THANKS FOR ALL THE LOVE :)

THANKS FOR ALL THE LOVE :)
CLICK ON ABOVE IMAGE TO ORDER YOUR COPY OF THE NOVEL

July 26, 2008

a false promise i made today...

Is it fair to give someone hopes about something which is probably never going to happen??
As a doctor, i find myself in a horrible spot when i have to build up a false hope in my patients, especially when i know there is nothing to come of it...
and sometimes i have to lie too just to avoid the hopelessness they would experience if they actually got to know the truth....
Today i promised yet another patient sucha false hope....
"rose dcosta" (name changed), a 33 year old female suffering from schizoaffective disorder was discharged today from the hospital with the hope that if she takes her medication regularly and on time, we would see to it that she gets a government job in 4-5 months...
she was overjoyed on hearing this and thanked me profusely because she had always wanted a government job and she would finally be working...
i felt a lump in my throat when she thanked god for bringing me in her life to show her the way towards fulfilling her dream....

what did i do here??? i used someones dream to tempt her into compliance...for whose good...her own!
outcome: the patient in most possibility will come for regular followups to me without missing a single dose...
why? because ive promised her a dream of 12 long years and she has placed her trust in me....
but what after 4-5 months???
what when she will realise that i lied to her just because i wanted to motivate her and improve her negative attitude about the 'antipsychotics' she is receiving...
wouldent she be let down?
what if during these 4 months, i am not able to counsel her enough and slowly but surely break the news to her that her dream might never come true??

and all i thought about while promising her was about these 4 months...
the "take one day at a time" philosophy took over me...as i overlooked the fact that what i was dealing with was someones long term plan....
it was a sensitive issue...but all i wanted was time...time during which the patient will maintain premorbid levels and not relapse due to poor compliance...

am i wrong in doing that?...professionally, no..because all i thought about was the patients health...
but ethically, i did make a false promise right?...a promise that i know i wont be able to keep...
knowing about her mental illness, she has been refused several jobs in the past as she wouldent be able to maintain cordial relations with her collegues due to the 'delusions' and other perceptional disturbances she suffers from....her psychotic nature would also affect her work...
and outta frustration she has given up on the treatment and skips her medication...only worsening the situation further...

i got to know from her husband that she had always wanted to have a clerical job in a government institution...and thats when i planned on using her dream to her benefit...
i spoke to her husband about this "motivation (read 'false hope') plan" and another thing im afraid of is that he might just disclose it to her in a fit of anger (since her relations with her husband are also strained due to the delusions she suffers from)....
and then?? then what??
the motivation plan which is supposed to keep her compliant for the next 4 moths will come crashing down.....
the trust she has shown in me will crumble....

all these thoughts tortured my grey matter as i handed the discharge card to rose dcosta...
keeping my fingers crossed and hoping this would improve her condition atleast for whatever time possible....and that one fine day, she would be fit enough to fulfil the dream which was (mis)used with the sole intention of helping her attain it someday...

19 comments:

Anonymous said...

“Never deprive someone of hope; it might be all they have.”<~~~ i read it somewhere... all u did was right ...after 5 months its upto her to understand how the hope helped her to get out of the ailment... she would be more then happy to learn that it was More then help....


That is what i HOPE


A Germ

Lena said...

you did what you had to, pri. Of course you have doubts now, but it will help her, right?
maybe there is a point in coming month to prepare her for that explaining that that job is not good enough for her, not like she is not good enough for the job.. i dont know.. but i am sure you will deal successfully with it and help this woman the best way you can :)

Solitaire said...

I don't know Pri. I would not have done that. There are many other ways of motivating your patient to follow through with the treatment plan.

Read about "MOTIVATIONAL INTERVIEWING" on Wikipedia. We have had some training in it. It was primarily used for patients with substance abuse problems but can be used with patients with any sort of resistance.

Hope that helps!
Don't kill yourself over what you did. It's OK.

ash89 said...

You did the right thing. Dont think about it too much

Alok said...

It’s done; you can not change it now. There is no point think now, what you have done is right or worng. You have done what you found to be the best one. There are many instances where we try our best to keep the lights of hope burning but again we take risk to an extend where everything stand upon an assumption … whether it really helped only time will tell us, no one can really comment on that part.

