From Maku Faida to Faida!!

From Maku Faida to Faida!!

Maku Faida! To Faida! That is the aim!

Settling down in the practice in Kuwait and the Arabic patients, this is the one combination you dread! It roughly translates to “No use”, which means that the patient has not had any relief of symptoms in spite of taking your treatment!

This also means that they are not happy and this is also like the first strike or the yellow card for you! If there is one more strike like then you will get the red card! That of course means that the patient would curse you or shout at you or many times not bother to say anything and only be silent (this is more scary sometimes!) and go to another doctor!

When a patient comes back immediately after start of treatment; which is within 2-3 days then you know that he or she is not feeling better! Many times I am so relieved when such a patient just comes to ask for the leave letter because I then know that they are feeling better!

When they come after the course is completed then you are still not feeling tensed since they have most probably come to use the free follow up and just come to tell you that everything is ok!

Many of my giddiness patients do come back sooner since many of the tests would be pending and they would come to show me the report and of course I would categorically tell them in the first visit itself that it will get better slowly and not immediately!
Some times though when they come back, you can have a look at their face and the slight negative nod and then you know it is a case of, “Maku Faida!”.

Once I saw a patient in my hospital clinic and he was one among a big rush of patient! All he had was some ear irritation and no wax! I told him that no cleaning is required but he was not happy! When he has come for getting the ear cleaned, you cannot convince them that it is not required!

I saw the same patient after one day in another clinic! He did not recognize me and blasted the previous doctor saying that that doctor did not see properly and there is wax in his ears which has to be cleaned! That previous doctor of course was me! But then I did not say anything and used my vacuum and ear suction to clean the flakes in his canal! Then after cleaning I used the camera system which was available in that clinic to show him that the ear canal is clean!

Most patients, and for that matter most humans, have the maximum belief only on themselves! So when they see with their own eyes, they believe! You can give tons of evidence of the contrary but if he or she is not convinced then you cannot help him or her!

Now coming to another Maku Faida! This patient came after three days of severe headache and categorically told me in Arabic that he is having no relief with medication!

I was out of options since the diagnosis was correct (or so I thought!!, so I told him to go for an X ray which actually an ENT surgeon would never do! We would rather go for a scan! Back home ordering an X ray of the sinuses was laughed upon by the ENT surgeons! Here of course the patient feels more happy if they see a report or that the treatment is heading in the right direction! And the X ray is like a additional proof to him!

The X ray report came as expected and I told him that he has to take an additional injection so that the pain would go! He said he was already taking injection! Then I added a nasal spray! He already had a nasal spray with no relief! Then I had to calm myself and think!
Finally after I remembered a scene from the series House about how the patient was not taking the spray properly! So I asked him whether he was taking the medication properly asking about each medication!

He said yes to all and finally said that the antibiotic I gave he did not buy and he was using his own antibiotic from Egypt!
I asked him for the photo of the same and saw that it was a medication which sounded like an antibiotic and also was expired!
With a big relief I told him that he can stop all medication and simply buy and use the antibiotic I have given and I am sure he will feel better!

Needless to say he did not come back after that!
I am optimistically hoping that he is doing good and that is why he did not come back again rather than thinking negatively!
That is when you are happy most of the time when the patient does not immediately come back after the treatment is over as you think or comfort yourself that the patient is better now!

When they do come back you fervently hope that they have come to thank you and tell that they are doing better and not come to say, “Maku Faida!”

The sketch is of the most important part for a doctor! His or her ear! If we listen properly then we can reduce MAKU FAIDA!

Dr. Sriram Nathan