Monthly Archives: May 2017

G-Bhai, The Suicidal Intellect.

G-Bhai, The Suicidal Intellect.
© Dr. Rajas Deshpande
 
G-Bhai is an extraordinary genius, and all that he lacks in the matter of manners, culture, and grooming oneself to a neat and clean appearance is compensated for by his superb analytical abilities and internet access. He was so engrossed in Google all the time, that he was nicknamed G-Bhai by his family.
 
A few weeks ago, he went to his boss, who owned one of the biggest profitmaking multinationals upon earth. The boss was absorbed in his divine meditation about new tricks to lay off more IT personnel in pursuit of that greatest human achievement in today’s world: moolah. G-Bhai, who believed in complete equality, sat cross legged in front of his boss, and scratching his beard, told his boss where all the boss and the company could improve. © Dr. Rajas Deshpande
The boss, amused by free entertainment, asked G-Bhai where he learnt it all.
“Internet” said G-Bhai, and showed some Googled statistics to his boss.
“Thank you, you are fired with immediate effect” said the boss
.
G-Bhai wasn’t affected at all. With his oversized grey T shirt, jeans, slippers and laptop that connected him to all the internet data, he was still the king.
 
He thought of adventure, and went to the Indo-Pak border. The firing and shelling was full-on. He met an Indian soldier who asked him to hide in his shelter. The soldier, who had spent all his life upon the border, was prepared to even die for this citizen, so gave away his helmet to G-Bhai.
G-Bhai was intensely searching the internet, wearing the soldier’s helmet.
“Don’t fire the gun like that” told G-Bhai to the soldier. “This website says the right way to fire is with the gun aimed at oneself”. The soldier ignored him and continued to defend the border. Just as he held a hand grenade to be thrown, G-Bhai held his hand. “Let me search first if you are doing it correctly” he said. The soldier, now in defense of his own life risked, slapped G-Bhai tight and asked him not to interfere. © Dr. Rajas Deshpande
 
G-Bhai proceeded to write a very critical review of that soldier, saying that in his opinion, all the soldiers were doing it all wrong.
 
Then he went to the court and tried to teach the lawyers how to argue, and the Judges how to analyse cases and deliver judgments. He showed them multiple websites from which they could learn law. “We are all equals, why are you sitting so high?” he asked the judges and tried to sit on the Judge’s chair.
After six months in jail, upon his release, G-Bhai went to the police commissioner to teach her how to deal with crime and criminals, based upon internet searches from different countries. He came out limping, and refused to tell anyone why. © Dr. Rajas Deshpande
 
Due to excess stress, his health worsened. He went to the best of the doctors. He demanded that he wanted a complete check up to reach the most correct diagnosis. He was advised tests. He researched the internet and did only the tests he thought were necessary, because he thought all doctors were corrupt. He reached a very reputed doctor with the test results. The 70 year old doctor examined him, checked the reports and told him: “You are a failure in your own life, you have excess stress, and are unable to handle it. You are jealous of everyone who is doing well, and therefore you have developed a complex that everyone who does well is either corrupt or wrong. Go home, exercise, find your own life and deal with yourself” When he tried to show the experienced doctor what internet said, the doctor smiled and asked “Did you also net-teach your parents how to make you?”. © Dr. Rajas Deshpande
 
G-Bhai then went to many doctors in many pathies. Then he researched and tried many home remedies. But his health kept on worsening. He was very upset and started a blog of criticizing that all the doctors. Here, for the first time in life, he discovered success: he was an instant hit, because there was a huge population who agreed with his views. There are more buyers for poison than for wisdom in this world.
 
But unfortunately by then, his kidneys failed due to experimentation with various medicines and various pathies. Now he is undergoing dialysis and posts his anti-doctor articles from the dialysis ward. The old doctor recently visited him with his flock of medical students, and spoke with empathy to the bitter G-bhai, who tried to show the old doctor some more internet references about his treatment.
 
