Doctors or Demigods?

Since I was born and raised abroad and after having lived there most of my adult life, I’ve come to expect a certain amount of quality when it comes to the most basic amenities in life.  Protection from police forces, drivable roads, clean water, and quality health care – all examples of the basics millions of us around the world take for granted.  All these topics are separate blogs in and of themselves but for now, my main gripe is the quality (or lack-thereof) of medical and dental care in this country – and the corresponding accountability that one would assume exists in such professions.  I’m not saying that high quality is not available here – I’m just raising the point ‘how is one to discern quality from mediocrity in this case?’  In a place where there is little to no regulation, no standardization and a blind faith general acceptance, without question, of whatever is being relayed by medical professionals – how is the average person to know when to do a figure eight and leave before the damage is done?  I once had to have dental work done and after a careful examination it was determined I would require two teeth extractions and one filling, each in subsequent sessions.  Later when I went in to have the procedures done, I was sitting in the dentist’s chair, fully comfortable with the doctor’s abilities, only to discover that the filling had been performed on a tooth that was to be extracted a week later!  If I hadn’t been conscientious enough or proactive in the business of my own healthcare, it would have just slipped by, I would have had to pay for it and then assume the mental and physical damage of having yet another filling done, in vain.  The sad part is that this took place in a well-renowned, ISO-certified facility. 


I feel that though it is a major hospital in Karachi which, despite bearing the internationally recognized ISO logo all over it, there is a major lacking in many of the typically anticipated aspects that one would expect of a city’s best medical care facility.  Ample amount of clean beds with linens that are not several decades old; an ER with the accommodation to privately hold those waiting for emergency care, rather than in the midst of all the others while vulnerably lying in a stretcher clothed merely in a hospital gown ; Proper grief counseling and the availability of such when needed, rather than only during office hours; twenty-four hour availability of anesthesiologists awaiting duty that may call as per the birth of a child, again rather than just during office hours.  Is this too much to ask?  Another question I’ve found myself asking since the first time I required medical care after moving here, is “why aren’t I treated as an equal in this patient/doctor relationship?”  In fact, as I see it, I am hiring them for their services and should have the rights of any other consumer for goods/services.


All I am asking for in my doctor(s) is accessibility, credibility, reasonable hygiene in the treatment environment, progressive practices (as opposed to rigid and old-school attitudes) and basic respect. 


Where is the concept of doctor/patient relationships?  Rather than the relationship being a lopsided one of authority versus submission, I rank being able to relate to my doctor and vice versa, very high on my list of priorities.  Rarely have I witnessed a doctor in this society, who is open to questions, comments and, dare I say, criticism.  As a patient who is very proactive and used to an open-door policy of communication, I am appalled at the sheer demigod mentality of many, if not most doctors here.  With the amount of research one is able to accomplish these days, it should be of no wonder to doctors when we want to discuss in detail what our options are, when we openly desire a second opinion (without the need to hide it from doctor #1), or when we would like to opt out of one or the other prescribed method of treatment.  SO WHAT if the patient is taking an active and proactive role in their health and that of their close family?


