Monthly Archives: April 2018

Ban the Entire Medical Profession!

Ban the Entire Medical Profession!
© Dr. Rajas Deshpande

We were always much entertained by a very famous surgeon who would just sit all dressed up in the operation theater. As the worried relatives kept praying in the waiting room, the patient was operated by some other experienced and skilled doctors employed by this ‘famous’ doctor. He would just sit watching TV in his private room within the operation theater, till the surgery was over. Then, he would come out with a benevolent smile, pretend that he was too exhausted, and tell the relatives “that was an extraordinary case. We had almost lost your patient. I had to make a great effort, use all my dedication, knowledge and experience, but finally I could save him. You are very lucky”. Needless to say, the relatives would touch his feet, overwhelmed by emotion, little knowing that this surgeon has not even touched their patient. Bills floated swollen. The patient or the relatives never knew who actually saved that life. In our education to be doctors, we also learnt “what not to do” from such doctors!

With a recent speech in London, I was reminded of this.
It was very unfortunate that the Hon’ble Prime Minister of our own country spoke quite demeaning about the entire Indian medical profession in a foreign country. Nearly one third doctors in the developed world are from India, leaving India because it offers them no good opportunity, compensation or even basic security. The PM seems to disown the patriotic doctors who try to survive in and serve India. Where is the love for India? Does one demonstrate it by showing everyone else in the country down?© Dr. Rajas Deshpande

Let me at the outset clarify that there are some corrupt doctors, some get favours from pharma, and some participate in malpractice. The government always had rights and law in their hand to act against such doctors. The hubs of corruption evolve when the government allows medical seats to be bought for the meritless rich. Our govt. allows crores of sales of medical seats.

We wish our PM also spoke about how many political leaders in this country own medical colleges and what is the actual income that they generate by sales of UG / PG medical seats? Like the prices of all drugs and stents, why not reduce the price of medical seats too?

He said that Indian doctors “do not travel to Singapore to see poor patients”. Was he serving the poor Indian farmers in London? How many poor farmers or labourers accompanied the PM or his delegations on any of his foreign trips? For a PM who has extensively travelled the world, to criticise highly educated doctors for traveling abroad is so unbecoming! Doctors interact with experts from other countries for learning, continuing medical education, and just because Indian politics has screwed the nation into poverty, doctors cannot stop that interaction which is a standard learning process all the world over. Just as Indian politicians who go abroad for treatment to Singapore and London etc. don’t go there to have fun, doctors too do not go for just fun but for a grand purpose: to bring in new knowledge and skills to Indian people.

Then he said that he “enquired” about stents and found that doctors were “”duping” / deceiving all patients into buying costly stents. The PM has himself said in many speeches that he is not educated much, any medical discussion needs high standards of education, scientific proofs and statistics. I am sure that the right people / departments / doctors were consulted by the PM before taking such decisions. Why did he then say “I found out and changed this” rather than “our medical experts / team did this” ? Under the privacy laws no one will know what stents go into which class of people, but from what the doctors see, most politicians and high placed officers opt for “the best and imported”. © Dr. Rajas Deshpande

We wish that the PM, on his next foreign trip on an international platform, also speaks about the state of the government-run hospitals, the federal funding for healthcare, the quality of healthcare provided at rural and primary healthcare centers all across India, the gross inadequacy of staff and the absence of specialists, ICUs, Operation Theatres, in almost all government-run hospitals.

We also wish the PM speaks on an international platform about the state of hostels for undergraduate and postgraduate medical students in India, where they have to live about 4-6 people in a small single room, while the huge luxurious premises for various govt. officers and ministers lie vacant most of the time.© Dr. Rajas Deshpande

We wish the PM also speaks about the good doctors (all his recent speeches imply that there are no good doctors in India), extraordinary medical achievements of Indian doctors, about those who serve in rural India while facing humungous difficulties, those who bring medical tourism to India, those who run so many charity hospitals, those who bring world class healthcare to Indian patients, those grassroot doctors and paramedics who effectively carry out the govt’s schemes all year round by hard work, including polio and other vaccinations, mother-child care etc. without “just once posing” for the media?\

Even under various govt. health schemes, the poorer class patients go to cheaper general wards, while a senior officer from the same office will receive premium class healthcare at a private hospital. This “class-discrimination” in healthcare by govt is not justified. Wish the PM spoke about this too.

