Standing Ovation, Doctors with Hemlock

Standing Ovation, Doctors with Hemlock
© Dr. Rajas Deshpande

It is not new that the world has chosen to torture and kill the right and good. From Socrates to Mahatma Gandhi, the speakers of truth and advocates of good have been punished by a majority addicted to the illusions of both. Socrates, who was declared guilty and awarded death by drinking poison hemlock, had a chance to escape. He chose not to. ‘A true philosopher is not afraid of death’ he said. He chose to drink the poison.

At this very moment, thousands of young doctors all over India have chosen not to run away from the deadly virus: because they believe in the ultimate sacrifice: for saving the life of millions. They are the true heroes of India. If a soldier dies, the whole nation rises to salute the sacrifice. Nearly 400 doctors die, and our administrators said they did not have information about it in the parliament. © Dr. Rajas Deshpande

Digital India, where there wasn’t a day without messages about Aadhar cards, PAN linking, etc., and so many other messages reached everyone, yet unable to know tell how many doctors died. We can tell exactly how many patients were positive, how many tests were done, how many discharged or recovered, but we cannot tell how many doctors died while treating them. Shame!

Thousands of junior / PG doctors, interns and medical officers are being forced to work not only against their wish, but against all fair constitutional rights. They are being threatened and punished even after overworking. Their salaries have been cut, some have not been paid for months now. Everyday, patients too are frantically searching for good covid care beds.

Hospitals are overflowing, no beds available in some places, many centers are closing down because of lack of resources, but what we really need now is an IPL. We don’t have money to pay the doctors, create more healthcare resources for thousands of dying patients, but we can definitely watch cricket and forget all that. There’s nothing wrong with sports or entertainment, but is this the right time? Will the IPL profits be used for creating more hospitals? All through the economic crisis, I was amazed by the perpetual news of few Indians getting higher on the list of the richest in the world. I do believe that they are good at whatever they do. However, what was most ironical was that yesterday I read the news of people urging one of India’s richest businessman to buy the Man-U team. Mind you, people did not want a hospital for the dying poor, people did not ask the billionaire to pay the unpaid covid warriors, they asked him for buying a football team!

Add to this the new law about Violence against healthcare workers “During pandemic”. How can this be best described? “No murders, crimes, corruption during summer months”? Or “No stupid talking between 10 AM and 10.30 AM”?© Dr. Rajas Deshpande

The point is, dear Covid warrior doctors, please understand that the society does not want you, it only wants your free service without offering either respect or remuneration. The government has not even responded to our petition about human rights for doctors who have been slogging, carrying the pandemic burden on their shoulders as everyone else hogs the credit of recovering patients. Postgrad medical students have been denied education in their own branch for over six months now. They have been denied leave, permission to meet sick parents, or even a quarantine after exposure that is followed world over. They also face extremely hostile relatives and goons every day in hospitals. Many doctors who died just as they started their careers, are not even acknowledged! Just as every responsible institution in the country has taken precautions to safeguard itself from the virus, working online, just as the parliament is mulling over whether to cut short the monsoon session as some members were positive, no one wants to think about those actually dying every day facing covid patients: our doctors.

I have never felt so frustrated about the future of doctors in India. I have carried a proud torch of being an Indian medico and am blessed to have a great connection with most present generations of brilliant doctors, but I haven’t slept peacefully last few months knowing that my juniors, students are left to die in the pandemic. Every effort being made is quashed or falls on deaf ears.

I can only say to every doctor in the covid ward right now: humanity will always be grateful to you for drinking this poison hemlock just like Socrates did: bravely and in service of truth and good. If Mahatma Gandhi was alive today, he won’t have published his own achievements, instead, he would have made the country realize how indebted it is to your sacrifice. I believe in the power of one. Mobs never achieve anything. Each one of you out there is a hero saving lives, even when your own countrymen seem to have forgotten and abandoned you.

My Standing Ovation to every doctor working right now anywhere in the world, especially in India.

© Dr. Rajas Deshpande

Picture Courtesy: By Walter Crane The story of Greece : told to boys and girls (191-?) by Macgregor, Mary, Public Domain, https://commons.wikimedia.org/w/index.php?curid=32804549

A Love Letter For All Haters Of Allopathy

A Love Letter For All Haters Of Allopathy
© Dr. Rajas Deshpande

Allopathy / Modern medicine is like my mother to me. Naturally, when someone tries to spread misinformation about this path of healing, it is my territory to defend, and I will. I am open to the idea that I may not understand other pathies well, I understand mine only because I studied it well. Time and again, I have received many articles criticising Allopathy in many languages. Most of these articles make claims about their own ‘pathy’ being divine or magical, curing everything. They justify this with some twisted quasi-scientific logic, very convincing for those who are a few sandwiches short of the picnic.

We Allopaths save more lives on any given single day than all other pathies combined can save over months. Thousands of doctors from other pathies who have recovered from heart attacks and strokes and other critical medical conditions will testify that Allopathy saved their lives. The facts that there are far more Allopathic hospitals all over the world, that corona patients in ALL countries are being treated primarily by Allopaths leaves no space for any argument whether Allopathy is useful or not. © Dr. Rajas Deshpande.

To understand basics of medicine, it takes five years for the highest rankers of each generation. To criticise it without studying it requires an outstanding idiot.

Think Cricket. We all enjoy seeing the Master Blaster perform, aware that he has gone though extensive practice and patience to be where he is. Yet even those who have never qualified to be in their own family’s cricket team, will advise the Master on TV how to play. They can be ignored as certified nincompoops. The other category- copiers- are most dangerous. They will just pick up the Master’s style / words, copy the technique, use all the same external paraphernalia and then pretend to be superior to the Master Blaster. Truth and scientific logic then takes a hit out of the boundary.

From Mahatma Gandhi to Einstein, from Daniel DeFoe to P.G. Wodehouse, from Bachchan to Tendulkar, greatest of the great have faced undeserved criticism from envious, jealous, noodlebrained nobodies whose only chance to some attention is criticising any success, achievement and affluence. © Dr. Rajas Deshpande

Some of the best brains in each generation get into Allopathic medicine, and are trained in a curriculum made by highly educated achievers in the field of science. The same Nobel prize as was won by the greats like Guru Rabindranath Tagore, Amartya Sen, Abhijit Banerjee, Dr. Hargobind Khurana, has also been won by those who form the basis of Allopathy or Modern medicine.
Our science is based upon the principles and practice of basic biosciences like physiology, biochemistry, pharmacology, genetics, all defined by geniuses across the world. We follow the principles of scientific evidence as defined by science, not by personal whims and hunches. . Our paths are enlightened by brilliant guidelines of people who discovered the causes and treatment of diseases like malaria, tuberculosis, HIV etc. saving millions of lives. Each year, there is a Nobel prize dedicated to medicine.

Thus, thought processes of many generations of geniuses in science have made us Allopaths. We we are in fact relieved to know that everybody cannot understand us. That would have made our minds average.

Millions recover every day from heart attacks and strokes, thanks to Allopaths. Millions who would have otherwise spent their life on bed, walk well again because Allopathic knee and spine surgeons can perform complex surgeries, cheapest in India. Ask any patient of Parkinson’s Disease, Epilepsy or Heart failure, what happens if they miss their Allopathic doses. It is our challenge to anyone who hates Allopathy to take care of one dialysis patient without dialysis, treat one bleeding brain injury or one heart valve defect without surgery or one patient of respiratory paralysis without ventilator. © Dr. Rajas Deshpande

Maharshi Charak and Maharshi Sushrut are respected all over the world because of their own good work. I have met some very respectable Ayurvedic pratitioners. They never use Allopathic terminology to impress thier patients or name their medicines. They know their own limitations.

Using the terminology from Allopathy while criticising it is like calling your wife by the name of your neighbour’s beautiful, out-of-reach wife whom you like. From migraine to arthritis, from brain to corona, why do they use the words of the very science they refute? The height of this idiotic ridiculous is to twist scientific information, using Modern medical terms (protein, genes, virus, corona etc.) to justify the basis of their own treatments! How in the name of science are you going to treat a condition which your branch didn’t even know the name of? These hypocrites will use X rays and MRI, blood tests etc. reported by doctors – radiologists, pathologists in Modern medicine and prescribe their medicines saying that the Allopathic medicines are useless!

Why are bridge courses requested if Allopathy was useless? Why don’t we see those various criticising pathies open up their own original hospitals and practice their own science, why would so many graduates from different pathies be working with allopathic hospitals today? If you are so confident of your pathy being superior, please take an oath that you will never practice other pathies, that you or your family will never take treatment from any another pathy. © Dr. Rajas Deshpande

My Allopathy/ Modern Medicine is not perfect. We have failures. We have limitations. We have multiple, dangerous and sometimes fatal side effects, all recorded and informed to the patients. Nothing is hidden. Our pathy is unfortunately costly, as it has many licences, instruments and processes. But we have the largest number of people all over the world rushing to us every moment, we are here and ready, day and night, serving and saving them, with scientific principles universally accepted and respected.

Every accident goes to an Allopath, bleeding and dying, in a hope to survive. Most diagnosed cancers receive their treatments and some are even cured in Allopathic hospitals. Every coma reaches an Allopathic hospital, with their family’s folded hands begging to bring back a father, a mother, wife, husband, child back from the clutches of death. Most of these go back alive and happy, some we cannot save. Are these failures of Allopathic medicine your strengths? Could you have saved those? Do our minor inabilities, limitations, failures make you feel great? If so, you need a visit to a qualified psychiatrist: if your pathy has one.

It is pathetic to see the excessive quackery allowed in rural India, looting innocents with cheap deceptive tactics, false claims of curing jaundice, rabies, paralysis, epilepsy and what not. It is pathetic to see famous public figures criticising Allopathy and then themselves getting admitted in the best, priciest, Allopathic hospitals in India or abroad. What other proof of shameless hypocrisy do we need? Criticising Allopathy is a serious disease. I think it is a type of anosognosia: inability to understand the reality of one’s own illness/ condition.

After reading such baseless criticisms of Allopathy, my foremost wish is to invent ways to perform a brain transplant on their authors. However, a “rejection” of a good brain by their bodies (you know, a dangerous side effect of Allopathy) is really worrisome. So we will let them be- please treat yourself with your best medicine: Allonil.

© Dr. Rajas Deshpande

Allopathy is now known as “Modern Medicine”. However to reply the critics and to best reach masses I have used the term Allopathy, which they use while criticising it.

Welcome to translate this article in local languages with due credits. This article is only aimed only at those who spread misinformation and hatred for Allopathy. I do not disrespect any other recognised pathies.

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How Far Should A Doctor Go?Is Our Society Ready To Change?

Change This Medical Scene: Article Two

In the last article I had written all the reasons that make doctor’s unity impossible, and had also pointed out the fallacies of some medical professionals. Accepting that yes, some doctors are wrong sometimes, let me go to the next part: our society.

  1. The Absent Scientific Mindset:
    We have a biased society beyond reconciliation. People have made up their minds about negative image of medical profession just like they make up their minds about the good or bad of any religion, army, country or even their concepts of self-intellect. One cannot expect a predominantly illiterate, superstitious, accusative, emotionally biased and financially deprived population to understand the principles and practice of a complicated science. They will advise others even if they are failures themselves. People think that information on the internet makes their knowledge automatically scientific.
  2. ‘Trust Me, But I Won’t Trust You.’
    You see, I am the patient. The best of the patients who have near complete faith in a doctor also have trust issues hidden deep within, and these are unmasked often under the headings of “second opinion”, “it was insisted by someone that we consult another doctor”, etc. While it is patient’s right to get a second opinion, it is a doctor’s right to ignore false claims of complete trust, so often essential to concrete the relationship. Most affluent, intelligent and literate patients openly question everything out of mistrust, research (both their rights), and when they find that everything was correct, or when the patient actually improves, they still want the doctor to have complete trust in them, and treat them just as good as family. Trust building takes time, and the concept that trust is bilateral is conveniently forgotten! © Dr. Rajas Deshpande.
  3. ‘Some doctors are bad, so everyone should treat me free.’
    This is the conclusion drawn by even the best brains in most fields. These people have a funny logic: Allopathy is a fake branch, all doctors are corrupt, all pharmas are selling useless drugs at a very high price, all hospitals are made for looting people, but when I am sick, I will search for the best and most experienced Allopath, in the most advanced costly hospital, ask them to do all the tests to tell me I am safe, give me the best medicine out there, because if it’s my life I don’t care about money. Then when I get better, I will take a screenshot of the huge bill and write a frigging crying worldwide post about how they looted me. No one asks them why in the first place they did not go to a cheap / free government hospital or other pathies which they can afford?
  4. ‘Complete Health and 100 years life is everyone’s birthright, and it is every doctor’s inherent duty to serve me free or cheap as I have paid taxes for their education.’
    Even in government colleges, every medical student pays huge tuition fees every year, and postgraduate doctors are made to work like slaves for many years under inhuman conditions. Then they serve an unfair bond. There is no direct expenditure for a student, whatever the government invests is for the healthcare set-up to treat millions of poor patients, and the budding doctors are USED for this task, to mask thousands of unfilled doctor’s posts.
  5. ‘I am not scared of death”.
    I will drink, smoke, eat tobacco or roadside / unclean food, won’t exercise, take as many fake medicines as I can from internet, skip masks and hand washing or social distancing. I will take risks and participate in adventures, ride bikes without helmet, drink and drive, sleep with multiple partners…. until I fall sick. Once I am sick, not only am I scared of death, but everything bad that happens to me is the doctor’s fault. Till the time I am well, I am a hero on my own. The day I fall sick, I am the victim of some medical conspiracy to earn money. © Dr. Rajas Deshpande .
  6. Social media is my power:
    Most people with a cellphone and internet think they can defame anyone now, no one will bother to confirm the truth and doctors don’t have time to argue. Be it about pseudo feminism, alleged nepotism, BLM agitation or religious discussion, one has to be extremely careful now, not to step on the innocent toes of hidden snakes. They will blatantly twist facts, lie, cry, allege, accuse and tarnish the image of someone who invites their displeasure, denies them the facility of exploitation. Open threats to doctors and hospitals to defame them on medical websites, apps and social media have become an ugly reality: Deny someone free treatment, false certificates, billing concessions, and they don’t hesitate to screw the hard earned reputation of a doctor. This endless and faceless blackmail is the widest point of the valley between doctors and patients today.
  7. I will talk incessantly furnishing useless, unrelated details, but you must be calm, sweet, nice and listen without interruption- because no one in my family listens to me. Even if other patients are waiting outside, I will repeat and repeat, just because I have PAID YOUR FEES. Some patients treat a consultation as a melodramatic, monologue opportunity in which a doctor is expected to shower compassion and sympathy, time immaterial. I have always envied the patience of my psychiatry and psychology colleagues.
  8. I can be lousy, incorrect, disorganised and human by committing mistakes, but You cannot! I can forget, you cannot. I can skip medicine for days, but if a nurse misses a single dose, be prepared for a ruckus, a financial / legal suit, a long facebook post. I can be late, I can skip appointment, but you cannot. I must get rest, food, sleep, family time as it is human right, but you cannot, because you have chosen this career.
  9. Complete ignorance of achievements of Indian doctors.
    Indian doctors are undisputed champions in their fields, standing equal to the best in the medical world, in the most advanced countries. Many of them have left: not to be caught in the BS created by a large population that serves only a selfish purpose of exploitation. Rich doctors are not made to feel guilty in any other country except India. Indian doctors work longer hours, more years, in worse conditions, earning far less, still our country treats them in an extremely disrespectful manner.
  10. The faulty concept of “Service”:
    If you think that healthcare should be free, advanced, cheap, available as per your wish, we agree. Do tell the government. They should make great hospitals, pay to hire highly qualified doctors, and treat millions free. But if you think that every doctor is your ‘cheap servant at wish’ we disagree. If the society expects that doctors, teachers, police and army should feed themselves only with songs and compliments, they are wrong. Why should a hard working and brilliant doctor not earn well? We want to give the best possible life to ourselves and our families too.
  11. The ultimate hypocrisy:
    If you can all advise doctors about humanity and compassion, why can’t you do it yourself? Or is compassion reserved for doctors only? We recently had a migrant crisis. Millions of poor people left because they had no homes, food or money. Why didn’t our media and politicians appeal the society to accommodate these migrants wherever they were?
  12. Our society conveniently forgets that complicated medicines, high end surgeries, procedures, equipments and technical expertise needs high-end money too, and its pricing is not the choice of the doctor. Just because something is costly, the society (and often the politicos and media) automatically presume that the doctor has a share in it. Some doctors indeed may misuse this as mentioned in the last article, but to avail of a known costly resource and then to suspect the very person who saves your life to be corrupt is ridiculous.
  13. Mannerless misuse of courtesy is a tragic Indian disease affecting all fields. Phone calls, messages, allegations, false alarms of emergency, begging for concessions in spite of an ability to pay, all are considered normal. More you tolerate, more you are exploited.
  14. I will not explain this, but by and large most of the society is jealous of the respect and affluence a doctors gets. Most cannot grasp the concept of an intellectual income. Be it illiterate stars criticising superspecialist doctors on national TV, or be it reporters of evil news, the ability to speak has become a weapon to unleash their hidden envy for everyone who achieves something. Doctors become their natural targets.
  15. Last, but very important: there indeed are very trusting, good patients who think of their doctors as equal to Gods, and every doctor’s heart goes all out for such patients. Anywhere in the world, a doctor will happily empty his/ her pockets and break all barriers for such a patient.

