Dear All,

I have just had a horrible reminder of one of the worst trends of modern medicine: doctors who overmedicate without any concern for the actual patient or their healing.

Last week I had to take my mother into hospital emergency in Karachi after her blood pressure had become dangerously low and she could barely retain conciousness. A cocktail of medicines (including steroids) caused this.

Tests revealed that her white blood cell (WBC) count was dangerously high and her urea levels were twice the maximum level. Although this denoted a severe infection in the body, she had not been running a fever. The reason for that was that a (supposedly well- reputed) doctor had put her on such a high dose of steroids that all symptoms (like fever) were masked.

Another supposedly top-notch neurologist known to a friend of ours had recommended this well-known and supposedly ‘good’ neurologist.

This specialist had treated my mother’s increased loss of sensation in her feet and legs. Her blood sugar was high so diabetic neuropathy was the most likely cause but he also checked for other factors with a plethora of tests including a couple of MRIs.

Once spinal and other symptoms were ruled out, this supposedly competent specialist prescribed a cocktail of medicines: instead of one medication to control blood pressure, he prescribed two different ones. Instead of one medication to control sugar levels, he insisted on giving two different medicines. He prescribed high doses of steroids and a number of other medications to cover various bases. He even prescribed a medicine which is given to patients who have had a kidney transplant or who suffer from rheumatoid arthiritis. My mother fits into neither category, and thankfully we didn’t start her on this. When asked about the prescription he appeared to be quite offended by any questions or queries.

What was the result of all this? My mother went from being an 85-year-old woman managing various health issues but being otherwise mentally alert to being a disoriented and pained-looking geriatric patient, who would get confused and appear miserable at all times. She was still not able to stand steadily on her feet and no improvements were visible -- quite the opposite. She began to become disconnected and sometimes incoherent as her speech became slurred and her references incomprehensible.

This was the result of the cocktail of medicines prescribed by this reputable neurologist.

It’s worth noting that only did this specialist not like being asked about his treatment plan, he also was not really very interested in the welfare of the patient.

The question is: why would any doctor want to prescribe so many new meds to an 85-year-old patient with a history of high blood pressure and diabetes, who is also on blood thinning medication?

I have found it mind boggling and, if this has resulted in damage to the kidneys, then it is simply criminal. But it is also a good illustration of this horrible trend of regarding patients as ‘cases’ rather than actual human beings in need of healing: "Oh here’s a patient, let’s get them to pay a few thousand rupees, make them wait a few hours in clinic, prescribe every possible diagnostic test and scan, and then tell them to take a dozen or so different medications. Oh, and who cares what happens to them afterwards…"

The best doctors, as most of us know, are those who treat patients with empathy and attention and who assess them not just on test results but on a combination of factors in which thorough examination and observation is absolutely key. And overmedicating is not just careless but also cruel. It puts people under severe financial pressure and often causes irreversible damage to patients.

The sad fact is that these doctors are not made accountable for prescriptions that destroy, instead of save, lives. Therefore, patients and families need to be extra vigilant; one must question all prescriptions, do some basic research on drug contraindications and side effects, and probably avoid arrogant doctors who get offended if asked about their ‘treatment plan’ for the patient.

Best wishes