Will the PM also speak about the doctors/ health department officials and ministers who help him bring good changes in Indian Healthcare? If the entire modern medicine profession was so bad, why doesn’t the PM ban it completely and provide healthcare with different Babas and Gurus so rampant with powerful blessings today?

We so much wish that the PM speaks on an international platform how he justifies brutal violence against doctors all over India.

India deserves far better healthcare. But that starts with the facilities for majority: at the level of government-run hospitals, healthcare facilities all over India, reachable for the common man, affordable equally to all classes. © Dr. Rajas Deshpande

Unless all the government hospitals provide high quality free healthcare to all without discrimination, unless all the problems that the govt can resolve in a day by sanctioning adequate staff and funds for government-run healthcare are sorted out, it is futile to just increase the gap between the doctor and patient by blanket-defamation and maligning of the private healthcare on public platforms, especially international. Incidentally, our private hospitals also cater to millions of poor and the very ministers who run the country.

I have nothing personal against any political leader or party, I am hopeful of good changes happening in Indian healthcare. But I feel compelled to speak about the other side, the good doctors who are the pride of our country. I must defend the good in my profession, because I love it just as I love my patients, just as I love my India.
© Dr. Rajas Deshpande

The “Cheap Competition” among Doctors: a Hidden Cancer.

The “Cheap Competition” among Doctors: a Hidden Cancer.
©Dr. Rajas Deshpande
Neurologist, Pune.

A majority of medical students in India are actually from poor or middle class background. Most students come in this profession for service to the suffering and also for social respect. Every doctor passing out in India does not pay crores of rupees for education. This is a system created and maintained by all governments for their strongmen as a source of huge earnings. Many of these “paying” students also work hard and earn their degree. However some few look at the amount spent as an investment and try to earn it back by unfair means. This is NOT the fault of the majority of good doctors (both non-paying and paying) who work hard to acquire their skills and help the society. © Dr. Rajas Deshpande

As the society expects “cheapest” advice even for most complicated health issues, some newcomers, those who are under qualified, those who do not have a good number, and some who don’t have the confidence keep their “Consultation fees” quite low, and rely upon alternate income: through tests, procedures and surgeries, through percentage in hospital bills. Thus, though the ‘entry ticket’ is low, the ‘hidden charges’ compensate for the doctor’s (genuine) hard work and skill.
However, not all ‘low fees’ doctors are bad, but keep their rates low to be able to compete, no one wants to criticise those who have low fees for ulterior motives. This competition to keep the consultation fees low to attract patients has generated most evils in the medical practice. Unfortunately, this is unlikely to change soon, as most people prefer this.© Dr. Rajas Deshpande

The low “Consultation fees“ model works best for even good, skilled and experienced surgeons and branches with procedures (plasty/ scopy etc.), where the patient usually does not question the charges for the procedures or surgery, just because every patient prefers best skilled doctor. There is also a recent trend to offer even “procedures and surgeries” at a competitive low cost by some hospitals, who employ the inexperienced or inadequately qualified/ trained doctors, beginners, lowest skilled nurses, technicians and other staff and instrumentation, catheters, joints, other prostheses. The whole show will be put up for “short term goals”, risking patient’s life and compromising many aspects of good care. In many “cheap packages”, the long term outcomes may be at risk.

Those who run hospitals have many profit sources: right from the tea sold inside the hospital campus to the room charges, pathology and radiology, nursing, drugs and everything used, they earn profits under multiple headings. This is also why they can afford to keep their consultation fees extremely low. However, most doctors employed at such hospitals are not paid anything besides their own low consultation fees, while they remain the face of the “total-bill” for all patients. This system encourages rich doctors who invest in alternative sources of income than the consultation fees alone. © Dr. Rajas Deshpande

Physicians / specialists must rely only upon their OPD consultation and IPD visits. If a proper examination is to be done in each case, and all questions of every patient are to be addressed, one cannot see more than 20-25 patients in a day. Thus if he / she keeps low fees, it becomes difficult to sustain in any Indian city. So they must see as many patients as they can, only addressing the immediate medical issue, and unable to answer many queries of the patient and relatives. If a good doctor decides to spend more time with each patient, and gives up relying upon the “hidden income”, he must charge a much higher consultation fees to just sustain in a good city.