Unfortunately, here it is considered defiance or hard-headedness when one questions any aspect of their healthcare. Case in point: As a first-time pregnant woman a few years ago, I had a natural propensity to read up on anything and everything I could find on the subject and so I had lots of questions.  Is green tea ok to drink during pregnancy?  How much DHA should I take and for how long during each trimester?  How much is too much fish for fear of mercury poisoning?  Do I need to get rid of my cat or just keep him at arm’s distance to prevent toxoplasmosis?  The first inkling I had of the situation of doctors vs. patients and the utter blind faith with which many people carry on according to their doctor’s suggestions, came during my first pregnancy in Karachi when I dared ask these questions.  To make matters worse, I ‘interviewed’ my short-listed choice of doctors, to see which one shared the same basic [medical] philosophy I believe in.  It was a painstaking and disheartening experience when I learned that this exchange of philosophies was about as unwelcome as a power outage in the dead of summer.  In sharp, sharp contrast – my doctor abroad (for my next pregnancy) asked me herself whether we were on the same page.  She read through all six pages of my birth plan and made every attempt (successfully) to accommodate most of my requests.  SO, SO different from the experience a good friend had with her pregnancy here in Karachi, during about the same time I was abroad.  Despite her repeated requests to be given a local anesthetic during a (fairly routine) Caesarian section, it seems very likely that since she tried to take an active role in this discussion and decision, she was forced to undergo the surgery under general anesthesia, something which resulted in a major complication, bringing her dangerously close to death and causing considerable collateral damage to her trust in the system.  Her doctor at the time is considered one of the best in the field, having studied abroad and is even certified with an accredited international association, yet after repeated one-sided ‘discussions’, in the end it was the doctor’s stubbornness that prevailed.


Most recently (and the main reason I began writing on this blog), I suffered near to sure irreversible damage to a tooth, after a local dentist whose thriving practice resides on the main and bustling main street of Karachi handled and re-handled my tooth, resulting in a botched-up root canal that was otherwise a routine procedure on a fairly simple tooth.  The dentist never told me of the damage that was done to my tooth.  Instead, I was left to discover the problem after months of pain and suffering.  Never mind the eight visits and countless injections and the doctor’s numerous attempts at completing this simple procedure.  The fact that I had to discover the truth on my own accord really makes it hard to trust the system again.  Why can’t there be an organization such as the Better Business Bureau (USA) – where companies and institutions who have received numerous complaints, are cited and advertised, their shortcomings investigated and their administrations penalized?


Adding insult to injury to all my experiences, there is no regulatory body looking out for mishandling, ill-placed medical advice and (worst of all) medical malpractice.  The medical profession can practically get away with anything.  I am asking what are we to do if the healthcare industry is not held accountable. How can we overcome this problem, and promote progression rather than regression?


16 Comments so far

  1. farzal on January 14th, 2009 @ 9:43 am

    There was an article in Dawn just yesterday with chilly title of "‘Gynaecologist’ convicted for killing woman"

  2. MB (kar_munib) on January 14th, 2009 @ 10:55 am

    well written dude, just cut the post into initial and full portions. Its coming all on first page

  3. human01 on January 14th, 2009 @ 10:57 am

    Welcome home sis…..your post reminded me of the lead character of "Choti si Dunya" an old TV play about a guy who came back to his village from England after spending a while there and the response of his fellow villagers on his "normal" behavior that he became accustomed to during his stay abroad. In this TV play’s analogy, our whole society is full of JANU GERMANS…the arrogant "KUNWEY KEY TOADS" think they know it all…
    All the things you mentioned is pretty standard and routine practice where you used to live, may be same every where in the rest of the civilized world, may be that’s why they are called civilized. I guess, the answer to your question is pretty simple, we are not there yet….and seems like, it will take ages for us to develop such kind of awareness & sense of ownership & responsibility. Irony is, in this age of internet & light speed communication, we claim to become very modern but in reality we got just the glitters but no essence, no spirit. As you mentioned, ISO stamps every where but without ISO spirit. I don’t know, I really feel sad, feel hope less & frustrated some times….. I think education is the key, the only solution. I am not sure when, but the day we as a nation have that ultimate tool, it will resolve most of these issues.
    BTW we have a dentist here @ KMB as well & I am sure if you’ve consulted him, your experience would’ve been relatively pleasant one….

  4. seskey on January 14th, 2009 @ 12:27 pm

    Since I was born and raised abroad and after having lived there most of my adult life, I’ve come to expect a certain amount of quality when it comes to the most basic amenities in life. <— BB you have started the RANT with contradiction.

    YOU ARE EXPECTING TOO MUCH, from the system which is dysfunctional.

    We in Pakistan LIVE on DAY TO DAY basis, Cheers !

