Sunday, December 23, 2018

Doctor patient relationship

Much has been written about the doctor-patient relationship. We have heard of doctors who are friendly, understanding and reassuring and others who put the fear of God every time the patients meet them. Such doctors, whose tribe is growing, are impatient, unfriendly and very often rude to their patients.
I have had the pleasure of dealing with both types of doctors in my fairly long life. I remember, in my student days in Bombay, where I grew up, we had a family doctor whom we would visit for all our health related issues- be it common cold or anything more serious. A very negative person, this doctor would mention the name of some dreadful disease or the other while listening to our complaints. If it was a severe cough, it could be because of Tuberculosis; if it was a stomach ache, it could be because of ulcers or appendicitis. I always hated going to him. But my father believed in him and felt that he was a `rasiana` ( lucky ) doctorIt did not matter that he frightened us beyond our wits! However, we did become alright after visiting him. Consuming the special mixture in glass bottles with dosages indicated by paper stickers and the packets of medicinal powders that was dispensed by  his compounder - a tribe which has vanished thanks to the invasion of prescription drugs for every ailment.

I now have a family doctor who is ever positive and cool. As soon as you enter his consulting room he will check your BP and pull out a prescription pad and start writing the names of medicines to be taken even while you are describing your symptoms. He does not believe in prescribing unnecessary tests. In my anxiety whenever I requested him to recommend some tests, he would say ` For your age , all your parameters are ok. No need for any tests. Just take these medicines as prescribed and you will be alright`. Whenever I suffer from any ailment for more than two days, I rush to him and invariably begin to feel alright after meeting him and paying his fees ( Dakshina!). That is what trust in a good, friendly doctor does to you! He can be rightly described as an `Intuitive doctor`. 

On the other hand my experience with a heart specialist a few years ago was dreadful. A couple of months after becoming a member of the `Stent men`s Club` ( yes, I have a stent in one of my arteries after I suffered a heart attack), I had gone to see him regarding  a stomach related bleeding problem I was undergoing. After hearing my complaint when he screamed `Blooddaah`, I almost had another heart attack. Instead of pacifying me and telling me that the bleeding problem was because of the blood thinner tablet I was having after the stent procedure and that the problem could  be sorted out with alternative medication, he frightened me beyond words.  How I came out of his clutches and got cured of the problem is a story by itself


It is a fact that majority of  modern day doctors who lead a highly stressful life have no time or patience to listen to their patients’ complaints and rush with tests and treatments  without taking the patients into confidence. Result is that most of the patients visiting  specialists very often feel  cheated and exploited.

 Even as I was thinking that  it is high time that Medical colleges  taught  human psychology as a subject to the doctors during their training period I was happy to a read news item that India has already joined a long list of countries that have included a course in medical ethics as part of an undergraduate medical education. The Medical Council of India calls it `Attitude Ethics and Communication Competencies` under which the medical students will be `trained in effectively communicate with patients and their relatives in a manner respectful of the patient`s preferences, values, beliefs, confidentiality and privacy`. Wow, that sounds great. Can we hope for ` Ache din` for patients in their dealings with doctors in India?

Wednesday, December 5, 2018

Three generations of herbal medicines

It was a week before Diwali when I had gone to interview Mr.Badrinath, the current owner of the iconic Dabba Chetti Kadai- well known for `Nattu Marundu` ( traditional herbal medicines). The small  shop on the busy Cutcheri Road in Mylapore was teeming with customers. It took me almost 50 minutes to get the attention of Mr Badrinath, seeking an interview with him for this article. He rightly advised me to come after Diwali and preferably around 11am when he would be comparatively free. Two weeks after Diwali when I reached his shop around 11.30 am, on a weekday, I was surprised to find Badrinath still surrounded by half a dozen customers. And there was a continuous stream of customers arriving  by foot, by two wheelers, and by cars. It took me 45 minutes before  Badrinath agreed to spare some time for me and  answer my questions while he continued to  attend to his customers – some placing specific orders with a long list in their hands, some seeking his advice about the ideal medicine for their specific health issues and others seeking his approval for herbal medicines recommended by some other doctors. Mr. Badrinath was catering to the demands of every one, unfazed,  without loosing his cool and with  information on his finger tips. He was being helped by his wife and two assistants in identifying and packing the medicines.

 Badrinath is the third generation of the Chetty family to run the business started by his grand father  Krishnaswamy Chetty together with  his brother way back in 1885. Though initially it was  started as a Kirana shop also having a paints section, it started specialising in herbal medicines only in the early Nineties. The starting of Venkataramana Ayurvedic college down the road in 1905 provided an opportunity for the shop to supply raw materials to the dispensary being run by the College. That was the beginning of the evolution of the shop specializing in Herbal medicines. Since the products were neatly placed  in tin containers on display, it came to be known as the `Dabba Chetty Kadai` in the neighbourhood which eventually became the official name of the shop-a memorable brand name for quality herbal medicines, which has survived for 127 years.

Though in the early years the shop sold only the raw materials required for making medicines at homes  based on Patti Vaidyam, ( Grandma Remedies), in recent years based on the demand from the customers, who were hard pressed for time, the shop started selling ready mixed medicines- mostly `legiams`. Though the Diwali legiam is most in demand during the Diwali festive season which lasts for about two weeks, what sustains the shop is the continuous demand for post natal` legiams` used by young mothers after the delivery of their  babies. The shop also sells a few typical puja items apart from a very limited number of branded Ayurvedic products, supplied on demand.

I was also surprised to learn from Badrinath that the shop which went through a  lean patch a few years ago has picked up business with a  lot  of youngsters patronizing the shop. It seems the internet and the increasingly popular ``google doctor`  are playing a major role in the revival of the herbal medicines among  the youngsters. I could vouch for this judging by the number of youngsters who visited the shop. Three of the six customers whom I talked to had come to buy the `Post natal Legiyam`.

Do his customers come only from the Mylapore area?  Mr.Badrinath`s prompt response was, `No sir, they come from all over the world. Wherever our people are located in India and the world, they come to us  searching for specific items. Many of them are from USA, Australia, Middle East, Europe etc. and belong to all age groups.  It is the  word of mouth advertising  and our guaranteed quality which have helped us gain popularity over the years.`

 Most popular items are `Chukku, Homam, Panam Kalkandu`.  The major problems for which the herbal medicines are sought are for common cold, Diabetes and other seasonal ailments, besides ,  the ever popular `Post natal` legiams.

 I asked Badrinath, a commerce graduate,  who has been running the shop for the last 40 years, if he ever thought of growing bigger  and opening more branches like  what other Food and Snack units like Grand Sweets or Adyar Anandh Bhavan have done.   He said he was content with the current operations where he could guarantee the quality of the products sold from his shop which occupies just 180 sq. ft area and another 280 sq. ft  godown area located in the neighbour hood.  

He was hesitant to talk  about the future of the shop. His two sons  who are still in college may or may not come into the business, as  it involves a lot of hard  work , sweating it out in a road side shop amidst the constant noise from the passing vehicles enveloped by the smoke,  dust and grime which naturally follow  the heavy traffic on the road. Yet, since it is a profitable business one of his sons might get into it and take the `Dabba Chetty brand name`  to greater heights as the second generation of the owners of Grand Sweets have done to that iconic brand. Let us hope Badrinath`s  dream comes true and the  `Dabba Chetty Kadai` continues to serve its customers in the years to come.

This article has appeared in the Madras Musings issue dated 1-15, December,2018