The old doctor then told his students: “This is what I would call a suicidal intellect”.
© Dr. Rajas Deshpande
 
 
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The Overdose of Medical Advice

The Overdose of Medical Advice
© Dr. Rajas Deshpande
“If the doctors want to go to a five star hotel, they must pay for it” said someone recently in a headline.
Well yes, like any hardworking honest professional, even a doctor may want to go to a five star hotel occasionally, and have a good time, especially given the sadness that surrounds his / her profession. There is nothing that prevents me as a doctor from wanting to go to a five star hotel once in a while, and I do not feel guilty about wanting to live a good life. Earlier, I was happy to attend some great lectures by the world’s best doctors brought to India by the pharma industry (because the government never can), now I will just pay for myself.
Whether a five star meal comes from the profit of pharma industry or the hard work of doctor’s fees, there will be objections for sure. The problem is not the five star meal, the problem is elsewhere. So the different ministries can officially host super luxurious parties on different religious / non religious occasions to woo voters via the taxpayer’s money (and the media will describe the Biryanis and Gulab Jamuns in paragraphs), but the doctor must never eat a free luxury meal!
Many non medical professions, industries, financiers, film industry people, bankers and builders host dinners / other events at five star hotels, and many government officers / ministers attend them. Do they all pay for themselves? Just because a minister attends a five star dinner, he cannot be presumed to be doing a hidden favour to some industry, likewise, a doctor attending an academic event cannot be presumed to be doing a favour to any pharma. © Dr. Rajas Deshpande
It is doubtless that some doctors may have misused this facility and overspent. But the huge advantage: giants in the different medical fields from the developed world coming and educating the doctors in India will be greatly sacrificed by such limitations.
Given the social envy and jealousy against the doctors now rampant, it is probably an inevitable but unfair step by some organisations recently to ban pharma sponsorship of certain medical events at five star hotels. It is also a good initiative to reduce drug prices. But then, can the same organisations and even the federal bodies show the same guts and ban following malpractices too:
Open sale of undergraduate and postgraduate medical seats all over India, that creates funds worth trillions, benefitting even some in the highest offices of the country? Where does this money come from, and where does it finally go? Are we innocent enough to presume that the patient is not ultimately paying for this? © Dr. Rajas Deshpande
Under the medical consumer protection act, is not the government required to make all the facilities of healthcare available at all government hospitals in our country at subsidised rates? It is argued that taxpayers are paying for the education of medical students who enter medical colleges by merit, which is wrong, because the taxpayers are actually paying for good health facilities at the said hospitals. But most of the hospitals / medical centres run by the government are understaffed and run far below acceptable conditions. How many government health set ups have been evaluated for accreditation by standard bodies, and what are the results?
The insurance companies and corporate hospitals have held the private doctors prisoners of their atrocious conditions, and even the paying patients are being provided a substandard service, thanks to a total absence of any willingness to question any of this on the part of administration.
The demand and supply of “Cheap everything” in medical profession has now gone to such a dangerous extent, that substandard staff, incompletely qualified professionals, low rate medical instrumentation and quality of service, and above all, ineffective / low quality medicines have become a horrific reality already, even at some corporate hospitals dominated and dictated by the insurance sector.
They are giving people what they want: Glittering Cheap Healthcare. It is so surprising that the patients are happy with only this one quality of service and drugs: cheapness. The day that our society will understand that like anything else, good healthcare will cost more and will obviously involve more profit-making, our health scenario will improve. © Dr. Rajas Deshpande
The IMA, while trying to play safe and readily making rules like banning sponsorship, should take a firm stand to fight against the one sided war waged upon the medical profession by some.
Written in a state of perfect peace, not frustration.
Because I am not sold out to the desire to be liked by everyone, especially those against doctors.
© Dr. Rajas Deshpande

Annapoorna

Aai.jpeg

Annapoorna

“Everyone who enters our house must be offered water, a cup of tea, and snacks. If it is lunch or dinner time, offer meals. Never differentiate, be it poor or rich, friend or enemy, someone you like or dislike, offer them the best fresh food you have. You will always be happy when you feed someone. Also, never even tell a beggar that you don’t have food, it is already humiliating for them to have to beg for food”, she taught us. She scrupulously followed it herself.

