Thursday, October 04, 2012

Chaotic Medical College alias CMC, Vellore

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I was told by many after I settled in Vellore never to go to this “renowned” Christian Medical College (CMC) if you don’t suffer from some life threatening condition. If you go there for treatment of ordinary fever or cold they will treat you like a piece of shit. Other day I went to CMC to give treatment for my daughter who was suffering from fever and cold and that day happened to be the worst day after our return back to India.
Let me narrate what happened. Our daughter was suffering from cold for the last fifteen days.  In those fifteen days she had fever during the first three days and the last four days. During the last four days, she only had fever from 1:00 AM to 6:00 AM in the morning. She was eating well and also playing well rest of the time. So on the four day morning around 5:00 AM when she had a temperature of 100oF, we took our daughter to the health center of our school that was at a walking distance from our home. The doctor there told us that her blood needs to be tested and it would be better to take her to CMC. He gave us a referral slip to CMC.
We came back home prepared milk for our daughter and went to CMC. We reached their by around 7:30 AM. By that time fever had subsided and our daughter was OK. We went to the pediatric casualty and they told us that since it is not an emergency you need to see the doctor as an outpatient. Time was around 8:00 AM and we grabbed some breakfast and stood in the line to take an appointment to meet the doctor. By the time we reached to the front of the queue it was 10:30 AM!
Me: I want a private appointment with a pediatrician for my daughter (there is both private and general appointment).
Cashier: There is no private appointment available for next five days

Me: We came here for blood test and we cannot wait for five days.