The social anger against doctors mostly comes from increased expenditures on health and unrealistic expectations. Although there are greedy doctors, a majority are just doing their best to make a good name by offering the best service at a low price. Quality healthcare will always come with a higher price-tag, a good doctor will have a higher fees, and that if one wants the “backdoor / cut / referral practice “ to end, one must be prepared to pay higher fees.

In a country where loud and sweet talk, deception and lies are preferred by majority over genuine service, honesty and truth, it is difficult to change the basic attitudes: on both sides..

There indeed are some honourable doctors and hospitals who know the value of their own service, and offer the best to their patient. But even they are usually considered “Greedy” by the very patients whose miseries they end. There are senior / skilled doctors who charge from three to ten thousand or more per consultation, and most of our powerful and ministers go to these doctors too. Although this consultation fees appears high, the accuracy of the opinion and advice often save the patients lacs of rupees. If a surgeon advises a surgery, he/ she can earn many thousands, but if the same surgeon with his skills and experience treats the patient conservatively, avoids surgery and gets good results, the patient is unwilling to pay even half the price of that surgery for the same result. What would anyone do in such a case? The concept that “A Right Opinion by the Right Specialist” saves the patient huge amounts of money and discomfort is yet to dawn upon the Indian society.

The market of cheap has always survived, but in the long run, cheap options always come with a greater final price tag upon health: often your life.

It is my sincere appeal to all my fellow practitioners from the newer generations to please change this structure. See a moderate number of patients per day, charge according to your skill, experience and time, do not undercharge or bargain, then alone this system of backdoor incomes will gradually change. Of course you must consider concessions for the really poor, and accommodate those who cannot pay by keeping a separate time/ OPD for them.

© Dr. Rajas Deshpande
Neurologist, Pune.

PS:
Many city-based imbeciles without any doctor in their family will immediately say that all doctors should go to villages. Those who suggest that, please make your own children (if you have) doctors (if they have the caliber) and send them to villages. Why doesn’t the government make it compulsory for every mla and mp who draws lifelong financial benefits from the country’s exchequer, to send their kids to medical schools and serve in rural India compulsorily? Why is it not compulsory for the elected members to take all treatment in their own electorate? Every law is bent every which way possible to accommodate the healthcare requirements of all the rich and powerful, whether it is kidney transplant or joint replacement, but when extending healthcare to the poor and unaffording, the same people from various ruling parties conveniently point fingers at the medical professionals!

Please share unedited.

एक आशीर्वाद का रंग (डॉ. बाबासाहेब आंबेडकर की स्मृति को समर्पित)

एक आशीर्वाद का रंग
(डॉ. बाबासाहेब आंबेडकर की स्मृति को समर्पित)
© डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट पुणे

दवाई की मात्रा को सावधानी से गिनकर मैंने इंट्रावेनस सोल्यूशन तैयार किया. सुई पहले से ही लगाकर रखी थी. “मैं दवाई का इंजेक्शन शुरू कर रहा हूँ. अगर कोई भी तकलीफ हो तो तुरंत बताइये, मैं यहीं बैठा हूँ” मैंने उस बूढी औरत से कहा. अपने दर्द की परतों के पीछे से वह मुस्कुराई. उसका बेटा, मेरा लेक्चरर डॉ. एसके , वहीँ खड़ा था. उसने अपनी माँ के सर पर हाथ रखा, और कहा, “ये मेरा विद्यार्थी यहीं रुकेगा. मुझे बाकी पेशंट देखने हैं, आज काफी भीड़ हैं. तू चिंता न कर माँ, अगर कुछ जरूरत हो तो इसे बता देना”. वह चला गया.