My mother, Dr. Usha Kalidas Deshpande, insisted that no one should ever be hungry.

In spite of herself being a fulltime professor who was much involved in teaching, whenever I returned from school, she was usually available to make hot fresh poli / chapattis and my favourite curries. Dinner, as a rule, was almost always made by her. She remembered the food choices of my father’s friends, their students, my friends etc., and often cooked something quickly for them to eat whenever they visited.

“A man who does not sometimes cook for his family cannot fully understand his woman”, she often said. My father fully supported her views and sincerely attempted to cook till we all told him that he can instead take us to a hotel. He was happy, and so were we! (Although he made delicious omelettes!)

Mom taught me to cook too, right from making chapattis (of course the first few I made were disco chapattis). This immensely helped me in later life as a single parent, as I could often cook things that my kids liked (at least the poor boys said so then). Needless to say, we follow the food / host rules set by mom at our home even today. I loved the “Poli / Chapatti / Paratha” made by her so much, that when she passed away, gave up eating these.

Today is her birth anniversary.
Every year that she was alive, I had asked her “What would you like for a birthday gift?”. From the time that my salary was 1250 INR per month as an intern till two years ago when I could get her anything she could wish, her answer never changed: “I have everything, what else can I want?” with a smile! She was never fond of any jewellery, luxury or show off, so we always wondered what to gift her. Now after she has left us, we have finally found the right gift for her.

We (my sister and myself) have decided to start a new tradition in our mother’s memory: annadaan / food donation, whereby at least one hundred people will be served complete meals on this date at a center near Pune.. My children have gladly agreed to continue this tradition after me. Anyone from any religion / caste / age will be served, the only preference will be for the really poor and sick.

It is said that one should never speak about anything that one does for anyone else. I am guilty of that crime here, but the only reason to write all this is: most of the mothers feed their children along with their friends too with this same love. If this motherly bliss is passed on, also including those who really need to eat well, those who do not get to taste a complete meal every day, it will be a real tribute to one’s mother and a tiny return of what we received from her. One can of course always choose the form in which to remember one’s mother, I have chosen this, and felt like sharing it for my close ones as well as for those who knew my “Annapoorna” mother, Dr. Usha Kalidas Deshpande.

Dr. Rajas Deshpande
16th May 2017

My Earning As A Doctor

My Earning As A Doctor
© Dr. Rajas Deshpande
 
It was an emergency night, and we were trying to cope up with the excessive load that every government hospital must accommodate. One of my early postgraduate emergencies. The living, the dead and those in between were being rushed in continuously, and we were dealing with the emotional ups and downs at an almost impossible pace. In the same moment we were Gods and heroes for some, and devilish villains for others.
 
Nature, age, illness, delays, illiteracy and poverty are easy to fight with sometimes, but not what people expect from a doctor.
 
I was writing on the ward desk, filling up the necessary paperwork, an irritating interruption in a clinician’s life. Trying to recall something, I stared for a moment at the long stretch of that huge ward. My senior resident Dr. Sunil was performing a procedure called pleural tap, where fluid is removed from the chest. He was from a very poor and rural background, but had excellent merit. Most people made fun of his looks and language, that made him silent and aloof. © Dr. Rajas Deshpande
 
An old man came out of the toilet, accompanied with his wife. He was about 80, was admitted and had recovered from a stroke. He was scheduled to be discharged next morning.
While walking to his bed, this old man suddenly collapsed, his wife unable to hold him. He was about 10 metres away from me. Sunil and myself reached there immediately, shouting for the crash cart, and started resuscitation. We tried for many minutes, as the patient’s wife stood a few metres away, sobbing.
 
