Martha’s Rule: A Wake-Up Call for Medical Second Opinions
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- Martha’s Rule: A Wake-Up Call for Medical Second Opinions
By Dr. Colin Joseph
“Doctor… my daughter’s illness is getting worse. It seems this treatment is not
working for her.” – The mother, Merroppe Mills, said this pleadingly to the doctor who
came to treat her daughter. Not just once, but many times… But no one paid heed to
her words. Instead, they said dismissively, “We are treating her properly. This is just a
minor infection. It will go away in a few days.” Seeing Merroppe Mills’ anxiety, the
bystanders of other patients also said, “You have come to the best hospital in
England. It is your luck to have arrived here.” Merroppe also tried to console herself
that way. She also believed that the UK’s healthcare system was the best, and among
them, King’s Hospital was very famous.
She tried to console her mind that her daughter Martha would be jumping around like
before in a few days, as the doctors said. But Martha’s condition was worsening day
by day. She writhed in pain. She couldn’t eat. Her only food was the liquid given
through a tube. Within days, bleeding started. Even then, the main doctor treating
Martha and the junior doctors kept saying, “We are treating her properly. This is just a
minor infection. Everything will be fine in a few days.”
Feeling restless, Merroppe Mills searched on Google based on the symptoms. To her
shock, the word pierced her heart: ‘Sepsis’. A condition that could take her daughter’s
life if not given immediate expert treatment. As soon as she saw that, Merroppe
Martha’s Story
cried and told the nurse there, “I think Martha has a septic attack. She needs expert
treatment as soon as possible. She should be moved to the ICU.” The nurse looked at
Merroppe with disdain. Then she said, “Don’t just think about things by looking at the
internet. There are knowledgeable doctors here. They will decide what treatment to
give your daughter. This is just an infection.” Merroppe Mills was certain that the
doctor had made a mistake in the diagnosis. But who to tell? Who would listen?
Everyone else was still saying that King’s Hospital was the best and that it was their
luck to be there. Martha’s condition was getting worse every day. The ICU was right
next door. There was no rush of patients there. There were empty beds. The mother
thought her daughter would be saved easily if the doctors decided to move her there.
She prayed for that. But nothing happened. The main doctor’s position was that the
treatment he had decided upon was the correct one. He also thought it was foolish
to send the child to the intensive care unit where the doctors were not as
experienced as him. The junior doctors and nurses surrounding him were all firm
believers that he could not be wrong.
Even then, Martha was battling death. Severe diarrhea. Bleeding. Fever. Difficulty
breathing. Gradually, her breathing stopped. Even at that moment, the doctors said
as if nothing had happened, “This is the first time in the history of this hospital that a
patient has died due to pancreatic trauma. So many patients who reached this
condition have recovered and gone back from here within days. We don’t know how
Martha’s death happened.” Martha’s mother was certain of how she died. “Even
though I suspected that the doctor had made a mistake in her diagnosis, if only I had
gotten her examined by another expert doctor… my daughter would still be with us.”
Due to the mental depression caused by her daughter’s death, Merroppe even started
Martha’s Story
saying that she herself was to blame. Her mind kept blaming her for not insisting on
taking her daughter to another doctor when she felt that the diagnosis and treatment
were not correct. Martha had not been sick until then. She was a thirteen-year-old girl
who dreamed big about life. One who insisted that life should be joyful. Their life was
indeed joyful. Although she had the heavy responsibility of being the Executive Editor
of the famous Guardian newspaper, the mother of Merroppe Mills was very attentive
to the well-being of her family, consisting of her two daughters and husband. On
holidays, the family would be on vacation. During that summer holiday, too, they were
travelling. To escape the daily hustle and bustle, they rented a small house on a
hilltop where there was not much human presence. They made sure there was no
Wi-Fi or phone to disturb their peace. In the following days, they cycled around. They
swam joyfully in the sea. They bought and ate their favourite dishes from roadside
stalls. It was during such a trip that Martha fell. While cycling on the concrete path by
the sea, Martha lost her balance on the sand spread by the waves and fell. There
were no visible serious injuries. A round red bump on her stomach where the bicycle
handle had hit. Nevertheless, they went to a nearby clinic. The doctor was not there.
The nurse was describing the injury over the phone. The doctor advised over the
phone that he did not need to come to see the patient and to give her Paracetamol.
When they reached home, by dawn, Martha was so restless that she couldn’t stand
or lie down. She writhed in pain. That’s where the frantic rush for treatment began.
At the first hospital they reached, detailed examinations were done. It was found that
the pancreas was injured in the fall. However, the care was given in the ward as if it
were not a big problem. After a few days, those in the hospital felt that Martha’s
condition was not safe in their hands. That’s how Martha was moved by helicopter to
the very famous King’s Hospital in London for expert treatment. What happened after
that is what we read at the beginning. Martha’s mother says, “Only what I found is
correct. No other physician can make a diagnosis beyond that.” It was that doctor’s
ego alone that threw my daughter into a death before her time. Long after her
daughter’s death, when Merroppe wrote about her family’s misfortune in The
Guardian, the world came to know how the ego of some doctors had caused so
many people to die before their time like this. Merroppe’s emotional writing and the
interview she later gave to the BBC could not be read or heard without tears.
Because Martha’s near-murderous death happened in the UK, one thing happened.
The public woke up. The government woke up. A cry was raised for clear legislation
to prevent such a tragedy from happening again.
Martha’s Story
In the British Parliament, the ruling party and the opposition joined hands for
Martha’s Law. Although Martha died, Martha’s Law is a ray of hope for patients today.
Today in Britain, a doctor cannot arbitrarily decide on treatment against the wishes of
the patient and their relatives. If there is a suspicion that the treating doctor’s
diagnosis is wrong, the patient or relatives have the right to get the diagnosis done
by another expert or more than one expert (second opinion).
According to Martha’s Law, ‘every day the doctor should assess the patient’s
condition himself and also ask about the condition the patient is experiencing. If the
patient feels that the condition is worse, the doctor should reconsider their
conclusions. If necessary, the doctor himself should seek the opinion of another
expert doctor. Following the concept of Martha’s Law that came into effect in Britain,
many other countries in Europe have started implementing patient-friendly laws.’ I
will decide the treatment and medicine. Just take it without question,’ no doctor will
say that there anymore. Because they have accepted the reality that life belongs to
the patient and the right to preserve it belongs primarily to the patient. ‘That happens
in the outside world. It won’t happen in our country.’ Is that still the thought? The right
to a second opinion will happen here, too. Where can it go without happening? It
should happen not only for the patient but also for the doctors. We, too, can wish for
a death that is not before our time, can’t we?