डॉ. एसके की माँ को कैंसर के लिए कीमोथेरेपी दी जा रही थी. इसमें से एक दवाई का सॉलूशन तैयार करना और उसे इंट्रावेनस (खून की नसों में से) बराबर मात्रा में देना काफी मुश्किल काम था. मेरे गाइड डॉ. प्रदीप (पिवाय) मुळे ने मुझे कुछ दिन पहले ही इस दवाई के बारे में सिखाया था, इसलिए डॉ. एसके ने मुझे बुलाया था. मैं तब एक सरकारी दवाखाने में अपने एमडी मेडिसिन के पहले वर्ष का रेजिडेंट डॉक्टर था.

कुछ समय के बाद मैंने देखा की उस पेशंट की यूरिन बैग (पेशाब की थैली) पूरी तरह से भर गई थी. वार्ड में काम करने वाली मौसी किसी और काम से बाहर गई थी. ऐसे हालात में एक रेजिडेंट डॉक्टर को हर काम करना पड़ता है. मैंने ग्लव्स / दस्ताने पहनकर नर्स से एक बाल्टी मांगी, और यूरिन बैग से उसमें पेशाब निकलकर वार्ड के बाथरूम की तरफ चल पड़ा. तभी डॉ. एसके वापिस आ गए. उन्होंने मुझसे वह बाल्टी मांगी, कहा “मैं ले जाता हूँ” पर मैंने कहा के मैंने ग्लव्स पहने हैं, मैं ही रखकर आता हूँ. मैंने वह बाल्टी वार्ड के बाथरूम के बाहर रख दी, मौसी बाद में उसे साफ़ कर देती. © डॉ. राजस देशपांडे

जब दवाई ख़त्म हुई, तो डॉ. एसके ने मुझे चाय पीने के लिए साथ चलने के लिए कहा. हॉस्पिटल के पीछे ही एक छोटी सी चाय की दुकान थी. थोड़ा हिचकिचाने के बाद उन्होने कहा : “सुनो, ग़लतफ़हमी न हो, लेकिन जब मैंने देखा कि तुम मेरी माँ के पेशाब की बाल्टी लेकर जा रहे थे, मुज्झे अचम्भा सा हुआ. तुम ब्राह्मण हो ना? जब तुम बाहर थे, तो मेरी माँ ने भी मुझ पर गुस्सा किया, और कहा, क्यों मैंने तुम्हे वो बाल्टी उठाने दी. हम बहुजन समाज से आते हैं. तुम्हे पता भी होगा, मैं अपने समाज के एसोसिएशन का नेता हूँ.”.

मुझे पता था. डॉ. एसके के नाम से काफी लोग डरते थे. पर एक निहायत बेडर और आक्रामक नेता होने के बावजूद वो एक अच्छे दिलवाला इंसान भी था. जब भी किसी पर अन्याय होता, तोह बिना जाति-पाती के बारे में सोचे वो उसकी मदद करता. गरीबों के लिए उसे विशेष प्रेम और सहानुभूति थी. किसी तरह का भेदभाव उसे पसंद नहीं था.

मैंने कहा “सर, मैं ये सब नहीं सोचता. पेशेंट तो पेशंट ही होता है, पर यहाँ वो आपकी माँ भी हैं, जो भी उसके लिए करना पड़े मेरा तो कर्त्तव्य बनता है. मैं अपने मन में कभी जाति-पाती का विचार न करूँ, न ही कभी किसी से भेदभाव करूँ, ये ही तालीम मुझे मेरे माता पिता ने मुझे बचपन से दी है”. © डॉ. राजस देशपांडे

“ठीक है”, उन्होंने कहा, “मेरा तुम्हारे बारे में कोई पूर्वग्रह / प्रेज्यूडिस था, वो अब चला गया. अगर तुम्हे कोई भी विपत्ति कभी भी हो, तो बड़ा भाई समझकर मुझे बता देना.” . कितनी ईमानदारी और धैर्य से उन्होंने एक कठिन बात को सरलता से कहा था!
जबतक अपने आप को दुसरे भारतीयों से ऊंचा या अलग समझने वाले हर भारतीय को कोई पश्चिमी जातिवादी (रेसिस्ट) “ब्राउन / ब्लैक” कहकर नीचा नहीं दिखता, उसे भेदभाव का दर्द नहीं समझ सकता.

