Monthly Archives: December 2015

What should your neighbour’s spouse wear?

A four year old girl was quite irritable, bleeding from the wound over her forehead, occasionally lapsing into unconsciousness. Her father told the doctors that he was unaware how exactly the child sustained the injury while she was playing with her younger sister. The casualty doctor asked about the patient’s mom, and was told that she was at home nearby, attending the other kid. 
It was 10 PM.

She was rushed to the CT scan room. An expert radiologist Dr. Avi saw the 3D CT scan of her head, and immediately commented “Boss, this is not a fall. This is inflicted trauma, the wound has fractured and displaced the skull bone far wider than a falling impact could. Is this child battered?”

The kid was shifted to ICU. Senior Neurosurgeon immediately saw the kid and started treatment, suggested close observation. The doctors quizzed the father again, who kept on saying nobody knew how the child sustained the injury. A police information note was sent, the father and mother were interrogated. Nothing else came out. 

The child improved over next two days, but on the third day had a convulsion. New medicines were started. The parents who were silent for two days panicked. That evening, they came to the treating doctor: both crying, they begged him for few moments of confidence and privacy. The sobbing mother then revealed: the father was swinging the kid around himself, holding her by her legs, when he suddenly lost balance and the kid’s head was rammed high speed into a concrete parapet. “Please don’t tell this to the police, we are poor, it was our mistake, if there is a police case my husband will lose his job.. we don’t have any other source of income. We beg you: please save our kid, we will pay whatever you want, but please don’t tell the police”.

The doctor had to inform police, as the child was still in the hospital, and duty surpassed both sympathy and promises. Upon follow up a week later, the parents revealed happily: that there was a kind, helpful social leader who had arranged for proper “settling” of the issue and that all was fine.

If the outcome had not been good, one wonders what the media headlines would have been.
There recently was a headline about how patients do not have any “easy access” to complain about medical care issues and negligence, corruption etc. , and the need of a forum for addressing grievances of all patients easily. Also that medicine has become a “Dhanda” (a derogatory word for business). 
Well, the legal authorities have declared medicine to be a paid service / profession, and the patient a consumer, so no argument there. Every hospital has a medical director, almost every patient or relative knows where to complain if they are unhappy. Many go directly to the police station. (This practice and the blackmail therein had become so rampant and harmful that the Supreme court had to issue orders NOT to register an FIR against a doctor or hospital without consulting local medical authorities.) This is an established procedure in all professions (Sorry, Dhandas): that you complain only via the legally available channels. 
There are fewer chances of threatening the doctor now with a police case or media defamation just because one had access to those. Hence the hoopla about “Not having enough to do against erring doctors and a corrupt profession”.

© Dr. Rajas Deshpande
Many a TDH spoke ill about the medical profession, generalising the blame while conveniently forgetting the fact that the number of patients getting better and surviving are far more than the actual bad outcomes (all of which are automatically presumed to be the doctor’s fault by many). 

