The Diagnostic Problem (Pt 3)

It was a few years ago that a physician wrote an article for the New York Times. A woman came in to see him. She had a knee injury, and had gone to the medical library and studied her kind of injury. It was clear that one kind of surgery had the best outcomes for her problem, and that the physician in whose office she was sitting had the best reputation for that kind of surgery. As soon as she had explained all this, the physician ordered her out of his office and said he would never accept her as his patient. He never saw her again, and said he would never accept anyone as a patient if that person had gone to a medical library and read about their condition.

Farook is, of course, convinced that he is taking his cousin to the best physician in Dubai, in fact, the best in the UAE, but he still wants extra assurance that this physician is prescribing the best treatment, not the treatment that will be most profitable to the physician. He didn't say so in so many words, but he had asked me to look over his cousin's medical records and go to the library.

I saw one major anomaly: the physician was prescribing anabolic steroids, and the library said anabolic steroids were very dangerous and ineffective for the condition Farook's cousin had. I tried to explain to Farook what I'd found. 'No time. We talk later.'

He asked me to come with him and his cousin one Monday.

Farook used to live about 500 meters away from me, and often called and said, 'You busy? Come with me, I wait you in front your building.'

Now he lives on the other side of Dubai, and his cousin lives in Sharjah, so he wanted me to come to his neighbourhood, a two hour drive.

When I got there, he said, 'Doctor office no see patients today. We take breakfast.'

I really didn't have time, so I said, 'I already had breakfast.' Farook was disappointed, so we had shisha for a couple of hours, then I went off to work.

The next day, I made the trip again, and Farook and his cousin met me and we went to the clinic.

We had to wait, since Farook had told me 9 am since the appointment was at 11 am, and he didn't want to be late.

Finally, the three of us were admitted to the inner sanctorum of the physician's consulting room.

Farook said, 'This my friend. He no speak Arabic and he not know any medicine, so he just sit here. Please talk Arabic.'

So the three spoke Arabic. The cousin wasn't allowed to say much, and I wasn't allowed to say anything.

After the usual 15 minute consultation, we left. Farook seemed happy with the results, whatever they were.

'Now we take big breakfast.'

'I've already eaten,' I said. I hadn't, and I was starving, but I also had a lot of work to do, and it was too late to spend another two or three hours having a leisurely brunch. Farook was very unhappy.

'You no take breakfast yesterday, and you no take breakfast today. I really want to take breakfast with you.'

And I really wanted to get to work, so I took my chauffeured limo to the office. (My private limo has my initials on it, Dubai RTA in big, bold letters. Since Arabic is written right to left, that's really Dubai At R.)

It was now clear that Farook was afraid the physician was not giving his cousin the cheapest and most effective treatment, but he didn't want to be booted out of the physician's consulting room like the New York lady, so he took me along as his rabbit's foot. He figured that the physician, seeing a Western face, would be afraid to prescribe the wrong thing. Farook (I assume, since it was all in Arabic) was being obsequious and agreeing wholeheartedly with whatever the physician recommended, and didn't want me to mention that I had been to the medical library, or give the slightest indication that anyone had checked up on the physician, but he hoped my Western face, sitting silently in a corner of the office, would convince the physician to diagnose correctly and prescribe that much sought (and often missed) cheapest and most effective treatment.

Whether Farook's latest scheme worked, I have no idea.