Thread by @netshrink

Thread: Indian understanding of quality & effectiveness of medicines.
Many moons ago, I was contacted by a father from Bihar for his 35 yr old son. Had schizophrenia for nearly 15 years & not getting better since many years. Had seen many Drs but no benefit. He had heard ++

of me from a relative in Pune. "Can I please get my son to see you" he sounded desperate. I normally dissuade people from making such long journeys esp when they have already seen so many Drs + chronic illness. Don't want to raise their hopes. In this case, the father ++

a senior government official was quite insistent. He also had relatives in Pune to stay with for few days.
He took an appointment & arrived (with his wife & son) a few weeks later.
We did our usual assessment for new patients incl checking past treatment papers & current +++

treatment. He was on a long list of medicines - everything under the sun, only thing missing was a birth control pill 😀
Father said he had spent lacs on Rx & current medicines were costing him ₹5k a month.
I wrote him q prescription & assured him we will try our best +++

Leaving, wife & he made repeated pranams & he insisted his son touch my feet. I told him if he did that - it's over, I am not doing his Rx. The father was not sure, but probably decided to humour 'great docotr' & told his son to back-off. I also told him to contact me on phone ++

in few weeks. Took the next patient in.
Few min later, receptionist peeps in through the door "Sir, that pt from Bihar is back & father is very angry"
Honestly I had no idea why he was upset. Finished the pt in front of me & then called family in again ++

"We had come to you with great hopes but you are making fun of us". I did not understand.
He threw the prescription & a few strips of medicines in front of me. I check the medicines & told him the chemist had given him right medicines ++

"kya Sir, these medicines only cost ₹500/- for a month's supply.
I have spent lacs on my son's treatment & you are writing such cheap medicines..what use I'll they be?"
That was the reason for his anger. So asked him to sit down & did a masterclass on the prescribed ++

medicine. Told him clozapine was one of the most effective medicine + I don't prescribe medicines based on cost.
He seemed sceptical and reluctantly picked the prescription & meds. "Chalo" he said to his wife & son & pushed them out of my consulting room.
I never ++

expected to see him again.
So I was surprised to get a call from him a month later. Sounded very cheerful - apparently son was doing better. Attributed it to my medicine. Didn't have the heart to tell him his son was better bcoz the side effects had gone down from ++

stopping the unnecessary cocktail of medicines.
Anyway to cut a long story short, son slowly got better, now holds down a simple job.
Moral of story: Expensive & lots of medicines are not necessarily better.
Remember this in #Covid times.