Our own colleagues make statements like “ We should actively stop medical corruption” which is as vague and useless as some political speeches. The Medical Councils explicitly ban doctors from maligning and badmouthing their own colleagues. The corporates throw out doctors who do not fit into their corrupt practices. Everyone cannot start a superspecialty hospital (even minor hospitals require over 50 permissions, many wet). So the only way one can contribute to a “corruption free” medical practice is to follow it for oneself. Many do this silently, but the generalisation by media and society never excludes them, and they keep on facing the brunt of baseless allegations, disrespect and often harassment.
 “All this problem is because there IS actually corruption in medicine. There ARE greedy doctors who extract money from the patient” say some of our own colleagues. There is no denying that there are corrupt doctors, but by discussing this on social or general media are you (a) defusing the situation and solving the issue or (b) trying to prove at the cost of others (especially younger generations) that you are yourself better than them? 
If at all a separate non-medical body is made for “Grievance redressal” of patients, the same body should also redress the issues faced by doctors about many patients: blatant lies, hiding of crucial information related to patient’s health, presenting false data, self-medication, non-compliance with doctor’s instructions, continuing addictions and prohibited food or lifestyle, intimidation and interference with work, pressurising for false certificates, assessment and medical insurance documentation, disability or retirement claims or benefits on sympathy grounds, and above all: penalty for filing false complaints. The doctor should also be able to report the “domestic physical or mental harassment and denial of prompt medical care” to the patient by relatives to such a forum.
If at all a “Social or Media Forum” on public demand is dealing with corruption and malpractice issues in medicine, let them also include all other professions and public utility services by rotation. Can we imagine TV channels/ newspapers holding “Open discussions” about corruption in judiciary, military, government, Media etc.? Then why this “social special media court” for doctors alone?
Wonder how much money the TV channels spend towards poor patients or some other charity. Wonder if media is a business.
A judge is not allowed to report another judge to the media or society directly. Nor is a military official, minister, police or any other responsible professional. Have you seen police, judges, military officers, government officials, ministers malign their own systems, allege corruption among their own colleagues upon social or general media? That is breach of privacy and confidentiality. Why cannot doctors follow this simple rule: please go through available options to report the malpractices rather than mislead the public and media.
One can understand the jealous allegations of medical corruption by some non-medical professionals who have neither studied the issues facing doctors, nor have qualifications to talk about it, for the simple reason of venting out frustration where there is no resistance. One can understand that such “social loudmouths” do not speak about themselves or their own profession simultaneously, nor do they have courage to openly talk about the real rampant corruption in any other field.
It seriously hurts when our own colleagues talk of it as if it is a one sided coin, as if all doctors except themselves have chosen this profession for looting people. If there is corruption there are also legal channels to resolve the issues. Please respect them rather than badmouthing your own profession in an already paranoid environment. For a few corrupt doctors and a few irresponsible ‘sociophilic orators’, why should every honest doctor face the brunt of social anger?
No one should be corrupt, and no one should allege others of corruption without completely making their own family, colleagues, profession and government corruption free. 
It is like telling your neighbour’s spouse what to wear, while your spouse is you know what.

© Dr. Rajas Deshpande

High alert: Doctor in 5-Star Hotel!


As a middle class doctor, he was always scared to enter a five star hotel.

His parents were simple ethical teachers all their life, the type who have “One dinner in a five star hotel with family” high on their “Bucket list” of lifetime dreams. It so happened that a minister was attending a marriage function of a local liquor baron’s daughter in a five star hotel, and this doctor of ours was posted as a doctor on duty in the team supposed to tag along with every minister’s convoy. The minister’s secretary graciously asked everyone in the convoy to have the “B” class buffet arranged separately for the staff. This included our doctor on duty too.

As this was his first encounter with a five star hotel meal, the doctor couldn’t help being curious and asked the waiter about wanting to see the typical menu especially for the prices. The courteous waiter obliged him. Upon a glance at the menu our doctor was too happy: he could definitely afford to bring his parents there on their marriage anniversary, as a special treat, if he saved half a month’s salary.

His parents, wife and child were beaming with pride as they entered the five star hotel. They had their best clothes on, which were still a level below the managing staff of this hotel. The five star staff sensed the “one timers” and behaved as high handed as they could. Just as the family finished their calculations of approximate bill of their culinary wishes, they realised that it was still a costly affair. Carefully folding their sweet hunger pangs, they ordered overlapping desires and waited.

“Hi! How come you are here? ” someone slapped our doctor on his shoulder. It was his classmate from school, who had dropped out after matriculation. He now owned a petrol pump, thanks to his father in law in the government. “Our Scholar has now become big doctor” complimented the friend to the doc’s wife, artificially greeting his parents. “I am a regular here.. Do let me know sometime when you visit.., now you must be having so many companies sponsoring you here: Saala Doctor log ki aish hai yaar”.

