How “incompetent ” our doctors
Ambassador’s Diary
Dr Samiullah Koreshi
Monday, October 11, 2010 - It has become quite a routine for our power elite who are now getting all the facilities of treatment at government expense which was once available to government servants because they the government servants are poorly paid and could not afford expensive treatment even in Pakistan in private hospitals. . That was the reason why the government servants were given treatment at government expenses in Government hospitals. Now by and by the Government servant has been elbowed out and the political bosses who spend crores on their elections are getting far more facilities for treatment at Government expense and they generally want to go abroad for treatment of all kind of health problems. It is now fashionable to go for serious ailments abroad to US or UK They think that Pakistani hospitals and doctors, surgeons are no good compared to foreign doctors or foreign hospitals. How incompetent are our doctors is a matter which needs to be examined.
Can Pakistani doctors/surgeons treat cancer, perform open heart surgery and brain ailments. ? In August 1995, I had what seemed to be a heart attack. My friend immediately took me in his Suzuki van to the PIMS, which then was still a far cleaner and well managed hospital because it did not treat such inordinate number of outdoor patients as now, may be several times more than in those days. I was rushed to I C U and some young doctors attended me giving me injections which put me to sleep. ICU was fairly well maintained, clean and not over crowded in those days. Next day when on his routine rounds of the ICU, its head of the Cardiology Department, Dr Afzal Mattu looked at my case history sheet , expressed his satisfaction on the immediate treatment given to me by the young internees but the third day on his morning rounds he looked at my treatment sheet and carefully saw my pale hands and asked me a number of questions: Are you passing any blood in urine or stools. Reply No, Have you lost your appetite Reply No, Have you lost weight recently , Reply No. Dr Matto looked at my hand closely and said “ Surprise . Why have you recovered fast so soon . No I am not satisfied by your replies, I must have your blood examined and abdominal X ray done. The blood examination showed my hemoglobin very low just 7 whereas it should have been 12 at least. He said :You have too low hemoglobin. I will give you iron pills . My Hemoglobin started to improve. No I still do not believe you . You are passing blood, Matto said . You should leave the ICU and move to VIP room and have stay there till we have your complete diagnostic pathology tests He said he did not believe that I was not passing blood . I have a number of tests for a week in the PIMS. I was annoyed being detained in the hospital. After the X ray and stool tests Matto said Dr Koreshi You have cancer. You must have operation immediately.
The interesting point was that Dr Afzal Matto was a Cardiac Specialist or head of Cardiology and I had gone for what was described as an angina attack yet he went much beyond his responsibility – to discover cancer. I was getting impatient to go home having been in PIMS for 15 days . The iron pills have been increasing my hemoglobin . Young doctors suggested that the quick improvement in my hemoglobin level indicated that it might not be the case of passing blood but some other disease and wondered whether I needed the painful cancer surgery. They advised me “No need to be in a hurry for an operation” Matto insisted on his diagnosis, Then I requested my friend General Aslam Beg to speak to the Commandant of the Military Hospital in Pindi to have my tests at the MH supposed to be the best laboratory .He telephoned Major General Arshad Commandant of the MH to have he had my tests done same day . The tests were done in few hours. General Arshad looked at them and said Doctor Koreshi No question that you have Cancer of the intestine, You better go for operation right away Do not lose time We can perhaps still save you, Go to the PIMS for the operation right away.
Dr Ghayur Ayub, a Pakhtun from the Tribal belt , a very noble and kind surgeon was the head of Surgery in the PIMS . His father had been in the Foreign Service. He was willing to do the operation right away but before that he wanted to have my heart tests that I can survive the operation. The lady head of that Department in PIMS was not willing to clear me to undergo surgery and said that You are a high risk persons. You can die on the table during the operation. Dr Ghayyur Ayub said that he was ready to undertake the surgery if the lady incharge of the lab would clear me for the operation. Finally I argued with the lady saying I rather die of the operation table than of Cancer and got her permission to undergo the operation . The problem was to get four bottles of blood. My wife went from pillar to post but with no success. Finally Lt General Moinuddin Hyder then Adjutant General arranged it from the CMH .Dr Ghayyur Ayub did the operation warning my wife that I could expire on the surgery table. He opened me and came out of the Surgery room to tell my wife that it was localized cancer- in first stage- and had not spread . He did a successful operation I needed no blood transfusion and I gifted the four bottles of blood to the PIMS for use on some needy persons.