Abhishek Khanna said...

well done doc.. great job.. first time in life m proud of u..
seriously u did a nice job.. lets c if it works out or atleast she takes her medication for nxt few months.. uske baad dekhte hain kya hota hai

*~*{Sameera}*~* said...

You did whatever you could that is in your hands.And according to the Hippocratic,you did the right thing ethically :)

Hope she gets better.Sometimes,we just have to leave it to Him..

Vrij said...

Hota hai, hota hai.. I guess in our profession, sometimes these white lies need to be told.. patients ask us if they'll be completely cured, and sometimes we do have to say that yes, they would be, even though we have a doubt ourselves.

I'm sure the faith will take ur patient to her cure. Dont worry. U did fine.

Urv said...

I don't think am in a position to judge what you did... But lets hope everything turns out for the best...

Princess Mia said...

well u did it only to motivate her, so i dont see no harm in it, u didnt lie to take advantage of the situtation right so dont be so hard on yuself for it , its alright gal

Keshi said...

we all give false hopes sometimes...sadly. its human to do that. u do that cos u dun wanna upset the other person. Sometimes we need to do that instead of being painfully honest.

*HUGS*

Keshi.

Rakesh said...

u should explore more option for treating a patient...if u think u have misshandled..u mean it u are wrong and try not to repeat the same mistake.for a doctor it needs patience for patient.

Pri said...

@ anonymous aka mr germ
i sincerely HOPE so too :)

@ lena
i plan to tell her during the subsequent followups...but will put it to her gradually and not suddenly...hope she takes it well....
all i want right now is her to take her medications regularly and this was the only option to make sure of that.....

@ solitaire
that is part of my followup plan---referring her to our psychologist :)
unfortulately we cant devote much time with every patient due to time restaints and busy opd's.......
so we make sure u guys fill up the gaps :)
as for 'rose' i couldent see any option but the one i chose....several other motivation techs have been tried on her in the past but none have worked...

so keeping my fingers crossed....

@ ash89
thanks foir saying that ash...felt nice :)

Pri said...

@ alok
ur right alok...i did what i thought was best at that given time and situation....
whether it was right or wrong, only time will tell.....

@ abhishek khanna
well thats EXACTLY what i had in mind....
the lady has never taken medication for anytime longer than 2 months at a stretch...so i hope this time, the motivation will atleast get her regular for 4-5 months.....

@ sameera
hmm agree...i hope so too :)

@ vrij
yea...ive been in this position before...i usually avoid giving 'false hope'....
try my best to place as much as the truth to the patient...because im aware of how much it hurts when ur hopes are let down....
but sometimes i guess, a hope is all you have......and if u take that away, it would leave behind nothing......
so its better to use that hope to build something constructive than just destroy it...thats what i tried to do here....
hoping it works for the best!

@ urv
i understand....i hope so too....

@ princess mia
i would NEVER lie to take advantage of the situation (being a doctor, i dont see how its possible to do that)....
i just did what i thought would help her the best....

@ keshi
i know keshi...the truth often hurts the most!

hugzz

@ rakesh
well, had there been any other option i could think of, i would never have resorted to this one....
the patient has never been compliant for the past 7-8 years and has often relapsed due to irregular medication....
no amount of motivation and emotional counselling has helped....
so i did what i thought would help her best in this situation....
if given a chance again, i dont think i could convince the patient into compliance any other way than this....
so even though i have a thousand thoughts worrying me about what i did, i have no regrets....

Rakesh said...

it mean u have done good job..no regret:)

secret admirer said...

worry not!
u did the right thing..........
i have full faith that u will always do the right thing :)

your secret admirer

Veens said...

i dnt knw Pri... maybe u did the right thing! i dnt knw what i wud have done

Vandita said...

tough call but i guess u didnt have much of a choice ... i dunno what i wudve done
i esp read what sneha had to say to this...

Pavi!!!! said...

I u'stand why u did wat u did. n for ur sake n her sake i hope things work in a +ve manner.

But if i was in her place..I'd rather have u tell me the truth..Take ur time n xplain it to me..but nope..no false hope..no lie for me....
(i feel strongly abt this..coz an incident close to this hppnd with me recently)