He was dead. He had had a sudden cardiac arrest.
It was the third death in the ward that day, among the thirty emergencies admitted.
 
Dr. Sunil went to the patient’s wife. and informed her. He got her some water, and sat with her for some time. Then when he resumed the paperwork, I noticed he was feeling sad and tearful too, like myself. The old man and his wife had both been so nice to us. © Dr. Rajas Deshpande
Only a doctor knows the traumatic feelings of having to resuscitate someone who was talking to them a few moments ago. Believe it or not, almost every death certificate makes a scar on a sensitive doctor’s mind. The trauma is perpetual, hidden, but also real.
 
As we arranged for their transport (the couple had no relatives and were from a nearby village), the old lady sat by her husband, touching his face and crying. When she left, she said “God bless you, you people still tried so much. We are both old, what can you do! This is my destiny. I hope God takes me up quickly too, I have no purpose in life now”.
 
Sunil went to the doctor’s room and broke down. This was unusual. I tried to console him, myself feeling very sad. Then, Sunil looked out of the window and said in a heavy voice: “My mother died exactly like this, in a hospital ward, when I was a child. I was with her. That is when I decided to become a doctor and save lives. At such times I feel very hopeless”.
 
“Oh”, I said, not knowing how to react, “Where is your father now?”
“He passed away long before my mother, he had fever, but they did not have money to take him to a hospital. He died at home.” Said Dr. Sunil.
In some time, we went for a tea and composed ourselves again. The night was to bring many more who needed us stable, so we returned in few minutes.
 
The next day, we presented to our professor the forty two cases admitted in emergency, a usual count at most medicine emergencies. Going home after over 36 hours, I could not eat that day. A doctor should not be too emotional, but then no one makes themselves, one can only control reactions. © Dr. Rajas Deshpande
 
Fast forward to the future: my father, one afternoon at home, collapsed suddenly and was taken to the nearest hospital three minutes away, but could not be resuscitated. I was in Mumbai, far away from him. That phone call still rings in my ears. Sometimes I have to sit down at the memory of that call, it breaks me.
 
I did not curse that doctor to whom my dad was taken. I did not blame anyone. I did not go to the press or police. I did not think that the doctor was wrong or was working for money when someone was dying. It is impossible. One who thinks that a doctor will think of money in the face of a dying patient is probably also the one who never fully believed in God, and also questioned their own mother’s love for themselves!
 
Like almost every sensitive doctor, like Dr. Sunil, the only way for me to forget the agony of losing my dear ones was to prevent this from happening in anyone else’s life.
 
So what if most of them think I worked for money, so what if they refuse to ever acknowledge gratitude in words or in deed. So what if they only look at the money I earn through my hard work.
 
My real earning, like that of every sensible doctor, is the reduced burden of suffering in the human world. The tax I pay is my blood and sweat. Those who do not use these currencies will never know their value.
 
© Dr. Rajas Deshpande
 
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White Paper of a Doctor’s Dilemma

White Paper of a Doctor’s Dilemma
© Dr. Rajas Deshpande

“Sir, I come from a family of doctors, who have always practised high values in Medicine. There was always this burning desire in me to do good. I felt that the country needs young doctors who are willing to work hard. but somewhere something inside me has changed. Now, with the on-going assaults against doctors, this clinical establishment act in West Bengal and in general the distrust and anger the public has against doctors, it has suppressed my older self. So much so, that I’m considering going to the USA now, even if that means doing residency all over again. I see my batch-mates and friends who went to USA after MBBS, really happy, earning well, enjoying holidays with friends and family. I do not envy the work part, I will always choose a day in the Operation Theatre rather than at the movies or hiking.. just that slowly my main motive for becoming who I am today is fading away.”

What a heartfelt question, a dilemma not only haunting me, but many doctors, especially from the younger generations, who started out to do something good for the country, have been dynamic, brilliant and hard-working, and now want to leave India!

