Is 'honor' more important than your wife's health?

Few days ago a doctor who is well known to me called to ask the diagnosis of one of his distant relative who is under my treatment.
 I hesitated.
 I asked him why you were asking that question.
He said that the guy was admitted in a critical condition in another hospital.I asked further details and realised that the patient is in deep coma and not in a position to give consent  to reveal his diagnosis.
Then I told the doctor that his relative was under my treatment for last 5 years for HIV related illnesses. He was very surprised.Nobody in the family it seems know about it. But I was not surprised.

Let us call this guy Mr K.
He was referred to me 5 years ago by another doctor after he was found to be HIV positive while he was being investigated for recurrent fever. He came alone to me and was mentally a wreck. I could make out that he was thinking about taking his life.
It was very difficult for me to convince him that there is treatment for this and everything is not lost. I told him you can live as near normal life as others if you take proper care and regular medicines. Then I told him that his wife has to be tested.
 He said he cannot tell this to his wife as she will be shattered and the family life will be doomed.
" It is better for me to take my life than to tell this to my wife".
"OK you should tell this after some time.But meanwhile do not have any sexual contact,I warned".
He agreed.
Every time he come to me I used to ask him about informing his wife and he was adamant that he cannot.
I continued to prescribe medicines and monitor him. He was doing fairly well continuing his job and doing everything he need to do as the head of the family.
He did not attend my OPD for last few months and I was wondering what happened to him. I was afraid he was not taking medicines properly and his illness must have exacerbated.
What I was afraid of happened.
Just now I received a more dreaded news. His wife was also tested positive for HIV, though she appears relatively healthy at present.
Was she positive at the time of her husband's diagnosis? Or did Mr K broke the promise he gave to me and had sexual contact with her even after knowing he is positive.I hope it was the former.
 If she was already positive and I knew it I would have been able to manage her health better.Should I have insisted on bringing the wife and telling the truth before prescribing medicines for Mr K?
Why Mr K refused to tell the truth and test his wife?

Is 'honor' more important than your wife's health? 

What is your speciality?

"What is your speciality?"

I was attending a Party in a relative's house in a City far away from my workplace. I had to face this question more than once that night. I was speechless for a moment.

I am asked that question whenever I am among strangers not connected to Medical profession and always find it difficult to make people understand my area of work.

Should I say I am a General Physician?

Then they will say 'Oh you are a General Practitioner" which is not quite correct though many consider us as glorified General Practitioners.

Should I say I am an Internist?

Then they will ask what that is and I will have to explain that an internist is a doctor who specializes in identifying and treating diseases which do not need surgery. Many will still not understand.

Sometimes I say I am a Diabetologist. I have trained myself to be one and most of my patients are Diabetics thanks to high incidence of Diabetes in Kerala.

But am I just a Diabetologist?

No I do not want to be considered only as a Diabetologist. I also had some training in Rheumatology and also in HIV/AIDS.

Many well wishers have asked me why you are not concentrating on one sub-speciality/super-speciality.

"Why don't you take a DM in Cardiology or Neurology? You can earn double for the same amount of work"


But I never wanted to confine myself to one organ or organ system. Also after spending almost 10 yrs in training in Medicine I did not want another 3 years in Medical College. Being an MD in Internal Medicine I believed I am competent enough to tackle most of the cases that come to me. I could also work in smaller towns without much infrastructure unlike a sub-specialist. I also felt that work of an Internist is more exciting, dealing with a large variety of disease conditions.

So I never tried for a DM.

We the Internists always used to say jokingly that a Sub-specialist [we never call them super-specialist] is a doctor who knows more and more about less and less. Sub-specialists will say we are just jealous.

Now after 14 years of practice as an Internist, when I look back I do not have any regrets.

But I am still speechless when that question is asked.

"What is your speciality?"

Fake therapies.How can we stop it?

"Doctor, can I take 'Abcdxyz' for control of my Diabetes?"


The patient in front of me was asking about one of those numerous alternative 'medicines' for Diabetes advertised all over the media.

Iam asked such questions very often and my standard reply was I am a practioner of Modern Medicine and had little or no knowledge of other Medicinal Systems.

"Is there any harm in taking such medicines?" will be the next question and I will reply that I do not know.

Do I really do not know anything about such alternative medicines? If so why? Should I have been able to guide my patients better about the usage of alternative medicines?

Modern medicine is the science that tries to use all the new knowledge and technology available for mankind to improve the health of human beings. Being a practitioner of Modern Medicine and a keen follower of all research that is taking place in this field I should be able to tell whether a therapeutic method is superior, inferior or useless in comparison to currently accepted treatment method.

So how can I research the data regarding these so called ‘wonder alternative medicines’ for Diabetes? Is there any research ever done for these drugs?

The truth is no good quality research takes place before such products come into market. The Company that produces and markets such drugs never provides any research data. Just plain logic should make all of us realise that these medicines are ineffective because a medicine that can be proven to reduce blood sugar even by few milligrams can make billions if it was scientifically approved. The mere fact that no effort is made to get scientific approval for such products by conducting scientific studies tells us that these products are just placebos sold to unsuspecting public with massive advertisement budgets.

Should we stop such Fake therapies?

Many will say that even though such therapies are ineffective they can do no harm, so why one should try to stop them.

The Companies are fooling unsuspecting people using the name of ancient Indian science Ayurveda. People are wasting their hard earned money by buying and consuming useless products. They could have used this money for a much more useful purpose in bettering their lives.

Also how can one surely say that there are no harmful effects for such products without any proper studies? So stopping of such fake therapies is important for society's health.

How can we stop such Fake therapies?

Most important step should come from the Government. All such alternative medicines and supplements should undergo rigorous scientific testing before they are sold in the market. Advertisements with exaggerated or false claims should be severely curbed.

As a practising doctor I should strongly discourage patients from taking such unproven therapies. I should explain to them that their money will be wasted and no one has any idea of the side effects that it can produce.

With increasing awareness among Indian consumers I feel that people of our country cannot be taken for granted any more. Useless [and maybe harmful] products minting money for unscrupulous Companies should be stopped.