I now have come to a conclusion that this will never change, as change is a BILATERAL phenomenon, and our society is beyond that capacity as of now.

Do we take advice from those who haven’t been able to run their own healthcare set-ups well for decades? Do we listen to the ignorants who do not have the simple courtesy to wear masks during pandemics? Do we learn from a media that converts some celebrity’s tragic suicide into an opportunity to earn? It is a choice.

Will our society change? “How far should the doctor allow exploitation?”.

The Answer My Friend, Is Blowin’ In The Wind!

© Dr. Rajas Deshpande

This is the second article of the series, to be read only with other articles. The last two articles will propose the solutions.

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Change The Medical Scene, India: Article One. Healthcare Failure In India: Problems And Solutions

1: Etiopathogenesis
(c) Dr. Rajas Deshpande

This is my heartfelt attempt towards initiating a change in the Indian healthcare system. We all, even the government, wants it to improve but nobody seems to know where to start.

I appeal the younger generation of doctors to please think deeply about this article in terms of your future, unless you want to face the same humiliation, insecurity, inhuman attitudes, suppression and threats all your life, just because you are divided. I intend to offend no one, my non-Utopian aim is that every patient as well as every doctor should be happy, healthy and satisfied. There indeed are more good than bad doctors in India, but guess who dominates the scene.

In this series of articles I have tried to first identify the basic problems, and will propose probable answers in my later articles. Before we analyse outsiders, let us first take an honest look at ourselves.

Problems Within Medical Community:

  1. We have many class differences between doctors. This is the most prominent cause of non-unity of doctors. These class differences may be summarised as (a): Intellectual: some doctors are far more intelligent and skilful than others. (b): Cultural: some doctors know the best ways to behave and speak with patients, others have an arrogant, ill-mannered, abusive and sometimes filthy, inviting a bad reputation. (c): Academic/ Clinical: some doctors are trained at extremely good institutes, some put in gigantic self-study efforts, and therefore are academically and / or clinically better even if their medical degree is the same. (d): Financial: some need financial support and critical effort to survive through medical courses, fighting till in their thirties to settle down, while for some others, financially it’s a cakewalk.
  2. Shameful tendency amongst doctors, of discrimination based upon State, Caste, Region, Religion, Academic Institute, City, Financial Status or Political party, generating an “Insider-Outsider” culture. This has also resulted in many hospitals employing doctors from a particular religion or socio-cultural/ financial status even if better candidates are available. Few honourable exceptions.
  3. Jealousy, Insecurity and Envy: There are successful and struggling doctors in every branch. The shameful tendency of some established doctors to suppress and disallow juniors in their institutes is well known. Most wise institutes now employ two or more competing masters in every branch and fire up their egos against each other, to have them fight tooth and nails. Guess who profits and who bleeds. The comic tragedy is that even very brilliant doctors fall prey to such tactics. © Dr. Rajas Deshpande.
  4. Financial desperation: Juniors who come from poorer backgrounds, in spite of better abilities, have no money to invest, make their own hospitals, and must work at bigger hospitals under such competing seniors, and the only way they are allowed to survive is by getting better numbers. This results in a very hostile, bitter work culture.
  5. Killing Humanity: The entire medical community is guilty of perpetually ignoring, intimidating, suppressing and blackmailing medical students, especially postgraduate resident doctors. India has probably the worst inhuman treatment for its budding and junior doctors, with no one interested in addressing their problems. They live in most pathetic conditions, often six in a single room. They are inhumanly overworked, with a shameless answer “We did it, now you do it” from their seniors. “No food and No sleep” is nothing to be proud of, it is Torture. Post graduate students and resident doctors are not only FORCED to work far beyond human capacity, they are overtasked with mindless curriculums. The “Slaves” in our history were far better off compared to how the resident doctors are treated today in India.
  6. Extremely low quality medical institutes: Guess who owns and runs these, still churning out valid degree holders.
  7. Nepotism: Where “Premium” students, often children of the powerful, politicians, administrators, doctors, socially prominent are treated differently, groomed specially and airlifted to success while others, however meritorious and efficient, are humiliated and suppressed. © Dr. Rajas Deshpande.
  8. Master-Slave Culture: In every private or Corporate owned hospital, there is an unwritten rule: never cross the Master-Slave boundaries, never ask questions, you are here because we allow you to be. Should you dare to correct someone about policies, ethics, financial irregularities, excess profiteering, you are unceremoniously thrown out, given the title of a rebel, a troublemaker, and your reputation as a doctor is torn beyond redemption. This is the worst for surgeons than physicians, as ‘badmouthing’ / deliberate ill-reputing of a surgeon can ruin their entire career. Unfortunately, it is not only the hospitals, but different classes of doctors mentioned above participate in this mudslinging too. No institute in India has an honest troubleshooting department for doctors. There is no respite, there is no organisation, doctor’s body, government department that protects a doctor thrown out, defamed or harassed by corporates or big hospitals. Very few hospitals are doctor- friendly.
  9. Even in government service, sycophancy is the strictest tradition.
  10. The SP Syndrome: Shoelicking-Postholders are the worst tragedy in healthcare. Even after being qualified doctors, these ‘doctors’ have learnt the quick-ladder culture to sit in a medical administrative chair. They know which side to please, and are seldom seen working in the interest of either the doctors or the profession. They have but one agenda: strengthening their chair-bum glue. They are found almost everywhere in healthcare, and many enjoy the administrative superiority and control over better qualified and even senior doctors. There are rare honourable exceptions who try and balance the hospital and doctor’s sides. However, those involved in policy making are rarely in direct contact with the patients, have rarely had a reputation / experience of good medical practice, and are happy with hypothetical speeches sweetened for their powerful masters. Senior doctors have never stood up for an unfairly fired or colleague, and often our own community disowns a doctor harassed by healthcare giants or government. Thousands of excellent doctors have either left the country or live in dark anonymity just because there was no Godfather for them. This is a major cause of policy failures and pathetic research in Indian healthcare, inspite of having some of the best medical brains upon earth.
  11. The only thing that helps a good doctor is long-term goodwill generated over years, where patients spread a good word about their relief from that doctor. Against this is pitched the permission to hospitals for self-advertising, which often misleads the society.
  12. Once a doctor starts a hospital, there are so many taxes / overheads that he / she must shoulder, so much paperwork, that it is difficult to concentrate upon patients alone. Add innumerable laws, restrictions, rules that make it impossible to sustain over long term. Bribes are a stark reality wherever rules, restrictions are involved. This is why many doctors have closed down smaller hospitals.
  13. While doctors are only allowed to charge their (mostly) limited fees, almost everyone else in the profession earns a lot more profit, often unjust. From rooms, service, nursing, gloves, catheters, to procedures, from canteen to labs to radiology to pharmacy, the hospital and pharmas earn profits everywhere (this is acceptable in proportion of the investment). The one paid least in the final bill is the doctor / surgeon, who usually earns a piddly sum in spite of being the most important factor in the chain. The doctor is also primarily responsible medico-legally for every case. Patients are upset with the doctor even after saving their lives because the bill is fat, not knowing that most doctors have no say in hospital billings. © Dr. Rajas Deshpande.
  14. The Corruption: There is no denying the fact that some doctors participate in various “unethical” means of earning via “commissions”. While all corruption is wrong, this is an extremely hot and debatable issue, where many questions are unanswered. For example, if a doctor owns a hospital and a lab and a pharmacy, he can profit under all three headings, but if a doctor working with him is also paid from this profit, it is presumed unethical. Our society is too financially biased, and it will never accept the necessity of profits in healthcare. However, the same society or its government has no answers to what a good ethical doctor should do if there are financial emergencies like this pandemic where his / her income is near nil. Hence the doctor is left to ensure his / her own income, with or without patients. Our society will preach doctors a lot of pompous lessons of ethics and compassion, but won’t feed the doctors family if he is in financial trouble due to all the good and free work he does. To completely eliminate “backdoor incomes”, the only way is that the doctor’s fees will shoot up.
  15. Over-smart Attention seekers: This community of doctors will do anything to garner attention. They will make news for being cheapest, they will construct new theories of individual, private research and blabber about them on national / state channels, massage the egos of power, speak against their own colleagues just to get praise from society and media and so much more. They hunt celebrities and powerful to be seen with, always speak the language of “Sweet, Beautiful, Positive” and imply from their wisely framed speech that only they can understand compassion and patient’s feelings while other doctors don’t. These are the usual early birds on TV, who criticise their own professional colleagues whenever there is violence against doctors, preaching about communication, making the society feel that ‘bashing up of junior doctors’ is justified, just because they could not communicate well. They will go to any unscientific extent to fool the public to be in good books of the government and administration, and completely vanish when their profession is suffering. This attention-seeking community has done the worst harm to medicos and the reputation of our noble profession.
  16. Doctor’s Organisations: “………………………………………………………………………………………………………………………………………………………” .

To Be Continued
© Dr. Rajas Deshpande

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Disoriented


© Dr. Rajas Deshpande

“Doc, he appears confused. He has delusions. He was very methodical and logical earlier. He had excellent deduction and was considered a genius among his colleagues. Yet now he himself does not understand that he is making gross mistakes in making simple decisions. He appears completely disoriented…” the lady gave me an update in a deeply concerned voice. The devastating fear of mental, intellectual decline of a beloved is not grasped by all. For want of simplicity, we term it dementia. However, the meaning of this term is far broader and deeper than what most people can grasp, and the mental agony that the spouse goes through is beyond many a people’s emotional basket too. Infections and low sodium levels can often worsen the mental-cognitive personality of the elderly. I advised her a few tests to be done urgently and returned to my quarantine chores.

Her words kept on echoing for some time in my mind. This pandemic has challenged what the humanity perceived as truth till date. Disoriented, demented, illogical, delusional: isn’t that what the whole humanity has become today? Hasn’t this virus uncovered our intellectual, emotional limitations and selfish vulnerabilities? Have we not become exactly what the best human souls taught us never to become: money minded selfish humanoids hiding behind facades of clever and intelligent, politically correct wordplays, fatally attracted to glamour and clamour, emotionally cut off from the world, concentrating upon our families, cults, religions and regions? And of course, intermittently well-crafting the social service façade by donations, our signature face on every penny.

Financial success and numbers have become the new, hidden definition of life. Some wisely hide the word ‘Financial’ in the prior sentence. We won’t be able to name any financially unsuccessful / poor geniuses from the fields of medicine, science, art and even sports. I do not hate capitalism, in fact I believe that wealth creators are the ones who fuel the world. But among these are the compassionate and human who would rather be a million short of their billion rather than destroying a competitor and his/ her business. Squeezing-twisting every arm in the giant machinery that governs laws to finish everyone else and engulf everything with a gluttony that is hailed as business acumen is a real tragedy unfolding right now. We very gladly become the proud cogwheels of such ‘man-eating’ giant machineries that bleed competitors to a certain death.

While never being able to make peace with our neighbours we speak of world peace. We cannot bring ourselves to acknowledge the good in our competitors and enemies, we cannot deal with those with a different religion or country, come what may! While excepting ourselves from laws and rules we blame and blast those others who break laws. While secretly cultivating the filthy “money is all that matters” gene in our next generation, we encourage blindness towards the moral, ethical bypasses required to earn humungous money. The amount of real happiness, truth and honesty that needs to be sacrificed to be extremely rich is the worst inheritance our next generations will have to suffer from. Clever Wordplays is the sociopolitical success mantra of today!

