Hyper-ventilation

“When it comes to my health, I would like my doctor to base her decisions on science rather than what she, or some lawyer, thinks will stand up in court.” – Richard H Thaler

Lucy was a beautiful girl of 11 years. She was studying in a prestigious international school here. She is a bit on the healthier side and quite attractive.

She had a bout of hyper-ventilation in the school prayer hall and it being a VIP school, the authority promptly took her to the nearby cardiac center of the Care Group of hospitals. ECG was normal, she was advised to consult a pulmonologist.

Lucy’s father is very well connected in our Railway, so she was given a post facto referral to that corporate hospital and also a referral to pulmonologist.

The pulmonologist labeled it as “Hyperventilation” but suggested EEG and Neuro consultation. The parents were worried.

Unfortunately, the EEG was slightly abnormal. The neurologist though labeled her as Hyper-ventilation but has added MRI.

This time Lucy’s father came to me with a ashen face, but he insisted on a referral to Apollo. Just after the MRI, Lucy had a bout of Hyper ventilation right inside the scan room.

She was promptly admitted to the ICU of Apollo. Today his father along with a group of relatives came to me for a post facto approval of her admission to Apollo.

In this whole episode, I didn’t have a single opportunity to examine the child. The parents, though very respectful, are least interested in my clinical opinion. In the confusion of Neurology, Cardiology, Pulmonology somewhere the child had lost her identity as a whole person.

Young healthy girls around puberty are likely to have attention seeking disorder like Hyper-ventilation. It is almost normal and requires no treatment. But It is always reinforced by the extra attention and sophisticated investigations given to them.

Doctors on the other hand, have to worry that if they stop administering a test that might cause more harm than good, they will be sued for malpractice.

…. ….

Richard Thaler sums it up so nicely – “When it comes to my health, I would like my doctor to base her decisions on science rather than what she, or some lawyer, thinks will stand up in court.”

Richard H Thaler has won the Economic Noble for 2017.