Dr. Arif Maghribi Khan


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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; besides, the role of food adulteration in Kashmir is yet to be confirmed as the cause of cancer. Our neighboring state Punjab has the highest rate of cancer in India, in this country’s breadbasket, 18 people succumb to this deadly 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 reveals 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 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.

Coming back to psychology of treatment in patients getting dialysis and suffering from cancer, it is very important for all doctors to know the way as how to break the news to patients about dialysis or cancer. Unfortunately in Kashmir and outside I have seen some doctors informing the patients in a very casual way, like “Your both kidneys are damaged, all cells destroyed, now you have two choices dialysis or kidney transplant” and psychologically such a approach of doctors is nothing short of a shock to the patient. Such patients tend to 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]. Dialysis may be a small thing in European countries but in Kashmir, it a matter of grave concern for the patient because of non availability of facilities for dialysis and non availability of donors. 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 its 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. In the same way, the patients of dialysis ought to be apprised about how the patients who have fought these diseases  like Rajnikanth or long list of famous cancer survivors who fought the disease like 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 thereabout, 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 sympathetic 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 is care by which we acknowledge someone’s sorrow, we sense how they feel, we try to understand how it affects them and 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 the power of motivation. If better health facilities or money were the only reasons, then all celebrities and rich would have lived forever. The key for the patients getting dialysis and cancer treatment is motivation from concerned doctors, counselors and finally self motivation.

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