Posted inBulgaria, Commentary, Southeastern Europe

Doctors, Death, and Debates

While a tragic case reveals doctors’ errors in communication with patients and with society, they are not the only ones to blame.


While a tragic case reveals doctors’ errors in communication with patients and with society, they are not the only ones to blame.


By Boyko Vassilev


In the beginning, the sad details were unclear. A three-year-old boy died after having been four times in three different hospitals. Some of the doctors involved claimed this terrible outcome was inevitable: the initial, apparently minor symptoms usually tend to mislead, and haemorrhagic pneumonia, they pointed out, tends to develop quickly and be deadly. Yet the story did not end there.


The desperate parents complained of neglect and lack of organization. They met Prime Minister Boyko Borissov and reportedly showed him recordings of misconduct of “the secretaries of the three directors” of hospitals in question. After the meeting, the media-savvy Borissov said he felt “depressed,” and felt that there should be “retribution.” He then asked the hospital directors to step down for the duration of the inquiry.


The internet crowd, however, did not want to wait for an inquiry, and started calling the doctors “murderers” and “bunglers.” There were even appeals to hang them. The accused medics and their colleagues responded with defiance and counteraccusations. Everyone else picked a side and rushed to defend it.


Journalists, who should have been responsible for finding out the truth, traded impeccable accuracy which this overheated case deserved for hot takes and heated emotions. Instead of carefully investigating the details, and using their judgement to weigh the evidence, they hurried parents, witnesses, doctors and lawyers into their studios for live interviews – a form of communication that is highly persuasive but not necessarily balanced.


The result was easy to predict. With emotions left unchecked, facts remained un-checked, too. Whatever the inquiry’s result, the public has already delivered a conviction.”


It is the errors in communication that are the most important. Many Bulgarian doctors, under great pressure in their everyday work, and facing a constant lack of resources, have problems communicating with patients, and with the public. Even when doctors get things right, they fail to communicate them properly.


The doctors in this case gave their side on television, yet failed to put across their message convincingly: the main thing that came across was anger. The eye of a careful media observer could have easily spotted this, and redressed the balance, yet this failed to happen.


This scandal, alas, does not solve – or even address – any of Bulgaria’s real healthcare problems. The system needs more organization and systematic control. Paediatric care in particular is notoriously under-financed. Paediatricians protested this year but their plight attracted little attention. Despite Bulgaria’s proud tradition of producing high quality doctors, we see them now emigrating in higher numbers to wealthier countries in the West.


Thankfully, Bulgarian medics do not yet have the legal pressure their Western colleagues have been facing for decades. As yet, we see no mushrooming of lawyers’ bureaux around hospitals, and the term “ambulance chaser” still does not have a Bulgarian translation. But that is the future and it is approaching. Increasing patient awareness will come hand in hand with rising living standards. Today, patients bring their smartphones to make secret recordings of alleged medical misdeeds. Tomorrow they will bring their lawyers.


This story shows how unprepared we are for the “brave new world” of social networks, where hate moves more quickly than love. Emotions triumph over reason – and biased opinions over proven facts. Talks of retribution bring temporary PR gains but do not help to heal the environment. Tragedies destroy real achievements but bring no catharsis. The absence of strong journalistic scrutiny makes everything far worse. These are banal truths, but that does not make them any less true.


Bulgarian doctors will feel the heat first. They will work more cautiously, more hesitantly, even fearfully. Patients will suffer because unconfident doctors might be reluctant to take risks – and will try to divert the harder cases to other colleagues and hospitals.


In the end, the whole of society will bear the brunt. If we are caught up in fake accusations and fake news, we may not be able to find out the truth at all. Experience shows that worldwide trends come late to the Balkans but, perhaps by the same token, stay longer.

What can we do? Maybe it is impossible to stop a tsunami. Or to prevent doom. Yet we can try.