This incident occurred last year. When I had to repeatedly watch the footage of attacks on doctors, I was reminded of it once again.
I saw the 50-year-old woman, who was weak and exhausted, around midday in the outpatient department. She was suffering from severe fever and body aches. The previous night, she had visited the emergency department with the same problem and had seen the duty doctor. After examining her, the doctor had advised her to be admitted. However, she refused admission, saying, "I don't need admission. I can see the doctor tomorrow in the OPD. For now, just give me some medicine, and that will be enough."
(Still, our people haven't understood that the concept of "temporary medicine" doesn't really work. Fever and body aches are common symptoms for many diseases. How can treatment be prescribed without knowing the exact disease?)
She had been running a fever for three days. Initially, she had thought it would go away on its own. But when the fever worsened, she began to experience shortness of breath and was brought to the emergency department. When I saw her, she still had a high fever, body aches, and some shortness of breath. Her son was explaining things to me as she could barely speak due to exhaustion.
"Looking at her current condition, it doesn't seem like a good sign. Thorough tests and investigations are required. Because of her shortness of breath, she needs to be admitted to the ICU."
Her son responded, "What's the problem? There's nothing really wrong with my mother. She doesn't need admission or ICU. No, not at all."
She had high fever, body aches, and slight jaundice. Looking at the symptoms, it seemed to be a severe illness like dengue fever. However, I told them that more clarity would come only after blood tests, an X-ray, and abdominal scans. After this, they agreed to admit her.
After the OPD hours, I went to the ICU to see the patient again. The preliminary blood tests showed results similar to those for dengue fever. By then, her shortness of breath had worsened, and the X-ray showed signs of ARDS. ARDS is one of the most severe conditions among serious illnesses like dengue, and if a person develops ARDS, there is a 60% chance of death, regardless of the disease that led to it. Things were worse than I expected, and the patient had to be shifted to a ventilator. She couldn't survive much longer without it, as her blood oxygen levels had dropped.
I discussed the case with the pulmonologist and the critical care doctor. They also agreed that shifting to the ventilator was the best option.
Explaining the need for a ventilator to her relatives was my first challenge. It's a tough task. Because, from their perspective, the patient was conscious, even though she was speaking with difficulty. Naturally, they may wonder why a patient like this needs a ventilator, especially when there are many misconceptions about ventilators. People often believe that patients on ventilators will never recover, and they also think hospitals use ventilators as money-making devices. As a doctor, it was my responsibility to explain things to them in a way that would leave no room for doubt.
When I went to the ICU, only the patient's husband was there. The son I had seen earlier was not present. Since the husband had the most right to make decisions regarding his wife, I took him into the ICU and showed him his wife. I explained her condition and the problems she could face in the next few hours. After understanding the seriousness of the situation, he signed the consent form for the ventilator, and we moved her to it.
That night, when I went for rounds, as expected, there was a large crowd of relatives and locals. Then, the questions began to pour in.
I called both sons inside and sat down to talk to them.
"What is wrong with mom?"
"I strongly suspect it’s leptospirosis."
"When will we know for sure?"
"We have ordered a test for leptospirosis, but the results haven't come yet. However, since all the symptoms point to leptospirosis, treatment has already started. We cannot wait for the results, as the longer we wait, the more dangerous it becomes for her."
"But isn’t there a problem if we give medicine for leptospirosis without being sure?"
"No. Leptospirosis is a bacterial infection. There are other bacteria that show similar symptoms to leptospirosis. So, when selecting an antibiotic to fight the infection, we choose one or two medicines that can treat all types of bacteria, including leptospirosis. This is the practical approach in modern medical science, and this is what I am doing now. Also, I don't give much importance to the test for leptospirosis. The chances of getting a positive result depend on several factors. No test in the world is 100% accurate. Some tests can show positive only after a few days of the onset of the disease. If we send the test before that, it may show negative. Moreover, the quality of the lab results also depends on several factors. So, even if the result is negative, it will not change my diagnosis or treatment."
"How did mom get leptospirosis?"
"The disease spreads when urine from infected rats comes into contact with the body. People working in fields, those working in unhygienic areas like streets, and those who bathe in public places like ponds are at risk."
"Ah... mom always bathes in the same pond, but we didn’t get infected. Why is that?"
"Several factors determine how the infection spreads. The bacteria enter the body through small cuts or abrasions on the skin. Not everyone has visible cuts, and each person’s immune system is different."
"So, does this hospital have all the treatment options, or do we need to take her somewhere else?"