I had never thought that I will witness anything more emotionally traumatic after seeing the hundreds of dead bodies and bleeding, broken-bone victims during the Killari earthquake. Today’s migrant crisis appears to cause deeper wounds than that upon our soul. This is a very tragic question, but what causes more hurt: witnessing dead bodies or extreme suffering of the living? Millions of migrants facing the worst wrath of fate, walking under a scorching sun towards a faraway home with their children, some dying, some delivering on the roads, strong men and women labourers breaking down and wailing – will be a shameful and guilty memory which I will carry for the rest of my life. We have excess caps and shoes; they are walking in rude heat bare headed and barefoot for hundreds of miles. We are discovering new cooking skills, they are discovering new depths of hunger. We are complaining about broken air conditioners, they are gasping for a glimpse of their beloveds in their zuggi-zopdi. We are too comfortable and grateful knowing that we are not them.

That India is overpopulated appears to be our strength on social media. We can show how many million fans, hits and likes there are, but we cannot speak a word about a tragedy which happens right in our backyard. We are scared of the worst: socio-political ostracisation, defamation, destruction of a hard-earned reputation and closure of financial support for survival. An intellectual is more scared of losing freedom of creativity, giving his best to the world and so mostly decides to be a silent spectator around strongmen with their invisible socio-political weaponry. Society as a whole has never protected or rewarded its intellectuals, especially in backward countries.

This pandemic will go. Few will have changed their perceptions of the world. Few understand that anything requiring a crowd must please a crowd’s intelligence quotient. Because crowds gather for hate easier than for love. Look at what content gets the best response: hate mongering, roasts, nudity, vulgar language and sloganeering. None of these is a proud achievement of humanity, yet these are the top hits. Pleasing a crowd can entertain, can earn one money, fame and votes too, but cannot ever bring this world health, happiness or peace. Entertainment, although critically essential for a stress-free mind, although soul-awakening, will never be among the first essentials of reducing hunger, pain, disease and suffering. There indeed was a time when entertainment was creative, with art, literature, acting, music and sports, fulfilling for the soul, but now only the superficial, jaded antics and the gaudy glitter with numbers remains the identity of most entertainment forms.

We indeed are disoriented. Yes, I too am guilty of some such disorientation. I have consciously decided to change. I do not have all answers right now, but I better appreciate the bigger picture now. My perceptions of what matters most have further changed. My faith in human nature has been deeply wounded, but my hope has always won, and I will help it heal even now. The current crises just told me what human race truly needs. My wish to make everyone understand has decided to take a back seat. My wish to do what I can is in the driving seat now. My contribution will be probably too small, but I have started.

I want to be well oriented for the rest of my life.

© Dr. Rajas Deshpande

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Suspend All Doctors, Cancel Their Registrations…


© Dr. Rajas Deshpande

Have you ever spoken with a doctor, a judge, a police, minister or an an IAS officer in their office? Almost every common man has had almost a similar experience: an arrogant air of authority, hidden hints of superiority and a subtle dose of “I know better than you” whenever one tries to argue. Now we know all of the above can be wrong occasionally, at all levels. Of course, there are exceptions in all professions. In a new world which is now shedding away traditional chains of inequality and racist slavery, we Indians are probably the most reluctant to change. In performing one’s duty, no one is superior to those they serve.

A doctor needs to be patient and compassionate with the ill-behaved and arrogant, unlike police, judge or minister who will punish people for such behaviour. Additionally, far before COVID19, there have been fatal infections like MDR Tuberculosis and other viruses which have endangered and even killed doctors. The stress of this daily fear of death is difficult to explain to the idiots who argue “but you yourself chose this profession, nobody forced you, you knew all the time about these risks”.
My dear infinite stupid, yes, I chose this profession willingly, knowing the risks, but to live on and serve, not to willingly and knowingly expose myself to fatal infections. A soldier joins the military ‘to live on and fight and protect the country, not with a wish to die with enemy’s bullets’.
When a citizen tells them from the comfort of a protected home that “You already knew you could die in the army”, it is ingratitude and insult to their profession. We choose to be in this profession because our compassion and courage is higher than our fear, not because we want to die. To be honest, we do not expect many to even grasp this concept. © Dr. Rajas Deshpande

I have deep respect for some Judges, IAS and police officers who are geniuses, and the first mark of a genius is a humble openness to all logical argument, with parsimony of words and zero presumptions of having a superior knowledge. Even a few minutes with them enhances your life. They are calm and respectful of others. Their language is never “Suspend, Fire, Transfer or Shoot”, because they know what it takes for a genuine person to reach where they are. These geniuses are far above attention seeking, cheap media publicity, arrogant show of authority and blame-mud-slinging to cover their own mistakes, inferiority complexes, and inadequacies.

It takes longest time and a hardest curriculum with hands-on experience of years to make every single doctor. The more specialised a doctor becomes, the rarer it is to replace his experience. Still anyone can commit mistakes.
If a Judge, a police Officer, a Minister, an IAS officer is wrong, does our constitution allow any TDH in media or society to get up and threaten them with suspension? Can you imagine a nagarsewaks / municipal councillor / local politico, goons or even major/ minor officers threatening a judge, IAS officer or a commissioner with cancellation of their rank, licence or degree? Even the courts of law do not suspend anyone or strip them of their hard earned registration without giving them a complete and patient hearing.

Yet almost every TDH in almost every nook and corner in India, from temporarily elected less-schooled representatives to highly educated junior and senior administrative officers often threaten on TV channels that doctors’ registration, licence and degrees will be cancelled. This apparently gives them a sense of pride and accomplishment and also sends a wrong message to a public that these doctors must serve.

In a country where the policy makers have miserably failed for generations to create enough doctors for their population, where we still continue to have that discrepancy, suspending a doctor is like snatching away food from someone already dying of hunger. One doctor gone screws up many patients’ lives. There’s no other profession where generations are taken care of, lifelong, by one person. Yet apparently, some officer’s egos are more important than those patient’s families, health and lives.

Every day there are news of political, social reasons of suspending, threatening doctors. Deny concessions, freebies, shoe-licking, decline to compromise upon scientific principles or accept inhuman conditions for doctors, and almost every officer unleashes their administrative adrenaline pumps against the entire medical profession. Refuse to accept incorrect policies and guidelines that are against patient’s interests, and insubordination leads to losing your jobs. The most shameful and pathetic addition to this “Suspend-Crazy” admin category are some senior doctors who fail to guard the principles and juniors of their own glorious, noble profession. © Dr. Rajas Deshpande

Like every Judge, Police or IAS officer, even politician, every doctor has also worked very hard to earn their degree and licensing. Every Medical college and University in India is approved by the government. The Medical Council of India has been given the authority and statute to license a medical practitioner upon presenting his / her degree and following principles it has laid down. No one other than the MCI should be able to cancel the licence of a registered medical practitioner. Every case of suspension of a doctor: whether a postgraduate or a senior doctor should be referred to a separate impartial MCI committee. Even the Hon’ble courts of law usually request expert opinion before concluding about medical issues / cases. Yet, our admins and politicians from different states suspend and threaten doctor’s registration cancellation as if it was granted by them or their party or government as a favour. No. We don’t accept that. Every IMA branch in every city must stand by such victimised doctors, protest such injustice, represent the harassed doctor and protect him/ her.

There of-course are doctors who commit mistakes, like Police Officers, IAS officers, Ministers or even some Judges. All of them should be accountable and be brought to the right penalty with the same dignity as others. No one has the right to pretend that a doctor is a slave to their whims, greed and tantrums. © Dr. Rajas Deshpande

The Hon’ble Supreme Court has very clearly stressed the fact that it is very important that doctors should be able to work and make their decisions without stress, insecurity, duress or fear. The article above intends to highlight that same purpose, especially in the light of some recent happenings. Every doctor out there is risking life only to save others, serve the nation. They do have problems, issues and insecurities that need sorting out. Please address their issues scientifically and logically, rather than inhumanly threatening them by suspension and cancellation of licences because you have no resources, funds or answers. Treat your doctors with the same compassion that you expect from them. Or, if you know better, if you want doctors to blindly follow unscientific instructions of admins and whims of politicos why make doctors? Suspend all doctors at once and do it all yourself.

India will definitely be healthier if you listen to the doctors, and don’t threaten or suspend them for trivial reasons.
Jai Hind!

© Dr. Rajas Deshpande
Written with a sad heart that on one hand where the Hon’ble PM has asked people to respect and appreciate the efforts of doctors, nurses and other corona warriors, many are looking for reasons to corner, threaten and suspend them at the drop of a hat, sometimes just for headlines.

Please Share Unedited.

Distance Yourself, Doctors.
© Dr. Rajas Deshpande

Dear Indian Doctor,
Congratulations on your bravery to face a pandemic without much support or protection. However it looks like once again a lack of funds and scientific PPE availability will be conveniently translated by one and all into “Doctor Bashing” by sermons on call of duty and other emotional yet unscientific logics. Even some administrators who have exposure to screened few, sitting six feet away from everyone are wearing PPE and N95, while appealing doctors to start opds saying there’s no risk. Should one examine a patient without touching? Do we have seven feet long hands? If we are expected to go within 2-3 feet of the patient, aren’t atleast N95 and gloves essential? But logicless arguments only waste time. Always labelled ‘Money Minded Medics’, now when doctors are sitting home, not minding money, everyone wants them to be in the forefront, appreciated by groups clapping from the safety of their homes. © Dr. Rajas Deshpande
But you know what? This has always been, this will always be. Do not expect any major change in social mindset. None of them had merit or patience to study hard for 10-15 years to become a doctor. None of them even knows what sacrifices are required in daily life, family life and personal exposure to fatal conditions on a daily basis. Their tiny grasp is limited to the last visible part: the fees for service. With an exception of honourable few, most cannot understand a medico. Least those who must please and seek attention of majority. And Majority was seldom right as per history. © Dr. Rajas Deshpande. Logic-less mobs are a reality.
Only those among us who shoe lick and toe line will be projected heroes. Most of us are beyond that. It is pathetic that no doctors’ organisations or glamorous bigwigs stood up against some of the major issues concerning fatal risks to our next generations. (DO NOT FORGET THAT).
That’s why writing this: it Is now upto each one of us to fend for ourselves. Stay calm. This is also not a time to argue with administration. Keep concentrating on your own safety while doing the best for every patient. Wear double masks if you don’t have N95. Wear cloth head cap that you can wash. Wear plain spects/ goggles. Use gloves always. If at all you touch patient wash hands thoroughly. Limit examination to necessary. Ask every patient and relative to cover nose and mouth before entering your chamber. If sanitiser is not available use spirit. Leave wallets, purses, bags in your car/ locker. Disinfect your stethoscope, torch and other instruments. Use digital blood pressure machines where possible, if you must auscultate, have the patient turn away face. Change bedsheets and pillow covers frequently. When you leave hospital please wash exposed skin thoroughly. Upon reaching home leave your footwear outside, cover your face and walk straight to the washroom. Change and immediately soak your clothes in detergent plus hot water. Take a thorough wash with preferably hot water, especially washing exposed areas like head. Take your vitamins without fail. Those with high bp and sugars please take rest and leave freely, don’t take your own health for granted. Eat well, stay safe, all of us have to save thousands and thousands for many more decades. Please do not forget that medical practice is far above and beyond one pandemic, covid or not. We must be available to serve all other deserving patients, and for them we must now take the responsibility of our own safety. No one ever stood by doctors’ well being, no one ever will.
Haven’t we always been distanced by the envious, jealous and unscientific? It’s our turn to use that distance and stay away from those. For every patient who deserves us.
All the best.
© Dr. Rajas Deshpande

Note From A Doctor Who Worked Against Plague and Many Other Epidemics


© Dr. Rajas Deshpande

When I volunteered to work in the plague ward during an epidemic while working as a resident doctor, my parents justifiably panicked. I was all excited and trying to stand upto my own ambitious expectations. That was a different time. Many epidemics later, now I am careful. Ambitions and expectations are the same: to serve most and to be the fearless best, but there’s an addition: to be very careful. © Dr. Rajas Deshpande

If I know you by myself, you too must be dead scared and frustrated. Not of death alone, but of the perpetual uncertainty atleast now.
Let us remind ourselves that like the umpteen fancy fears and frights in our mind, over ninety percent of bad things that our sometimes-villainous minds project actually never happen. Some bad does happen, but we have learned to move on, whatever happens. Let is not dwell on the fears and umpteen negative scenarios which our minds are creating right now, especially those related to our loved ones, and stupid musings about what happens to our belongings. If we look back, we realise that all of us have been addicted to negative thinking in negative situations. Even the ghosts below our bed have grown up now, it’s high time we do too!

Ok, this virus is indeed bad, there’s a huge risk. But there are countries that have already defeated this virus by arresting its spread. There are many (94% minimum in India) who will recover even if they catch this virus. The better we stay away from each other (my hobby) and wash hands (my passion for which almost every posted student has made fun of me), the faster we will defeat the bugger. Fear generates too much negativity and affects our mood and even immunity. This semi-irrational fear in our mind needs to be replaced by learned ‘care’ and abstinence from the tendency to return to thoughts about death. © Dr. Rajas Deshpande

I am as tired of the ‘house arrest’ as everyone else too. I am longing for those long drives in sun and rain. It is difficult to concentrate when under fear. But then there indeed are things that engage my mind (of course, besides this frigging cooking, cleaning and laundry) more passionately than any of my fears: that I want more life, that I want a better tomorrow. I am lost in the thoughts of finding love, making friends that vibe, finding cures for neurological patients, driving an Aston Martin one day, and of course the traditional yet true wish: leaving a legacy of something great behind myself: just like most of you think too. Let’s keep planning, now while we have time to reset priorities.

If I was authorised (don’t shoot yet), I would have banned all those media channels from spreading fear. I am only authorised to suggest this to my sane friends who are suffering from immense fear: turn off your TVs, take a book, have tea or coffee, chat with family members and take a nap if you’re bored, rather than digging for bad news. © Dr. Rajas Deshpande

Make notes about what plans you have to stay safe till you reach hundred. Implement them with a resolution that you will witness the end of this pandemic and achieve everything you want.

