I agree prevention is better than care, but sometimes diseases do come unexpectedly. Due to easy accessibility of diagnostic tools or lack of seriousness shown by patients more and more people are being diagnosed with cancer or chronic kidney diseases. In all these cases the role of food adulteration in Kashmir is yet to be researched. Our neighboring state, Punjab is home to the highest rate of cancer in India. Here, in the country's breadbasket, 18 people succumb to the disease every day, according to a recent report published by the state government. There are ninety cancer patients per 100,000 people compared to the national average of eighty. And the Malwa region, in Punjab has been dubbed "the cancer belt" of the state because of its particularly high incidence of the disease. According to J.S. Thakur, professor and researcher at the Postgraduate Institute of Medical Education and Research, who has conducted extensive studies on cancer in Punjab. His one study shows that contaminated water from rapid industrialization and excessive use of chemical fertilizers for high-yielding crops are contributing to the steep rates in the state. Kashmir which purchases huge amount of vegetables, fruits from Punjab in winter and all the year, it should have alarmed researchers and state government here, but alas nothing has happened. As one friend told me, we still have not controlled adulteration of milk which is consumed by pregnant, breast feeding women, and children, not to talk of artificial colors, steroids in poultry, interestingly local poultry has not much of a share in production of poultry products.
Any way coming back to psychology of treatment in patients getting dialysis, cancer, its very important for all doctors to know the way they break the news about dialysis or cancer to patients. Unfortunately in Kashmir and outside I have seen some doctors telling patients in a very casual way, like "Your both kidneys are damaged, all cells destroyed, now you have two choices dialysis or kidney transplant", psychologically both of which are nothing short of a shock to the patient. Firstly, few facilities of dialysis and non availability of donors for kidney disease patients. Dialysis may not be such a horrifying thing in European countries but in Kashmir it's nothing short of a catastrophe to the patient. On hearing this many patients get PTSD, which include acute anxiety, depression, denial[why me], fear, shame[ all of my colleagues going to work and I at home and guilt[ oh I should have been careful with my diet etc]. Similarly many patients are bluntly told "You suffer from Cancer and first it will be surgery, and then might be chemotherapy and hopefully your life expectancy may improve". And again the patient may get PTSD. Many say it's age of google, we should tell patients all. I agree, but there are more compassionate ways of telling a patient, depending from one patient to other patient. When we inform a person about his HIV/AIDS status, our focus is more on giving real hope to patient and advantages of getting treatment, like living a healthy and prolonged life, not transmitting it to wife or children rather than few negatives. Similarly patients of dialysis need to be told about role models who are on dialysis for decades like Rajnikanth or long list of famous cancer survivors who fought the disease like the cricketer Yuvraj singh,[lung] Manisha Koirala,[late stage ovarian cancer], Lisa ray, Director Anurag Basu who was given two months by doctors, Mumtaz [breast cancer], Kylie Minogue pop star.
The way dialysis is done has changed significantly over the last decade or so, thanks to high-quality water purification systems; better management of patients, especially their nutrition, anemia and bone metabolism; and better-quality, high-flux biocompatible membranes, and so on. It is not uncommon now to have long productive life-spans on dialysis. According to The Indian Express Bollywood megastar Amitabh Bachchan made a startling revelation about surviving only on 25 per cent of his liver today, having lost the rest 75 percent to the deadly Hepatitis B virus. How many know this in Kashmir? He is often seen promoting hepatitis immunization.
We can use empathy, which forms a component of compassion. No patient in world would be encouraged by sympathy, things like "Oh look at yourself, you are shadow of yourself ". Empathy is when we literally share a feeling with someone, this can bring great comfort to the person we are empathizing with. Doctors job is a tough one, specially of a nephrologists' or oncologist as they treat thousands of patients yet compassion can be used as a powerful tool to motivate patients. Doctor cannot afford to be weak emotionally, yet nothing is as natural as compassion. Compassion and care, and empathy in attitude. We acknowledge someone's sorrow, we sense how they feel, we try to understand how it affects them, yet with compassion we do not become emotionally involved. We are engaged yet detached. We are standing back and looking on with kindness. By showing compassion in this way, it allows us to be compassionate without suffering from compassion fatigue or emotional burnout. Compassion can mean simply kindness of words; it can mean patience, generosity, respect and understanding. Why these celebrities' survived? The only answer is medical treatment along with motivation. If better facilities or money were the only reasons, then all celebrities and rich would have been living and never died. The key for patients getting dialysis and cancer treatment is motivation from concerned doctors, counselors and finally self motivation. Its developing power of mind over body.