I was dying, finally get some relief by falling asleep only to be woken up and asked how I felt.

This didn't make any sense to me then and still really doesn't. There are much better ways to check and see if a person is still alive or not. Over the last week I've slept an average of 14 hours every day. I've been out of work, went to the hospital to get a doctors note (worst hospital in Virginia I swear) and I've generally been a vegetable. Though I don't like being sick, the rest has been fantastic. I'm starting to feel like I love my bed, covers and all, more than I love myself hahaha.

Our local hospital has the reputation of being a terrible place by all standards. Over the last few years they've even closed down some services because people refuse to go there. I drive 30 minutes routinely to see a doctor because I'm not going there either. But, when I had to go the other day I was too weak for a 30 minute drive one way so I settled for this rotten place.

The nurses were great. They were friendly, attentive and had a great bedside manner. Then the biggest idiot I've ever had the misfortune of encountering came in as the doctor. I'm not sure he had a legitimate medical degree even though I know the law required him to. Something tells me he had been kicked out of practice or forced to retire then came and took this position. He walked in, told me he was sure I had a virus because I was under the blanket they had given me.

Hmm...yeah okay. Then he proceeded to tell me it wasn't the NORA virus because they hadn't seen any cases of that since last month. He also knew I didn't have the flu because he had seen several other patients with my symptoms and had tested them and none of them had the flu. So he wasn't even going to test me. He then proceeded to talk as if I wasn't in the room and he went on and on about the NORA virus. Okay, if I don't have that then what is the point? My final diagnosis - an unknown viral infection.

He sent me on my way with a cough syrup prescription. I wasn't coughing. I hadn't been coughing and hadn't told him that I had been. I told him I couldn't cough because my throat was too dry and if I tried it felt like I was ripping my throat to shreds. So why did I need something to stop my cough? Hmm... Then at the end I asked him for a note for work, he argued that I didn't need one because I would have my discharge papers. I tried explaining that wasn't sufficient and he walked out of the room like he didn't hear me. The nurse chimed "sure" the first time I asked her, no explanation needed.

Anyway, so I'm home in bed and my family has been very helpful. Bringing me things to drink when I asked and not waking me up. This is how the sick life should be. They have not came in and out of my room talking loudly or waking me up for anything. They haven't tried to feed me foods I couldn't swallow nor have they forced me to take medicines that make me gag. I definitely prefer this lonely style of sickness lol. Because here in the US, no one wants to be around you and catch your germs. I'll take it!

What are your experiences with getting sick in Indian culture vs. another culture?
Do you prefer to be fussed over in Indian style or left alone in American style?

17 comments:

  1. When I am sick I prefer being left alone too, people should just make sure I get my sleep and that is it.
    Since we live in a nuclear familly setting I fortunately don't have to deal with the family checking on you every five minutes, the only challenge when I am sick is to keep my 3.5 year old entertained with TV long enough so that I can catch some shut eye on the couch until DH comes home and takes over.
    I was sick once while visiting the in-laws in Lucknow, they were of course worried and kept asking how I was doing all the time, the only thing that stopped them from coming in my room all the time is that our room is on top of steep stairs outside the main building. But I'm sure they would have otherwise, because, they kept wondering if the medicines I was prescribed were efficient enough and if we shouldn't go to another clinic to double check when I was still not fully recovered after one tablet out of the 5 day course. They panicked the same way when my daughter fell sick with a viral fever 2 years ago.

