Zydus Hospital Cancer Centre Zydus Hospital Anand Unit

The oldman's Pursuit

COVID19 has created unprecedented crisis and challenges particularly to the health care setting where it has given significant blow to the existing "Doctor-Patient" relationship what now we can term as "In-Person Consultation".

Particularly in India, where we would have seen images of "No calls / No messages / No WhatsApp consultation" in OPD clinics of many doctors owing to the legal issues related to this type of "Teleconsultations", The Board of Governors (Medical Council of India) was very quick to formulate and publish the "Telemedicine Practice Guidelines" dated March 25th, 2020 - on the first day of the nation wide lockdown.

As a famous saying goes, "Never let a crisis go to waste", me & many of my colleagues started exploring the world of teleconsultation. The purpose of this blog is to highlight the first hand experience of how it was useful to save one of my patient's life.

That day began as usual with intimation from the telemedicine team regarding an appointment at 1 PM for a eighty two years old gentleman. When I began teleconsultation, I did not see the old man, but a young lady presenting me the case scenario and narrating the complaints of extreme weakness, easy fatigue, loss of appetite so severe that he has hardly eaten anything since last 7 days. Upon enquiry I found that she was the granddaughter of the patient. I requested her to adjust camera so that I can see the patient and there, What I saw was a moribund old man sleeping over bed. He was not even able to talk or sit on his own. I urged to terminate the teleconsultation & explained the critical situation stressing them to shift him as early as possible to healthcare facility.

The relatives understood the gravity of situation & with-in an hour they were with the patient at our emergency department. I examined the patient thoroughly & ordered the tests which were clearly showing infection in the lungs with liver and kidney injury requiring hospitalization. The appropriate & timely administered treatment brought the old man's vigour back with resolution of lung infection along with normalization of liver & kidney functions. The oldman was discarged after what her granddaughter expressed with a tinge of tears in her eyes and a small smile - a breakfast of Dhokla & cup of tea after 7 days.

The telemedicine guidelines does give the right to a doctor to terminate teleconsultation if the patient is not present. When I think in retrospect, this moment was overcome by requesting the lady to adjust the camera and finally I have my reward of discharging a patient in previously restored state of health.

In the end, I would like to quote, "No circumstances - however catastrophic - can endanger the immortal relationship of the patient and the doctor".

- Dr. Jaykumar Mehta

MBBS (Gold Medalist)

MD, DNB, MNAMS, PD Fellow (Pulmonology)

Consultant Interventional Pulmonologist (Zydus Hospital, Ahmedabad)