Dear Dr. S,

Firstly, yes, the times have changed. Doesn’t the first page of most standard textbooks teach us: “Medicine is an Ever Changing Science”, now we must add the external scenario to this. We must change accordingly. Add laws, add medically inept judiciary, add media, add too many impractical conditions of practice where among the two sides involved in a profession, only one is legally answerable. I should write a prescription not of the best medicine I know, but of the cheapest one. In the face of lost faith and partial law, no relationship can be very cordial. Nor can any empathy be forced for a patient who suspects the doctor of wrong intention or inadequate skills. © Dr. Rajas Deshpande

Given the increasing number of Google empowered pseudo-literates and even genuine illiterates who are now questioning every medicine prescribed, every test advised, not because of curiosity but in an obvious visible distrust, it is becoming increasingly difficult to keep patience with practice. The combination of a western/ over-legalised medical service with a free-monger society, where instead of education, science, research and health, the taxpayer is happy paying for corruption in almost every sphere, lifelong deluxe travel, food and living expenses of everyone who has been elected even once to almost any civic body, no one wants to think logically about why there is healthcare failure in such a huge country that generates such high taxes.

Recently a headline about “Doctors prescribing costly medicines” hit the media. Why doesn’t the government make available free / cheap healthcare for everyone? Make all medicines free at all government hospitals. Why expect those who invest decades in making a medical career and then practicing under loans to keep on working with minimum incomes? Why aren’t there any laws against the corporate hospitals? Why don’t the same politicos speak about some of the capitation fees institutes that generate trillions, and also allow the quality of the medical education to be compromised? I wish the prime minister also says some day that we will make all medical education free for all merit holders, because the country needs more doctors. Why make it difficult at both ends for the doctors? © Dr. Rajas Deshpande

I can also be a high handed hypocrite and advise you the humbug: that a doctor is a social servant, that a doctor must only choose to live the life of a saint and never think about earning or a decent / luxurious life, that the society needs you etc. We live in a society where while searching for a groom, every father’s first question (if not the bride’s) is “How much does he earn?”. The stupid thought that a doctor should not earn a profit for his talent and hard work is redundant. If the society needs good doctors, it must also learn how to remunerate and treat them. It should also learn not to generalise that every doctor is corrupt. It should be intelligent enough to know that medical care can neither be free nor can be entirely based on charity or profitless structure. © Dr. Rajas Deshpande

But our society is far away from understanding this. The “High” of hate and criticism drives mobs berserk in the land of logicless thinking, and we Indians lead this game. To be opinionated by media and illiterate politicos and speak without studying is the sign of a degrading time. © Dr. Rajas Deshpande

My dear friend, I will be honest with you. Ten years ago, I strongly felt I should return to India and serve people. I doubt it now. I have urged hundreds of students to return to India after their higher medical education in the west. Now when some doctor is beaten up, killed or tried by media before law, I don’t feel justified to urge anyone to stay here.

You have only one life, and living it fully, enjoying health and peace of mind, joys of living is also your duty to yourself and your family. Are you inclined to do social work without recognition, with allegations and trials, in a society that refuses to respect a good doctor? Are you inclined to let a “Social change in the attitude of public over decades” take effect, by which time your career / life will be almost over? Are you ready to be tried by the media, taunted by the court even before being proven guilty, and punished by those in power, not because you are wrong, but merely to please people? Are you prepared for a scenario that even if you do 50 years of cleanest practice and save thousands of lives, when you are blasted all over the media for your first mistake, not a single patient will stand up and say”This is a good doctor”? If so, stay in India, this country really needs very good and honest doctors, even though it cannot respect or trust any. © Dr. Rajas Deshpande

In this country without a healthcare vision for the future, this is indeed a sinking ship, with opportunistic invasions not only from various unrecognised pathies, but with a society that is increasingly destroying the possibility of good healthcare for all in future, in its quest for free, and cheap, under the threat of violence.