After the operation Dr Guayyur Ayub advised me to go to the NORI, Nuclear Oncology Research Institute, for further treatment of chemotherapy. Dr Kizilbash head of Nori prevailed on me as also Dr Ghyur Ayub that the precautionary treatment of chemotherapy should be taken which lasted under the supervision of Dr Faheem of NORI for three years with a break of three months each time. Each session of chemotherapy lasted for three hours. Thereafter I had periodic test tests to monitor that cancer did not recur and by the grace of Allah Almighty there was no recurrence of the problem I had a cousin as a Consultant at the Agha Khan Hospital where too I had check ups and tests.
The total expenditure on three years treatment. Operation, technical examinations, cost of chemotherapy etc came to Rs 60,000. At the early stages of the problem, I consulted my cousins where should I have the treatment, Some of my cousins are the /were the top doctors and surgeons of Pakistan . They said the PIMS is one of the best hospitals in Pakistan , both doctors and the facility wise. I have about 30 doctors/surgeons in my “family” cousins , mostly women doctors in Karachi , including my daughter. It was their unanimous view that PIMS is one of the best hospitals in Pakistan. I experienced it . The nursing there was superb and as a token of my appreciation I left a big cake for the nurses when I left PIMS.
The fact to day is that except for advanced cases of brain surgery , very complicated cases of heart or for treatment of those ailments which require very advanced machinery etc, Pakistanis are capable of treating several cases of cancer, heart diseases , bone surgery etc. In open heart surgery Pakistanis have done quite well. Islamabad, Lahore and Karachi provide quite good treatments in all such diseases. I was asked by PIMS doctors whether I would like to go abroad for treatment I preferred Pakistan , for several reasons. Quick treatment and immediate surgery was one. Expenses was another. It would have taken time to get Government sanction for treatment abroad, if given and by that time the cancer would have spread. And what would have been the cost of full treatment? By and large Pakistani doctors are as competent as foreign doctors. They lack latest equipment, machinery and advanced medicines, not professional competence.
Can Pakistani doctors/surgeons treat cancer, perform open heart surgery and brain ailments. ? In August 1995, I had what seemed to be a heart attack. My friend immediately took me in his Suzuki van to the PIMS, which then was still a far cleaner and well managed hospital because it did not treat such inordinate number of outdoor patients as now, may be several times more than in those days. I was rushed to I C U and some young doctors attended me giving me injections which put me to sleep. ICU was fairly well maintained, clean and not over crowded in those days. Next day when on his routine rounds of the ICU, its head of the Cardiology Department, Dr Afzal Mattu looked at my case history sheet , expressed his satisfaction on the immediate treatment given to me by the young internees but the third day on his morning rounds he looked at my treatment sheet and carefully saw my pale hands and asked me a number of questions: Are you passing any blood in urine or stools. Reply No, Have you lost your appetite Reply No, Have you lost weight recently , Reply No. Dr Matto looked at my hand closely and said “ Surprise . Why have you recovered fast so soon . No I am not satisfied by your replies, I must have your blood examined and abdominal X ray done. The blood examination showed my hemoglobin very low just 7 whereas it should have been 12 at least. He said :You have too low hemoglobin. I will give you iron pills . My Hemoglobin started to improve. No I still do not believe you . You are passing blood, Matto said . You should leave the ICU and move to VIP room and have stay there till we have your complete diagnostic pathology tests He said he did not believe that I was not passing blood . I have a number of tests for a week in the PIMS. I was annoyed being detained in the hospital. After the X ray and stool tests Matto said Dr Koreshi You have cancer. You must have operation immediately.