Cashier: Then can I give general appointment?
Me: Yes.
Now I paid him and he asked us to go to the first floor. When I reached the first floor, the scene was nasty. It was a 15x15 meter room and there were more than 500 adults and kids waiting in that room. As I glanced through that room I could see kids with all kinds of diseases, even contagious diseases like chicken pox sitting there. There were only few chairs (may be a maximum of fifty) but all were occupied and even the entire floor was occupied by kids and their parents. That room resembled a platform of a typical railway station like Chennai. 
I went to the security guard and asked him what I should do next. He asked us to go and stand in a queue on the extreme end of the room to get the token number to see the doctor. I went and stood there while my wife and daughter stood on one side of the room. While I was standing in the line I saw one kid puking on the floor dirtying the floor. No one came to clean and other kids started playing over it and people started walking over it for the next 10 minutes before someone came to clean it. It was gross, I must say! 
I stood in that queue from 10:45 AM and then my turn came at 11:30 AM. The man sitting in the counter saw my receipt and told me that my “case book” has not come up and I should come back by 12:15 PM very rudely. I tried to explain to him that it took me 45 minutes in queue to reach here but he was not ready to listen. 
Now I came out and went back to the end of the queue again. This time it took me one hour in the queue for my turn to come. Now I got my token number and it read “206”. The token number being called was “122”. I went back to the security guard and asked if we can go, have lunch and come back. He told that numbers are called at random and “206” may be called within 1 minute or 1 hour. So we started waiting. After around 45 minutes the screen on top of that room showed “206” and we went inside to see the doctor. 
That was a small room with a table. On either side of the table two doctors where sitting and both were treating patients separately. Our doctor was a young lady by name Christina (by the way the nurses were making fun of her and from the scant respect she was getting from duty nurses I am not sure if she was an MBBS student doing her final year house surgency or a qualified doctor). The conversation that happened between the doctor and us: 
Wife: My daughter is not well for 15 daysEven without slight hesitation and without checking her
Doctor: It may be dengue fever. Now every other child has it.
Wife: She has cold for 15 days and not fever. We are here only to check her blood.
Doctor: (after checking her chest and back using stethoscope) She should be kept here under observation for couple of days.
Me: Doctor, we are here only for blood test. She is perfectly normal.
Doctor: She is not well for 15 days. It may be dengue fever. We will start the first dose of medicine now. It cannot be given orally. It has to be given through IV. Also, please give the blood and urine right now to test.
Me: Doctor, can’t we wait till the blood results are out to start the treatment?
Doctor: If we don’t start the treatment now it may get aggravated.
Me: What antibiotics are you giving and can’t we give it orally?
Doctor: I don’t have time to answer all your queries. Lots of patients are waiting. Go to Room No. 8 and the nurse will help you.
Doctor called the next patient and we went to room no. 8. It was a 15x5 meter room with 15 odd beds. We waited for about 30 minutes on the side before a nurse came to us and saw what the doctor has written. She immediately asked us to go to one counter and pay for doing the blood and urine test. Then she asked us to get the medicine and other accessories required to give the antibiotics from the pharmacy. 
Now my wife and daughter went to pay the money and I went to pharmacy to buy medicines. There was close to 100 people in front of me in the queue at the pharmacy. Another long queue and another long wait. Now while I was standing in the queue, I called my wife’s brother who is a doctor and told him about the medicine. He was telling me that the antibiotics the doctor prescribed was a third generation one which is powerful that is usually given only after blood results are positive. I confirmed the same with another doctor I knew. It took me two hours to get the medicine and by the time I came back with it, it was 4:30 PM. My wife also just finished paying for the blood and urine test. 
By the time we reached back to room no. 8, all three of us were exhausted as we hadn't taken our lunch. Now the nurse comes and takes the needle to poke the fore arm of our daughter and fix it there. She draws blood for various tests and then kept it closed to give the dose of antibiotics the doctor had prescribed. Our daughter was crying continuously as this was the first time someone was poking a needle into her fore-arm. 
Now the nurse takes out the medicine from the packet I bought and to all our surprise the dosage given was wrong. The doctor prescribed 450 mg and they gave us only 250 mg. The nurse told me to go and get the correct dose. I got really angry and told her it is not possible for me to go and wait there another two hours. We told the nurse that we don’t want to give this medicine to our daughter before the results of the blood test came and we want to talk to the doctor. 
Nurse calls the doctor and she comes to that room. Both of us were very upset and tired and we talked to the doctor in a little harsh tone and loudly.
Wife: Tell us why you are giving these antibiotics before the blood test results are out?
Dr Christina (C): Your daughter’s liver and spleen are enlarged and so this medicine is required. 
This is the first time she is telling about the liver and spleen. Luckily for us one senior doctor there overheard our conversation and came near us. That doctor came to us and started a conversation with Christina
Senior Doctor (S): Which medicine did you prescribe?
S: What is the blood platelet count?
C: We have just given the blood for testing
S: Then why are you giving this medicine to her now?
C: Madam, her liver and spleen are slightly enlarged
S: Slight enlargement is so common in kids at this age.
S: Don’t give this medicine. If after the blood test if there is a fluctuation in the platelet count then give her this injection.
Now I asked the nurse to remove the needle they poked into our daughter’s forearm as she was crying continuously and has not eaten anything from morning. They told us that if the blood results come positive they need to give injection through that needle and left it on. The time then was 5:30 PM and we were told that the blood results will come by 6:00 PM. 
We started our wait. An incident we saw while waiting made both of us lose all confidence in that doctor. One small kid (may be two months old) was being treated in the room. Suddenly the kid developed fits. The nurse rushes to Christina, who was treating our daughter and asked her what to do to revive that kid. The doctor raised both the hands and gave an expression “why are you asking me; what do I know?” After that she took the phone called someone and then told nurse to give some medicine. On the way back we could hear that the nurse was cursing the doctor like anything. 
By 6:15 PM the nurse told us that blood samples reached the lab only now and results will be out by 6:45 PM. Our daughter was still crying and has become extremely weak. She refused to eat anything also. Around 7:00 PM my wife went and asked about the result. The nurse coolly told her that the doctor left for her house and only that doctor can see the result. 
We were there for more than 12 hours now without having any food and now both of us lost our control. We shouted at the nurses with full throat; the entire floor could hear us shout. We demanded that our daughter be discharged immediately and the needle from her hand be removed right now. Other doctors and nurses came there and we shouted at them also. We came there to give the blood for testing and it was over 12 hours and they were taking us for a ride. Now the nurse removed the needle and we came out of the hospital fully exhausted. 
Next day all the blood results came and everything was negative. God saved our daughter that day from the heavy dose of antibiotics. The very next day we took our daughter to two pediatricians in the town and both told us very specifically that there was no enlargement of liver or the spleen! 
Looking back, we spent over 12 hours in CMC; in that over 7 hours was wasted standing in various queues; remaining sitting in those rooms crowded with people with not even a single quality doctor around. Doctors were mostly students and the way they were diagnosing the disease was so pathetic. So my advice, avoid CMC as far as possible especially if you are suffering from health conditions that is not life threatening. Otherwise you will repent later.
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Anonymous Prasoon Panthayi said...