Most of us will meet again at that bright end of this tunnel! I want you ‘smiling healthy’ when there.. Whatever little number of close friends I have know that I never say goodbye.
I prefer “See you again soon”.
Take Care till then.
© Dr. Rajas Deshpande

Please share unedited

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

Survival Of The Quickest

© Dr. Rajas Deshpande

This young and brilliant man, Adil Masalawala, suddenly appeared to have changed. His behaviour became different and unusual. He started mumbling and replying irrelevantly. He also had fever intermittently. His caring and worried wife Mrs. Venus consulted a physician who sent them to a psychiatrist.

The psychiatrist checked Adil and advised him admission. He started with some medicines, but suddenly Adil’s behaviour became hyper, his body started becoming stiff. Then he became drowsy, and his body started shaking violently. An MRI of the brain was reported normal. That’s when the psychiatrist advised a reference for neurologist.

When I first saw the patient, he had many features that could also be caused by side effects of some medicines. Sometimes it is impossible to conclude whether it is the disease or the medicine which is causing certain symptoms. I suggested that we stop all antipsychotic medicines. That could also be a dangerous decision. The family was counselled, and they agreed. Adil’s drowsiness improved, but he became very agitated, and his stiffness and shaking worsened.

There are many neurological diseases of the brain which start as abnormal behaviour. Strokes, some infections, tumors and swellings are examples of treatable, but there are many untreatable and dangerous conditions too. The only way was to urgently investigate the patient further. Although the family was baffled and panicked, Mrs. Venus expressed complete trust in our decisions, and allowed us to shift the patient to the ICU. I could not answer many of their questions, I did not clearly understand what exactly was happening, but this uncertainty and challenge is what medicine is all about.

There is fluid in and around the brain, which nourishes the brain and also acts as shock absorber between the skull bone and the brain. Many diseases like cancers and infections can be diagnosed by studying this fluid, which can be taken out by inserting a needle in the lower (lumbar) spine. We checked this fluid, and we got the first clue: that we were possibly dealing with a viral infection of the brain. Many more costly blood tests were required to find out which virus was causing this. The family clearly stated “Do whatever is needed in your opinion”. We sent the tests and found the answer: Adil had one of the most rare and dangerous viral infection of the brain, called Japanese Encephalitis.

About 30-40 percent of patients with this diagnosis do not survive. There is no definite treatment for this virus, but many of the manifestations can be treated and excessive care is required to avoid life threatening complications of the swelling that it can cause in the brain.

On the fourth day, Adil had convulsions. His condition worsened. We kept on treating each complication as fast as possible and tried to balance the effects and side effects of the many strong medicines that were being used to control convulsions, shaking, and the brain swelling. Besides knowledge, wisdom and experience, our major strength was the trust of patient’s family who never questioned any decisions.

Many patients who develop abnormal behaviour are mistreated as having a psychiatric problem. Most qualified psychiatrists are aware of the red flags and refer patients for a Neurologist’s opinion. However, a majority of patients with psychiatric problems in India are first taken to quacks, magic healers, mantrik-tantriks, who delay the whole process of correct evaluation, diagnosis and treatment. This leads to many deaths, and this is worst in case of cancers treatable in earlier stages.

False advertisements, some even approved by highly placed offices, celebrities and authorities attract people from all classes and cause severe delay in initiation of the correct scientific treatment. While our governments rightly pressurise allopaths to write generic medicines, they mostly turn a blind eye towards rampant misleading false advertisements claiming cures of incurable diseases and centers that flourish reaping from the hope of millions of illiterates.

We almost thought we had lost this case to a permanent disability. Adil’s body had become completely stiff, his memory had become unreliable to a great extent, and he had an incapacitating tremor. After a few days we could gradually stabilise his general condition and shift him out of the ICU. In a few weeks he was discharged, improving slowly. His family, especially his wife fought for his normalcy like a true warrior, and once he resumed his senses, Adil too made every possible effort to recover fast. One day after a few months, he was back to normal again, we declared him cured and fit, physically and mentally. He resumed his job.

Today after about ten years, Mr. Adil Masalawala and his wife Mrs. Venus came over for some trivial issue, and we recalled the horror that we went through and his victory over it. In this case, I thought it was the “Survival Of The Fastest” as the family did not waste any time in quacks, arguments, objections or mistrust, and let us doctors do the best for the patient in the fastest possible way. We are grateful to the family for this trust, and Adil’s survival and recovery itself is our reward. God bless the couple with a long and healthy life!

© Dr. Rajas Deshpande

Real Story, Real Names, With Patient’s Express Permission. Grateful to Mr. Adil and Mrs. Venus for the permission to share the story of their victorious battle.

Please share unedited.

150000 Deaths, 500000 Accidents Or A Strict Law?

(c) Dr. Rajas Deshpande

Neurologist Pune/ Mumbai

Ask any doctor in India, how traffic related deaths and injuries cause havoc in the casualties every day. In a country with nearly five lakh traffic related accidents and one lakh fifty thousand deaths every year, with many more lakhs seriously injured and disabled for life, the strictest of the traffic rules and highest penalties are not only justified, they are mandatory. Any doctor will testify the daily typical histories of drunk driving, unqualified driver, jumping signals, overspeeding, gross neglect of lane and general traffic discipline. Add parents who allow under-age children to ride and drive, husbands who wear helmets while rest of the family rides on two-wheelers without helmets and so on. Most horrific is the case of people with medical conditions unfit for driving: thousands are out there with heavy vehicles, risking the life of everyone around. This is gross negligence.

Indians take pride in describing the how safe and peaceful it is to drive in a Western country, where everyone follows traffic rules, but the same Indians gladly use the philosophy of “If everyone follows the rules then I will also follow” to break rules in most cases. In fact, a national shame is that many take pride in breaking traffic rules, disrespecting and attacking traffic police, and indulge in road rowdiness.

This new traffic act is a bold and welcome step by Mr. Nitin Gadkari, and every right minded doctor and intellectual should welcome it in the right spirit. In a completely unruly traffic scenario, the fines and punishments should indeed be intimidating to prevent traffic crimes. Any effort to dilute it is like saying “Let People Die”.

To please the society by diluting this act so as to allow risking the lives of thousands is a dangerous and foolish proposition. At least doctors should strongly stand by this act. The Hon’ble Minister also posed a logical question: “If you do not break the traffic rules, why should you be afraid of being fined?”. This law and the high punishments are all indeed in the best interests of tyhe society and the nation.

The only probable amendment to request in this act would be to also add severe penalties and punishments to the contractors who have ruined roads by substandard work, potholes also cause many a deaths. A huge population comes with spinal, vertebral, neurological and orthopedic problems created by bad roads. Let the ones who make such roads or do not maintain them also face law with the same equality. There also should be non bailable arrests and severe punishments for road rage and violence.

Congratulations and Thank You, Mr. Nitin Gadkari, for this act.

(c) Dr. Rajas Deshpande

Neurologist Pune/ Mumbai

Please Share Unedited. Nitin Gadkari

Marathi Version on my FB page.

The Fairy And The Prince

© Dr. Rajas Deshpande

The beautiful radiant lady wheeled in the patient’s chair and wished me with a pleasant smile. Some smiles, however beautiful, have a tragic shade. I looked at the patient Rohan. A very well built fair young man in his late twenties, must have been very handsome in the past. He sat paralysed below the shoulders, one eye closed, face twisted, and a large surgical scar upon his head, partially covered by a cap. He could not speak. Any movement would cause violent tremors. He was wheelchair bound and had to be assisted even for toilet.

Rohan and Riya had married just two years ago, against the wish of their parents. Both from very affluent, but uneducated families. Both worked at the same office. In a few months after marriage, Rohan had developed high blood pressure, and was advised treatment. Unfortunately, he got carried away with some false claims about some herbal medicines shown on National Television channels and stopped the BP medicines. The obvious happened: one of the blood vessels in his brain ruptured due to high BP, and there was a huge bleeding. A Neurosurgeon had done an excellent job by taking this high-risk case on operation table in emergency, to suck out the blood clots and save his life. However, the damage was already done by then, much of his brain was damaged on one side. Riya had been caring for him since then. She looked after him just as a mother cares for her newborn.

“Doctor, we know his paralysis will not improve now. But he is brilliant, I know his brain thinks fast and accurate. Since this stroke he cannot speak. We have come with some hope for his speech. If he could just tell me what he feels, if something is bothering him, what he wants, etc., I will be very grateful” his wife said.

We started treatment. In a few days, Rohan could speak legibly, so she was very happy. Rohan’s parents were very happy too. © Dr. Rajas Deshpande

One day, Riya’s father came with her. He asked her to wait outside my room for a few minutes, she reluctantly left. With folded hands and tears, he spoke: “Doctor sahab, my daughter married against our wish. I have forgiven her now. But I cannot see her spending her life like this. She was the most brilliant girl in our town, she had even rejected job offers to go to America because Rohan wanted to stay in India. You can see that she is still young and beautiful. Anyone will marry her; she is one in a million. I’m not saying this because she is my daughter, but you can see for yourself from how she cares for her husband. She has become his attendant now. What is her fault? How can a father see his daughter wasting away her youth like this? They have no family life. I cannot even speak to her about this. Her mother tried but Riya refused to speak. She speaks very highly of you, so I have come with this hope. Please help us”.

This was very difficult, but a duty too. If not me, who could even attempt to resolve this?

“Let us ask her about her thoughts” I told her father and requested him not to react when she spoke. We called her in. I told her in short how her father felt. She sat straight. Her face became distorted and she wept silently. Her father kept on patting her while weeping himself.

“Papa, when Rohan could recently speak after so many months, the first thing he told me was to leave him and marry someone else. He refused to eat his medicines, saying that I should leave him. Then I promised him that I will leave him after two years. That was a lie. I know he will die if I leave. I could feel his love even when he could not speak, that’s something more precious to me than whatever you think I will get if I marry someone else. Till the day he had this bleeding in the brain, he made sure I was best taken care of. He never had his food before me. How can I spend even one happy moment with anyone else knowing that Rohan is suffering in this same world? Would you be proud of me if I did that? Did you teach me to be so selfish?” She broke down. © Dr. Rajas Deshpande. Her father did not say anything. They left.

In a few weeks, Rohan followed up again with Riya. He is now gradually learning to operate a computer. He plans to start his own online business. Riya is helping him do that, while continuing to work. They are now planning for a child soon.

This fairy I met was more beautiful than any other in the dreamy stories I had heard all through my childhood. I am glad that I am a witness to this divine fairytale.

I know even of another couple, where the girl had developed a paralysis in her college days. I had counselled her and her boyfriend about future uncertainties and a possibility of a compromised married life, given her illness. “That’s not the most important thing for us” he had said. They married. Today, about 8 years since then, they have a healthy, happy kid, and he still cares for her as much, now when she is in a wheelchair. This knight lives in a rented house, runs a small grocery store, rides a bicycle, wears the simplest of clothes, yet has a heart that would put to shame many a real princes!

My world as a doctor is full of beautiful fairies and knights, named caretakers. It is because of them that thousands of patients are surviving with dignity today. Medical care is so incomplete without them! I remember my favourite author Richard Bach’s words from “The Bridge Across Forever”: “Princesses, Knights, Enchantments and Dragons, Mystery and Adventure… not only are they here and now, they’re all that EVER lived on earth!” How true!! © Dr. Rajas Deshpande.

Among the stories of sadness and suffering, most doctors also come across best of the human hearts and minds, highest forms of love and care. Such patients and relatives reinforce our own trust and faith in the ability of human efforts to heal. Thanks to what I learn from my patients, my gratitude for being a doctor is endless!

© Dr. Rajas Deshpande

Dedicated to all caretakers, young and old, who silently sacrifice much of their life caring for their loved ones.

Please Share Unedited.

“Dev Borem Korum” (Thank You)

(c) Dr. Rajas Deshpande

As the plane landed, I called up the driver who was scheduled to pick me up from Goa airport.

“Hullo, Mr. Clement? I’m Dr. Rajas”

“Haan daktar. Tu aaya kya? Bahar nikalke miss call de mai ayega” (Have you arrived? Come out and give me a missed call, I will come there”) . He would have said the same sentence to the President as well. Goans are least hung up on artificial flowery language, they are the friendliest lot as a society. It was after a year, that the same Clement said to me: “Tere liye apun jaan bhi dega parwa nai” (“I can give my life away for you without any hassles”), when I thanked him for something.

Goa has some excellent Neurologists, and my visiting is actually redundant. Yet somehow, maybe because they keep quite busy, or sometimes patients seek a second opinion, I have been seeing a good number of patients every visit. In the very first visit, after I saw an elderly lady and explained her the treatment, she bowed and said “Dev Borem Korum Doctor”. That means “Thank You Doctor”.

Then I pleasantly noticed: irrespective of what was the diagnosis, what treatment was given, whether there was treatment for the patient’s condition or not, whether the patient improved or not, almost every patient said either “Dev Borem Korum” (Thank You) or “God Bless You Doctor”. Even if surgery was advised, even if there were side effects of medicines, even if the outcome was not as expected in rare cases, the “Thank You”and “God Bless You” never changed. It had nothing to do with any particular social class. The rich, the poor, the educated as well as the uneducated, people from every religion, every age group said it. It is a part of that culture: the Goan culture.

Late one night after the OPD, when we were driving on a beautiful long empty Goa road near the beach, I mentioned this fact to my friend Dr. Samuel (God Bless Him for the exotic dinners he takes me to!), he stopped his car and looked quite affected. “I wondered whether anyone else had noticed that. It feels so beautiful! When the patient is grateful and brings you blessings, you automatically feel responsible to do the best for them. Money never matters in that relationship. We must never take patient’s kindness for granted. So many of them actually say Thank You, God Bless you, but sometimes we are too preoccupied with work, anger, ego and other things to reciprocate and encourage that kindness”.

I told him about my late Professor Dr. Sorab Bhabha, who stood up and greeted every time a patient entered or left his cabin. The onus of initiating a good doctor-patient relationship primarily lies upon the doctor, and it is extremely essential to follow the best of manners and etiquette, kindest of language when dealing with patients.