The interesting point was that Dr Afzal Matto was a Cardiac Specialist or head of Cardiology and I had gone for what was described as an angina attack yet he went much beyond his responsibility – to discover cancer. I was getting impatient to go home having been in PIMS for 15 days . The iron pills have been increasing my hemoglobin . Young doctors suggested that the quick improvement in my hemoglobin level indicated that it might not be the case of passing blood but some other disease and wondered whether I needed the painful cancer surgery. They advised me “No need to be in a hurry for an operation” Matto insisted on his diagnosis, Then I requested my friend General Aslam Beg to speak to the Commandant of the Military Hospital in Pindi to have my tests at the MH supposed to be the best laboratory .He telephoned Major General Arshad Commandant of the MH to have he had my tests done same day . The tests were done in few hours. General Arshad looked at them and said Doctor Koreshi No question that you have Cancer of the intestine, You better go for operation right away Do not lose time We can perhaps still save you, Go to the PIMS for the operation right away.
Dr Ghayur Ayub, a Pakhtun from the Tribal belt , a very noble and kind surgeon was the head of Surgery in the PIMS . His father had been in the Foreign Service. He was willing to do the operation right away but before that he wanted to have my heart tests that I can survive the operation. The lady head of that Department in PIMS was not willing to clear me to undergo surgery and said that You are a high risk persons. You can die on the table during the operation. Dr Ghayyur Ayub said that he was ready to undertake the surgery if the lady incharge of the lab would clear me for the operation. Finally I argued with the lady saying I rather die of the operation table than of Cancer and got her permission to undergo the operation . The problem was to get four bottles of blood. My wife went from pillar to post but with no success. Finally Lt General Moinuddin Hyder then Adjutant General arranged it from the CMH .Dr Ghayyur Ayub did the operation warning my wife that I could expire on the surgery table. He opened me and came out of the Surgery room to tell my wife that it was localized cancer- in first stage- and had not spread . He did a successful operation I needed no blood transfusion and I gifted the four bottles of blood to the PIMS for use on some needy persons.
After the operation Dr Guayyur Ayub advised me to go to the NORI, Nuclear Oncology Research Institute, for further treatment of chemotherapy. Dr Kizilbash head of Nori prevailed on me as also Dr Ghyur Ayub that the precautionary treatment of chemotherapy should be taken which lasted under the supervision of Dr Faheem of NORI for three years with a break of three months each time. Each session of chemotherapy lasted for three hours. Thereafter I had periodic test tests to monitor that cancer did not recur and by the grace of Allah Almighty there was no recurrence of the problem I had a cousin as a Consultant at the Agha Khan Hospital where too I had check ups and tests.
The total expenditure on three years treatment. Operation, technical examinations, cost of chemotherapy etc came to Rs 60,000. At the early stages of the problem, I consulted my cousins where should I have the treatment, Some of my cousins are the /were the top doctors and surgeons of Pakistan . They said the PIMS is one of the best hospitals in Pakistan , both doctors and the facility wise. I have about 30 doctors/surgeons in my “family” cousins , mostly women doctors in Karachi , including my daughter. It was their unanimous view that PIMS is one of the best hospitals in Pakistan. I experienced it . The nursing there was superb and as a token of my appreciation I left a big cake for the nurses when I left PIMS.
The fact to day is that except for advanced cases of brain surgery , very complicated cases of heart or for treatment of those ailments which require very advanced machinery etc, Pakistanis are capable of treating several cases of cancer, heart diseases , bone surgery etc. In open heart surgery Pakistanis have done quite well. Islamabad, Lahore and Karachi provide quite good treatments in all such diseases. I was asked by PIMS doctors whether I would like to go abroad for treatment I preferred Pakistan , for several reasons. Quick treatment and immediate surgery was one. Expenses was another. It would have taken time to get Government sanction for treatment abroad, if given and by that time the cancer would have spread. And what would have been the cost of full treatment? By and large Pakistani doctors are as competent as foreign doctors. They lack latest equipment, machinery and advanced medicines, not professional competence.
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