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  2. The first 2 years we were married I became violently ill 3 times & actually required hospitalization.
    I actually had such horrific diarrhea & cramping no one dared get between me & the toilet.
    For whatever reason, the first time I became ill with the horrific diarrhea I asked my husband to take me to the emergency dept. at the closest hospital & he said we couldn't go because he was 'busy'.
    World War Three then erupted (both in my bowels & in a massive quarrel with my husband).
    WTF?
    I asked to be taken to the hospital WE WILL GO TO THE HOSPITAL!!!
    DAMMIT!!!
    (For God's sake I'm a doctor, I should know when I need to go to the DOCTOR!!!!!)
    UGHHHH!!!
    I swear everyone from Srinagar to Kolkata must have heard this fight. I actually passed out (from dehydration) & had to be carried on a gurney in an ambulance. Husband knew he was in BIG BIG trouble & ate his 'humble pie'. (He now immediately asks me if I want to go to the hospital for any sniffle or ache.)
    Anyhow, it was the usual disaster going to an Indian hospital. The physician did not take a stool sample to determine the pathogen in question- (he decided to make an 'educated guess' I suppose) & prescribed the wrong antibiotic. I was properly rehydrated by IV though so I felt a bit better & was discharged in 6 hours. Plus it was an 'open ward' with people screaming in pain & hacking their germs all over (I thought I'd take my chances at home rather than endure any more of that).
    Needless to say in 3 days it was obvious the antibiotic the Indian physician had flippantly prescribed was NOT WORKING.
    Yup, projectile diarrhea again.
    Went to a different hospital this time- damned doctor argued with me, said a stool sample was not necessary & prescribed the same antibiotic the first time. I stayed at that hospital for 8 hours being rehydrated by IV, cursing Indian doctors, & screaming at husband to get me the HELL out of this town & to a REAL DOCTOR!!! NOW!!! BEFORE I DIE!!!
    (I now know that you have to be really over-the-top melodramatic & emotional to get an Indian's attention- be they physician or husband).
    So off to Kathmandu we go & I see a cardiologist friend of mine who orders a stool sample STAT- it is positive for Amoebiasis. In fact so POSITIVE the amoebas are happily making cysts & I am in danger of a liver access. YUK. So I stay in hospital for 3 nights being pumped full of the CORRECT antibiotics & lactated Ringers solution for my extreme dehydration again.
    The End.
    What a friggin' fiasco that could have been avoided had a properly trained physician ordered a simple, easy, cheap, microscopic stool sample!!!!
    Argggh!!!

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  3. Oh this is such a problem, not just in India but everywhere. I would say moreso in India though; people feel better so they stop taking the antibiotic and "keep the rest for the next time" instead of getting more medication. NO! FINISH THE COURSE! Otherwise they are allowing the bacteria to build resistance to the antibiotic. There are now strains of TB that nothing can treat in India thanks to widespread antibiotic misuse. There's a campaign going in in healthcare to create 10 new antibiotics by 2020 but drug companies don't like investing in them :( Better course of action is to only take antibiotics when necessary, the right ones, and when you take them, finish them. This is basic public health information every doctor should tell every patient.

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  4. The first thing that shocked me going to the Doctor in India is that regardless of what you are sick with, be it a bacterial infection, or a viral fever down to a common cold, they will prescribe antibiotics. If they tell me All I have is a nasty cold, then I don't take the antibiotics they prescribed, I am against it.
    After my daughter was born I suddenly got floored by a huge fever and breast pain, 3 weeks into breastfeeding, turns out it was mastitis, and the Gyno that saw us there was quick to prescribe something and see me out without even really taking a look at me, a week and a half later I was back to the OPD with an even more excruciating pain, more fever and the Doctor who saw me was the one that was on duty the night I gave birth, she made me lie down on the table, and was taken aback at how nasty it looked for a scond mastitis just barely out of the first course of antibiotics. When she looked at the script her colleague left she said "I can't believe she even prescribed that anti-biotic, it's not strong enough to deal with a mastitis!" The rebound mastitis was so bad that my doctor feared we might have to result to surgical drainage, but decided to first put me on a 4 day super strenght antibiotic course and asked me to come back, fortunately that worked, so she then asked me to be on the same antibiotics at half the horse dose I was for another 10 days to really make sure the infection was efficientl killed...turns out the first mastitis was treated with the wrong type of antibiotics and for a too short duration which led it to come back with a vengeance. And sadly, as you said this is a common thing in India :(

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  5. The lack of sample testing and proper treatment in India baffles me big time. I once asked my gyno to test me for PCOS because I suspected it all along and sure enough the minute I went off the pill I went 50 days without a period which I knew from experience was going to happen as off the pill I never really even had anything remotely close to a regular cycle my entire life. I was also unexplainably putting on weight, but that particularly enlighted lady told me "You are a foreigner, that's why you gain weight, you guys only eat junk food" arggggh! How the hell did she even came up with that explanation not knowing a thing about my lifesytle and diet? Seems that fair skin + blue eyes = junkfood addict in her book.
    I had to put my foot down, turns out I had PCOS and Insulin resitance as well. And all I needed was some metformin to regulate my cycle, but that idiot prescribed such a low dose of it that it did regulate my cycles but was probably not enough to sustain a pregnancy, 3 cycles later I was pregnant, and my due date was supposed to be DH's birthday and that moron was like "Oh great we will make sure the baby arrive on that date only" What?????????????? At this point both DH and I were very uncomfy and changed OB-GYN right away, I miscarried a few weeks later, the new OB then said that with such a low prescribed level of metformin the chance of it happening was much higher, she actually did ask me on the first visit to double the dose, but it was probably too late by then.

