In our first issue, we are introduced to some of the leading characters of Medthics. Dr. Garg, the attending physician of a medical ward, Anish, the senior resident physician, and Harmon, the junior medical student. The hierarchy of the characters are established and we are given insight into the behavioral interactions of our characters amongst each other and towards their patients.
Addressing Specific Issues:
Our first issue has received some feedback from readers and as author of this particular story, I'd like to take the time to clarify some issues brought up.
At the end of the story, the junior medical student confesses to having caused a pneumothorax in the patient.
What is a pneumothorax?
A pneumothorax is an unnatural air space surrounding the lung usually due to some form of trauma (like a knife stab wound to the chest) which causes air to rush in during inhalation and restricts the lung from expanding (this can be fatal since a person would be unable to breath.)
A pneumothorax can also be inadvertently caused by the removal of a chest tube (chest tubes can be used to drain excess fluids surrounding the lungs). The removal of a chest tube (if not timed properly with an air tight seal) can allow for the opportunity for air to rush through the preexisting hole thus causing the pneumothorax.
2) What is ethically wrong with the events in the story?
As the title of these series of stories indicate, Medthics is intended to address issues pertaining to ethics in the medical field. We've had readers state that there isn't a clear ethical "problem" presented in the story.
While it would be more characteristic to discus about issues pertaining to the "classical" topics of abortions and euthanasia, ethical scenarios in medicine are rarely so blatantly obvious. In fact, many of the so-called classical examples of unethical behavior as portrayed in popular media are often over-exaggerations of subtle behaviors of a clinician that is taken in the wrong context and blown out of proportion. This makes for excellent drama, but is hardly realistic.
What I tried to portray in this particular issue are subtleties of clinician behavior that are more attuned to what actually occurs in the real clinical world.
Had this story been written from the patient's brother (Rohit) point of view, then the emphasis would have been placed on the attending's (Dr. Garg) untimely choice of answering his cell phone while breaking bad news and the subtle apathetic social gestures that might be conveyed to the brother and fellow clinicians.
Yet, this story is seen from the junior medical student's point of view and as such, the behavior of the attending is seen as simply one of many events that the medical student witnesses. The day simply moves on. The emphasis of the story, thus, is focused on the medical student's doubt at the ending of the story in which he is unable to convey his feelings to his lay friend about the path of being a doctor.
Thus, what I've tried to illustrate is what actually occurs rather than a stylized version of what MIGHT occur.