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Dr K K Aggarwal

The spiritual prescription I am sorry

By Dr K K Aggarwal
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Two hardest words for a doctor to say: “I’m sorry.” Most defence lawyers counsel doctors to not apologize to patients. Their view is that if you say you’re sorry for something, you are implicitly taking some degree of responsibility for whatever has happened. In other words, you are pleading guilty. The complainant’s lawyers may use a doctor’s apology to the maximum extent possible to show the doctor knew what they did was wrong. The usual approach is deny and defend. But,

  • Apologizing after a medical error is the humane thing to do.
  • Patients often sue simply because it’s the only way to find out what went wrong.
  • Erecting a wall of silence is “enough to make someone very angry. And it’s awfully easy for an angry person to find a lawyer who will listen to them. At that point, it’s too late to say sorry.
  • Over 35 states in the USA have passed laws prohibiting doctors’ apologies from being used against them in court (apology laws).
  • By promptly disclosing medical errors and offering earnest apologies and fair compensation, one can hope to restore integrity to dealings with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits.

Apology, the spiritual answer

  • The word ‘sorry’ is synonymous with apology.
  • To err is human, to admit one’s error is superhuman.
  • Sorry should be heart-felt and not ego-felt. You should not only say sorry but also appear as being genuinely sorry.
  • Tremendous courage is entailed to face the victim of our wrong doing and apologize.
  • It is generally seen that those who are in harmony with their life and consequently with themselves, find it easier to say ‘I’m sorry’. They are the positive, conscientious ones who are at peace only after making amends for their misdeeds.
  • The word ‘sorry’ in itself is imbued with so much potential and power. Within a fraction of a second, grave mistakes are diluted, tepid and estranged relations are brought alive, animosity and rancour are dissolved, misunderstandings resolved and tense situations ease out resulting in harmony and rapprochement.
  • To forgive and forget is a common spiritual saying.
  • Remember, we all make mistakes and seek forgiveness form GOD every day.

Harvard Medical School’s 4 exercising tips for people with diabetes

By Dr K K Aggarwal
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Get a “preflight” check

  • Talk with your doctor before you start or change a fitness routine, especially if you are overweight or have a history of heart disease, peripheral vascular disease, or diabetic neuropathy.
  • A complete physical exam and an exercise stress test are needed for people who are 35 or older and who have had diabetes for more than 10 years. The results can help determine the safest way for you to increase physical activity.

Spread your activity throughout the week

  • Adults should aim for a weekly total of at least 160 minutes of moderate aerobic activity, or 80 minutes of vigorous activity, or an equivalent mix of the two.
  • Be active at least 3 to 5 days a week.

Time your exercise wisely

  • The best time to exercise is 1 to 3 hours after eating, when your blood sugar level is likely to be higher.
  • If you use insulin, it’s important to test your blood sugar before exercising. If it is below 100 mg/dL, eat a piece of fruit or have a small snack to boost it and help avoid hypoglycemia. Test again 30 minutes later to see if your blood sugar level is stable.
  • Check your blood sugar after any particularly grueling workout or activity.
  • If you use insulin, your risk of developing hypoglycemia may be highest 6 to 12 hours after exercising.
  • Do not exercise if your blood sugar is too high (over 250).

Be prepared

  • Should you experience a medical problem while exercising (or at any time), it is important that the people who care for you know that you have diabetes.
  • Keep hard candy or glucose tablets with you while exercising in case your blood sugar takes a sudden nosedive.

Medical Profession Follows Krishna and Not Rama

By Dr K K Aggarwal
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Teachings from both the epics of our country are taught to every child during school age. The first being Ramayana and the second being Mahabharata. Ramayana depicts Lord Ram as the savior of truth and a person who lives an in atmosphere of truthfulness till the end. Ramayana probably is a reflection of the collective consciousness of Satyuga where the majority of the people believed in truthfulness.

Then came an era of Tetya or Dwapara yuga where the definition of dharma (to hold people together) changed as per the collective consciousness of the people. The teaching of Lord Krishna in Mahabharata was that you have to live with truthfulness but speaking a lie can be your dharma in special situations. He said that a lie which can save somebody’s life without affecting any other person may be spoken and a truth, which if spoken can hurt somebody or is not going to harm anybody if not spoken may not be spoken.

Today we are living in Kalyuga and Krishna of today is every medical doctor treating a patient. For the interest of the patient and the society if doctors were to follow the principles of Rama, miseries would have increased. We as medical professionals are taught the example of Krishna and not Rama. We are taught that our utmost duty is the comfort of the patient. In doing so we are taught not to tell a dying person that he is going to die or not to tell a cancer patient that he is going to die in the next two to three months.

As a part of our social commitment a job of a medical professional is to save the life of a person. Everybody knows that prostitution is a crime but both Govt. of India and National AIDS Control Organization (NACO) have a program in which they distribute free condoms to the commercial sex workers. Similarly, all addicts during de–addiction are provided drugs as a part of the prescription though the quantity has been defined as to be lower than 5 grams. All addicts are treated and not put behind the bar.

The Law today state that an attempt to commit suicide is a crime (section 309 of the Indian Penal Code 1860) and consuming a drug is also a crime. But medically a doctor would look it differently. For him attempt to suicide is linked to an underlying depression and the patient needs a treatment and not jail. Addiction is a disease and every addict on similar grounds need de–addiction program and not jail.

The country’s Law is very harsh and needs to be changed. Probably when the law was made addiction was not considered a disease.

Punishment for a person attempting to commit suicide should be to get a compulsory treatment for depression in a time bound manner and for an addict to get a complete de–addiction done in a time bound manner.

The answer is not punishment but rehabilitation. But till the Law is changed, the only way medical professionals can help patients with attempted suicide is to write that it was accidental and patients who are addicts is by showing that either it was accidental ingestion or he or she ingested an unknown substance.

Most of the doctors are taught not to do urine or blood test in such cases because if the test comes out to be positive, the police will have no other alternative than to arrest the addict and put them behind the bar.

The Law says that possession of cocaine in anybody’s house can amount to imprisonment. Will the same law apply to the Chief Minister or Lt. Governor of a state if cocaine is found in their state or Prime Minister of President of the country if cocaine is found in their country?

But if we look from the angle of law makers under section 64A in the NDPS Act, there is a provision that the court can direct drug addicts to get rehab done in a Govt. de–addiction centre. But most of the doctors are unaware about this. Doctors can easily label a patient as drug addict and save them. But how many people would like to be labeled as an addict or prefer a Govt. centre when best of the private sector de–addiction centers are available.

The bailable arrest of doctors in Rahul Mahajan case is a clear indication for the medical professionals to stop thinking that they are next to GOD and they have any social responsibility. They should follow the rule book of the law and state observations as they are.