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  6. Yeah, I know how you feel. There is just no comparison between a good doctor and some half-assed moron. I am recovering well now but it's all my own doing and has nothing to do with the doctor. I got my own medicine and nursed myself back to health.

    I too have discovered you have to be melodramatic with Indian husbands lol. Although I must admit that mine isn't always responsive to it. I have to use it in the right circumstances or he just goes to sleep. Ha! I'll get the hang of it soon.

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  7. Hi

    All big cities in India have excellent hospitals like Apollo, Batra, Vedanta and Escorts. Most of them have excellent doctors. The facilities are so good that many foreigners come to India for medical tourism to get treatment at half the cost. I guess you guys were comparing medical facilities with your home country which perhaps were not up to the mark here. There are good hospitals and bad hospitals everywhere.

    Stomach infection is a common problem in India due to the hot and humid weather and general unhygienic conditions. Even Indians fall prey to it regularly. I think that is why your husband and the doctor had this casual approach to it. Though, in times of emergency it better to go to hospital than to self medicate. You take some home remedies like mint, rock salt and heeng to get over it. If it is more severe you take antibiotics like Norflox or Methorogol. Even chemists suggest these medicines, which is not always the right think to do. Homeopathic medicines like Nux 30 and Carbovege is also very good in the initial stages.


    I guess you guys have some mental block regarding Indian medical facilities based on some bad personal experiences.

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  8. Apple-

    I am a US trained physician.

    Medicine as it is commonly practiced in India is called '3rd World medicine'.

    'Cheap' is the main concern & you are correct the Indian physicians tend to go by the motto 'Common things are common.' And then prescribe some broad spectrum medication that covers a variety of the most likely causes of the illness without doing any diagnostic tests NOR even taking a decent history of the patient.

    This is NOT how medicine is practiced or taught in the US.

    Taking a medical history of the patient is the MOST IMPORTANT & CHEAPEST way to elicit valuable information from a patient- Indian physicians rarely (if ever) take a history & often ignore what the patient has written or said.

    I have NEVER seen an Indian physician ask a patient if they have any known drug allergies or ask a female patient of child bearing age if they could be pregnant before prescribing ANY medication- (I have personally treated pregnant patients whom have been prescribed medications by Indian physicians that should NEVER have been given to a pregnant woman- the affects of this misprescribing ranged from miscarriage to severe birth defects.)
    ANY patient presenting with diarrhea so bad they require IV rehydration & they have passed out at least deserves a microscopic stool exam!!!
    That should be common sense!!!
    And in a country like India where Typhoid, Cholera, Shigellosis & parasites like Amoebiasis are endemic- I would damned well do a fecal smear to rule out these potentially FATAL infections & to determine if there is any occult/hidden blood present!!
    If the physician were to prescribe the wrong medication or if the patient were to use one of the useless home remedies you recommend with one of these 'BIGGIE' infections they'd be dead within 2 days (Yes, you can poop yourself to death- one of the most common causes of morbidity of children & adults in India is dehydration & electrolyte imbalance from diarrhea!!!) That would also be MALPRACTICE in the US & most other countries.

    Anyway I could rant about this for days.
    Apple, medicine in India is not 'world class' in any sense & many of those foreign tourists who come for cheap treatment end up with nasty & completely avoidable nasty nosocomial infections & iatrogenic problems.
    I recently witnessed a surgery in a very reputable Delhi hospital where the surgeon just LEFT in the middle of an operation to remove a lung tumor, he did not return for 2 hours- I have NEVER seen this ANYWHERE in any country I've ever worked in. Luckily the patient didn't bleed to death or go into shock- but I'd venture his chance of infection just skyrocketed.
    There is NO excuse for this, it would be also be MALPRACTICE once again.

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  9. I went to Fortis in Amritsar and they tried to stick a used needle in my arm. The guy didn't seem to understand why I would be upset as I made him throw the old one away and open a new one. I also had to ask for the tests I wanted, they never recommended anything. You have to go in, request to be billed for the tests you want, get them done then go see the doctor. The tests aren't ordered based on your symptoms. You have to guess (or basically diagnose yourself) and hope you're right and that the doctor will read them properly.

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  10. Hi,

    I can understand what happened to you. Your body was affected by a foreign infection which your immunity was not used leading to violent reaction plus wrong diagnosis. This led you to conclude that all Indian doctors are crap.

