When we lost that simple 'Compounder'
Growing up as a high school kid in the 80s in a small town, the hospital I ended up when I ran fever rarely was run by the company my father was working with.
As I enter a hall, there will be a counter to the right labeled ‘compounder’. There I can see a person wearing a white uniform surrounded by colorful liquids in a school chemistry lab-like setup with glass containers spreading a repulsive smell in the air around.
I will wait outside with a token for my turn. When the Doctor summons us, I will enter his enclosed chamber and I will be delighted to see the familiar, clean shaven, smiling eyes behind the thick framed spectacles. Dr. Rao will be greeting us.
He would know every family, the children and their names. Just seeing him will make me feel relieved, and most of the time make me forget that I am ill. The only terrifying thing I used to have was the end part of that five minute consultation. Whether the Dr. will scribble in his green ink, some medicines or an injection.
He will enquire about my school, studies etc. and would have checked my tongue, throat, ears, made me lie down, checked my BP inflating the rubber of the sphygmomanometer, put a thermometer under my tongue and would have assessed the situation ending up with the scribble on the paper.
I used to closely watch if he is writing anything like ‘tab’ for tablets or ‘inj’ for a jab and when I see tab, I will find myself relieved and turn loquacious, trying to strike a conversation about a book I am reading. If I find it is going to be a jab, I will mumble ‘Dr. please no injection’ and see if he changes his mind.
The interesting part is when I handover the note from the Dr. to the compounder. I will find him give me a tonic concocted on the fly mixing the colored liquids. For various types of problems mixing those colored liquids in some way helped. He will wrap some tablets, often white and sometimes pale yellow in color.
And most of them tasted bitter. I was a bit proud that I could swallow them first and delay gulping the water unlike others who felt like puking if they did that.
Almost all the time I was alright after taking those medicines. The trust on the Dr. was enormous. Not a single moment I would bother to ask what those medicines do to me. I don’t remember paying as it was covered part of my father’s pay.
But the situation was not very different going to a private Dr. who may have charged five rupees utmost for a visit.
I remember seeing pharmacies springing up in that town and the prescription and purchase of medicines got separated.
That ‘compounder’ was totally done with.
If I contrast this experience with the Dr. I go to now for a fever, it is wild.
I will join a queue of people waiting after calling the hospital for Dr.’s availability or fix an appointment in an App on my phone.
My Dr. is a bit old and he will be peering into a monitor. I will tell the problem. He will be nodding his head, with his spectacles lying halfway on his nose. He is very good in diagnosing and he will do all those customary checks.
He will then likely write some tests to be done before he can prescribe the medicines. I will most likely drive to the lab to undergo all the tests drawing blood from me. Wait for results to pop up in my Inbox, go back to the Dr. show the results, get the meds and go to a pharmacy, buy them and later I would have googled to check the medicines as to what part of my symptoms they are mapping etc.
It will be a course for a week and then I will be weak and drowsy for another week with the medicines, at times with a bloated stomach, slowly getting back to finding the taste of food.
Even for simple things, the Dr. would need some sort of a blood test. When the results are given, it is more of a confirmation, as often I won’t find him going through all the numbers printed on it.
The money, the time , the people and system I deal with have all grown by several orders of magnitude. It’s big business, big industry, and most importantly it feels very much like I am dealing with a business entity rather than that Dr. Rao with those friendly smiling eyes and the alchemist of a Compounder.
My illness is no longer something simple dealing with few friendly and caring people. Instead, my illness plays a tiny part to run a gargantuan machinery. The bigger the problem, the more vigor I add to the running of that machine.
This is where I feel it all began to fall apart, when everything became service-oriented, with me tying the different ends of the process flow machine, turning me into a Medical Record feeding into a massive database anonymized and fed into algorithms to detect patterns hiring graduates with complex sounding degrees and executives with fancy titles running mega corporations, spanning continents and time zones trying to solve often times what turned out to be just a fever.
As an individual, I lost that magic of simplicity, of walking out of the hospital with the fix, and instead became a data item in a large process flow in a world where humans and their problems are rapidly becoming data points to build an even bigger machinery.