Why we need a second opinion

When people find out that I’m a doctor, conversations often take a medical turn. Thus, I have come to know, from experience, that most people like to talk about their health and those of their significant others.

“My daughter nearly had an appendectomy,” a mother recounted to me recently. “We brought her to a clinic because of a stomachache, and after doing an ultrasound, the surgeon told us that she has appendicitis, and had to be confined as soon as possible for surgery! Of course, we believed him, and said that we will make preparations. But after we got home and she managed to poop, her stomachache subsided completely! Instead of going back to the hospital, we decided to consult another doctor, who said it was just a bad case of food poisoning!”

She concluded: “Imagine what could have happened if we followed the first doctor, and she got operated on! All for an upset stomach! That’s why I always go for a second opinion.”

To be fair to the first doctor, his recommendation for admission may have been a prudent course: While he might have made a diagnosis of appendicitis, he didn’t really propose an immediate appendectomy. Diagnosing patients is not an exact science; doctors need some time to make a definitive one. Even if a doctor makes a wrong diagnosis, I would still go back to them because they would have a better idea the next time around.

But the patient’s mother has reason, too, for some skepticism. Some studies show that up to 20 percent of all appendectomies are unnecessary—just as up to 15 percent of caesarean sections are actually unwarranted. When one’s life and health are at stake, surely we want to know as much as we can to make sure that the risks are worth taking.

In titling my column “Second Opinion,” I draw from my medical background to remind us that many of our society’s issues also need alternate ways of (re)thinking and (re)telling. All too often, dominant narratives go unchallenged, either because they are held by those in power, or because they have been held by our society for far too long.

The diagnosis of our country as a “narco-state,” the prescription of capital punishment, the prognosis of a disaster that can only be averted by authoritarian rule: All these require a second opinion—hence the enduring relevance of these editorial pages, and of responsible and fearless journalism.

But the need for different perspectives go beyond the vexing political issues of our time. The advent of late modernity and globalization’s uneven terrain has given rise to various technological, environmental, social, and ethical conundrums. Certain ideals of “development” and “progress” are taken for granted, leaving us with little or no time to reflect on their ramifications. Significantly, our country is faced with worsening inequities, which allow people living in Metro Manila to inhabit entirely different worlds: one of survival, another of decadence, and in between, a resignation to a never-ending commute.

But out of the multiplicity of issues at hand—from the existential to the everyday—the writer will always be pressed to choose which to highlight. In this, I bring in the tradition of social medicine, whose early exponent, Rudolf Virchow, once said that “doctors are the natural attorneys of the poor.” Is not malasakit(empathy) the logical and moral response to our intimacy with sakit (pain and suffering)? Our commitment indeed should not just be to art or truth, but also to social justice.

A second opinion, however, remains an opinion: It does not rule out the validity of the first, nor its own erroneousness. Moreover, like the cardiologist who sees a heart defect and the psychiatrist who sees a broken heart, it is entirely possible that we are looking at different parts of the same whole.

And so it is with the conversation I hope to join. From a monopoly of discourse, we should move not so much to dichotomies as to pluralities: a multitude of voices that can hopefully move us further in the ongoing work of understanding each other, making sense of our ever-changing culture, and finding our nation’s place in the world.

Comments to gideon.lasco@gmail.com.