    I think it a cultural thing, common cold, stomach upsets have been traditionally effectively treated in India through home made treatments. Everyone is not drinking contaminated water or food in India. It is the hot and humid weather which is conducive for bacterial growth. It is not feasible to rush to the doctor every time in India. Home made remedies have been tried and tested for ages and not mumbo jumbo as you made it out to be.

    I had conversation with an experienced an Indian doctor. He stated that in their days, the books were written for American/British doctors. So, they had to modify them to suit the Indian conditions. They never had access to fancy gagets and relied on their experience and keen eye to make the diagnosis. This was the case when I grew up when doctors could make a diagnosis by merely checking the pulse of the patient. There is something called medical acumen and experience also. Today, with all the diagnostic tools, doctors are unable to tell whether a patient is suffering from chingunia or swine flu. The number of patients in a govt hospital in India runs into thousands allowing doctors to hone their skills. But they being humans, may make errors in judgement like all professionals.

    The hospitals that I talked about are not just hospitals but five star hotels for foreigners. You are not acknowledging their results because it hurts your ego. Everything in India has to be sub standard as per your prejudiced view. Moreover, such medical tourism will affect your own medical industry. Cheap definitely does not mean sub standard.

    "3rd World Medicine". What arrogance. The Indian doctors must be practicing vodoo and black magic. You are in great danger in India. I am not interested in Indian doctors but your remarks smack of racial prejudice.

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  11. Apple,
    You wrote & I quote-
    "Your body was affected by a foreign infection which your immunity was not used leading to violent reaction plus wrong diagnosis. This led you to conclude that all Indian doctors are crap."It is YOU who are stupidly & arrogantly defending Indian doctors.

    I don't work in the US health care system, so 'my' health care industry (as you so inanely put it) is NOT affected by ANYTHING in India. Quit jumping to unfounded assumptions.
    I've been a physician for 20 yrs, working in India, Nepal, Honduras, & Guatemala for UNICEF.
    Amoebiasis is caused by AMOEBAS, NOT BACTERIA. Amoebas are a PARASITE.

    My body was infected by a foreign infection which my immunity was not used to?
    That led to a 'wrong diagnosis'?
    You are NOT making sense & ANY physician worth his/her salt would take a patient's 'violent reaction' as a HUGE red flag that something 'out of the ordinary' is going on.
    Apple, you are only making a fool of yourself, you obviously know very little about healthcare or infectious disease.
    Please take the time to educate yourself on a topic before posting or risk making an ass out of yourself again.
    There's no excuse for the crappy medicine I've seen practiced in India, asking the patient intelligent & adroit questions is the cheapest & most useful tool a physician can utilize.

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  12. Your arrogance speaks for itself. There is no solution for a prejudiced views. I have to routinely deal with doctors, because my mother is diabetic. She also underwent heart surgery. Patients may not understand medical jargon but they do understand where the doctor is leading them. I personally have never faced unhygienic conditions in the hospitals/clinic I have visited. This is not even about doctors, you have something against Indians I guess. If wrong medication and unhygienic conditions were so rampant, there would have been an medical epidemic in India. I am not the only one, there are millions like me. Don't tell me we got lucky. In rural areas it may be a dicey situation. I suggest you take a dip in the Mahakumbh, It will have a calming effect on you and also strengthen your immunity.

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  13. Apple,

    Let me ask you one thing-

    Do you recall the poor young woman that was brutally raped and disemboweled in the Saket district of Delhi?

    Do you recall that young woman was taken to a Delhi hospital & later had to be 'air lifted' to Singapore?



    If India has such wonderful 'world class' hospitals & physicians why would they have to send her to Singapore to be treated?


    I can tell you why, the poor woman needed a bowel transplant & India has absolutely no physician nor facilities that can achieve such an operation.


    There IS a 'medical epidemic' in India & Indians like you who refuse to acknowledge the problem are therefore part of the problem. Most Indians live in rural areas, did you not know that either?


    My mom suffered diabetes also, I am sorry to say your mom is getting diabetic treatment that went out of date in the US in the 1980's & in Western Europe in the 1970's (Western Europe is usually 10-20 yrs ahead of the US in most areas of healthcare.)
    Don't you want the BEST for your mom?

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  14. I am not certain if I am qualified to have a proper perspective on this because I have never been sick enough to require hospitalization. Actually, I have. A few years ago, I became extremely ill, and ill for a few weeks. My wife took me to the doctor. After having some tests done, he gave me some medicine, but I did not feel better. After I continued to not progress, he suggested that I go to the hospital to have more tests done. I considered it, but then next day I decided that I would not go there, partly because I did not want to incur an expense that I felt was not necessary and partly because I was afraid of language difficulties. (The doctors, I felt would know English, but the nurses would not.)
    In the U.S., I did not have the benefit of Socialized Medical Insurance--none of which has anything to do with Health Care--so I have always been healthy (or healthy enough) because of my fear of hospitals.
    In India, there seems to be a greater range of things designed to keep a person healthy, so I am glad that I am here.