As the doctor hastily clarified to his family that it was not so, he had lost half his joy, and the parents most of their smile. His father still reiterated that they really didn’t care for five star meals, and will be proud if their son stays on the “right path”. They guiltily finished their dinner, feeling way out of their place. Restless, the doctor paid cash from his pocket in front of his parents and child so they were convinced that this was indeed his hard earned treat.

On the way out, the kid started shouting ecstatically: he had seen his favourite cricket player in the lounge. As they all ogled at the cricket star with his actress girlfriend, the kid begged the doctor: he wanted an autograph of his idol. The doctor requested the hotel staff, he was allowed, and the cricketer obliged. “I am a doctor at civil hospital ” said our doc. Nobody seemed to have noticed what he said, although everyone had heard it. ” So what???” was the universal expression.

The lounge was now all full of glitz and glamour, people from almost all professions were there, except obviously teachers, doctors or labourers. There were lawyers and judges, there were reporters and police, there were celebrities and artists and criminals and politicians. Nobody had any trace of guilt, and most of them were there sponsored by someone. Some were being paid by their company, some by government, many by means of bribe. All the remaining had money which they were not born with, money they had earned from others for whatever it was that they did for earning.

There was a medical update seminar going on, great doctors in the field of medicine from developed world were lecturing Indian doctors. This notice was guiltily displayed in a corner by a pharma company that had sponsored the event. Many who crossed the notice commented freely: “Look at the doctors today: they get all free booze and food from the pharma and then prescribe wrong medicine to everyone! All this medical corruption and malpractice must be banned, these doctors must be sent to jail! They survive by looting poor patients!” etc. “Why can’t doctors live simple lives, avoid all luxury and hold their meetings in poor one star hotels or govt colleges? Why do they need enjoyment or good food that they cannot afford? Why doesn’t the government ban doctors from entering five star hotels?” they asked innocently!

This was all way beyond explanation for our doctor. He had never felt so belittled for his profession. There was nobody who cared to look at the big picture. His merit and his education were his cross and his curse: to carry upon his shoulder, while those from other professions who didn’t care to have merit or ability could jealously preach him ethics that he alone must follow.

As the family cramped into the doctor’s small car, there was a loud panic. Someone had become unconscious. “Any doctor around?” shouted the cricketer frantically. His girlfriend had fainted. Just as our doctor took her pulse, the hotel manager kept shouting: “Don’t worry sir! I will get the best specialist in the town: let’s take her to that five star hospital: The owner is my friend “. She had become conscious again, after some sugar solution, apparently normal.

The five star ambulance left, screeching its siren aloud. Nobody cared to thank our middle class doctor. This was his duty to attend emergencies, taken for granted by all and ordered by law.

Addicted to scientific thinking, the doctor commented to his wife late that night:

“What percentage of people entering a five star hotel do you think are earning ethically and honestly? How many are there directly paying for themselves?”.

His wife hugged him, smiling. “I don’t know. But I know this: none of them is as proud as I am”. Her pride was reward enough for him, he had learnt to forget and forgive everyone else. For the sake of sanity required while treating his patients the next day.

(C) Dr. Rajas Deshpande

Have Doctors become Mechanical?

(c) Dr. Rajas Deshpande

Sir, most of your stories you share are from your internship days. I have worked as an intern for past 10 months but almost never encountered/experienced such heart touching events and I don’t think, i am any less humane or sensitive than you must be(guessing by your posts). then why almost every intern is so mechanical about his schedule and work? Has the nature of work/ job profile of interns changed to mere mamagiri? Or Its just that, you always went the extra mile to be the awesome being you are! Awaiting your reply eagerly.. Dr. AA

Dear Dr AA, yes doctors have become more and more mechanical, also preoccupied with too many non-clinical tasks like USMLE / MRCP / pg entrance studies, digital addictions and excess non-duty work. Talking to the patients and making them open up is an extremely difficult art. Just like we don’t open up to any roadside stranger, patients do no talk much to a disinterested doctor in a hurry.

