Tuesday, 02 January 2024 12:17 GMT

Misdiagnosis Is Kashmir's Silent Killer. I See It Every Day


(MENAFN- Kashmir Observer)
Representational Photo

By Dr. Fiaz Maqbool Fazili

He was only twenty. Tall, soft-spoken, and worn out from months of back pain that wouldn't go away.

He had already seen doctors, taken painkillers, undergone surgery on his spine. But when he walked into our cancer hospital in Kashmir, everything about him said something deeper was wrong.

We ran tests. He had bone metastases. Cancer, advanced. It had likely been there all along, silently growing while everyone was focused on the wrong problem.

He died shortly after.

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There was nothing more we could do by the time he reached us. And what makes it harder to live with is that his story is not rare.

In just two weeks around that time, I saw five more patients who were misdiagnosed or diagnosed too late. The signs were there. The system missed them.

As a surgical oncologist, I see the aftermath of diagnostic failure every day. I see the late-stage cancers that started with symptoms as simple as a cough or back pain or unexplained fatigue.

I see the patients who had the wrong surgery, the wrong medicines, the wrong label. Some spend months being treated for diseases they don't have. Others are told they're fine, until they aren't.

Diagnostic error is one of the most dangerous and under-discussed threats in healthcare.

A recent study published in the BMJ estimated that 371,000 people are seriously harmed by misdiagnosis in the United States every year.

In India, where data is far less transparent and access to care is often uneven, the impact may be even larger.

And yet, the conversation around it barely exists.

We have built a system where accuracy is assumed and doubt is discouraged. Doctors are expected to know, quickly and confidently.

But diagnosis isn't a moment. It's a process, one shaped by knowledge, experience, instinct, time, and fallibility.

Errors happen for many reasons. One of the most common is cognitive bias.

A patient walks in with back pain, and a doctor thinks,“It's muscular, like the last hundred cases.”

That assumption narrows the frame. They start searching for evidence to support their first thought, not test it. It's called anchoring. And it's dangerous.

Overconfidence is another culprit. A rare cancer is easy to miss when you've never seen it before. Add to that the sheer pressure on doctors in overcrowded public hospitals, too many patients, too little time, limited resources, and the margin for error widens.

But it's not just the doctors. Patients delay care. They normalise symptoms, self-diagnose, skip follow-ups. They hold back information. Sometimes it's fear. Sometimes it's denial. Sometimes, they simply can't afford to see another doctor.

In Kashmir, many of my patients travel long distances and wait weeks for a consultation. By the time they reach us, precious time has already been lost.

Technology, which is supposed to make care safer, doesn't always deliver.

Electronic medical records can bury critical details in endless files. Radiology reports might flag a suspicious finding, but unless someone reads closely and acts, it's as good as invisible.

The consequences are brutal. A misdiagnosis can turn a treatable illness into a terminal one. It can cost a family their savings, their stability, even their loved one.

And what's hardest is that there is often no clear person to blame. Everyone did their part. Yet the patient still slipped through.

It doesn't have to be this way.

We need to treat diagnosis as a discipline in itself. That means building systems that encourage reflection, second opinions, and multidisciplinary reviews.

It means training doctors not just to know diseases, but to question their assumptions.

It means redesigning hospital processes so that test results are tracked, not lost. It means time, more of it, to talk, to think, to ask again.

We also need to empower patients. Health literacy is as critical as any medication. People need to know which symptoms to report, when to seek help, and why early intervention matters.

In Kashmir, I've seen public awareness campaigns make a real difference in breast cancer outcomes. The same can be done for colon, cervical, and lung cancers, if we invest in it.

And we need humility. From the people in white coats. From the systems that train them. From all of us who assume that certainty is a virtue in medicine, when it is often a mask for risk.

I still think about that twenty-year-old. I wonder where the diagnosis first went wrong. Was it the scan that wasn't ordered? The lab result no one followed up? The voice in a doctor's head that said,“It's just a strain”?

We may never know.

But I do know this: he didn't die because his cancer was untreatable. He died because it was unseen.

  • Dr. Fiaz Maqbool Fazili is a surgical oncologist based in Kashmir. He specializes in cancer care, patient safety, and hospital systems.

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