World Peace - Bharatiya Vidya Bhavan Australia

Low Salt Syndrome
There seems to be a sudden spurt in cases of low salt
syndrome being diagnosed inside the Intensive Care
Units in hospitals these days. Any unexplained illness,
especially coupled with delirium or coma, where the diagnosis
is not obvious, is labeled as Low Salt Syndrome!
The laboratory reports do oblige doctors in their efforts.
Admission to an Intensive Care Unit has become
sine qua non for any elderly patient getting admitted to
the hospital, irrespective of his/her disease.
More and more doctors seem to be treating the reports
rather than the patient and admissions to ICUs
are on the increase these days. The reasons for this
epidemic seem to be more than one. A recent American
study showed that 90% of the hospital profits (not
income) come from keeping dying patients in the ICU
for the last ten days of their final outward journey. The
leading medical journalist of New Zealand, Hillary Butler,
labelled the present scenario in modern medicine
as a Corporate Monstrosity. Ruth Richardson, a medical
historian, seems to agree with her view. All human
ills, in every field, not just in medicine, are the direct
fallout of Corporate Greed! There is a movement in Europe
against Wall Street Greed, but, in effect, it is not
just the Wall Street; greed exists across the board in
the corporate world.
An experienced American physician, Ken Murray, in a
candid article in Zocalo Public Square, an online magazine
of ideas, exposed what doctors do when the
chips are down for themselves: Almost all medical
professionals have seen what we call futile care being
performed on people. That’s when doctors bring the
cutting edge of technology to bear on a grievously ill
person near the end of life.
The patient will get cut open, perforated with tubes,
hooked up to machines, and assaulted with drugs. All
of this occurs in the Intensive Care Unit at a cost of
tens of thousands of dollars a day. What it buys is misery
we would not inflict on a terrorist. I cannot count
the number of times fellow physicians have told me, in
20 | Bhavan Australia | July 2012
(Hyponatraemia)
words that vary only slightly, “Promise me if you find
me like this that you’ll kill me.” With the corporatisation
of hospitals there is pressure on the hapless doctors
to earn more and more to be economically viable.
“For a man with a hammer in the hand and wanting to
use it, everything in this world looks like a nail needing
hammering”, was the considered opinion of Mark
Twain. These coupled with routine poly-pharmacy
being practised on every patient, especially in the
geriatric age group, makes it possible that the adverse
drug reactions and drug interactions add to the burden
of low salt syndrome in this age group. Drugs as
the cause of hyponatremia should be kept in mind in
every patient proved otherwise. The other causes of
hyponatraemia are rather uncommon except in patients
in heart failure.
In recent studies in the US, it was clearly shown that
unless an ICU has round the clock unless specialist intensivist
support, mortality and morbidity does not
come down with any ICU. The present interest in
teleintensivist support for ICUs has been shown to
save many lives compared to the conventional ICUs.
So simply getting patients inside an ICU where there is
no round the clock specialist intensivist cover, the
mortality could be more due to various other disadvantages
of ICU which are beyond the purview of the
article. The Commonwealth Fund and Rand Europe announced
this week that the United States ranks last
among developed countries in “mortality amenable to
health care”.
A study by Banks, Marmot, and Oldfield showed that,
“by most measures, people in the highest one-third of
income in the United States have outcomes similar to
those in the lowest one-third in the United Kingdom—
the rich in the United States, having unfettered access
to expensive, high-tech, but fragmented and depersonalised
care, are not better off than the poor in a
country that has a comprehensive system for providing
access to integrated, personalised, prioritised