A very sweet girl who followed up for epilepsy recently told me that she visited me not only for medical purpose but because she was inspired by the way I appear calm and composed, the fact that I never raised my voice and always spoke compassionately with everyone. I had to tell her the truth. “Thank you mam, but I am quite short tempered outside the hospital. Even the junior doctors working with me sometimes find me intimidating. But I have to change when I am with a patient. I don’t think that any patient comes to me because I am any better than anyone else in the profession. I prefer to think that they choose me because they trust I can solve their problem. Will you be rude to someone seeking your help? Then how can I get angry with a patient? Every patient coming to me has that hidden trust, which I must justify. Only rarely, if the patient misbehaves or says something insulting, do I lose my calm.”.

“That’s what I like. So humble!” she had to have the last word!

Yes! The day I bring my ego inside the hospital, I will no more be a good doctor. Even the most illiterate patient understands when the doctor is being rude or artificial. Only when it is genuine, the patient will feel the warmth of my compassion and care. It has nothing to do with sweet talking or a show of affection. The only way to do this is to actually incorporate it within one’s depths so that it becomes one’s originality. Kindness and compassion must be the original, genuine qualities of every doctor who expects gratitude from each one of his patients. It does work in most cases.

After dinner, Dr. Sam took me with two other friends to the beach and we silently stared at the luminous moon for a long time. The music of those waves matched the dance of that moonlight upon the ocean. Just as one can feel the glow of the moonlight upon one’s skin, I could feel those numerous blessings keeping my soul warm and happy.

(c) Dr. Rajas Deshpande

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Slaughtering The Precious

(c) Dr. Rajas Deshpande.

At the casualty door she started shouting at me even before I went in. “We don’t want any tests. We don’t want to admit him in any critical care unit. Keep him in the general ward you have, we are now financially exhausted. Give basic medicines only “. Mrs. Julie, the patient’s daughter, went on:”We have already signed palliative care form”.

“Let me see the patient first “ I said and went in.

The resident doctor had earlier told me that the patient, an old man, was conscious, speaking quite well, aware of his illness. He was intermittently getting unconscious for a few minutes. He had high grade fever. He had lung cancer, and a brain scan a few days prior had revealed that that he had a secondary in the brain too. He had just completed his chemotherapy. The resident doctor had already started medicine for fits just now.

As I examined him, the jovial Mr. Shaw smiled back and told me that he was feeling a little giddy and tired, otherwise he had no complaints. He could even stand and walk without support. His blood pressure was normal, but the heart rate was quite high due to the fever.

“I think you have probably developed seizures due to the secondary in brain. There seems to be some infection too, we will run some tests and start antibiotics” I told him.(c) Dr. Rajas Deshpande.

“When will I feel better, doctor?” He asked, “I want to be home and spend every possible day of my remaining time with my grandchildren. I want to also finish a book I am writing. I am told I have only a few months left. How much time do I have? Six months? Four atleast?” he asked, still smiling. Only doctors know what a smiling face with a crying heart actually looks like. “Every passing moment is extremely precious for me, doc! Please cure me fast” he said.

I assured him that if the tests showed nothing serious, he could go home once fever subsided, but the fits needed long term treatment. While we were having this talk he suddenly stiffened and his body developed jerky movements, then he became unconscious.

Ordering the emergency injections for fits, I told the casualty doctor to shift him to the critical care unit.

Coming out, I explained this to the angry daughter.

“Doc, we don’t want to treat him in any ICU. We also do not want any tests now. Please give him tablets instead of injections, we want to take him home as soon as his fever goes down” she replied.

This has become very common now, relatives of elderly people admitting them in hospitals, but refusing to do any tests, use injectable / costly medicines or shifting to critical care units. A doctor cannot refuse patients in such a condition, and it is an extremely painful, stressful situation to not be able to correctly investigate, treat a patient because relatives are unwilling. Ninety Nine percent of the times, money is the only reason. There are many charity, low cost and even good government hospitals, but the relatives also want the “show”of having admitted the patient at some posh hospital. Beyond a certain level, Private

hospitals cannot go on funding tests and treatments of hundreds of such patients even on a compassionate basis, because the poverty in India is never ending.

Compassion is the most abused entity in India.(c) Dr. Rajas Deshpande.

I told her that even if they had signed for palliative care, his current condition was treatable, his fever and fits caused him distress and could be treated, but she staunchly refused to let us send any tests. We started with oral medicines after a lot of deliberation, keeping fingers crossed that he responds. He did.

On the third day, Mr. Shaw walked out of the hospital with his patent smile.

Just next week, his daughter returned to the OPD: “Doc, dad passed away two days ago. After going home he had fever again, but we decided to manage him at home. Somehow he could not get through this time. I have come to get your signature on these bills from his last medicines, we want to get reimbursed”.

“Was he seen by a doctor at home?” I asked her.

“No doc, we gave him the same medicines that he was earlier given for fever. We also searched online and ordered them. But in a way we also feel he is now relieved of all his troubles” she said, hushing up the topic.

I signed the papers, a duty and an obligation.

In every hospital, every day, we see parents rushing, crying, selling everything they have, urging doctors to save their children on one side, and grown up children urging doctors to hasten up the deaths of their parents on the other . Many sweet, politically correct and legally blurred terms are now available for masking these murders.

A patient with a terminal illness may himself sign for “non-aggressive / palliative” care (meaning pain relief, superficial / minor treatment without aggressive effort to save or maintain life), or if the patient is not in a good mental condition to sign such a consent, the relatives may sign so. However, in India where children mostly are responsible for the medical bills of the elderly, they flatly refuse to treat even treatable, reversible conditions citing “öld age” as a reason. Even in case of patients with terminal illness, to presume that someone is immediately unfit to live, or fit to die is like saying it is okay to terminate their life at someone else’s wish. This is cruel, unethical, immoral, and should stand supported in no courts of law.

However, these murders are a daily routine in India, and law has tied the hands of treating doctors and hospitals as one cannot investigate or treat a patient when the relatives haven’t given a consent. An evolution in the fraternity as well as in this society is necessary if a change is expected.(c) Dr. Rajas Deshpande.

Otherwise, when we all will eventually be old, however much we want to live on for a few more days, one day someone will decide that we don’t deserve to continue to live, without ever wanting to know what we wished.

(c) Dr. Rajas Deshpande

Please share unedited.

The Most Precious Jewels Upon Earth

© Dr. Rajas Deshpande

“Sir, next is our old free patient” my receptionist announced on the phone.

Divya, the smart young girl of 8 years jumped into my cabin, and grabbed her chair with an authority. Confidently looking at me, she questioned, “how are you today?”

Her parents, embarrassed and charmed at the same time with her sense of ease in this big hospital, facing a doctor, hesitantly stood behind her. I requested them to sit down and went through the routine questions.

“She is all good now, no fits since last two years. She has been regular in her school and has started studying well too” her father reported.

I examined her and wrote her a renewed prescription. I noticed the mother wiping tears.

“What happened?” I asked.

Quickly smiling, she just gestured with her head “nothing” and looked at her husband.

“Do we need any tests, Sir?” Her husband asked, “We will do whatever is required”. I could feel his palpitations. They were scared that I may tell them tests, and that would mean financial disaster.

He works as a pantry boy and can barely pay the home rent with his salary. His wife somehow makes ends meet, looking after this sweet daughter and a younger son.

At the age of five, Divya had had her first convulsion. Her parents had rushed her to the government hospital. They did not have the money required for Divya’s tests and medicines even at the government hospital. So they resorted to something that hurt them worst: they had to sell little Divya’s silver jewelry, which was the most precious thing in their house. Even that was not enough, so they borrowed money and started her treatment, her father worked extra hours.

That was about three years ago. Divya’s fits continued, but her parents did not give up. Their whole life had but one aim: to stop her fits. Even after being less educated, Divya’s parents decided to go with scientific treatment, ignoring all pressures to take her to different weird people including magic healers. They did not give up hope, their will power was their boon.

Two years ago, a doctor friend sent Divya to me. With some changes in prescription, her fits completely stopped, she has now become just another normal child.

“No tests are required. Please make sure that she is regular with the medicines” I told them.

As I wrote this, I got a little emotional myself, this was the first time I had heard of any parents having to sell their daughter’s jewelry for her treatment. On one side, I was proud that even after being surrounded by perpetual pits of poverty, this girl child’s parents did not skimp upon her treatment just because she was a girl child (this often happens), but on the other I felt anger and shame that my country still lacks a basic healthcare infrastructure that can offer free quality treatment to at least children.

Yet, this had taught me my lesson. Willpower and hope are the mightiest and most precious jewels upon earth, far tougher and far more beautiful than any diamonds. For there are many who own diamonds but have neither willpower nor hope.

Meeting this rich family today was joy enough, but a greater bliss was when the kiddo put her arm upon my shoulder with the same confidence. The world is indeed hers!

© Dr. Rajas Deshpande

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“If Only”

© Dr. Rajas Deshpande

Dr. Raina sat devastated in her chamber. Medical tragedies are a part of any doctor’s daily life, but this was cruel, because it was preventable.

A young patient in 20s, Mr. Pandey, was brought to her, with mild headaches. He had started dieting and exercising a month ago, and the entire family was hooked on to some herbal preparations that claimed to confer health without any side effects. His examination was completely normal. The patient and his highly educated parents were extremely anxious. Dr. Raina had explained to them that even if the examination was normal, sometimes headaches may be the only early warning sign of some diseases, and hence she would recommend an MRI of the brain.

“Is it necessary? Does his examination tell you something is wrong?” asked the father.

“His examination is normal, however, in many diseases that manifest only as headaches, one may not find anything wrong upon a clinical examination” Dr. Raina explained.

“Like what? Which diseases?” asked the mother, hardly aware that her anxiety was adding to her son’s distress.

Dr. Raina hesitated. When the patient or family is already so anxious, how can one utter names like cancer, tumor, aneurysm, etc.? If the doctor uses such words, some patients lose their sleep for weeks even if the tests reports turn out normal. A doctor has to be wise enough to avoid worrying the patient unnecessarily. © Dr. Rajas Deshpande

“Well, infections like sinus disease, pressure changes in brain water, and some others which are rare” Dr. Raina said cautiously.

“Any dangerous diseases? How much is the possibility? Can we wait?” the father bombarded.

Dr. Raina controlled her discomfort and agitation. Educated or not, when a patient visiting a doctor talks as if they know better medical decision making than the doctor, the doctor mentally switches off the ‘compassionate involvement of a doctor’ and becomes a ‘legally alert’ medical professional. Questions are welcome, suspicious cross examination is not.

“The possibility of finding anything grievous like clots or tumors is extremely low, but this is usually the standard investigation to complete the evaluation of the case” she replied. She had told them to get the MRI done. They asked if it was an emergency. She said it didn’t appear to be, based upon the normal examination. She wasn’t ‘God’ to see inside the body.

She prescribed the patient some simple medicines for headache, preparing for another round of questions.

“Are these steroids? Are these antibiotics? Do these cause addiction? Do they cause damage to the liver or kidney?” she patiently replied to the family. © Dr. Rajas Deshpande

Why won’t a doctor think of these things when writing a prescription? Do you ask a pilot if his steps while flying are correct? Do you cross question a Judge about how he makes his decisions? Do you ask a soldier fighting with terrorists why he is firing, how many bullets, and in which direction?

The mother checked the medicines and said “Don’t mind doc, but I will first google these medicines and then start in a day or two. We will also think about the MRI”. They left.

Just two days later, the patient was found unconscious in his bed at home. Rushed to the hospital, his brain showed blockage of the venous channels in his brain, that had caused huge bleeding. He was operated in an emergency and was now paralysed on one side. He had also lost speech. The surgeon who operated the patient could manage to save his life with a great effort. The parents were still suspicious about the surgery being wrong. Many opinions were obtained, and it finally dawned upon them that what was being done was the best. The combination of unknown content medicines, low water intake, atrocious dieting and exercise had probably caused clots in his brain, leading to the blockage and bleeding.

One evening, when Dr. Raina was passing by the wards, the patient’s mother stopped her. “He is our only child. Our whole life was woven around him. Will he ever speak? Will he ever walk? Please tell us the truth”.

“We will try, although it looks quite difficult. It may take weeks to see some improvement. But we have seen miracles, let us hope for another” Dr. Raina replied. It was useless to blame anyone now, she refrained from the obvious ‘if only’. © Dr. Rajas Deshpande

They came back in a few weeks after discharge. Now the son was in a wheelchair.

The mother proudly told Dr. Raina: “You know doc, after discharge we took him to a remote village in south India, where he was given special massages and an ancient secret diet. That’s why he is now improving, he has just learnt to say “Aai (mother)”.

Dr. Raina did not reply. There was no cure for the disease of faithlessness in the society that she worked for.

© Dr. Rajas Deshpande

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The Light Divine

(c) Dr. Rajas Deshpande

The lady in the ICU appeared quite disturbed and shaken. Bewildered, she kept looking at her husband’s face, wiping her tears and his forehead with a corner of her saree.

Her husband, Mr. Mohan Vitthal Kadam, was critical, he had also gone completely blind suddenly and paralysed. While working as an electrician with a company in Jejuri, he was often noticed to have high blood pressure inspite of taking regular treatment with his family doctor. One day at work, he suddenly had a severe headache and went completely blind. Terrified, his colleagues rushed him to the nearest hospital. His blood pressure had shot up far above the dangerous levels. The local doctors gave him emergency treatment and sent him over to Pune. That’s why I had come to the ICU.

I introduced myself politely to his wife, and asked her the details. Sobbing intermeittently, she told me what all had happened. I examined Mr. Kadam. His BP was still high, but not in dangerous zone anymore. He was confused, unable to speak clearly. His left side was paralysed too. He pointed towards his head, indicating that he had a headache. His MRI showed many areas of his brain damaged due to high blood pressure. The areas which control the visual information coming from the eyes were damaged heavily. His brain was swollen dangerously. He could need an emergency surgery.

This condition, known among doctors as “Cortical Blindness” is a common but griveous condition: the patients eyes and the nerves are intact, they actually can see and carry the images to the brain, but the visual areas in the brain cannot see / read that information, because they are dead or injured. I informed this in simpler words to Mrs. Kadam.

“Will he ever see me again? Will he see our kids? How can he live the rest of his life with such blindness?” her questions came mixed with sobs and tears. I had very few answers, but I told her I was hopeful of a recovery. “We will first concentrate on reducing the swelling upon his brain, so we can avoid surgery” I told her. Their son came over and attended his father alternating with his mother. Mr. Kadam ‘s brain swelling gradually reduced, surgery was no more required. His BP was well controlled in two days. His paralysis also improved, but he still was completely blind.

