Who will calm down the patients when the doctors themselves are panicking?

Dear doctors, I can try to empathise with your concern..

Let’s consider a healthy 35 year old..

10-30 out of 1000 in this age group will land up in ICU, about 1 will die.. (ballpark figures based on current situation)..

This is unprecedented for an illness that starts as an innocuous viral URTI..

There’s no way, in the initial 5 days, for me as a doctor to know whether the patient sitting in front of me will be one of those 10-30 ICU admissions..

Does that justify over treating everyone I see?

Continue reading Who will calm down the patients when the doctors themselves are panicking?

Old Strategies for a New Enemy

My big learning in this pandemic is that we need to use what we already know from years of managing respiratory diseases, rather than treat it like something very new.

We know that most viral infections get better with just supportive treatment.

We know that many doctors over investigate and over treat viral respiratory infections, including blood tests, X-rays, antibiotics, oral bronchodilators, alpha-agonists, and what not..

We know that many patients self-medicate, self-investigate, follow random advice from relatives and friends, and have many cultural taboos.

All of the above has just gotten much much more pronounced due to fear on all fronts..

At the same time, I know lots of doctors who are keeping the flame of rational empathetic medicine alive..

In my practice, only two things are new:

Continue reading Old Strategies for a New Enemy

COVID Diaries


I often ask my patients to record their measurements at home in a diary, and bring them to the next appointment. I find that this improves the self-efficacy of the patients and their family members in taking care of their illnesses, and helps us doctors take better care of them! At the same time it’s an ideal, and reality loves to wash away our best laid plans..

Some patients do check their parameters, some don’t. Some of those patients who do go to the trouble of measuring them regularly, may not record them! And those who diligently record them may forget to bring those readings when they come for a follow-up consultation! And some of those who keep meticulous records, stop after a few months.

I often tell my patients, “Your proper treatment will only start when you start maintaining a record, till then we’re just playing with your illness!” And truly, the home record is vital in adequately managing Hypertension and Diabetes Mellitus, and I’ve found it useful in other illnesses too, like Typhoid fever, and Food allergies.

I keep wondering how to inspire patients and family members to keep better records. I think I got some answers last year..

Continue reading COVID Diaries