Third World Mr.Brijesh Nair. Third World.

October 04, 2012 4:30 PM  
Anonymous Anonymous said...

How did you put your daughter through this torture for 12 hours? My limit is 2.

October 04, 2012 6:00 PM  
Blogger Raghav Agarwal said...

This is disgraceful. The medical profession has lost its sanctity and turned into a money-making business.Incidents like these just raise concern about the declining healthcare of the country. :(

October 04, 2012 7:02 PM  
Blogger Prachi said...

this was really sad..even i went CMC..n faced all queue situations..i was given so many tests to do..which were very after reading dis..its really difficult to trust the treatment of CMC..(which is considered one of the best option)..

October 04, 2012 7:18 PM  
Blogger Chandrasekharan Nair said...

Good post to open the eyes to others. Medical profession is a wonderful to us. Pray to god to save our lives without diseases, which is not possible.

October 05, 2012 1:34 AM  
Blogger Akshaya Borkar said...

Its everywhere in India. My husband had a fever in mumbai and he was treated for dengue/typhoid/viral without doing any blood test. When I refused to give him those high antibiotics, doctor used their scare tactics like, "Its India madam, viral infections are strong here, we have to give high doses to clear things. If you reject then he might die" I refused to budge and took him home and he was fine within 2 days with normal antiboitic tablets. This was very eye opening experience for my in-laws as they never doubted doctors ability before.

October 05, 2012 1:44 AM  
Blogger Parvez Mohammed said...

Dear Brijesh, I pray for good health for you and your family.
We are living in an upside down world, where a multi-millionaire film star gets special care ( may be govt sponsored for publicity ) and the common man is neglected.

Take Care.

October 05, 2012 2:21 AM  
Blogger winuku said...

I too am working in a medical profession even though not at CMC and would like to explain some misunderstandings u might be havin....
..CMC vellore is one of the few institutions in our country which offer affordable treat to a poverty sticken world such as ours. You can't help the long wait in the queue as you may not be the only one requiring treatment....there are many parents whose children maybe sick........
Dengue is caused by a virus and no one prescribes antibiotics for it...
Instead of complaining about a small system that is trying itz best to make a difference to this sad world ...try to appreciate the good work that they r doin wich u n I often fail to do.....

October 05, 2012 6:47 PM  
Blogger Umesh said...

Wow Brijesh and Deepa what a frustrating experience!!! Totally unacceptable what that doctor did to your daughter. I'm glad she is doing well now. It is sad that medical care is somewhat medieval and there is no concept of service. I hope things will improve.

October 07, 2012 3:08 PM  
Blogger opsudrania said...

Consult a good lawyer and sue them.

October 19, 2012 12:57 PM  
Anonymous Anonymous said...

And now for the punchline: dengue fever is caused by a virus and antibiotics will have no effect on a viral infection of any type!

October 19, 2012 10:39 PM  
Anonymous Anonymous said...

Its the same shit in the first world too( this is to the first comments)... ERs are filled with over worked and insensitive doctors.. anyways we went through with the same shit with our kid when she was 1 week old... effing pediatrician was one of a kind...

October 24, 2012 3:40 PM  
Anonymous Anonymous said...

