Fazli Sameer, at Those Fuzzy Days where the title of the article runs thus: “Ethics of Health Care: Waiting, Paying and Weeping,” … with highlighting here imposed by The Editor, Thuppahi
When my sister, Kumari, went for her annual cardiac check-up to the elite Makalanka hospital, we expected the usual strain, long hours of waiting, some tests, and maybe a bit of worry. What we didn’t expect was to be caught between two worlds: one where care came with a steep price and hidden payments, and another where care seemed trapped in endless waiting and fading patience.
Waiting. It’s the first and most universal experience patients face when seeking medical care in today’s clinics and hospitals. Whether public or private, the hours-long wait, without explanation or apology, has become the norm.
We sat among the crowded waiting room, in rows of metal chairs attached together like an airport departure lounge. Kumari was here for her annual cardiology check-up. Around us, dozens of patients shuffled impatiently, murmuring among themselves. Some were senior citizens in wheel chairs. Others were younger men and women, anxiety written across their brows.
“Been here since 12 noon.,” an elderly lady muttered to no one in particular. “And still no word on when I’ll see the doctor.”
A young woman nearby sighed, “They don’t care about us. They just want the money.”
Kumari’s turn came, and the cardiologist recommended an echocardiogram. Then came the unsettling part. “Pay the nurse directly in cash,” he said. “Skip the hospital reception.”
The payments keep stacking up with the passing time. We’d already paid 4,000 rupees for the consultant’s time, another 12,000 for a battery of cardio tests. Then came the echo cardiogram, the crucial test the cardiologist insisted on. But this time, instead of paying the hospital reception, the doctor asked for 4,000 rupees in cash, directly into his hand, via the nurse. She just said, “You have to pay the doctor Rs 4,000/- in cash. No receipt, no official channel, just a quiet exchange behind closed doors. We paid and he simply shoved it into his buttoned down shirt pocket.
Kumari looked at me, uneasy. “Is this normal?”
I shook my head. “Unfortunately, it’s not uncommon.”
“It’s how things work here,” the nurse whispered when I hesitated. The weight of the money felt heavier than ever, not because of the amount, but the secrecy and shame behind it.
Across the waiting room, outside, I overheard more stories:
“I had to wait four hours last month for a simple consultation,” a middle-aged man said. “The appointment was at 2pm and the doctor only walked in at 6. No smile, no eye contact, no apology or explanation. Just sit and wait.”
Another patient chimed in, “They push tests I don’t need, just so they can get a bigger bill.”
The unspoken truth hung heavy in the air: greed had crept into a profession once defined by care and compassion.
Doctors routinely prescribe unnecessary tests and medications. Pharmacies linked to medical people profit from these prescriptions. Patients become pawns in a profit-driven game, their health secondary to the bottom line.
The consequences are grave. Patients suffer financially, emotionally, and sometimes physically. Trust in the system erodes, leaving many reluctant to seek timely care.
This isn’t just about inconvenience, it’s about ethics lost.
The Hippocratic Oath calls doctors to put patient welfare first. But the lure of extra income through under-the-table deals and unnecessary procedures corrodes that ideal.
Some healthcare providers still uphold integrity and compassion despite pressures. But widespread unethical practices demand urgent reform.
Patients deserve transparency, respect, and care free from financial conflicts. Institutions must enforce strict guidelines and accountability. And professional bodies need to educate and discipline practitioners who stray.
Kumari’s experience is one of many. Behind the scenes of every waiting room, stories of frustration, neglect, and greed play out daily. It’s time we speak up, demand better, and reclaim healthcare for those it’s meant to serve.
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On another day, we were in a public hospital that offered free healthcare to many who couldn’t afford private care. But from what I’d heard, the challenges here were no less daunting. Patients from faraway places arrived before dawn, only to wait hours, sometimes all day, with no clarity when they’d be seen.
Inside the crowded waiting room, more than fifty mental health patients waited quietly, some rocking gently in their chairs, others staring into space, their faces a mix of hope and exhaustion. The clinic operated only from 8 a.m. to 2 p.m., a narrow window for so many lives depending on its care.
A young mother clutched her son’s hand tightly. His eyes were wide but distant, his small fingers twitching nervously. “He’s been waiting for hours,” she said softly, her voice trembling. “Sometimes he talks to shadows… I just want someone to understand.”
An elderly man sat nearby, his lips pursed in frustration. “I’ve been coming here for years,” he muttered. “The waiting never changes. They rush us through like we’re just numbers.”
A teenage girl, her face pale but eyes bright, whispered to her sister, “I wish they’d look at us like we’re people, not problems.”
A nurse passed by, busy and distant. One patient’s mother called out softly, “Please, a little kindness… even a smile.”
The weight of the waiting was heavy, but heavier still was the sense of invisibility, the feeling that empathy had run dry.
“I came here at 5:30am,” said Mr Perera, a man clutching a worn-out bag. “By 8, I was still waiting. They say the doctor will come ‘soon,’ but soon never comes. Just two of them trudged in at 9:00 to see the anxious patients waiting, holding a work book and a number in their hands”
“Last time, I waited three hours just for the nurse to take my blood pressure in the cardio clinic,” added Mrs Manohara, fanning herself in the crowded waiting room. “They never start on time. Some days, they don’t even show up at all. Should there not be a proper attendance register?”
The lack of discipline was apparent, staff moving slowly, conversations held casually while patients grew restless. But what cut deeper than the waiting was the coldness, the indifference.
Seated together, I held Kumari’s hand tightly. The contrast was stark: in the private hospital, the cost was unbearable and the demand for hidden cash payments humiliating. In the public hospital, care was free but came with the price of endless waiting and a profound lack of empathy.
Healthcare, in theory, is a promise to heal and comfort. Yet, for many, it’s a maze of silent suffering, between fees and waiting rooms, between official protocols and unspoken rules. And somewhere in between, the very oath to “do no harm” seems to lose its meaning.
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