There is no one without problems, no one who does not need more love and kindness, but people will not respond if they sense “artificial” empathy. Most illiterates and even infants sense true versus artificial love. So every doctor must learn to imagine himself/ herself in the patients’ condition, and genuinely solve their problem the best they can. There also is a growing tendency to think oneself “superior” to patient or other professionals. No one talks comfortably with the “high handed”. Indeed there are many patients/ relatives more intelligent than the treating doctor, the respect for a doctor is only for his/her medical prowess and kindness.

The first hint of “trying to show off more than what you know” switches off the patient. This tendency is also increasing among some doctors, who transgress their specialty and adversely talk about other specialists or professions. Even the illiterate patients understand (may not express) your overall nature in a few minutes. One must be very polite, humble and genuinely interested and helpful to every patient to be able to connect. In many cases half the agony is the fear of the medical situation. Every doctor does not have time, but those who spend more time per patient hit it well with the patient.

Hope that answers your question. Also, I have always kept a diary. I spent my internship in quite rural and backward areas, the faith in a doctor was still young, and I loved to talk to the “patient”, so time was not an issue. Like most young doctors, I was (and am) never fond of sleep. I had another advantage: I have been a loner.

I know you are (in fact everyone is) gifted by God / Nature a golden heart with a divine song. It is up to us how to use it. The practice of Good Medicine is almost as difficult as a spiritual life: many sacrifices are required. But one should not expect the patient to “Pay Up” or bear the brunt of our sacrifices. It is a choice we have made.

Take care and use the one chance of touching every heart you meet wisely, with immense passion, forgiveness and love. The returns will not be material, but I am sure you don’t care for material gains because you asked this question.

There is no “Extra Mile” for a good doctor. Whatever Good can be done, must be done.

God bless!

© Dr. Rajas Deshpande

Reply to a question asked by Dr. Arvind Arora, Intern, India.

The Synonym of a Doctor

The Synonym of a Doctor
(c) Dr. Rajas Deshpande

“Here, take this” Mr. Baliram thrusted three hundred rupee notes in my hand. In any other case, I would lose my usually short temper and react. In this case I couldn’t. I calmly kept the money back in his pocket, and said, “This is not necessary, Mama”.

Seventy plus, bent and wrinkled physically but not mentally, this farmer Baliram from remote inlands had brought his third and last son over to Civil Hospital Nanded.
His wife had died many years ago of Tuberculosis. His first son had died of a snake bite, and second by electrocution while trying to repair the pump that pulled water from the well in their farm.

This third son had developed a GBS or Guillain Barre Syndrome, which paralyses both the legs and hands, and also swallowing and respiration in most cases. The most dangerous thing about this illness is the sudden highs and lows in heart rate and blood pressure, which may cause death.

When the first son was bitten by snake, the truck driver who carried them to the nearest rural hospital charged them hefty, the medical attendant asked for bribe before starting treatment, and when he finally reached Civil Hospital Nanded, his son was barely alive, but the ambulance driver who carried him did not allow Baliram to get down before paying his money. The gasping son passed away in a few hours after admission. When the second son died on the farm, Baliram had a hard time bribing many to get the right papers to be able to perform the last rites.

It was thus natural for him to think that some money would ensure good treatment for his last son. I reassured him that it will not affect the treatment at all. I was an intern then.

He sat by his son 24/7, without any signs of fatigue. There are people who suck the blood of their own for their tiny suffering, and there also are those who do not have any of their own to cry upon the shoulder of.

My professor (a military-retired callous man, of the kind who thinks everyone is as stern, unemotional and strong as himself) bluntly told Baliram that his third son was also critical, and now required a ventilator. Baliram listened patiently, folded his hands, and calmly said: “Doctor Saheb, God will do what he wants. I will pray. You please try your best. This is my only son”.

