What's up, Doc? (Dealing with quack doctors)

JAKARTA (JP): Rizal's graduation from medical school left his parents flat broke. The poor traditional farmers had sacrificed all their properties, including the only rice field they had. All for one purpose: to make Rizal the first doctor in their village. They did not mind living in poverty and working as farm hands to make ends meet. They didn't mind eating cassava in place of rice just to save money.

And now, although they had to sell their only house just to be in Jakarta for their son's graduation ceremony, they were happy as larks as their dreams had eventually come true. "Now, no longer do we have to eat steamed cassava," they mused.

But, unfortunately, the cassava-consuming business didn't stop there. Becoming a doctor doesn't mean you can just start making money. A newly graduated doctor has to go through several years of service in a sometimes remote village before he or she is allowed to establish a private medical business. Rizal was assigned to a small village in Sulawesi with his parents in tow. He had to take them with him as they didn't have anywhere else to live. And the fact they had to face was, they still had to consume cassava because the villagers kept sending it to them as a token of their gratitude for the medical doctor who helped them for free.

Although being a doctor does not promise instant prosperity, the title has not lost its grab on young people. Every time I ask high school students in my class about the career they dream of, five out of ten say they want to be medical doctors. Their reason is that being a medical doctor is a noble profession.

Noble? I never have the heart to tell them that nowadays doctors are no longer that noble. They are just ordinary people made up of blood, bones, and flesh, along with needs. And just like the other creatures of their species, they crave luxury, expensive cars, big houses and all that. Gone has the time when a doctor would treat his or her patients without thinking of whether or not they could pay.

Nowadays, the services of some doctors depend on the prosperity of their patients. Visiting a doctor is just like sending your car to the garage. You will be welcomed with broad smiles if the doctor you visit knows you live in a prestigious area, and that you ride the latest German car. And the smile will be broader if he knows you are a hypochondriac.

At certain garages, the mechanics do unnecessary repairs on your car and replace spare parts whether they are worn out or not. In certain doctor's examination rooms, whether you need it or not, the doctor suggests a series of tests and examinations using sophisticated apparatus to ensure that you feel better and that he gets a hefty check.

A hefty check can also buy various statements that you may need from a doctor. If you do not feel like going to work, then you can ask a doctor to write a letter stating that you are seriously ill. This kind of letter is also helpful in avoiding the courtroom. If your doctor says that you are sick, then nobody could doubt it. You are "legally" unfit to be in the room where laws are said to be enforced. There have been many cases where culprits have sashayed abroad just because they have a "powerful" letter from a doctor.

"What is happening to doctors these days?" you may wonder. Have they become so greedy that they will do anything for money? Have they taken their professional vows for granted?

Well, I should not generalize. There are, of course, still many doctors who are not tempted to violate laws for money. There are still idealistic doctors who stick to their vows.

But I still remember an experience in 1995, when I took my oldest son to an emergency ward of a private hospital in Jakarta. He felt serious pains in his abdomen. The doctor on duty happened to be a surgeon. He nudged my son's stomach and then decided that he had to immediately conduct surgery to remove my son's appendix. Knowing a thing or two about diseases, I refused to sign the letter of approval he shoved toward me. "Not until a proper examination has been done," I said sternly.

The surgeon then threatened not to take responsibility if something terrible happened to my son later. "Well, don't blame me if your son dies of an infection," he said coldly, as though he was talking about a sick chicken.

Was I right! My son did not have a problem with his appendix, and that surgeon had lied when he said that the operation was required immediately. Had I approved of the surgery, my son would have lost his appendix for no reason at all.

"Well, appendices are gold mines for surgeons," commented my nephew, himself a doctor. "Here, with or without a problem, an appendix can be just snatched out in a $1000 operating spree. And the patient would not know the difference, because he can just live normally without one."

Women nearing menopause are another gold mine. Usually they complain about discomfort in their bowels. Some gynecologists see this as the source of money. My neighbor and my niece are two women who escaped the operation room after a gynecologist decided to remove their ovaries. Just like the surgeon in my son's case, the gynecologist said he must conduct surgery to remove the troubled ovaries. Otherwise, he would not take responsibility if something fatal happened afterwards. And now, 10 years after the threat, both women are still fit as a fiddle. The secret lies, they believe, in a second opinion. Returning from seeing the errant gynecologist, they went to see several others to seek second opinions, and found they did not have a problem at all.

Second opinions, I believe, are a must before you make a decision about illnesses that require serious treatment such as operations. That way, you can escape the operation room or at least avoid the risk of dealing with dodgy doctors.

-- Carl Chairul