Human nature is variable. There are four type of people, in one classification amongst many.
1. Great and humble.
2. Great and arrogant.
3. Not great and humble.
4. Not great and arrogant.
Of these two traits, greatness is relative. Someone could be greater than some people, and not compared to some other people. Arrogance is absolute.
We had a patient who was pregnant for the sixth time, with four living children. She was receiving antituberculous therapy, and had conceived. She came to us for medical termination of pregnancy.
"Did you not know that you should have avoided a pregnancy while on this therapy?" I asked her. "The drugs are harmful to your baby."
"No one told me" she said.
"Who is treating you" I asked her.
"Doctors from this same hospital" she said and showed me her case paper. Her doctor was indeed in our institute.
"Please ask him why he did not tell you about avoiding a pregnancy while on this therapy" I told her. I was unhappy with this doctor, because I had repeatedly told this department to advise all patients being put on antituberculous therapy to use contraception. Still we continued to get patients for MTP. MTP would be difficult, because the patient had active tuberculosis, possibly hepatotoxicity due to the drugs, and anesthesia could not be given safely. I wanted the doctor to feel the patient's wrath, which perhaps would educate him better than my polite requests. The patient went to see her doctor and came back after some time.
"What did your doctor say?" I asked her.
"He said nothing was wrong with getting pregnant while on antituberculous therapy" she said. "He has given me this number you can call if you want to."
I called that number. The Registrar took the call. He said he would get the concerned doctor on the phone. The concerned doctor turned out to be the other Registrar.
"I am the head of Ob Gyn" I told him. "Who am I speaking to?"
"I am Registrar" he said.
"I want to know why you did not advise this patient who just met you to use contraception while on antituberculous therapy?"
"We are overworked" he said, "too many patients."
"That cannot be justification for not counseling her" I said. "If she goes to court against you, you will lose if you give this explanation." He kept quiet. "Why did you tell her that there was nothing wrong with getting pregnant while receiving this therapy?" I asked. He kept quiet. Then I told him about difficulties in performing MTP on a patient of tuberculosis receiving therapy, and the advantage of avoiding this MTP totally by using contraception. "Now will you please tell me why you told them it was OK and gave them your intercom number for me to call if I needed any explanation?"
"The patient's husband was very arrogant" he said.
"He had reason to be so" I said. "His wife has to undergo MTP because you did not counsel them. But how can you afford to be so arrogant when you were in the wrong?"
He had no answer. I knew the answer anyway, he was in category 4.
