Ethics in Medicine with LEXIAMMA

By Dr. Nishita Bujala

Nishitha Bujala is a medical graduate from Kamineni institute of medical sciences and currently pursuing the USMLE journey. She loves to read and write and shares her journey on instagram through her page @thegirlnextdoctor.

Lexiamma, you are back after a while, what took you so long?

Hi there! Thanks for your love, I’ve been busy graduating from medical school. But now your favourite Lexiamma is back with real-life tips and tricks to survive medical school.

Hello! I am a tenth-grade student and wish to go to medical school one day. Is it as badass as Grey’s Anatomy?

As much as I want to say it’s similar to shows like Grey’s Anatomy and House MD, more often than not, your days are filled with regular cases – COPD, ESRD, asthma, GERD, cirrhosis. Very rarely are you presented with a zebra. The shows are glorified for obvious reasons, but residency in real life is very hectic, you don’t have the time to wash your toilet, let alone find the love of your life.

We went to the hospital for my grandmother after some lab tests. The doctor dropped the cancer bomb as soon as we entered the room. My grandmother did not take it well and we didn’t know how to deal with the situation. Any suggestions?

I am sorry to hear that. The doctor should have used the SPIKES protocol before delivering the news to you. It usually involves assessing the situation and addressing the patient’s emotions with an empathetic approach. Your grandmother now needs family support more than ever, so try to be there for her until she comes to terms with her diagnosis. Consult a psychiatrist if you see major behavioural changes. But until then, discuss with your family, the goals of her care and how you want to proceed moving forward.

Hi Lexiamma! I am an intern at a government hospital and posted in surgery. I can’t help but feel I am doing more harm than good to these patients with barely available resources. When will it get better?

Hi! Most aseptic dressings I have seen done at the hospital are septic dressings. There is a dire need to train students better, but I know how the inflow of patients in a high-volume hospital where you treat hundreds of patients every day might hinder the process. No doctor is perfect, but if we try to incorporate some strict protocols and smart initiatives, the lack of resources will take a back chair and improve the quality of care for the better. Let’s not talk about when it will change because it won’t. But you can.

Can you give us a few details comparing the quality of care in foreign nations vs India?

It’s not fair to compare foreign nations like the USA, a first-world country with India, a third-world country. Of course, there are differences in the quality of care, time spent with one patient and research-based medicine practised. While in some foreign countries’ health care is privatized and includes third parties like insurance companies, the free availability of health services in India is commendable.

I love your work! Do you have any tips for a recently graduated doctor who wants to practice medicine?

Congratulations baby doctor! It feels like a huge responsibility to start practising, but if you stick to the four pillars of ethical practice- do good, do no harm, ensure fairness, and provide autonomy- you should be all set. Remember all the good reasons you chose medicine.

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