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  15. You make a good point. India does have more types of health care options available, easier access to vitamins and such and the ease of getting into and using the medical system is good. You just have to be careful where you go though because not every doctor (in any country) is a good doctor or even knows what he's doing.

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  16. Hello Bibi

    Though you are telling truth about many aspect of Medical situation of developing countries ,I didnt like the negitivity in you. It may be because you are so oversaturated with the living condition in India that you dont want to see anything positive about it or may be India is the first third world country you have been.
    How can you compare the medical situation of the one of the leading countries of the world to the India where instead of using latest technologies in treatment,walking hand in hand with rest of the world in terms of new medical discoveries,the focus is how to reduce malnutrition,lower infant mortality rate,lower infectious diseases due to poor sanitation ?
    This definitely does not mean that doctor can do whatever they want( like using used needles).But i think slowly they are getting there.At least in Bigger hospital they don't do that anymore (i guess).It will take time for change to come.
    And about Physician not asking certain aspect of medical history (though i think detailed history is mandatory to anyone anywhere),I think taking history is shaped according the localities you are in.They might miss allergy history but i guess they might not miss asking you pertinent questions related to Dengue,Typhoid etc. Let me share my experience with you:

    I had headache for about 8-9 months.I saw many doctors here US. I literally did Doctors hopping.From one doctor to another,one state to another.Sometimes I was told it was migrane,sometime tension headache ,sometime referred to therapy,one of them even told that I should go to Hawaii to freshen up.Being Medical professional myself and having had migrane before,I just knew it was not migrane. I didnt stop seeking help.Finally one diagnosed it as a TB spine-cervical.I was isolated,started on antibiotic and I recovered.

    The point i was trying to make was medical professionals may miss the diagnosis which is not common to that place. But again It shouldnt occur ,whether in US or in India . But at least we can do our part,set an example instead of complaining.If you are practising in India you are doing it your way too meeting the international standard.That will also help other learn because many time those medical personnel who have not seen the world outside may think, the way they are doing is the correct.

    Change occurs slowly.
    Good luck for everything.
    And, I am US trained South Asian(not Indian) Physician working with Doctors without Borders.

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  17. Um, this particular post was about a bad hospital in the US. Previously I've written about the terrible bedside manner of Indian nurses, the treatment by professionals being sub-par and how Indian doctors who trained abroad were rude, racist, etc. Those things have nothing to do with the medical equipment. That's just pure rotten personality. And yes, I was stunned the lab tech at Fortis Escorts tried to use a dirty needle on me. I'm not sure how many Indians he used it on before I forced him to get a clean one. Again, that's not an equipment issue but a rotten personality issue. None of these things can be forgiven or dismissed based on India being a 3rd world country.

    Anyway, I've also mentioned terrible practices in the US here several times too. To address your reference to medical focus in India, not once was I treated for malnutrition despite the fact I was dropping weight at an extremely scary place, had all the classic symptoms of dietary related medical distress, I was weak and pale, etc., etc. If doctor's there are so good at focusing on malnutrition then they sure fooled me.

    You make a good point about medical history however, there are fatal allergies known the world over in medical communities. This includes India and unless a doctor wants to kill a patient or doesn't care, they usually ask you if you're allergic to the common medicines known to cause problems. That's not a US standard, it's international. I've seen many medical professionals both in the US and India that missed asking questions and I've been diagnosed improperly in both countries as well. I've tried to be realistic in that these issues can occur in both countries. How I was treated in India though was just absurd to me, especially since I was asked to pay more because of my skin color 90% of the time. That only stands to make a person more irritated with a situation.

    I understand your doctor hopping. I did the same myself for a while until I found my current medical system. It's a privatized system. If you can find a private hospital, I highly recommend it. The level of care and attention you get will be much better. Most of them even have a diverse panel of doctors from multiple countries you can request who would understand just about any situation/background. You only get one body and life, it shouldn't be wasted on poor medical treatment. I'm sure you understand this since you're a doctor yourself. Even if the technology is not there, you should strive to give your patients the best care available right? And would you ever be rude or mistreat a patient? Most doctors would not. I didn't find that to be the case in Amritsar among many of the doctors I've seen. That is why my attitude toward the system there tends to be mostly negative.

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