Once he could understand the situation, he asked only one question: “Can I see my wife and children at leaast once in life again?”.

“We will try, I am hopeful” I replied. We had started with all the supplements that help recover brain damage. When he was discharged after ten days, he was still not able to see anything. He returned today.

“After we went to our village, many people told us to abandon allopathic treatment and go for secret herbal medicines and magical remedies. Somehow, myself and my wife decided to have complete faith in what you had told us. We continued your medicines and kept praying. The only light in my life then was the trust I had that I will get better. After two months, I could suddenly see a light bulb at night in our home. I immediately called my wife and told her so. Then onwards, there was a gradual improvement. I tried every day to see the faces of my wife and kids. In another two weeks, I could see them again That was the happiest day of my life.”. Mr Kadam became emotional. “Doctor, my company offered me a substantial sum as disability compensation, but I did not want money. I only wanted to see my family. Now that I can, I came here to thank you. Now I can even read a newspaper…but the darkness of being blind was far less hurtful than the thought of never seeing my dear ones again.. I cannot forget that. Thank you again, You are God for us” Mr. Kadam said.

I told him that I was just another doctor, that we were both cared for by the same God, that any qualified doctor would have done the same. I had not done anything extraordinary. But it is difficult to control a grateful patient.

“No doctor, we believe that doctors are God’s hands specially made to treat patients” he persisted.

I could only thank him. Thousands of doctors all over the world, all across India, do this every day, and receive blessings and gratitude that fills up their hearts with a joy that cannot be described.

Now I think there is a reason why Mr. Kadam came today. Many good and bad things happened in 2018. While making resolutions for the incoming new year, I was thinking once more what is most important in life. Mr. Kadam provided with many answers to that question. What matters is gratitude for what you have, especially health, gratitude for your family, and the ability to help others through their darkness. Who except a doctor is better placed to help others with health and life? Whatever other resolutions a doctor may make, one of them remains a universal favourite: ’ Let all my patients improve, and live happily a long life. Let me make every effort for that.’

Thank you. Mr. &. Mrs. Kadam, for allowing me to share this story.

(c) Dr. Rajas Deshpande

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Be A Woman!

©️Dr. Rajas Deshpande

A major part of the pride of being a doctor is the freedom from any discrimination between humans. Every woman or man, from any religion or country is equally important, and also equally cared for.

Yet as a doctor I have often witnessed women being stronger than men when life presents any calamities, however explosive. Women are probably more emotionally destroyed with a traumatic event, yet they pick themselves up and fight like a mother for whoever they choose to stand by and protect. And we know, a mother makes a strong army! Any patient cared for by a woman heals faster, be it a nurse, a sister, servant, daughter, wife or mother, be it a girlfriend or just a woman without any relation. In any family, it is usually the women who keep the bonds of humanity and culture alive. We have so many biases about cultures and how women are treated, but it is an unfortunate fact: that women do things men find impossible. Hence the title, Be A Woman!

We often hear from working men in the metropolises how they cannot bring a parent in wheelchair to the hospital as it would be a lot of trouble and time.

Ms. Eshrak (a psychologist) and her sister (a bank employee) brought their mother on a stretcher all by themselves, all the way from Cairo, Egypt, to Pune India, in a hope to see her walk again. To travel to another country without knowing anyone there wasn’t their biggest problem. Reaching India from the war-torn middle east is a nightmare, but once they reach, local Indians, especially police officials are very cooperative in helping out especially patients coming for treatment to India.

They found a friend in a local Arabic student Mr. Ashraf Olafi, and had him search my clinic (I am sure any good qualified neurologist could have treated them equally well!). Their mother, suffering from Parkinsons Disease, walked after many months today, so they came with the two greatest gifts for their doctor: a smiling gratitude and blessings. Of course they brought a material token!

What better proof can there be of women not being dependent upon men? If only we recognised how incomplete and incompetent humanity would be, without the strength of women!

To artificially write about gratitude for women in one’s life and to thank them superficially to impress press and public has become a fashion, few do it from their heart. I pity those “high flying, successful” men who boast about how they respect women and consider them equal, while their wives are in fact taking care of their home and children, opting for hugely compromised careers. The truth is, a man, however strong, is always indebted to some woman!

Be A Woman!

That should always have been the correct slogan..

©️Dr. Rajas Deshpande

The Poverty Vow

(c) Dr. Rajas Deshpande

Long day. Came home. Ritual steamy hot bath to wash away the hospital feel, followed by steaming hot dinner. Switched on jazz, and I picked up the pasta. Heaven descended upon my tongue.

“How perfect this moment is!” I thought, and that’s where I was wrong. The phone rang.

“Sir, 18 year old buy, had fever since a day, took some tablets, became unconscious, now comatose. Vitals are stable, although he is coughing occasionally. No past history significant. Poor family, cannot afford treatment. Father is a labourer. What should I do?”

“Get him into the ICU, intubate if required and stabilise. Arrange for an MRI”

“OK Sir, but Sir they don’t even have a deposit. They had first gone to the government hospital, but as they were not happy there they have come here”. (c) Dr. Rajas Deshpande

“We will work something out. I am on my way” I replied.

In an hour, after examining the boy and seeing his MRI and other tests, we concluded that he had viral encephalitis. The standard medicines were started.

The boy’s father, an obvious poor slum dweller, was in a state of shock. The mother, sobbing, told me the history. I reassured them. When I explained the diagnosis and treatment they asked some questions.

“We don’t understand anything, we are illiterate and poor. Do anything Sir, Just save my son, Sir” the father folded his hands together. Private hospitals have a quota for free patients, but usually it is always overloaded. I requested the hospital management to please make this a free case, they accepted.

The next day, the child opened his eyes. On the third day he started responding. I was quite elated to have his mother speak with him. However, his respiration was still shallow, and blood presure very low. His heart rate was fluctuating due to the effect of viral infection. He was still critical. I spoke to his parents twice every day, specifically reassuring them. Poor patients must never feel that they are not equally cared for. (c) Dr. Rajas Deshpande

That evening, as I attended my patients in the OPD, the patient’s father came in, requested that he wanted to have a word. He came in with six other people. None of them could possibly be poor, given their get ups.

“Yes?”I asked.

The patient’s father looked at the giant next to him. “You ask” he said to the giant.

The giant, chewing his gutkha, askked me “What’s wrong with his son?”

“I have explained them thrice”I replied, “he has viral infection of the brain. There’s a lot of swelling upon his brain”.

“How come he is not improving? His BP was normal when he came. He did not have any heart problems. Now you tell us his heart is not functioning well” asked another medical superstar with white linen and gold teeth. (c) Dr. Rajas Deshpande

“Yes, this happens commonly with viral infections” I replied, feeling hopeless. How to teach complicated medicine to this pure- muscular class? I wondered.

“But you said he had infection in the brain. How come now he has it in the heart? Is the treatment wrong?” Asked someone similar among them, in a tone nastier than medical examiners.

I looked at the patient’s father. He was looking at the ceiling, deliberately avoiding eye contact with me.

“Listen, Sir”, I told them, “Your patient has viral infection, it has primarily affected the brain, but involvement or dysfunction of other organs is well known with such infections, this is not something new to us. We are on guard, dealing with the situation. Nothing is wrong about the treatment, in fact his brain swelling has improved, and he is conscious now. Ask his mother” I looked at her.

“I don’t know” she said, “we don’t find any improvement in my child. Nobody tells us anything”.

“Haven’t I explained you and his father patient’s condition every day?” I asked. They did not reply.

The white linen gold teeth spoke again: “We want a report. We want to show the case to another doctor”

That was a relief. I gladly wrote them a report. They went doctor-shopping all day. They returned next day. Almost everyone had asked them to continue the same treatment that we had advised, except some desperate non-specialist telling them to shift the patient immediately for a surgery at his hospital. Even our gold-toothed medical superstar understood that it was wrong! (c) Dr. Rajas Deshpande

“We will continue treatment here only. But our patient must survive” came an open threat.

”I will do my best, but I cannot guarantee you anything. You may please transfer the patient under the care of any doctor of your choice” I told them.

“No no, you continue to treat him.But if anything goes wrong, we will file a police complaint. We will ruin this hospital”said one of them.

I am allergic to threats. I don’t allow them twice from the same source in my life. How could any doctor guarantee that there could be no complications? How could I say that the patient could not react to any medicine in such a critical condition? If every patient could have guaranteed improvement, what’s the need for a doctor?

“I am sorry, I am planning for a leave next few days. I won’t be able to see your patient. I have requested our management to transfer your case to another doctor” I told them.

There was a movie “Teesri Kasam”in which the lead character, at the end of the movie, vows never to help the character of the lead actress in the movie, because the very wish and effort to help her has shattered his life, caused him regret. Most Doctors are now being forced to take such a vow. Urban Poverty is not so simple and innocent in a hospital as it appears to the media and society. Whether it is the roadside rowdiness of slum dwellers who roam around with weapons or a maid’s drunkard husband in civilised society, we all understand the misuse of poverty status well anywhere outside hospital, but somehow when this happens in a hospital, the blame is automaytically pinned upon the hospital or the doctor.

But who among the vote-mongers will speak against the majority voting bank?

(c) Dr. Rajas Deshpande

“My Turn Now”

©Dr. Rajas Deshpande

“I don’t want to live like this. I have stopped eating since today. Please do not be angry with me for this, but I cannot see you and my children suffer because of my illness. Let me go with peace” Geetanjali said to her husband.

Eighteen years after her marriage, in her late thirties, Geetanjali suddenly lost the function of one half of her body. Her children were still in school. Her husband Gajendra Jagtap works as a school teacher and does some farming on a small piece of land they own. The whole family was shocked and shattered with this calamity that befell Geetanjali. But Gajendra Jagtap decided not to be broken down by destiny, and took his wife immediately to the best hospitals in Mumbai. They were told that Geetanjali was suffering from Multiple Sclerosis. After a few days of treatment, they could not afford to stay in Mumbai and came to Pune as it was nearer to their village. The Multiple Sclerosis Society of Pune extended its helping hand. Geetanjali was yet unable to stand up or walk. ‘This illness is totally unpredictable, anyone can develop blindness or disability anytime’ doctors told them. Geetanjali felt hopeless. She was very depressed with the thought of stressing her husband financially to provide for the treatment expenses. She also worried if her children’s education will suffer due to her illness and financial constraints. This was the reason she decided that she did not want to live any further, and gave up eating or drinking anything.

But Gajendra was not the typical Indian husband. This B. Sc. Graduate who had taken up teaching in a rural school as his profession had a big heart, and harbored principles of equality and respect for women, just like a highly educated spouse in a developed country. He told Geetanjali, ‘You have served me and our children for over eighteen years now. When I was working in the school or in the farm, you looked after the home, cooked for us and fed us sumptuously. Now give us a chance to repay for what you have done for us. It’s my turn now. I am going to take care of you just like you cared for us.’ Geetanjhali could not hold her emotions and sobbed when she narrated this story to me.

‘At that point of time, I felt like living only to help my family. I decided to use whatever few healthy days I had to make my husband and children happy.’ She started to fight her disability with a new spirit, and in a few months could walk very well again. Since then she had attacks of this disease many times, but vehemently fought it to recover every time, with the help of her husband.

Gajendra told me “I explained my children our situation. I told them that we don’t have much money left, and that they must only complete their education based upon merit. We are very fortunate that our children decided to grow up quite early in their childhood. Both of them studied very well, and my elder son is now doing his post graduation which he got through a scholarship in Delhi. Even my daughter got excellent marks and is now pursuing her post graduation by winning a scholarship. Both of them take care of their own expenses, and never bother us for money. Even I have decided that whatever our destiny presents us with, we will face it with a smile, and never accept defeat in any situation. We have to visit hospitals many times, spend on treatment and investigations, travel many times, but we do it all with a spirit of winning together. Whenever she can, she still takes care of the home, and when she can’t, I do it with the help of my daughter. But we never feel desolate or depressed”.

In the developed world, people suffering from this illness get a lot of healthcare facilities, and even income tax concessions. However, this farmer from a lower middle class background who does not receive any such help, has not only resurrected his family, but created a new life for his wife with his sheer love and determination. The most admirable thing about his love story is the respect and feeling of equality with which he thinks of his wife. Geetanjali also stood up firmly with him to conquer this illness, with all her love and might. Together, they have indeed defeated their destiny.

We sincerely pray for the excellent health, well-being and long life for each member of this wonderful and ideal family.

© Dr. Rajas Deshpande

Neurologist, Pune

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Thirty Years of Suffering and One Tablet of Gratitude

Thirty Years of Suffering and One Tablet of Gratitude
© Dr. Rajas Deshpande

At the age of 18, he started noticing difficulty in falling asleep because of a weird pin-prick like sensation in his calves. He ignored it initially, but later in a few months it grew so severe that he could not sleep. Then started a nightmarish phenomenon of sudden squeezing sensation on the legs, sometimes with other abnormal and disturbing symptoms like gnawing pain, pulling and jerky movement of both legs. A little massage initially helped, but within minutes, symptoms returned, and now came up to his thighs. Many a nights, he could not sleep at all.

Lack of sleep worsened his daily performance, and he started getting irritable, confused and often very depressed because of the ongoing symptoms. There were phases of relief without any apparent reason, but the problem almost always returned with more severity. He went from one doctor to another, was told he had nerve problems, muscle fatigue, deficiency, and even psychological issues. Various tests done did not show any abnormality. In the last few years, his symptoms spread over to his hands and became so severe that he could not sleep at all. He tried many medicines from many pathies but had no relief. Then he started having suicidal thoughts.

That’s when Dr. Lakshman Sathe of Dodaich arranged for a video consultation with me for Mr. Rajendra Badgujar, now 50 years old, resident of Sindkheda. As any learned neurologist will have guessed from the description above, I concluded that Mr. Rajendra was a severe case of a rare disease called “Restless Legs Syndrome”. Although rare and more common in women, this extremely troublesome condition is now increasingly recognized in Indian population. This usually is caused by a genetic predisposition, but may also be associated with certain other medical conditions including iron deficiency. The most common complaints are ‘restlessness’ of legs, due to weird squeezing, pricking sensation or jerky movements. Very good treatments usually in form of tablets are available, but most of these tablets have serious side effects if incorrectly used. Also, only if the diagnosis is accurate and not associated with any other related conditions, patients respond well.