If you want peace for yourself while doing good to the society and earning well at the same time, choose a developed and civilised country: at least payments are better, you get time for yourself, the law looks at both sides, and politicos can be questioned. You can also fund some health charity in India from your earnings there. Last but not the least, no F. B. will raise a hand upon a doctor, and still will be justified by law, media or government.

© Dr. Rajas Deshpande

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The Music Called Life

The Music Called Life
© Dr. Rajas Deshpande

“What prize do you want”? My father asked me after I finished my tenth standard exams well.

I was desperately awaiting that question, knowing him well.

“A Sony Walkman” I replied almost instantly. I got one, the most basic Sony model, and lost myself for weeks in the stereophonic effects, collecting songs and recordings that had best quality. Right from the scratchy sound at the beginning, made by the record player needle-tip on the record disc, to the realization of different soundtracks on right and left, with separate sounds of each instrument. One favorite hobby was to select and follow only one instrument from the whole orchestra throughout the song.

Besides the music of MJ, Madonna, Beatles, the Indian stereo effect songs were a pleasure too. Ye bambai shehar haadson ka shehar hai (Kalyanji Anandji) and Pag Ghungroo Baandh, Thodi si jo pee lee hai (Bappi Lahiri) had the best stereo effects from the headphone. Kishore Kumar, Lataji, Lionel Richie, Cliff Richard, and Bee Gees became addictions. The collection grew enormously.

A cousin returning from the USA bought himself a Bose audio system, I was 18 then. I remember arranging the exact angles of the speakers, all directed towards one single chair at the center of the room, then taking turns to listen to “How Soon Is Now” (The Smiths). The strong wish that I must own the best music system for myself, make a music room in my home dawned that day, and is still thriving within me.

Much later, on a birthday, returning after ward work, I found a huge parcel at my hostel door, and the watchman told me that a fan had left it there. I had told some friends how I loved “Experiencing music”. Opening the box, I found the most advanced 8 speaker Panasonic music system, the home theatre one. That was one of the best gifts I ever received. The effectiveness of listening to music as a treatment for one’s negative moods is beyond question. I feel that good singers , those healers of soul, are better doctors than many medical degree holders,as their love songs and happy songs cure many a sad minds. © Dr. Rajas Deshpande

Recently when I listened to great music all the night with a very precious friend, a beautiful soul who understands that each instrument and even the voice of the singer has a different expression, other than the lyrics, who can feel music imprinted upon blood just as I do, I realized what I was missing in life. With this friend, the hear beats of life have become stereophonically audible again to me!

Technology has started drowning music into sounds, taking out meaning to be replaced by sound effects, we have almost lost the appreciation of the intricate fineries of meaningful music. The true feeling of listening to music is much like being underwater, if at all to compare: unless you drown yourself in it, you don’t feel it right!

Talking to patients, students, colleagues, this thought grew into a major revelation: we are losing our fineries not only about music, but also about feeling out other people: near and dear ones as much as strangers, both can have so much more meaning than the “bodies and words” that men and women have become now! There’s so much beauty in almost every human being who dares to preserve individuality without either copying anything or looking down upon anyone else.

An alert, feeling, self-aware mind that dwells upon the here and now is the best song nature has ever sung to me: and also the highest state a human mind can achieve. Unfortunately, we are lost in the digital-technology jungle, and take pride in either losing ourselves, escaping or running away from ourselves, or searching ourselves outside our own conscious reality. © Dr. Rajas Deshpande

I have decided for now: that I want to live this music experience without compromising: I want to to feel every bit and piece of the music that life brings to me, through songs and their lyrics, through the rains and the sun, through eyes, touch and silence, and above all, the resonance that it generates within me.

Only Love can match the beauty of good Music.

For the music called life is never sad, and I want to always walk towards a happy inner peace.

© Dr. Rajas Deshpande