| An Arab in the
modern world is an unique social phenomenon.
Sudden infusion of a large amount of wealth in a
relatively underdeveloped, uneducated and a
somewhat isolated community has produced a
situation which deserves a close study by
sociologists. Medical care facilities in
Arab countries were primitive before the influx
of petro dollars. A rich Arab now finds it
possible to travel to different parts of the
world and demand the best of the medical care to
which he is entitled because of his wealth. An
Arab patient has become a common sight in many of
the premier medical centres of the world. Many of
us can consider ourselves privileged that a large
number of Arab patients descend on our medical
clinics for their multitude of health problems
and have full faith and trust in us.
A wealthy
patient has several things going against him in
getting proper treatment. He is overinvestigated,
given multiple diagnostic labels, and
overtreated, very often needlessly. In the case
of Arab patients the problem is still more
complex because he cannot communicate with his
doctor in his own language. He is in an alien
society whose customs and ways of living are
different. Both the doctor and the patient cannot
communicate with each other; on the other hand,
each one wants the best of the other. The
problems that arise from this alienation and
failure of communication are liable to bring
disrepute to our medical profession.
I have in
the past written three volumes of 'Guides for
General Practitioners'. I developed confidence
when these books became so popular that amongst
practitioners some of them consider me as their
"guide, friend and a philosopher". Even
the B. C. Roy National Award given to me by the
Medical Council of India as an "outstanding
medical teacher" is largely a recognition of
the success of these guides. In my humble way, I
tried to show to the general practitioners a
common sense approach to identify their patients,
understand their symptoms and try to find out
what merits serious attention and what needs just
a watchful interim treatment with 'placebos'.
I have been
fortunate in having a large Arab clientele. I
have made attempts to study their language. I
have studied their social mores and living style.
I can make out how serious are their complaints.
From the nature of their brief encounters with me
I have learnt to place an Arab patient in his
correct geographical milieu.
An Arab
patient comes from a very wide geographical
region, euphemistically termed as Middle East or
Gulf, both of which are omnibus terms which fail
to describe the roots and soil from which a
particular Arab patient is moulded. A Kuwaiti
behaves differently as compared to Saudi. A
Bahraini is different from Yemeni and so on and
so forth. In fact the common clinical ailments of
Yemenis are so characteristic that I have a
chapter in the book entitled "Functional
Arab Syndrome".
My purpose
in writing this book is not to write a medical
treatise full of statistical figures and charts.
The purpose is very simple. Based on my clinical
impressions of Arab patients, I have given a
general guideline as to the behaviour of an Arab
patient in a medical clinic. It should permit a
doctor to recognise the Arab in its social
context. It would also help him to separate the
wheat from the chaff and differentiate between
functional and organic. It is meant to promote
better communication between a doctor and an Arab
patient, an interaction where two different
cultures touch each other in mute expectations.
In a way,
the present work is an extension of my previous
volumes for General Practitioners, primarily with
an intention to induce the doctor to understand
his patient in a rational commonsense way for
better diagnosis and sensible treatment. Once the
diagnosis is established there is nothing
specifically different in treating an Arab
patient. The book is based on personal experience
of 3000 Arab patients seen in my consulting
practice over the last fifteen years.
Towards the
end, for comparison, I have given an analysis of
similar number of random Arab patients admitted
at Jaslok Hospital. The analysis shows that Arabs
suffer from nearly the same diseases as in any
other part of the world. But what I have
discussed in this book is their day to day common
problems which we encounter in private practice,
for which usually the patients do not go to the
hospitals. And these problems have not been
discussed in standard textbooks of medicine,
written so far. Thus I have purposely omitted
discussion of diseases like Bilharziasis and
sickle cell anaemia which have been adequately
dealt with in the standard medical textbooks.
Finally I
must add that I have never met more generous,
warmhearted, God-fearing, trustworthy and
friendly people than the Arabs. The book owes a
lot to their patience and trust in my
ministration.
Insha
Allah.
O. P. Kapoor
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