Mr. Badgujar, who had suffered for nearly 30 years, had complete relief within a week of starting the new medicine, and is now not only having sustained relief with only one tablet, but has also slept blissfully over last two months. Still, that is not the reason for my article. This poor man travelled to Pune for 9 hours, daring the CoViD pandemic, with his family, only to personally say thank you to me. This single tablet of gratitude calmed my restless mind instantaneously!

Most neurologists can readily diagnose and treat this condition in the first or second visit itself, sometimes a few tests may be required. If the patient reaches the right specialist for various medical conditions, not only is he /she relieved at the earliest, everyone saves a lot of money and we can thus contribute to improve the reputation of our noble profession.

©Dr. Rajas Deshpande
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PS: Every qualified neurologist can diagnose and treat this condition effectively.

Say, doc!

Say, doc!
© Dr. Rajas Deshpande

“Doc, may I eat fruits?”
“Yes”
“Papaya?”
“Yes”
“Apple?”
“You can eat all fruits.”
“Banana also?”
“Yes”
“But I get vomiting after eating banana..”
“Then don’t eat banana”
“But you just said I can eat all fruits “
“I’m sorry, please eat only what you tolerate well. Anything else?”

Next patient.

“Till the time we finalise and treat the cause of your unconsciousness episodes, please don’t drive any vehicle “ I told the twenty year old girl whose family stood surrounding her dipped in worry.

Since after a head injury during riding, the patient had had fits. She continued to ride her moped to her college inspite of strict warnings by doctors not to drive. This time she was admitted because she had fallen from her bike as she had a fit while riding.

“How will she go to the college then?” asked her angry mother.

“You will have to make alternative arrangements” I replied.

“Can she drive a four wheeler?” asked her father.

“No”. I now understood that they didn’t want to understand the risk.

“Three wheeler?” asked a relative who had the most common Indian OCD: talking without thinking, expressing opinion because it’s a constitutionally granted freedom.

“What three wheeler do you want her to drive to college ?” I asked the OCD bro.

“No. I just asked out of curiosity “ he replied more guiltlessly than your favourite politician.

How many irrelevant questions should a doctor reply to patiently?
Running between emergencies, making crucial life and death decisions for others over 30-40 times a day, with zero allowance for mistakes and facing angry, troubled souls who we genuinely want to help, how much extra time and patience for irrelevant questions is a doctor expected to waste? If relevant and crisp, every doctor enjoys the conversation, effective communication. When that enters the realm of “charche pe charcha”, it frustrates the doctor. Imagine that happening about twenty times a day. © Dr. Rajas Deshpande

Can a doctor refuse to answer irrelevant questions? Yes, but that risks a bad online review, rating in spite of correct diagnosis and good outcomes!

The consultation charges that a regular doctor charges are meant for a thorough history taking, examination and deduction of possible diagnosis, advice about tests required, and the best possible options of treatment/ management. It also includes a to-the-point explanation and information to the patient and attendant. It doesn’t include the unending “questioning” and expectations that the patient/ relative should grasp everything immediately- medicine is indeed very complicated. We usually give patients the websites to read from, but it cannot be the doctor’s responsibility to make the patient understand everything- it’s like asking the Judges to explain their decisions and law to both parties involved in each case- every day.

Every medical student should learn how to patiently, courteously tell the patient and relatives to limit the conversation to relevant questions only. It is an art. One can also schedule a separate paid consultation in case the family had extended questions and needs the doctor’s extra time.

Just when I was finishing a late day, a patient who had just left returned, panting because he was running.

“Doc, I forgot to ask you- is it okay to smoke a few cigarettes? – I am quite stressed you know”.

I smiled and replied “No you can’t. Reduce stress rather than killing yourself slowly with both smoking and stress”.

That was a relevant question though, as it reminded me of reducing stress in my own life. © Dr. Rajas Deshpande

© Dr. Rajas Deshpande

Beyond Those Valleys and Mountains..The Story of a Doctor That Media Won’t Tell.

Beyond Those Valleys and Mountains..
The Story of a Doctor That Media Won’t Tell.
© Dr. Rajas Deshpande

Just after admission to a medical college, Rohan noticed that he had a twisting movement of his right hand. He was diagnosed with a common condition called “Writer’s Cramp”, which is sometimes disabling and resistant to treatment. He started changing posture and position of his hand to be able to write well and somehow continued his studies. His complaints kept fluctuating. His father, a primary teacher, passed away when he was in the second year of Medical School. His mother somehow managed with the tiny pension they received and Rohan completed his MBBS.

During internship his left hand started to become weak, he had numbness in some parts of the hand, and could not move two fingers. It was quite painful too. He came to us for his nerve damage. His worried mother had a hundred questions, fears and tears in her eyes. Studies showed that one of his nerves was severely damaged. There are very few reasons why this can happen in young patients. Diabetes, faulty Immunity, Genetic Diseases are common, but upon investigating, Dr. Rohan was found to have the most dreaded cause for his nerve damage: Leprosy.
Dr. Arjun Mapare started treating him for Leprosy.

I reassured them and we started on an unpredictable journey. I explained him the schedule of medicines and advised to continue his leprosy treatment.

Doctors get infected with dangerous diseases every day. However nerve damage especially in the hands endangers entire career of a doctor, and if treatment is not started in time, many develop lifelong disability. Nerve diseases are extremely troublesome, recoveries are rare, delayed and difficult in many.

Dr. Gajanan Bhalerao, my super energetic colleague known for his physiotherapy expertise took the challenge and worked up a strict plan which Dr. Rohan followed. He kept on working after permission from his leprosy expert.

Where there’s no light, faith guides us. Patience is a rare quality. For a few months we did not see much change, but we didn’t want to give up. Beyond those valleys and mountains that scare us, is the Sunrise.

Today, Dr. Rohan visited after many months, completely recovered from leprosy, and told us that his hands have full functionality, his nerve functions were normal and he was able to move his fingers well. His writer’s cramp in the other hand bothers him sometimes still, but what’s a doctor who can handle problems? There are hundreds of such passionate young medical students fighting through adversity right now in India, because they have a common aim- neither money, nor fame, it’s the wish to treat the sick and suffering, to save lives.

The credit of his recovery?
To Dr. Hansen who discovered leprosy bacteria, those who discovered its treatment, those like Baba Amte who spent life fighting the stigma of this disease and the thousands of specialists in urban and rural India who treat this every day …. and some thought Covid was all that’s important!

Dedicated to the memory of Dr. Baba Amte, worthy of Bharatratna and Nobel Prize both!

© Dr. Rajas Deshpande

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Photo:
With Dr. Rohan (Name Changed) and
Dr. Gajanan Bhalerao

Who Is Guilty Here?A Typical Indian Case


© Dr. Rajas Deshpande

“Sir my brother is critical. The doctors are not telling us anything about recovery. They don’t even reply to our questions about when the patient will recover. They are so inhuman! They should let the patient die if he is not going to come out of this illness, but they give us false hope that he may recover” said the friend, whose language precluded decency.

Having them seated, I requested details from patient’s friend accompanying the brother.

The patient, now in late thirties, had married against his family’s wish. He was boycot by his family, and started living with his wife. After a few days the couple started having quarrels due to his drinking habit. He frequently beat her up, and she often made a public scene of their private issues. He left her one day and returned to his family. His parents and brothers continued to taunt him. One day he was beaten up by his brothers, and in a fit of anger he drank rat poison.
He started vomiting after a few hours, became unconscious, and was taken to a quack who forced some magic potion in the patient’s mouth. Just after that, the patient had convulsions. “Take him to a doctor” said the quack. That’s when they went to a nearby rural hospital, which had no doctor. When they reached the city, patient was almost comatose. They took him to a low-cost multispecialty hospital. Upon admission his blood pressure was not recordable, breathing was almost nil, and heart was already beating too slow. The doctors there had acted fast and stabilised him, but by then his brain had suffered severe damage due to low blood pressure and very low oxygen.
In a week, he was stable, breathing on his own, opening eyes but unable to recognise anyone. Recovery in such cases is always very slow, unpredictable, and mostly incomplete. He needed supervision and nursing care, that was being done. Doctors were tired of the incessant repetitions of same questions: from relatives, politicians, and many other doctors. There’s a limit to how much compassion can one offer to its abuser. © Dr. Rajas Deshpande

I did what was the obvious thing to do: reassured the relatives that the treating doctors were doing a good job, that things were unpredictable in such cases, and that they should have trust in the ability of those qualified doctors to handle a case whom they had rescued from an almost certain death.

What ate my heart away was the blatant, glaring line of facts here: the family was not kind to him, the wife wasn’t kind to him, his relatives took him to a quack and wasted most precious time that could have saved a lot of brain damage, the quack used something that dangerously worsened the patient’s health, the rural government healthcare was inadequate, but none among the family or politicos ever said a word or questioned that. As if they were all exempt from humanity, and nothing about his health was any of their responsibility. © Dr. Rajas Deshpande
The doctors at that low-cost hospital, with minimum amenities, had still managed to save the patient, they did an excellent job, but were still labelled inhuman – just because everyone expected a full recovery of the patient, as if it was worthless to save a life unless it was complete, quick and cheap!
Indian doctors are already considered among the best all across the globe, we keep abreast of all advances in our respective fields by studying every day, we are easily available to everyone who needs our skill and opinion, we work far more than our colleagues in developed world, yet we are the most stressed, criticised, villainised and also poorest paid class of doctors, living under threats from one and all. Indian healthcare infrastructure is atleast fifteen years behind the developed world, it is us doctors who carry that burden of patient’s (googled) expectations upon our shoulders. It is frustrating to deal with the trustless, paranoid interactions with the relatives of those very patients whom we are trying to save.
What kills us most is the indecent, aggressive, violent way in which most doctors are abused in our country. Even the patients who do not recover completely speak in a vengeful, angry and complaining way to their doctors rather than any trace of gratefulness for whatever recovery was achieved.

The only way to possibly change this scenario is to change the society. Yes, to prefer a developed society where common sense and decency are not optional.

© Dr. Rajas Deshpande

Victim Versus Victim

Victim Versus Victim

© Dr. Rajas Deshpande

He walked in my chamber, trembling and sweating. A typical engineer, cute, nerdy and cultured, he lacked the usual poise, calm and charm that accompanies the true intellectual. Something was wrong.

“Are you ok? Do you need a glass of water?” I asked him, while glancing at the vitals that the nurse had recorded- his blood pressure was high but not in the dangerous range. His breathing was heavy, and his eyes red.

“No, Doctor, I… I .. my head..” he wasn’t able to finish his sentence. I let him relax for a few moments. Taking a deep breath in, he started: “Doc, I haven’t slept in fifteen days. My head is exploding. I feel like I will die. We did a heart check up yesterday as I had palpitations, but the cardio told me everything was normal”.

I examined him, there were no neurological findings except the extreme anxiety he was trembling with. Sometimes the mind is so troubled, it actually causes the body to manifest its suffering- causing giddiness, trembling, headaches, lack of sleep, sometimes even fatal conditions! Stress is indeed a major killer.

“Is someone with you? Are you under some stress? Where’s your family?” I asked, and he started to shake.
“I want to tell you something confidential, doc” he said, and told me one of the most horrific yet increasingly frequent stories of our times.

He is 34, married, and has a six-year-old child. His wife works too, but in a different company. He spilled out what was hijacking his mind:
“Fifteen days ago, on a weekend, my wife dozed off on the sofa besides me. Her cellphone was in the kitchen, and when I went to get a snack, a whatsapp notification appeared on her locked screen, it said ‘I love you too, can’t wait to see you. Wear white, you look beautiful ..”. The sender appeared to be a female name, but I was curious. I had complete trust in my wife and we had a very good life together. I woke up my wife and asked her to open that message, asking for details. She refused. I got very angry as she was trying to hide something. I told her that I was planning to call her father and discuss the issue. Then she told me the truth”. © Dr. Rajas Deshpande

“She had met one of her classmates in one of those ten year class reunions which have sprouted everywhere now. He started praising her, messaging her, and she said that she had fallen in love with him. She did apologise to me. I was devastated and wanted to run away, kill myself, because I had loved my wife dearly. The only reason why I did not do anything serious was our son, who is attached to both of us.”

“After a lot of thinking I decided to forgive my wife. I told her that I was ready to start again, but she had to completely stop seeing her classmate. I also requested her that I want to meet him once. We went to meet him. He is married too, has two kids, but his wife is not aware about all this. He bluntly refused to stop seeing my wife. He and my wife together told me that they cannot stop seeing each other, and that if I create any problems, my wife will approach various associations and police and tell them that I am abusing, harassing and being violent to her. You know what happens, doc, how law can be misused, how things can be twisted to make someone a villain. I am from a very cultured, educated family, we are scared of fights and legal matters, police cases etc.”

“When we returned home, my wife told me not to worry, and that if I did not interfere with their relations, I could also have the same relation with her as earlier. Now I hate her, I do not want to see her, but the thought of what will happen to our son and his future is killing me. I cannot eat, sleep or even think normally. I had severe headache since a few days, and today I vomited. My friend gave me your number, so I am here”.

Whenever someone is fasting for long, or for any reason dehydrated, the headache that follows could be extremely dangerous. We obtained an emergency scan of his brain and found that he was already developing clots in his veins, a condition that could have killed him if not treated in time. He was admitted and treated. His wife did come and attend him. He improved and was discharged in two days. I arranged for a counsellor for them, and now they are both undergoing counselling. © Dr. Rajas Deshpande

Besides the facts that I should never judge someone as a doctor, and that I am not a counsellor, I was appalled at the audacious threats (and in some cases a reality) misuse of police, legal machinery and socio-political forces under various disguises to corner and target someone. Recently a big retired police officer has commented “Show me a person, anyone, and we can show you his crimes”. The selective victimization of whoever one wants to target, while playing victim oneself, is the new name of the game: Victim Versus Victim with blurred definitions is the new world we are welcoming, thanks to the umpteen legal and social immaturities.

From gender to religion, from intellectual to financial achievements, anyone can now be blamed by anyone else, claiming to be a victim after using the system to get what one would never have achieved without that very system in place. In short, we are living in a world where a thief can enter your home, kill your dear ones, steal your belongings and if you catch and punish them, can play a victim card based upon anything from gender to caste, religion, nationality or political affiliation. This certainly cannot be called evolution, as survival of the most vicious villain will never favor human race.