Professor said “We are trying our best” and walked over. These military strongmen do not want others to see their tears.

Past midnight, after all paperwork was over and patients stabilised, I took permission from the resident doctor and went out to have my customary stimulation, only to find Baliram sitting alone, smoking in the parking area. I got tea for both of us and sat beside him. Silently, we sipped the tea, wrapped in smoke. To lighten him up, I asked him about his farming. He too asked me a few questions about my family.

“What do you seriously think, DoctorSaheb: will my son survive?” he asked. I did not want to lie. “Many patients survive, I am hopeful he will, provided his heart rate remains within limits” I assured him.

As I got up to get back in the ICU, he clutched my shirt sleeve. ” I am not good at talking doctor, but I am dying every moment inside. I feel like a fish out of water. Please do something. I have nothing left except this son. I cannot even cry, I am so scared. I do not know why I am facing this fate.. I have never hurt anyone in my life. I have always taught my sons to do good to others. If this one dies, I will just go back and jump in the river”.

My callous professor rudely fired us everyday for better care of each patient including this one. After a week, the patient started to regain his breathing ability. In two weeks, he was out in the ward. He was discharged with some limb weakness still remaining. My callous professor skimpily smiled as the patient left.

They came for a follow up in a month. He had almost completely recovered. Baliram was smiling. He touched the feet of my professor and gave him a small bag and a box of sweets.
Then he came over to me. “Give this to your father” he handed me a cloth bag.
“What is this?” I asked, reluctant and curious.
“Please don’t decline. I brought it for your father. Please give this to him”. He added.
Late that night, I gave the bag to my father, telling that a patient had sent a gift for him. He opened it. There was a cloth piece enough to make a kurta-pyjama, a Gandhi-topi and a white towel. There also was a “Prasadam” pack and a receipt of donation at a temple in my name.

My father asked me the details about this patient, and as I narrated this story, became tearful. “This is the best gift a father can want. This is what you must earn from every patient” he said in a heavy voice,
“This is why we made you a Doctor”.

…..
As much as we have evolved in law, literacy and scientific awareness, we have also become paranoid and emotionally deficient as doctors: a necessity in most cases, but a huge blow to the really poor, charity-dependent, taken-for-a-ride class.

While retaining professional smartness, let us also rekindle this thought: that there are some whose suffering only the doctors can end, some who will survive only because of our wish to help them out free. Many will talk about it, but except the doctor, there is no one who can truly help a poor patient. Many doctors do this today, but the flame can be passed on to the newer generations only by being an example.

One synonym of “Doctor” must be “Good Person”, for I am yet to see a bad human being in any Doctor. This is the core of the famed ‘Nobility’ of my profession.

(c) Dr. Rajas Deshpande

Pune Mirror : Pak Patient Improves, Shows Cognitive signs

PAK PATIENT IMPROVES, SHOWS COGNITIVE SIGNS

Pak patient improves, shows cognitive signs
Sajal with her parents and her doctor, Rajas Deshpande, from Ruby Hall Clinic (PIC:MAHENDRA KOLHE)

DOCS SEE SUCCESS IN CEREBRAL PALSY TREATMENT

Rare case of 7-yr-old had several complications and drug resistance that had to be overcome

A seven-year-old Pakistani girl born with cerebral palsy has been successfully treated by city doctors — despite severe infection and an umpteen number of complications —in nothing short of a medical miracle. Not only was she cured, she also started showing signs of cognitive abilities.

A group of doctors from Ruby Hall Clinic treated the girl, named Sajal, last week. She had been brought to the hospital with glossitis, laryngitis, pharyngitis, pulmonary aspiration, bacterial infection, urinary infection, skin rashes and severe sepsis. Timely medical intervention helped treat all these problems even though the child was resistant to several antibiotics. “This made it even more challenging for us to control her infections and treat her thoroughly,” said Dr Rajas Deshpande, head of neurology, Ruby Hall Clinic, adding, “The child came to us with seven to eight types of issues. It was very difficult for us to treat her. But, with the right antibiotics, we managed to ease the severity of her condition. Now, she is all set to fly back home.” He was helped by Dr Ventaramani and Dr Bamkin Amin in the case.