  5. textrovert on January 14th, 2009 @ 4:25 pm

    Some say education will eradicate such issues but i myself having being raised abroad and now in pakistan for uni realize that lack of education is not the only cause of our deteriorating beloved Karachi. After spending an entire year amongst freshmen coming from top class private schools of Karachi i feel the money their parents spent all this time didnt refine these youngsters. Surprisingly it is these youngsters that tend to follow simple rules such as avoiding to litter when they are away from pak for some kind of holidays but once they are in Pak they are back to square one of littering around & they are so impressed by the set of unwritten rules followed in western countries. To start with our youth is too reluctant for a change since they feel Pakistan is HOME and there’ll always be some one to sweep up once we are gone! A pity it is!

  6. fareen on January 15th, 2009 @ 12:28 am

    kar_munib: Thanks!

    Human01: I’ve seen Choti Si Dunya! I just don’t think we’re ever going to progress (like other third world nations who broke through to the other side) unless we change our complacency and stand up and demand accountability. Also, I am so glad I got the 2nd opinion of the Tooth Maestro before proceeding. Thankfully, his practice is going to try and rectify the problem.

    Seskey: Please explain where the contradiction is.. I’m just not seeing it. Also, I wanted to add that unless we expect more and more, we are not ever going to progress. Look at India. Though in many ways India is very similar to us, yet often I see excellent examples of a person or group of people who insisted on a higher standard, thereby breaking through the barriers of mediocrity, as I pointed out in the original post.

    Textrovert (LOVE the username by the way): Yes, I agree with you that a lot of our problems stem from a weak foundation and weaker love for our country. I remember visiting in ’76 with my grandfather and he had taken me to the playland in Clifton. It was so clean, people were so friendly and overal things were just so much better. That kind of pride in our surroundings has slowly diminished and is practically extinct now. I always shake my head from left to right in a blatant display of distaste whenever I see an educated (or uneducated) person littering. But it brings everything back to my main point; the need to hold people and organizations accountable.

  7. psychiatrist on January 15th, 2009 @ 12:23 pm

    I can not agree with the author of this blog more. I do however have my reservations.

    The problem is that instead of cursing one thing or another, we must admit that as a nation and as a whole, we still have a long way to go.

    Our education system is flawed, our health system is flawed, our economic system is flawed. Everything is flawed.

    The only way to change is to start from the scratch. There is a need for a change— in policies and attitudes.

  8. seskey on January 15th, 2009 @ 12:41 pm

    @Fareen BB the contracdiction ————-> "Since I was born and raised abroad and after having lived there most of my adult life, I’ve come to expect……."

    Had you been born & raised in the ‘SYSTEM’ you may have not EXPECTED or complained at all – IN OUR BELOVED (NON)ISLAMIC(NON)DEMOCRATIC REPUBLIC WE are FORCED TO "PAY" for everything which is BASIC for existance in places where you were born raised to be an adult, – drinking water, basic education, basic health, electricity & emergency services.

    what we lack in PAKISTAN is sense of ownership, being responsible for our own deeds,

    2 degrees out of 360 I tend to disagree that it is education.

    – The same mali, chokidar, driver, cook, maid, etc etc, act civilised human when they land elsewhere on JOBs, they don’t litter, don’t spit, don’t scratch balls in public, don’t JAY WALK, respect others, they become kind & courteous etc etc etc when away from PAKISTAN,

    whereas they go haywire rowdy the moment it comes to hometown which seems like its free for all GOVT is responsible for all not individuals, Mr. President has to come and clean the litter on sidewalk & Mr. Prime Minister have to step forward and stop the water leaking from your lawn hose — because we have voted for them and we are paying taxes for their comfort and we are free from our civic responsibilities………, & on & on & on, – (END)

    The core issue is sense of belonging, sense of ownership, feeling responsible and acting responsible.

