30 September 2013

A pediatrician cries over spilt milk

[In a parallel universe called ‘Humility’...]

I am taking a break. A tea break.  Without milk. I have 15 minutes. Enough to write down some thoughts.  Here goes.

There are things I can say and things I can’t.  I am a pediatrician, yes, bu I will not say, for example, whether or not I am a member of the Sri Lanka College of Paediatricians.  I can talk of things I’ve done and do, but I will not promise what I will do tomorrow or even what I will not do.  That’s as honest as I can get. That’s the limit of my humility.

I am a neonatologist. I also work in the private sector, charging exorbitant channeling fees.  Some might even say I am a businessman, for I am a major peddler of formula milk.  Indeed, I won’t be surprised if you, dear reader, see no difference between me and a narcotic drug peddler. 

For those who don’t know, a neonatologist deals with children under one month of age, in other words newborns.  I am frequently ‘in attendance’ when a delivery is made, especially if it is complicated.

More often than not mothers are pretty stressed out before, during and immediately after delivery, especially if it’s the first child.  Such mothers have never breastfed and often come up with the complaint, ‘No milk!’ On such occasions, I have not, as I should have, encouraged the mother to breast milk the infant.  I subtly introduce a term she has never heard before, ‘infant formula,’ and also throw in some brand names for good measure.  In this way I casually subvert the ‘6 month exclusive breast feeding’ recommendation, cooking up a new mix, ‘formula milk plus breast milk’.

In short, I cash in on the stress of the young mother.  At the end of six months, mothers often ask me, ‘How do I wean the child?’ I don’t talk of rice based food or mashed vegetables, fruit juices or fruit pulp. I immediately prescribe stuff that comes out of a box. Yes, I never fail to name some brand of formula milk.

You see, this is how I (and I know some of my colleagues do it too) get around advertising restrictions with regard to formula milk.  I am no nutritionist, but I know enough about nutrition, the nutritional needs of infants and little children, the anxieties of mother and of course the needs of those who peddle various kinds of milk based foods. And of the last, I am quite aware of the fact that false claims, exaggeration and scare-mongering are part and parcel of their marketing strategies.  They, like I, probably have heard the word ‘ethics’ but either don’t know the meaning or don’t really give a damn, either way.  

So you can understand, I am sure, that I will never ask other pediatricians or gatherings of pediatricians about sponsorships and other benefits.  I will never bother to assess the quality or safety of the products and brands whose names I toss out to anxious young mothers as though telling them ‘observe the five precepts’ or ‘say the Lord’s Prayer three times’. 

I am a doctor, yes. I know medicine. I am not a nutritionist, but I am aware that most patients treat doctors as though doctors know everything. In fact I could tell them what brand of fridge is best and I am pretty sure they’ll think ‘he is more informed than I am, so I will go buy that one’.  I abuse this trust. 

That’s what my life has been so far, ladies and gentlemen.  As I said, I will not say what I will or will not do tomorrow. For now, it is enough that I confess to what I have done and what I do now.  Spilt milk: I know there’s no use crying over it.  What’s done is done.  I may spill a lot more milk or I may not spill one more drop. If I did some spilling, I may cry about it, but I am not promising that I will. 

This is a ‘just-so-you-know’ note from me.  Anonymously penned.  For obvious reasons! 

Ok, tea break over.  There is some noise out there in the waiting area at the channel center.  Babies are crying. Mothers are probably anxious.  Doctor though I am, I can’t really explain why I am salivating right now.