Sajal’s mother, Shahzia, offered, “Sajal suffered from many complications and was not even able to pass urine or stool for three to four days in a row. We were not able to feed her or admit her to any hospital in Pakistan as many doctors turned us away, looking at her complications, saying there were no chances of improvement. That is why we came running to Pune and got her admitted at once. Sajal’s mouth had a lot of rashes, her lips were torn. No cream or gel given to us in Pakistan would heal her tearing lips. The infection was severe and kept spreading. Within three days of coming here, my child showed signs of improvement. Now, after six days, we are flying back to Pakistan.”

This is not her first visit to India; she has made several visits to treat her daughter’s cerebral palsy. “In the last few years, we took her to many countries, from Germany to Europe and Holland. But, no doctor was willing to take up her case. They said our child could never recover. Sajal had several fits and epileptic attacks in a day and a number of allergies and resistance to drugs. She was in a totally vegetative state. After coming to Pune, she began recognising voices, especially mine and my husband’s, reacting to light and also to her siblings. Now, there is more than 20 per cent improvement in her condition,” Shahzia added. She was told that no drugs for epilepsy or cerebral palsy were available in Pakistan.

“If the epileptic attacks of such patients are controlled well, learning or recognising people or voices can get easier. In Sajal’s case, we controlled her fits and her brain showed improvement. Strong antibiotics and antiepileptic drugs were given to her. And now, Sajal has improved by more than 20 per cent,” Deshpande stressed.

Other prominent doctors hailed the judicious treatment, with Dr Hemant Sant, president of the Neurological Society of Pune, saying, “A single infection is commonly spotted, but many infections coupled with complications is uncommon. Such cases are very challenging and a moment’s delay can prove life threatening.” Dr Sushil Patkar, a neurosurgeon from Poona Hospital and Research Centre, added, “Children born with this condition are very difficult to deal with. So, one has to be careful when they get infections. They need constant attention and care. Controlling seizures and convulsions should be the main aim to better the child’s condition.”

Dr Nirmal Surya, regional vice president of the World Federation of Neurorehabilitation and treasurer of the Indian Academy of Neurology, also brought out some ground realities. “Many a times, due to lack of hygiene or low immunity, children do get infections, but severe complication in one of them is usually not reported. With stronger antibiotics, such infections can be controlled and managed well, if the patient is brought in early. More important are rehabilitation, regular physiotherapy and proper diet, which can help boost the immunity for such special children,” he explained.

##################################################
This story was published in Pune Mirror today.

Thank you Dr. Bankim Amin, Dr. VenkatRamani, Pediatric resident doctors (Dr. Upendra, Dr. Tanvi Priya, Dr. Abhijit Kudale, Dr. Supriya Takle, Dr. Radhika Gupta,Dr. Suyog Choudhary, Dr Smita Sangade), Nursing and ward staff, Overseas care staff and so many others who made this possible.

Doctors always make one world, without any borders.
We all treat everyone alike, God / Nature decides about the outcome.
We were blessed with some smiles recently.

The miraculous recovery from infections and cognitive improvement in this girl is also due to the unending effort and sacrifice of her parents, who did not “Dump” the extremely challenged girl child as advised by relatives and society, but gave her the life of a princess, breaking umpteen impossible barriers that stood between her and the medical aid anywhere in the world.

Every parent has boundless love for their child, but these two parents have made her health their career.

May every child be blessed with such parents!

Thank you Ms Nozia Sayyed (Pune Mirror) for your dedicated awareness initiative, and Mr. Mahendra Kolhe (Pune Mirror) for the picture!

Abyss, c/o my country.