संयोग से, कुछ दिन बाद ही, मेरी अपने एक प्रोफेसर से कुछ तू तू मैं मैं हो गई . उन्होंने मुझे अपने चैम्बर में बुलाकर कहा ” जब तक मैं तेरा एग्जामिनर हूँ, तू पास नहीं होगा”. मैं परेशान हो गया. मेरी आर्थिक स्थिति तो खस्ता हाल थी ही, पर मेरा बेटा अभी छोटा सा था और मेरे माँ-बाप मेरे वापिस आकर उनके पास रहने कि आस लगाए बैठे थे. फेल होना मेरे लिए बहुत बड़ी मुश्किल खड़ी कर देता. © डॉ. राजस देशपांडे

मैंने डॉ. एसके से मिलकर मेरी परेशानी बताई. वो मुझे उस प्रोफेसर से मिलने ले गए. पहले उन्होंने मुझसे कहा के मैं उस प्रोफेसर से माफ़ी मांगू, बहस के लिए. मैंने माफ़ी मांग ली. फिर उन्होंने उस प्रोफेसर से कहा “राजस मेरा छोटा भाई है.इसे कभी कोई धमकी न देना. अगर ये परीक्षा में अच्छा परफॉर्म करें, तो इसे पास कीजिये, अगर नहीं, तो आप इसे भले ही फेल कीजिये. लेकिन अच्छा परफॉर्म करने के बावजूद भी अगर ये फ़ैल होगा, तो मैं जरूर आप के खिलाफ आवाज उठाऊंगा. बाकी तीन परीक्षकों से मैं पूछूंगा”.
प्रोफेसर साहब ने तब कहा के उन्होंने ज्यादा गुस्से में मुझे धमकी दी थी, उनका मुझे फ़ैल करने का कोई इरादा नहीं था. बात यहीं मिट गई.

परमात्मा कि कृपा, अच्छे गुरुजन और कड़ी मेहनत के कारण मैं अपनी एमडी मेडिसिन कि परीक्षा पहली ही बारी में ही पास हो गया. जब मिठाई लेकर मैं डॉ एसके के पैर छूने पहुंचा, तो उन्होंने मुझे अपनी माँ से भी मिलाया. उस ने अपने बटुए से सौ रुपये निकलकर मुझे दिए ही, पर बहुत प्यार से ढेर सारे आशीर्वाद भी दिए. © डॉ. राजस देशपांडे

अपने स्कूल और कॉलेज के दिनों में मेरे बहुत सारे दोस्त थे, समाज के सारे वर्गों से. विद्यार्थी कभी जाति के बारे में सोचकर दोस्त नहीं बनाते. कॉलेज के दिनों में मेरे डॉ. बाबासाहेब आंबेडकर एसोसिएशन के कार्यकर्ताओं से बहुत अच्छे सम्बन्ध थे, क्योंकि दो बार जब मैं किसी अन्याय के खिलाफ अकेला झगड़ रहा था, कोई साथ नहीं दे रहा था, तब उन्होंने मेरी बहुत मदद कि, उन्ही के कारण मैं अपनी ज़िन्दगी कि दो बड़ी लड़ाइयां जीत सका.

डॉ. बाबासाहेब आंबेडकर के पास दुनिया का सबसे प्रभावशाली अस्त्र था: फाउंटेन पेन. यह भी एक कारण है जो मुझे उनके प्रति बहुत आदर है. किसी और शस्त्र-अस्त्र कि जरूरत ही आदमी को नहीं है! समाज के दो समुदायों के बीच का कोई भी वाद-विवाद कभी भी झगड़ा या हिंसाचार से खतम नहीं हो सकता. एक-दुसरे के प्रति आदर और प्रेम दिल में रखकर साथ चलने से ही हम सारे समाधान खोज सकते हैं.

