Great Equalization: Is MBBS From India Equal To M.D. In U.S.A?

AAPI Journal • March 2009
SPECIAL ARTICLE
Suffocation
by Riddhi Shah, M.D.
Riddhi Shah, M.D.
Dominica, West Indies
...It has been a lifelong pattern
with me to come back to strength
from a position of extreme weakness:
I had been almost suffocated and
then found that I was breathing more
deeply than ever.
Saul Bellow
Doctors need to be both affable
and competent. Both of these traits
are equally important in patient
care. In college, I minored in
communications, where a premium
was placed on interacting with and
relating to an extremely diverse
student body. My volunteer
activities at the time – as a science
tutor in an inner-city high school
and working in the Emergency
Room of a sprawling public hospital
focused on honing these skills
outside the classroom. However,
while all of these experiences added
to my appreciation for medicine, it
took a near tragedy in the second
half of my sophomore year of
college for me to fully realize the
responsibilities entrusted to a
physician, and ideals I should strive
towards both as a medical student
and as a practicing physician.
A little more than four years ago
(even though it still feels like last
week), after my friends and I had
returned from a carefree Spring
Break, my routine physical was
anything but routine. My doctor’s
hands lingered a little too long, and
she seemed to grimace a little. First, I
mentally scolded myself for being
paranoid, but I knew as soon as she
asked if I performed monthly breast
exams that something was wrong.
Only after helping me up did she tell
me that there was a suspicious mass
in my breast. She gave me a moment
for this to sink in, and then quietly
asked if I wanted to tell my mother, or
if she should break the news. I
opened my mouth to speak, but no
words came out. Weakly, I nodded,
still thinking that I could wake up
from this bad dream at any moment.
When my mother entered the
exam room, my doctor explained the
situation as delicately as she could.
She detailed tests I would have to
undergo to determine whether this
was a tumor or a cyst, the likely
outcome of each and a tentative plan
of action. Upon hearing “tumor” my
mother’s eyes glazed over, since for
her (and most other Indian parents),
tumor almost reflexively means
cancer. Patiently, my doctor went
through the explanation again, even
more delicately this time, and then
added that there was no chance I
had cancer.
I returned home utterly shocked and
confused. My head, full of answerless
questions, was spinning. Why me?
Was this because of something I had
done? And of course, what now? Not
knowing what to do, I sought truth in
statistics since after all, numbers don’t
lie. On the Internet, I found statistics
that teenagers develop breast cancer
about 5% of the time. The first thing I
did was call my doctor. She had lied;
there was a chance, albeit a very small
one. She tried her best to console me
and then reminded me that since I
wasn’t just a number, it made no sense
to look for comfort in them.
The rest of that semester was spent
scurrying from one doctor to another.
For the first time in my life,
schoolwork had taken a back seat.
Everywhere I went both the doctors
and the nurses did their best to
convince me that they understood
how I felt. Even though I knew they
couldn’t possibly, their concern was
both palpable and genuine. I still
remember how the doctor performing
my biopsy sent for someone to hold
my hand and talk to me during the
procedure so that I wouldn’t see the
needle she used.
A few days after my biopsy, my
doctor informed me that I had a
benign tumor and that due to its size,
it would be best to remove it. I
could also just leave it alone, and
undergo surveillance in which case it
could potentially do more harm. I
opted for the surgery since although
scary; it was less scary than the
alternative. The surgery was
scheduled for August.
August came and went and
eventually, everything settled down.
In the end, I was left with memories
and a scar, neither of which will ever
fade completely. My work
experiences in college had helped me
develop some of the skills required to
me a doctor, but I wasn’t able to
completely internalize what being a
physician required until I had almost
“suffocated”. The opportunity to give
others the same warm care I received
is the impetus that will always keep
me going.
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