 

This incident occurred last year. When I had to repeatedly watch the footage of attacks on doctors, I was reminded of it once again.
I saw the 50-year-old woman, who was weak and exhausted, around midday in the outpatient department. She was suffering from severe fever and body aches. The previous night, she had visited the emergency department with the same problem and had seen the duty doctor. After examining her, the doctor had advised her to be admitted. However, she refused admission, saying, "I don't need admission. I can see the doctor tomorrow in the OPD. For now, just give me some medicine, and that will be enough."
(Still, our people haven't understood that the concept of "temporary medicine" doesn't really work. Fever and body aches are common symptoms for many diseases. How can treatment be prescribed without knowing the exact disease?)
She had been running a fever for three days. Initially, she had thought it would go away on its own. But when the fever worsened, she began to experience shortness of breath and was brought to the emergency department. When I saw her, she still had a high fever, body aches, and some shortness of breath. Her son was explaining things to me as she could barely speak due to exhaustion.
"Looking at her current condition, it doesn't seem like a good sign. Thorough tests and investigations are required. Because of her shortness of breath, she needs to be admitted to the ICU."
Her son responded, "What's the problem? There's nothing really wrong with my mother. She doesn't need admission or ICU. No, not at all."
She had high fever, body aches, and slight jaundice. Looking at the symptoms, it seemed to be a severe illness like dengue fever. However, I told them that more clarity would come only after blood tests, an X-ray, and abdominal scans. After this, they agreed to admit her.
After the OPD hours, I went to the ICU to see the patient again. The preliminary blood tests showed results similar to those for dengue fever. By then, her shortness of breath had worsened, and the X-ray showed signs of ARDS. ARDS is one of the most severe conditions among serious illnesses like dengue, and if a person develops ARDS, there is a 60% chance of death, regardless of the disease that led to it. Things were worse than I expected, and the patient had to be shifted to a ventilator. She couldn't survive much longer without it, as her blood oxygen levels had dropped.
I discussed the case with the pulmonologist and the critical care doctor. They also agreed that shifting to the ventilator was the best option.
Explaining the need for a ventilator to her relatives was my first challenge. It's a tough task. Because, from their perspective, the patient was conscious, even though she was speaking with difficulty. Naturally, they may wonder why a patient like this needs a ventilator, especially when there are many misconceptions about ventilators. People often believe that patients on ventilators will never recover, and they also think hospitals use ventilators as money-making devices. As a doctor, it was my responsibility to explain things to them in a way that would leave no room for doubt.
When I went to the ICU, only the patient's husband was there. The son I had seen earlier was not present. Since the husband had the most right to make decisions regarding his wife, I took him into the ICU and showed him his wife. I explained her condition and the problems she could face in the next few hours. After understanding the seriousness of the situation, he signed the consent form for the ventilator, and we moved her to it.
That night, when I went for rounds, as expected, there was a large crowd of relatives and locals. Then, the questions began to pour in.
I called both sons inside and sat down to talk to them.
"What is wrong with mom?"
"I strongly suspect it’s leptospirosis."
"When will we know for sure?"
"We have ordered a test for leptospirosis, but the results haven't come yet. However, since all the symptoms point to leptospirosis, treatment has already started. We cannot wait for the results, as the longer we wait, the more dangerous it becomes for her."
"But isn’t there a problem if we give medicine for leptospirosis without being sure?"
"No. Leptospirosis is a bacterial infection. There are other bacteria that show similar symptoms to leptospirosis. So, when selecting an antibiotic to fight the infection, we choose one or two medicines that can treat all types of bacteria, including leptospirosis. This is the practical approach in modern medical science, and this is what I am doing now. Also, I don't give much importance to the test for leptospirosis. The chances of getting a positive result depend on several factors. No test in the world is 100% accurate. Some tests can show positive only after a few days of the onset of the disease. If we send the test before that, it may show negative. Moreover, the quality of the lab results also depends on several factors. So, even if the result is negative, it will not change my diagnosis or treatment."
"How did mom get leptospirosis?"
"The disease spreads when urine from infected rats comes into contact with the body. People working in fields, those working in unhygienic areas like streets, and those who bathe in public places like ponds are at risk."
"Ah... mom always bathes in the same pond, but we didn’t get infected. Why is that?"
"Several factors determine how the infection spreads. The bacteria enter the body through small cuts or abrasions on the skin. Not everyone has visible cuts, and each person’s immune system is different."
"So, does this hospital have all the treatment options, or do we need to take her somewhere else?"