about (some) doctors and health care in Jamaica

Today I read an absolutely sad story in the Sunday Observer.  Essentially, a woman of Jamaican origins, residing in the UK, was in Jamaica in April of this year with her family.  She became ill and was rushed to  a  health care facility in Linstead.  She was diagnosed with pneumonia, and some amount of respiratory distress was evident.  The doctor on duty advised the family that there was not much more that could be done for the woman due to the lack of appropriate equipment at that facility.  That in and of itself is sad and scary: do not get into respiratory distress in Linstead!  But what happened next is what angered and upset me.  The woman’s family panicked and became (understandably) emotional.  They immediately wanted to transfer the woman to UHWI in Kingston, but that became a journey through beaurocracy and regulations and a negotiation with the doctor on duty.  Read the entire sad and depressing story here if you will, http://www.jamaicaobserver.com/news/Coma-calamity_12407307
The end result is that after a protracted period of time (while the woman was fighting for oxygen!) during which the doctor on duty locked himself in his office, choosing not to engage the family and calm them down and reassure them, leaving them to wonder and to plot their next move in fear and uncertainty, the woman was eventually transferred to UHWI and several months later, several millions of dollars later, she remains in a coma here in Jamaica, with the lack of oxygen being thought to be the main contributor to her present condition.
Here’s my beef: how dare the doctor on duty lock himself away?  How dare the doctor not make himself available to the family?  I know that he couldn’t pull a respirator out of his back pocket.  I know he couldn’t magically produce a well equipped treatment room.  But what he could do, he simply did not: that is to be present to reassure and to guide the family.  Yes, yes , yes…there are two sides to every story, and we did not hear the doctor’s side, but I have had several experiences of my own, which lead me to give the benefit of the doubt to the patient and her family.
Many years ago Miss World was about four years old and she started vomiting with severe stomach cramps.  It was a long weekend…I believe Easter, and the best option we thought was to take her to the public Children’s Hospital. We three bundled into their ER and eventually saw a doctor who gave her a well known analgesic/anti-spasmodic, antibiotics and rehydration salts.  Great, we took her home hoping that all would be well.  Twenty four hours we three were back in the ER.  This time we saw and African doctor who insisted that he had the magic cure as he dramatically pronounced that the said same anti-spasmodic would fix her once and for all!  I grabbed her chart out of his hands and hissed as I waved it around: “Did you not just review her chart?  Can you not read? She TOOK your wonder drug 24 hours ago and we’re back!”  That prompted a review and revision of her prescribed therapy, and in another 24 hours she was ok.  Man alive!  Suppose I did not know what questions to ask?  Suppose I was not assertive in the face of these people who qualify as doctors and feel that they are God?  Can you imagine Jamaicans who are not so educated doing business with this bunch?
On another occasion a few years later, Miss World again had a bad attack of gastro.  This time we took her to a private hospital, having to make a deposit of JD70,000.00 because she wasn’t on our health insurance.  Even in that private set up I had to point out to a very bored looking, sullen reluctant nurse that I had a concern that her IV drip was draining just a bit to quickly in my estimation.  Without even looking, she tried to fob me off.  But I was in no mood to be put off by someone that I was in effect paying, especially when the well-being of my offspring was at stake.  Was she for real?  When she inspected the set up she had the good grace to gasp and say: “Oh no!”  I wanted to choke her.  Seriously. 
Miss World was discharged and before we reached home she was writhing in pain and I did an about turn and headed straight up to the public UHWI.  At my request, her private paediatrician met us there to help expedite the process.  Again, this was at my hysterical insistence on the phone as I drove like a mad woman up to UHWI.  By this time I was panicked, hysterical and angry.  I handled the young doctor assigned to our case like a stuffed toy quizzing him in a very hostile, angry manner, even daring to question his competence.  To his credit, he did not respond like the Linstead doctor per the Observer account today.  He remained present, answered my every question and reassured me of the diagnosis and therapy.  I sincerely hope that the years have not jaded him and changed him.  Well that incident ended with me storming out of UHWI with Miss World in my arms cussing every doctor in sight because it was unbelievable to me that in the 21stcentury, a stomach ache which did not warrant surgery could not be cured! 
Doctors must remain accessible and communicative, even in the face of obstreperous patients and their families.  Remember that the only difference between doctors and us is that they chose to study medicine.  Big deal.  How impressive.  I studied botany.  He studied engineering.  She studied law.  We all have our function.  Being a doctor does not make you God.  Get over it and remember the oath  you took.  Remember too that when you are a private practitioner, we are your customers.  We pay you.  How dare you take appointments for dozens of us at the same time and then you waltz in up to an hour and half later?  I suppose to your mind, you are important enough for us to spend half a day waiting to be seen by you for 10 minutes max.  I have had doctors write me a prescription without even telling me what is on the said prescription and how it works.  Once I had the temerity to ask the doctor how a particular drug worked.  He replied that I could not possibly understand and that I was just to use it as per his directions.  Needless to say I gave him a lecture and explained that I had a science background and that even if I did not, his job was to break it down for me to understand.  I walked out and never went back to him.  He is still a prominent dermatologist in Jamaica.
I resent doctors who do not communicate with me.  I resent doctors who keep me waiting.  I resent doctors who make assumptions about me and my health without asking questions. But most of all, I am sorry for and scared for my fellow Jamaicans who don’t know how to ask and what to ask and who fear these people that we call doctors in Jamaica.  

One thought on “about (some) doctors and health care in Jamaica”

  1. Some years ago my housekeeper lost her baby at Jubilee. I went with her to speak with the doctor and he literally told her that she couldn't understand what happened so he won't give her the details. Mi back get up! I told him in one of those tones that we both went to UWI so he's to tell me. If I don't get it he's to break it down. I share the concern about the treatment of the poor and uninformed.

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