I empathise completely.
i ve waited 8 hours just to see a doctor and its extremely frustating ( read pissing off).
i know a doctor who works in cmc and i know they get paid shite so i dont think its the money they want really. I suppose the system is sort of overloaded ( hence your private appointment getting delayed by five days?)
But the advice you received on going there only if there are serious issues is def pertinent.

the other reason they tell me that excess tests are done is, because like opsudrania suggested, more doctors are getting sued and so practise defensive medicine -i.e. overtreat and overinvestigate which is more expensive for the patient (but you cant be sued) to prevent being sued for undertreatment/underinvestigation- i guess its the medical equivalent of -
you credit i no give. you get mad. i give credit you no pay - i get mad. better you get mad....
you ask treatment i give cheap- you sue i get ****ed. you ask treament i give expensive treatment ( you get ****ed - i no sued. better you get ****ed.
Though i m not an apologist for incompetence, and i should think the consumer protection act should actually be strengthened and made more severe, i do believe that a personal bond with a doctor helps and that is difficult to do in a medical college where one doctor treats atleast a hundred odd patients a day....

afterthought. you prolly paid a little over a hundred bucks for an general appointment ( you prolly pay a porter more?) ... its difficult to get a spray of orchids for the price of an aster isnt it?
and it would be great if you replied to some of the posts here- would like to know what you think...

January 11, 2013 11:18 AM  
Blogger Brijesh Nair said...

Yes you are 100% right about the pay in CMC. I knew few doctors there and they are paid so less. Few of them work for the love for their profession and others for the name CMC tag carries.
Yes I paid only 100 rs as that was the only option available for me to meet a doctor on that day. After that I found out good doctors (retired from CMC) around Vellore whom I can go in case of non-emergency.

January 11, 2013 11:35 AM  
Blogger ARYAN RAJ SHARMA said...

Sir, for a blood sample u could have gone to a lab instead of CMC.. In big hospitals only trainees treat people like this as doctors don't have time for all that. Still u ended it patiently and God saved from those antibiotics.. Aryan.

January 12, 2013 7:05 AM  
Blogger ARYAN RAJ SHARMA said...

Sir, in most of these big hospitals, generally doctors does not treat. Only the trainees or junior doctors are there which dont know how to deal with the situation. Thank God u were saved from all those heavy dose antibiotics.

January 12, 2013 7:07 AM  
Blogger anonymous said...

I totally agree that CMC is no more what it used to be. I also suffered in Shankar Netralaya, Chennai. It was some specific problem with my eyes but throughout my checkup there I was made a specimen examination for the MBBS students there. Frankly speaking there were very new and almost burned my eyes during retinascopy. I am looking for good independent clinics (especially like those for fevers etc.) located in Vellore. Please if someone could post them, it would really be a boon for a lot of people.

March 03, 2014 4:02 PM  
Blogger ak sharma said...

Its so disgusting that some trainees and some kids with tags of asst and assoc professors are running the show with computers. I have never seen a senior doctor for the last 10 days in cmc vellore.

March 25, 2014 5:03 PM  
Blogger jebaraj said...

Me a paediatrician who has done all my training in CMC went through the post with a lot of emation. Me a senior doctor now, with kids of my own realise how traumatic it is for a parent an ER encounter is. Me having worked in many developed countries, realise how much importance should be given to talking and explaining the problems to parents especially if they are literates.
CMC has one of the best post graduate training programs in the country. All over the world, in most of the well known hospitals, the doctor at the point of first contact and at the area of outpatient will be trainees though under supervsion of the seniors so that the apppropriate things are done.
. Doctors in india are not trained to talk to and communicate effectively with the patient/parent. We are taught to treat only the medical problems, unlike in the developed countries. I have seen in UK major treatment goof ups which would be unacceptable to me.
Moreover, a fever lasting for 14 days in a child is a concern, and many things are not definite. the body and diseases do not follow rules many times. a few doses of antibiotics may not harm but failing to start an antibiotic in a bad bacterial infection may lead to a life threatening situation.

looking at the issue, I think, the doctor should have explained to you about what is happening and how she is going to treat your child. I have learnt now and I always explain to the parents about what my thinking process is and also explain about how i am planning to approach the problem.
I have talked to my contemporaries who really are running the show in CMC about the Qs and they say there is so much of a patient load, that they are unable to cope up with.
I feel the best will be for small problems, trust your family doctor, keep the big institutions for more significant illnesses.
Sorry for the long post. But it is difficult to explain, I hope at least some things are clarified.

September 03, 2016 11:16 AM  

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