Meanwhile we doctors will try and maintain our sanity to be neutral and treat everyone for their best health.

© Dr. Rajas Deshpande

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Who Won Over The Pandemic In India?

Who Won Over The Pandemic In India?
© Dr. Rajas Deshpande

As the covid situation improves, now begins the race for looting the credit and masking, twisting the reality. There’s a lot yet to happen, we hope there’s no second peak, the situation is best described as unpredictable at present.
It will be conveniently forgotten that hundreds of doctors, policemen, labourers, many covid warriors like nurses, hospital support staff, ambulance drivers, and government officials died to save millions of Indians. It will be downplayed that hospitals and staff therein were pushed to inhuman tasks for over eight months, some without payment. It will be never recorded that many PG students died due to unfair and unsafe postings during this pandemic, thousands worked without payment for months. It will also be conveniently forgotten that private hospitals- usually treated by society and politicians as “money minded looters” – were the only existing mechanism that could save our country from a much larger death toll.
The reality is that millions of patients went home because our private hospitals, doctors, nurses treated them day and night, without caring for their own family.

It will be comfortably masked that many government healthcare facilities were a failure, that enough manpower could not be found to man jumbo centers, that we lacked any other government machinery to provide healthcare in such a situation except arm-twisting and exploiting private practitioners and hospitals. Let us never commit the mistake of presuming that such a pandemic will be a one-time rare event as some evil countries now know what biowarfare can lead to. While electoral speeches will claim “Success” in defeating covid, the truth remains: that COVID has exposed us, our poor preparedness and arbitrary actions often without estimations of how they will affect millions of poverty-ridden illiterates. While sloganeering and declarations of “Thousands of crores” will be announced for people during elections, no one will question why we have not built any more hospitals, why we are not recruiting more qualified doctors in government set-ups, and why doctors find it impossible to work at govt-run hospitals. The sad stories of big netas getting admitted in biggest private hospitals and getting best of healthcare while the poor people on the street kept dying because they could not find ambulance, ICU, hospital or even family members to support will never be forgotten. © Dr. Rajas Deshpande
We will never know who and why was given “Fast-track” certification for the emergency production and sale of huge quantum of PPE kits, masks, gloves, sanitisers, medicines (which were later declared questionable), tests for covid etc. Enormous profits were extracted even from doctors treating covid patients (because we all have paid huge amounts in last ten months for the safety gears, sanitisers etc.). We will never know how many thousand crores were earned by those who sold “immunity boosters” without a FDA validated scientific proof, taking advantage of illiteracy, ignorance and superstition in our country. The profits earned by one and all by the sale of these pandemic-essentials will remain hidden, and the bashing of private hospitals for overcharging will continue.

Let’s get the facts right: the private healthcare has sacrificed bigtime in this pandemic to save the life of millions. The credit of saving our beloved nation from a far more devastating outcome goes to these private hospitals, doctors at both private and government hospitals, postgraduate students, many brave, daredevil police officers, administrators like collector / commissioners, other grassroot covid warriors. Most declared policies were either ineffective or redundant. The courts in some states and even the Supreme court had to intervene and correct some wrong decisions, which itself saved many and eased the life of many more, we will be grateful to the Judges who took the best possible view of a blurred scenario. I must humbly thank certain political leaders, chief ministers of few states and others in the government for their individual hard work and involvement in this fight.© Dr. Rajas Deshpande

Yet, as our great nation India recovers, there will be proud chest-thumping by some leaders about “I / We defeated Covid Virus”. No. We doctors are a scientific community unblinded by bias. We know that Covid has unmasked the glaring, shameful shortcomings in our system. Covid has shown us our misplaced priorities. Covid has exposed the hollow claims of us being a developed, civil society. The number of maskless literates even during the peak of this pandemic is a proof of how backward we are as a community. India has almost no respectable medical research, we have a shameful federal healthcare infrastructure, we are considering non-doctors as teachers in medical colleges already sinking in quality, we have to rely upon quacks for healthcare delivery to the poorest and the rural, and yet the headlines of us donating nearly two million N95masks, HCQS to other countries gives us a feeling of pride, and we sing songs of a glorified glory.

The entire credit of pulling the country through this pandemic goes to every grassroot warrior, junior doctor, other doctor, nurse, private hospital, administrator, police. officer, and donors of multiple crores who sacrificed their life, family, or lifetime earnings for India.
Let no one befool you to believe otherwise.

© Dr. Rajas Deshpande

Dedicated to the real COVID warriors.

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The Most Dangerous Indian Cancer

© Dr. Rajas Deshpande

Being invisible, the ability to see others without them seeing you, combined with the inexplicable curiosity about the private businesses of others (for which Indians are world-infamous) makes this an irresistible hobby. Manners and etiquette are the last attributes for which we Indians are credited anywhere, so people think it’s like our birthright to be rude, reckless, abusive and judgemental to others.

Earlier when you criticised others, people questioned your own achievements, showed your own ridiculous stupid past, and what was most feared: often proved that you are a do-nothing hypocrite idiot who likes to relish in being critical and disrespectful of others. People could show everyone what a joke your own life was, how illogical, unreasonable and irrelevant a liar you could be. © Dr. Rajas Deshpande

Invisibility gave all such idiots a protection. The ability to hide behind a fake social media identity and troll others as a group, mob, media, political outfit or – most dangerously- a system which has access to the private information about almost everyone- has now become the worst social cancer that India has ever faced. This is far more dangerous, ugly, vicious and destructive than religious divides (people now know that’s a politically cultivated poison), class divides or any other social disease that has disturbed human fabric especially in India.

Trolling is a deadly disease fast destroying everyone almost everywhere, but worst in India. The reason- it has support from the highest of people who have the ability and authority to stop it but won’t. The courts and the law enforcement agencies don’t seem to have noticed the cruel havoc this is already causing everywhere. A suo-moto intervention to criminalise all fake identities and trolls doesn’t appear uncalled for.

Shall we just accept this trolling cancer as a reality of our times that comes as a side effect of social media supported freedom of speech? © Dr. Rajas Deshpande

Does a coward who hides his / her own identity have that protected freedom of speech? Is it freedom of speech to abuse and denigrate one and all, especially the rich, famous and the respected, to use language that inflicts worse injuries than physical wounds? Is it freedom of speech to threaten murders and rapes, to threaten violence and exposing someone just because they refuse to fall into your traps of expectation and exploitation?

It can NEVER be Indian culture to threaten women with rapes and murders on social media. Which religion, which culture anywhere in the world accepts such treatment of women and kids? Where are the various Indian guardians of regional supremacy, language, culture, clothing, food, festivals etc. when the women and children are abused openly on social media in their land?

Trollers in India reached a new low by threatening a young child of a renowned sportsman recently, and the very country whose who’s who are blabbering about “Beti Bachao” appear all silent. Isn’t it a crime to threaten a child on social media anymore?

Is merely deleting those comments sufficient, is it not required to identify, shame and punish such inhuman trollers?

The idea of being able to express one’s opinion in situations like dictatorships where revealing identity could be fatal is alluring. That’s probably why freedom of speech is protected by many social media platforms. However we now know that many of these social media platforms aren’t the innocent soldiers of an individual’s rights of speech and expression, but (probably sold out) manipulators working for political, international forces which pay them well- or worse- want to spread racist hatred between classes and harbour a supremacy theory, to flaunt numbers, spy upon people and even incite mobs to loot and kill. Many leaders, businessmen, artists, actors etc. have been completely destroyed by such trolling, elections swayed in favour of some, and we boast of an illiterate populace hooked upon free internet as our national pride!

How else do we explain the incessant flow of extreme abuse which has now become a source of income and entertainment? How else do we accept that law, national and international, has kept an option of anyone to open a fake social media account?

This cancer, a “Growth” of wrong practices in the body of every nation, is destroying precious bonds between humans: because everyone has an unseen private life, not essentially criminal, but open for trolling once exposed, and one who owns most trollers will be the King! Unemployment demands increasingly crass entertainment, and the ‘kings’ know this well.

We appeal to the Supreme Court of India to please declare all fake social media accounts illegal, and bring to books the trollers who use lies, abuses and threats online.

© Dr. Rajas Deshpande

The Hurt Passion Of A Doctor

The Hurt Passion Of A Doctor
© Dr. Rajas Deshpande

The recent picture of our favourite cricketer Mr. M. S .Dhoni exhausted and fatigued on the field caused a lot of concern, and we wish him best health with many more years on the field. The passion with which he plays is inspiring, we all love and respect him just like we have loved and respected Mr. Sunil Gavaskar, Mr. Sachin Tendulkar, Mr. Anil Kumble, Mr. Virat Kohli and many other greats that the Indian cricket has produced.

By the age of 40 or so, most of the heavyweight sportspeople usually retire from a competitive life and take over other, less tiring jobs. They have spent their entire youth in working extremely hard, with untiring efforts to perfect their craft. The fields of both sports and films are unforgiving, and exceptional talent is required to make it to the top. On the plus side however is the recognition, fame, and money that follows success.

Where does a doctor stand then?

While we cannot compare any two professions given the different client-base and frustrations of each, we can definitely draw some parallels. Competing intellectually starts from school for every doctor, innumerable hours in studying, applying the best mental effort to performance, and overcoming all temptations of a light-heartedly enjoying outside world are just basic compulsions if one has to excel at least in India. The extreme competition for medical admission is worst in our country.

However, that’s just the beginning, and the real struggle starts after one joins medicine: exhausting timetables, extra work and duties, unending patient loads of an hygiene- illiterate society abandoned on health front by its own government are the basic premises. Add expectations of immediate cures and filmy, miraculous recoveries with best recommended World-class internet treatments but with “Indian Compulsions” of charity treatment by doctors from their own pockets, and a never-ending game of moral-ethical looting, compassionless exploitation begins. In the midst of all that mud, a doctor must still keep studying to be abreast of all the modernities of his science, keep a calm mind and be polite and good to even the worst behaved.

Then come home and see pictures of compassion for celebrities. No we do not envy the celebrities. We love them as much as anyone else. We just hate the hypocrisy that our people have created: that if you choose a career in medicine, you are far less likely to be loved, whatever you do, however hard you work, and even if you lose your life. The whole government machinery which rushes to wish celebs and click selfies with them on every tiny occasion cannot have the list of doctors who died treating covid patients! Has anyone seen any selfie of any minister with the doctors who saved their lives from covid?© Dr. Rajas Deshpande
There are thousands of young and old doctors in India, this very moment, working in covid wards, more exhausted and tired than any cricketer in the world. They cannot retire: 99 percent are so financially dependant on their daily income or monthly salaries, that they have silently accepted the tyrannous, cruel policies of various governments to inhumanly exploit them. They are on the verge of death due to exhaustion, and some are already having thoughts of ending it all. Over 500 have died. But the very same society has no compassion for these exhausted doctors, it has abandoned the very heroes who have stood between them and death. Their salaries are pending, they have to buy their own masks and kits, and thousands are estranged form their families for quarantines.

A society that browbeats doctors and hospitals to convert compassion into acceptance of non-payment of bills (as if doctors do not have basic compassions and humanity that everyone else has!) has money to queue up in restaurants, bars, liquor shops, malls, and bet millions on cricket matches is still completely ignorant about the exhausted doctor. We can build everything else as development agenda, but India can not invest in doctors. It can have the most modern aeroplanes and bullet trains, but it cannot pay its doctors.

The young doctor is now rethinking. Many have chosen to change their preferences and not become a doctor. Most doctors do not want to push their brilliant children into this chasm called ‘medical practice in India’: a dark, exploiting, thankless, violent and vulnerable machinery to suck out the blood of the most brilliant minds of our generation. The most important part of becoming a doctor is to reduce suffering and save lives. No one, however rich, becomes a doctor with a mindset to earn out of the dying and suffering.

That very passion to save lives is being insulted, mocked, and widely abused by our great nation today. I will continue to write to my students, to the next generation doctors to please preserve this passion: that is the most beautiful part of your soul, and please do not let it be scarred by an unevolved, regressive and exploiting society that we live in. Take care of yourself. We have a mission to save lives, without thinking whether they deserve to be saved or not. We will shortly also devise strategies to end this exploitation.

© Dr. Rajas Deshpande

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The Future Girl and Her Message


© Dr. Rajas Deshpande

At about 7 PM, I was about to finish the OPD at Ruby. One last patient was waiting, I could see her in the waiting hall outside.

My N95 was on since 10 AM, and I hadn’t had an opportunity to drink even water since I entered hospital at noon. Fatigued, thirsty and heavy-headed, like most doctors today.

‘This isn’t fair’, I was thinking, ‘I don’t deserve this torture after so many years of hard work. This pandemic seems unending, this stress is piling up on my mind and body now,. The world seems to have come to an inhuman standstill’.

The last patient walked jauntily in, a young girl of 27, her eyes smiled excited. She’s been my old case of epilepsy since last three years. She works in a virology research set up, and had told me six months ago that she’s working on Corona. Her parents are working as labourers in a local government factory.

“How are you?” I asked, mustering a smile she couldn’t see.

“All fine Sir, no fits at all. I just came to share a good news. An American University has liked my virology work and offered me a job for three years. I am leaving in three days. I will begin a new life, I have decided to spend it for virology research. I just came to say bye to you. I will of course keep in touch, but I will miss you there” and she touched my feet.

“God bless you. Stay safe at all costs. I am sure you will reach great heights and win a Nobel. Don’t forget your parents. Let me know if you need anything anytime “. I said what I could.

I was happy and sad at the same time. Happy for her career leap, and sad that such a brilliant scientist was leaving India.

I was startled that she had shaken away my fatigue and the pandemic rust that was accumulating on my mind. A sign of youth, she had taken the burning world around her as an opportunity rather than being cowed down by it. She was going to wear a mask almost all her career life, and the thought didn’t seem to affect her. She had accepted the reality faster than anyone I knew. A mind made for the future, she was travelling to the US (she has reached now) at a time that the world was locked down.

The world hasn’t come to a standstill, I realised. It is picking up. It will thrive again and boom in few months. Till then I must keep all negativity away. Till then I must do whatever it takes to survive and live the best life possible even in a pandemic. She had unknowingly come to deliver that special message before she left.

She left teary eyed and yet with a smile. My tiredness was gone. My spirits felt rejuvenated, I was grateful that she visited. Like every doctor who gets up and puts on his mask every morning for seeing their patients catch on with their life again.

© Dr. Rajas Deshpande

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