The good news about bad news: Life Hacks by Charles Assisi

In medicine, as in other fields, even the best make mistakes and are prone to human error. In life-altering moments, trust but verify.

Medical doctors must not be treated as Oracles because they are fallible, vulnerable to errors and are human. These lessons were hammered into the head by veteran teachers and seniors at work on their doctoral theses when studying the biosciences to graduate. Over time though, I had forgotten the import of it all.

That is why on a road trip with friends some days ago, I ended up spending most of my evenings listening to war-stories from a neurosurgeon. We hit it off right away because once upon a time, I aspired to be a professional like her; and she always imagined herself as a writer. There was much to note about how our professional and personal lives have panned out.

My narrative included one about a brush with a brain injury more than a decade ago. This got her attention right away and she felt compelled to probe me more about my lifestyle since then. There was an air of finality in her words as she said it. “I don’t know of any other way to tell you this. You’re lucky to be here. But as a neurosurgeon who deals with trauma every day, given the pace you’re working at, and your lifestyle, you’ll be dead in 10 years on the outside.”

“And the best case?” I asked.

“You may live like a vegetable for a few years longer. But you’d be better off dead.” She appeared and sounded totally convinced.

On probing her about the data she had looked at, the kinds of cases she deals with now, and other such questions to understand how she had arrived at her prognosis, her answers appeared clear. It took a while for all of it to sink in. A voice in the head suggested I begin work on asking myself, “What dreams must I give up on?”

That is also when lessons from graduate school started to pop. It was inevitable then, that I seek a second opinion. And Dr Siddika Panjwani it had to be. She is a neuropsychologist currently associated with hospitals such as the Mumbai-based Lilavati, Wockhardt and the Institute for Psychological Health (IPH) Thane. Dr Panjwani was among the people who had first attended on me. We’ve stayed connected ever since.

“What garbage!” she yelled as I recounted the conversation. “There’s a difference between being blunt and being honest.” I didn’t get that and asked her to explain it. Insights on how data must be interpreted emerged.

When a medical doctor looks at the statistical average basis the available data, it allows them to make an informed guess on what course of treatment to take. Since Dr Panjwani knew my history, she also knew the average suggested I ought to have either ended up as a paraplegic or died over a decade ago. But here I was, talking to her, and on my feet. In much the same way, she spoke about the most recent case she had to deal with where the averages suggested the person would not succumb to a similar injury. But she did. Averages don’t talk about people such as me who survive or the one who succumbed to the same injury.

To offer more perspective, Dr Panjwani described how treating children is even more difficult. This is because while the averages may suggest something, their bodies are constantly changing. How far away a child is from the statistical average will makes itself evident to a surgeon only after the incisions are made.

As the conversation progressed, I could hear echoes of how senior professionals across other domains, mine included, behave. Most people will do all they can to prove their version of the truth is the only version. And as a professional goes higher up the ladder, most high achievers need more complex problems to stay engaged. It is inevitable then they make mistakes as well. What makes medical professionals such as surgeons any different?

It was inevitable then that I ask her how lay people such as me deal with a medical doctor’s assessment when a critical verdict is passed. “Trust. But don’t trust blindly. That is why you seek a second opinion and a third one as well if you think it is needed. While all of them may agree with each other, it is not necessary they may be right because all of them are attempting to guess basis the same data. And never forget, they all make errors—like the best of chefs do.”

That reminds me: Around the time the neurosurgeon was sharing her views, a cardio surgeon friend joined in. He looked overworked and among the first things he did was to call for a stiff drink and start chain smoking. It was impossible to miss the irony.

(The writer is co-founder at Founding Fuel & co-author of The Aadhaar Effect)