  9. jumanji on January 15th, 2009 @ 3:33 pm

    As a nation and as an individual we need to accept that we are at fault. Education is not the only problem it is the stubbornness that what we r doing is right is big issue. On road one can observe flashy cars driven by executives but seldom follow road signs / red light. R these executives Illiterate not at all. It is so disturbing to explain when your child ask "why people dont stop on red light". Just visit a park where children area is occupied by elders but if that park has a gunman around evreything is right. Youth are blamed for ill behavior nobody question the way they r raised. I saw a under age child driving a car and his father sitting beside him. The child was not in control and when a man objected he was given a hrash reply by father of child "mind your business it is my car and whatever I like". Just observe how marriage parties are conducted, barat usually arrives betwen 11 pm to 12 midnight and dinners served at around 1 am. Still we call ourselves normal and blamed Illiteracy for every evil. We will not change and so our lives will not change. Call it pessimisim but I have lost any hope of improvement that is more evident for people living in Karachi.

  10. psychiatrist on January 15th, 2009 @ 3:53 pm

    Unfortunately, Pakistan today seems to have come under the curse and wrath of Heavens. On the one hand, poverty is crippling the nation. On the other hand the people of this land are in the clutches of terrorism. To complicate things further, the likes of Mr. Zardari have come to the government.

    As an individual I I can choose but be disappointed and desperate. I am wondering as to what will become of us.

  11. kabirdas on January 15th, 2009 @ 10:40 pm

    The title of this post should have been: Doctors or Dacoits

  12. psychiatrist on January 15th, 2009 @ 10:57 pm

    Come on guys. All doctors aint that bad. My father is a doctor, he served poor patients all his life, without taking a single penny from them. He even went to treat his patients in their houses in the middle of the night.

    I am a doctor and I aint no dacoit myself. Please understand that there are bad people every where. But that never means everyone is bad.

  13. fareen on January 15th, 2009 @ 11:32 pm

    …I’m not saying that high quality is not available here…

  14. obiwankenobe on January 18th, 2009 @ 10:22 am

    You should please put the name of that dental clinic. Who gives damn what you went through when you are not willing to expose the name of place and not helping others.

    And I believe that doctors in Pakistan are doing wonderful job provided they do not have many resources. Here my doctor would just send me for all tests and would never dare to make any suggestion before that and that tests would cost hundreds of dollars and if there was no insurance, no one in west could afford those tests. Given that we do not have insurance system in Pakistan and people do not have much money to spend on these medical tests, the doctors simply rely on their experiences and make the bets decision with limited info on hand.

    How about thinking positive for a change ? :-)

  15. fareen on January 19th, 2009 @ 11:34 pm

    On Zamzama… near Pizza Hut. Purple sign. First floor.

  16. mk4peace on January 20th, 2009 @ 5:19 am

    I could not agree with obiwankenobe more about doctors making the best with what they have. I was born in Karachi but I did not grow up there. I went to Karachi as a mother of 4 and I could not fathom the practices of doctors. My son would be sick a lot with stomach issues. I took him to Mamji hospital, Agha Khan hospital, Ghayyur’s clinic and a couple others. Each had their own philosophy and diagnosis. I was so lost. I turned to a homeopathic doctor, who was kind of whacked in the head but surprisingly enough, his medicine worked the best!! Pakistan has this business attitude, much like the rest of the world, to rip off every person who can be ripped off. It’s everywhere, wether u r in a clothing store, at the doctor’s, at the police station, it’s everywhere. Everyone who has commented above has had valid points and it ALL has to be brought together to make our country a better place. There is a need for better education, better housing, regulations of companies, services and doctors, and also THE END OF LAW LESS NESS. People don’t follow any rules, regulations, because they don’t have to face any consequences!! Possibly a government actually set on improving the country can bring about these changes, but who is that? Who CAN do that? Maybe no one, maybe all of us? Only Allah knows…cause I sure as heck don’t!!!

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