A patient was undergoing some investigation in a medical college for a lump in the axilla (that's what we docs say for armpit). For days together the junior residents, the interns, the senior residents and the assistant and the professor were discussing the possibility of the cause of the lump. One opined that it sure had to be a tubercular lump but another countered that it could not be because the blood report was not at all suggestive.

Another shot from the corner, "Lets then go for the PCR."

The learned professor dispersed the crowd and finally sent orders for a repeat FNAC and a complete blood count. All this drama happened at the bedside clinic-the best place for medical students to learn. All the students then raced in their mind and referred the standards text-books each of them trying to refer a thicker one than his colleague. After two days the bedside clinic gathered again around the same bed. The Prof kept aside the file containing the final FNAC report and the count and the debate once again started amongst the healers and the to-be healers.

Finally the file was opened and the PG student read out the report, "The picture is suggestive of lymphoma. However kindly correlate clinically."

One of the young interns thumped on the bed saying, "I told you it would be lymphoma!" with all excitement of getting a correct quiz answer.

Suddenly, the patient caught the excited doctor and asked,
"Doctor, what does it mean?"
"Oh, that's a form of malignancy….a form of cancer!"

After saying this, the highly academic group continued with the discussion on the prognosis (chance of survival), treatment regimes and the complications of the various medications that could be used. After about a week the patient died suddenly.

Death certificate was to be written. It read…
Name: Mr.Nipamacha,
Age: 45,
Resident of: Kongba Maning leikai,
Profession: Lecturer, Modern college.

It sounds quite normal. A lymphoma patient was diagnosed with utmost care being taken in history taking, discussed and investigated and finally diagnosed in no time but had expired suddenly. May be it was one of the most dangerous type of lymphoma. The prognosis had already been explained to the family members beforehand. There was no medical negligence.

I do agree that there was nothing wrong in all the activities if taken singly. But over the course of time, at times we seem to forget that what we all are striving today are for the patients. We seem to have lost the sensitivity. I had just presented an imaginary situation in a hospital back home.

Can you imagine the agony of a patient who knows English very well listening to the medical group discussing his diagnosis and treatment and that too so casually like naming the several mountain ranges of South America!

In Medical colleges, every day, we would be bombarded with questions on medical science depending on which MBBS year we were studying. It had started with anatomy, biochemistry---a normal science and had gradually progressed to the living ones: medicine, surgery, orthopedics etc. We seem to have carried with us the answer- quicker-than-the-others-norm. We never seem to realise that we could be declaring a death sentence for a patient when we utter the word "cancer", "AIDS" etc.

Technically speaking this is known as communicating risk to the patient. (For more on this one can refer the website bmj.com) It is high time that we learn this subtle yet important side of medical science. I had also learned from practices like this and agree that such bedside practices should continue but with improvement taking into consideration the sensitivity aspects.

Gone are the days when doctors were discussing the illiterate patient's disease in a medical college located in a remote Rajasthan village. This is the 21st century and we see all development going in all spheres of life. People have become more aware and sensitive. Medical teaching and our outlook towards out patients had been good but should be better now.

At times, the remark made by Munnabhai MBBS in the film that carried this same name as the title,
"Yeh daktar lok dhai kitab parke apne aap ko bhagwan samajta hai!" (These doctors, after reading two and half books consider themselves God!) sounds quite apt.

Let's all try to improve and strive to perform the noble task entrusted to us in better ways.