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DIMAPUR — Doctors do their best to save lives, but not many people are able to empathise with how they deal with the deaths of patients. At the end of the day, doctors are humans, and the death of a patient can have a profound impact on them.
Dr. Khriezotuonuo Zatsu, a plastic surgeon at District Hospital Dimapur (DHD) who specialises in burns, post-infections, post-traumatic patients, and diabetic-injured patients, opens up to Eastern Mirror about how doctors are affected by the deaths of patients and how they cope with them.
‘It always affects us when patients do not make it’
“It always affects us when our patients do not make it. It stays with us. Even when we think that we have forgotten about it, when we look at similar cases, we remember,” said Zatsu.
Recalling her first experience with the death of one of her patients, she stated that the memories of the patient's death lingered for many days. Even now, whenever she encounters a similar case, memories of the death return.
Zatsu, the only plastic surgeon in a government-run hospital in the state, was transferred to DHD from Naga Hospital Authority Kohima (NHAK) in October 2023.
She stated that patient deaths are uncommon in her line of work, but there are instances where patients, particularly those suffering from sepsis, die as a result of failing to treat their wounds on time.
When a patient dies, doctors try to remain strong, believing that there is nothing else they could have done. However, in some cases, "we feel bad thinking that something could have been done if the patient had come to the hospital a little earlier."
When asked about the challenges she faces as a doctor, she mentioned that, as a mother of a four-and-a-half-year-old son, balancing work and family is the most challenging.
She also commutes by autorickshaw because she has yet to learn to drive.
She expressed a desire to go out, receive additional training, and learn new skills. For the time being, she relies on virtual learning and books to keep herself up-to-date.
The other side of palliative care
Dr. Nepuni Athikho, a pain and palliative care specialist with 24 years of experience, revealed that in junior high school, he planned to study theology. But, after meeting a senior doctor in high school who taught him that a doctor can treat the sick while also sharing God's love and changing people's lives, he changed his mind and decided to become a doctor.
One of the challenges of being a doctor is that there are no days off. "But that is what we are called to do, so I enjoy my job," he said.
As a palliative care doctor, he believes that they must make both patients and their families feel satisfied, particularly in end-of-life care, where communication is critical. He explained that when a patient is serious and doctors fail to communicate effectively with the patient's family members, it can result in an emotionally charged situation.
Sticking to the quote "cure sometime, comfort often, and care always," he stated that while some illnesses can be cured, for many chronic problems, life must end.
He said that most palliative care patients have terminal illnesses, so they must accept the core value that “palliative care accepts death as a part of life. So it does not try to unnecessarily prolong suffering or shorten life. But while in the process of giving good care, the patient travels longer than expected.”
When the patient is at the end stage, doctors focus on comforting the patient and his or her family. The approach is that in palliative care, it does not end with the death of the patient, but the family also should feel that they have been cared for, the specialist emphasised.
He admitted that if he is "too sorrowful" over the death of a patient, he will be unable to work as a palliative doctor. As a result, in palliative care, a doctor must accept that the death of a patient does not reflect medical failure or that he has failed in his duty, but rather that life must come to an end.
He narrated a case where a seven-year-old boy developed cancer, and being the only son of his parents, the father would kneel down and pray every day.
“The child was very jolly, and so even small progress made the doctors and staff very happy, and when the child passed away, it not only affected the parents but the whole team of palliative care, up to the extent of the staff needing counselling,” he shared.
High rate of delivery cases at DHD
Meanwhile, a senior doctor at DHD, who wished not to be named, updated that during the period from January to June 26, 2024, a total of 1,094 women gave birth in the hospital, out of which 282 births were through caesarean and 812 were normal deliveries.
He disclosed that during the period from August to March every year, on average, eight to ten babies are delivered in the hospital on a daily basis. The maximum number of delivery cases are from Assam, he said.
He also said that they perform two to three caesareans, besides other operations like hysterectomy, daily, so even on Sundays they do not get any rest.
Dismissing some people’s preconceived notion that doctors in district hospitals neglect their work, he maintained that the workload in district hospitals is very heavy and that the medical staff are always on their toes.
He further disclosed that doctors who are designated Class 1 officers are also not provided with living quarters or vehicles.