SREE PADMAVATHI VENKATESWARA FOUNDATIONOrdained to Inspire, Ordained to Serve

2018SREE PVF AWARDSESSAY CONTEST

TOPIC: MANAGINGTHE DIFFICULT PATIENT

SREE PADMAVATHI VENKATESWARA FOUNDATIONOrdained to Inspire, Ordained to Serve

# 40-3-13, Gummadi Rajagopala Rao Street, Krishna Nagar, Labbipet, VIJAYAWADA - 520 010. A.P.

Foreword

Sree Padmavathi Venkateswara Foundation, Vijayawada has instituted an unique model of presenting

annual awards of Excellence for a best medical essay written on a given topic for the postgraduate residents

of clinical specialities. The topic chosen for the year 2018 was "Managing the difficult patient" and the

information was sent to all the medical institutions across India. The essays received were shortlisted and

evaluated by an eminent group of judges. The first placement was awarded Rs. 50,000/- and second

placement was awarded Rs. 25,000/ - (This year two individuals got the same marks, so two had second

placement and each was given Rs. 25,000/ -). The other essays which deserved a specific mention were

identified and compiled as a booklet to be sent to all medical institutions to encourage the spirit of

involvement, competitiveness and bringing out one's latent talent.

It was a really amazing to note that the residents have chosen their real time incidents and put all their

efforts into a single page essay sufficient to vent their feelings and ideas. The thought process was clear and

lucid and made us feel that the given a suitable platform our residents can come out of their shell.

I fervently hope and trust that our forum of Sree PVF awards will herald anew era in the Postgradua e

resident education strategy.

I express my gratitude and acknowledge the contribution by Siddhartha Academy of General

Technical Education(SAGTE), staff of Dr.Pinnamaneni Siddhartha Institute of Medical ciences

Research Foundation, Principal Dr.P.S.N.Murthy, Medical Superintendent Dr.B. .Chander. Pro-

EMERITUS & back bone of our academic programme Dr. G.Eswar, Academic Director Dr. ~.

Administrative officers Mr.P.VR.Kiran and Mr.T.VSubba Rao, all my office staff and _ludri

helping me in bringing out this booklet.

I proudly present you the first booklet on medical essays on "Managing the D· ~....

February 23rd, 2019

SREE PADMAVATHI VENKATESWARA FOUNDATIONOrdained to Inspire, Ordained to Serve

# 40-3-13, Gummadi Rajagopala Rao Street, Krishna Nagar, Labbipet, VIJAYAWADA - 520010. A.p.

In this century, the trust relationship between the patient and the doctor is at the lowest ebb due to

various reasons. It is a neither contributed by patient nor the doctor but by consumerism and speed of

changing expectations to a great extent. In this scenario, it is important to inculcate and to rejuvenate the

faith between them by a good social organization.

In this endeavour, Sree Padmavathi Venkateswara Foundation started a nationwide program of essay

competition regarding real life events with patients among Post Graduates students of all the clinical

specialties in the medical field in our nation. This is to re-establish that doctors take the profession by

PASSION, not by FASHION to a great extent. This organization wanted to duly encourage and nurture the

needed environment, by establishing the nationwide competition offering first and second prizes among the

competitors.

The medical research in India is in a mediocre state in giving solutions to national health problems, as

such it is desirable to stimulate original, free thinking and novel enterprising ideas among the post graduate

medical fraternity.

This unique attempt at a national level is a small step to keep the faith in winning confidence of

suffering humanity at large. This annual event should be utilized by mammoth participation of the post

graduate students of all the institutions. Hope this will have apositive impact in the patient care.

February 23rd, 2019 WITH BEST WISHES

In service of Lord Venkateswaras:«.Dr. Chadalawda Sudha

MS, FRCSC,

Diplomate in American Board in OB/Gyn

Chair, Sree PYF

co2018 SREE PVF AWARDS

LET YOUR FAITH BE BIGGERTHAN YOUR FEAR

FIRST PLACE

by Dr. Nancy Garg

"Sometimes I inspire my patients; moreoften they inspire me. "

Every patient is a challenge but managing a difficultpatient is an actual test of our capabilities which arefar beyond the teachings at medical schools. It's an

art which is learnt by years of clinical exposure. Suchexperiences help us grow not only as a doctor but also as abetter human being. This comprises of a perfect blend ofapplication of our knowledge as well as our human values ofempathy and compassion. It is not just providing the sickwith adequate medical care but involves more ofresuscitating those who accompany the patient. This is whatthat differentiates between agood and a great doctor.

A difficult patient per se is an iceberg term with the tiprepresenting the problems faced by the treating doctor at thetime of first medical contact and the submerged portionrepresenting the long term complications and consequences.He might be the one who needs basic life support forsurvival or the one who is non compliant to therapyprescribed or with a lot of apprehension about the disease.The latter ones are the most challenging since knowledge ofmedical books solely will not suffice treating those whocannot trust their doctor specially in today's era whenviolence against doctors and similar medico legal cases areon the rise. So I believe that the very first step is to gaintheir confidence and let their faith in you be biggerthan the fear of illness.

Craig D. Lounsbrough rightly said "The challenge isne er based on the size of the obstacle that standsbefore me. Rather it is dictated by the degree offaith that rests within me. "

Dr. Nancy Garg3rd Year PG General MedicineSardar Pate! Medical College,

Bikaner, Rajasthan

If managing the difficult patient is a battle then getting thisfirst step right is like half the battle won.

I, foreone, realised the precision of these words in one of myexperiences working as a second year post graduate. Onceduring my casualty postings, at midnight, a female in her latesixties approached me along with her son with a complaint ofheadache. Even before I could take complete history, seeinga young girl in her mid-twenties, her son confronted measking where the doctor on duty was. I told him that I wasthe doctor on duty and assured that his mother will get thebest possible treatment available at that hour of the night. Hestill looked combative and did not even allow me to check hismother's blood pressure. While all this was going on ayoungmale patient was brought in who had ingested a poisonouscompound in heavy amounts. Since this patient neededimmediate resuscitation, I had no other option but to leavethe cantankerous son to himself. Me and my duty staff

immediately started CPR on the young gasping patient, gavehim all the necessary emergency care and shifted him to ICU.

Witnessing all this the same mother-son duo now came tome and asked for treatment. This lady was a hypertensivepatient who had missed her evening dose of medications. Itreated her appropriately and they both went back satisfiedand apologetic. After this experience the words of JohnQuincy Adams beamed across my mind, "Patience andperseverance have a magical effect before whichdifficulties disappear and obstacles vanish. "

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CD2018 SREE PVF AWARDS

Dr. Nancy Garg receiving Award

Dr. Debanjan Sinha Receiving Award

Jyothi Prajwalana by Dr. Nancy Garg

Dr. Sisira Pathuri receiving Award

Dr. Nancy Garg, Dr. Sisira &Dr. Debanjan Sinha