 

© Dr. Rajas Deshpande

Bruises everywhere, black, blue, purple, red and swollen. Especially groins, buttocks, thighs, breasts, back, neck and face. One cut on the forehead. Dried blood on lips.
She was sobbing, speaking in a muffled voice: “Can you imagine they beat up a woman like this?”

Single postgraduate woman, staying alone in a metropolis, in a building near the police station. Operated for a brain tumor, on medicines, occasionally gets spells of abnormal behavior and symptoms like staring, imbalance, speech arrest, slurring or passing out. Disowned by family because she had fallen in love outside their caste. The guy later abandoned her, married in his own tribe.
She is jumping jobs, never accepted for long at one place when they realize she gets such spells. Being young, tall, beautiful and fluent in English, she usually gets too much attention from men. She quit some jobs because her bosses made advances.

She often faced lewd comments and received “offers” from men in and around her society, whenever they found her alone on the stairs , elevator etc. Her angry responses and retorts offended many. Her “seizures” or blank spells were thought to be ‘witchcraft’. Her window panes were broken down, the landlord refused to help, asking her to leave. She could see faces in her windows at all times, especially at night.

Once when a local lady politician’s husband tried to hold her hand, she slapped him, unable to control anger. Within a few minutes, the politician, along with some other women and men, mobbed her flat. She ran out.

There in the open area outside society building, they all beat her up : grown up men and women together, alleging her of witchcraft, of theft, of ‘stealing their men’, of ‘luring men and children’ etc. This continued for about twenty minutes.
She limped to the police station. She was arrested as someone had just registered a complaint against her. The mob reached the police station with the politico, who alleged her of theft, violence and use of foul language. She was taken to the government hospital, After dressing her wounds and splinting her hand, she was locked up. Released next morning with a warning.

She had come to the our hospital next morning, asking for a new prescription as she was scared to go to her own apartment.

After the nurse offered her water and a tissues, I examined her. The wound mark of the brain tumor surgery was not affected, but there were bruises around it.

“Did you have vomiting? Did you become unconscious?” I asked.
“No, but my body is aching everywhere. I don’t have any money left, you had told me not to miss any doses of antiepileptics. So I am here”.
I offered her free admission in the hospital (My boss usually helps). She refused. She also refused to do any tests or to let me call her brother living in a nearby town.
“If he didn’t understand my love, he won’t understand my pain” she said, “ I will leave this city in a short while, that politico lady has threatened me with more thrashing if I am seen around again”.

As we arranged for the medicines for her, she sat there, hands around her legs, intense anger in eyes, chin resting upon the knees, her sobs shaking our faith in humanity.

On the day prior to her major brain surgery, she had said “Doc I am not afraid of death at all, it is people who scare me.” I understood it now.

We all are grown up with almost similar training: that civilized men never hit women. Our parents, teachers all always taught us the same thing. Where does it all vanish? How is it possible to kick the delicate parts of a woman, knowing that it will inflict agonies worse than death? The men and women who beat her up were almost all from a middleclass society, at least half must have been educated. In a country that worships so many goddesses, how can women be treated like this by mobs? Every single woman, whether normal or suffering from mental or physical illness, risks lust and violence even among the most educated and civilized. Where do we start to stop the mob cultures? Women’s Empowerment has remained caged in the umpteen videos and messages that circulate all over, while women are abused by the “Manly Men” and mobs alike.

The nurse and receptionist packed her some food, a month’s dose of medicines, and we offered to arrange a taxi to drop her home. With single depressed patients, the doctor must always think of a possibility of a suicide. I urged that she please call her brother or mother.

“No thanks Doctor”, she said with the most bitter smile I have seen: “I will not kill myself because people are bad. I want to live and enjoy life. I will go where people will understand and accept my illness… and respect me as a woman”.

She limped away accompanied by her own sobs.
I wondered for many a restless nights: where can she go?

© Dr. Rajas Deshpande