The first few patients who come to any doctor are not the best ones. These are the ones who come either because their own doctor is unavailable, or they owe him [their own doctor] money and cannot pay and sometimes for another opinion. It is only later on that they come to you out of choice. It is thus a hard grind to build a good practice and it takes years, as any GP will tell you. When I began practice the competition was not only from qualified ones but also from the innumerable quacks around. One of these had a formidable reputation for curing all the ailments by just feeling the pulse and went by the name of pulse doctor
One of this pulse doctor’s patients was brought to me by his mother. The boy had evidence of early malnutrition with the typical protuberant belly, discolored hair, pallor etc. I spent a patient half an hour trying to make her understand the importance of proper nutrition and how to make a nutritious meal with in her means. I gave her a prescription for a cheap hematinic and a wormicide and instructed her as to how this should be administered. She listened to me with a bored expression and took the prescription and went away. At that time I did not know what a formidable fellow the pulse doctor was! This was made clear to me within the next three days.
The lady came back and began her angry salvo, ‘What kind of a doctor are you? With your medicine my son nearly died. The pulse doctor saved him in time. You are still young and may not know the powerful effects of these drugs. Here after you be careful’ she ended, panting for breath. I couldn’t make head or tale of what she was speaking. I asked her what had happened to her son? ‘What happened you ask? I gave the medicine you gave and the boy passed hundreds of worms and many were sticking out of his bottom, and I ran to the pulse doctor and he pulled them out, he told me that you are young and inexperienced [true] and without knowing gave too strong medicine and so many worms came out, he said they should be removed few at a time like his medicines do. ‘You better be careful next time around, the next one may not be as considerate as I am to you.’ With this parting threat and without waiting for my explanation she went away.
10 years later.
That was a nasty day. I had returned after making my fifth house call and dog-tired I was but yet to start my evening surgery. There were some patients but they made way for an obviously sick person who was brought in by his attendants. I had not seen him before. History and clinical examination revealed possible pulmonary tuberculosis with cavitation, which proved to be so later on with a sputum examination and X-ray.
I told the patient the diagnosis and the treatment options. I also told him how with the prescribed treatment he should get better in a year [those days we were giving one year’s treatment]. I also told him to come daily for streptomycin injections.
I wanted to enter his name in my records and asked him. He said he is Dr------, my friend and foe the pulse doctor! Later when I came to know him better, I learnt that he was a qualified doctor! After this episode he sent me a number of patients whom he couldn’t handle and remained my friend till he passed away some years ago.