भाग्यवश, भारत में कोई भी डॉक्टर किसी भी पेशंट के बारे में सोचते हुए जाति-पाती का विचार नहीं करता. जैसे कोर्ट के आँगन में एक जज का अमल सर्वोच्च होता है, वैसे ही भारत के हर मेडिकल कैंपस में इंसानियत ही सर्वोच्च मानी जाति है. ह्रदय हो या खून, दिमाग हो या सांस, ये किसी भी जाति के अलग नहीं होते. बड़े दिमाग कि तरह ही एक बड़ा दिल भी मानव कि उन्नति का एक प्रमुख मानदंड है. © डॉ. राजस देशपांडे

मेरा सपना, मेरी प्रार्थना है कि समाज के विभिन्न घटकों के बीच में विभाजित विचारों के ये काले बादल हमेशा के लिए नष्ट हों. हम सारे एक दुसरे को अपनी जैसा ही केवल एक इंसान समझें, कोई भेदभाव न रहे. विद्यार्थियों में हर दरवाजा खोलने की, हर दीवार तोड़ने की क्षमता होती है, उनसे हमें बहुत उम्मीद है.

किसी भी भेदभाव को न मानते हुए हर पेशंट कि ज़िन्दगी और स्वस्थ्य के लिए दिन रात काम करने वाले वैद्यक समाज में से एक होने का मुझे गर्व है. अपनी प्रैक्टिस से बाहर भी, मेरा ये मानना है के जिस भी भगवान कि मैं पूजा करता हूँ, वही मिझे मिलने वाले हर व्यक्ति में मौजूद हैं.

एक पेशंट के आशीर्वाद का कोई रंग नहीं होता, दुआ कि कोई जाति यही होती. एक डॉक्टर होने के नाते मेरा धर्म, मेरी जाति, और मेरा कर्त्तव्य सारे एक ही है: सिर्फ इन्सानियत.

डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट
रूबी हॉल क्लिनिक पुणे

जरूर शेयर करें.

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

Carefully calculating the dose and mixing it with the intravenous fluid with precision, I told the kind old lady: “I am starting the medicine drip now. If you feel anything unpleasant, please tell me.”

Through her pain, she smiled in reply. Her son, my lecturer Dr. SK, stood beside us and reassured her too. He had to leave for the OPD, there already was a rush today. “Please take care of her and call me if you feel anything is wrong” he said and left.

Dr. SK’s mom was advised chemotherapy of a cancer. It was quite difficult to calculate its doses and prepare the right concentration for the intravenous drip. Just a month ago, my guide Dr. Pradeep (PY) Muley had taught me how to accurately prepare and administer it, so when Dr. SK’s mom was admitted, he requested me to do it for her too.

The drip started. After a few hours, I noticed that her urine bag needed emptying. The ‘mausi’ supposed to do it was already out for some work. Any resident doctor in India naturally replaces whoever is absent. So I wore gloves, requested a bucket from the nurse, and emptied the urobag into it. Just as I carried the bucket with urine towards the ward bathrooms, Dr. SK returned, and offered to carry it himself, but I told him it was okay and went on to keep the bucket near the bathroom where the ‘mausi’ would later clean it. © Dr Rajas Deshpande

Once the drip was over, Dr. SK invited me for a tea at a small stall outside the campus. He appeared disturbed. He said awkwardly: “Listen, please don’t misunderstand, but when I saw you carrying my mother’s urine in the bucket, I was amazed. You are a Brahmin, right? When you were away, my mom even scolded me why I allowed you to do it, she felt it was embarrassing, as we hail from the Bahujan community. I am myself a leader of our association, as you already know”.

I knew it, to be honest. His was a feared name in most circles.He was a kindly but aggressive leader of their community, but always ready to help anyone from any caste or religion, to stand by anyone oppressed, especially from the poor and discriminated backgrounds.

“I didn’t think of it Sir! She is a patient, besides that she’s your mother, and I am your student, it is my duty to do whatever is necessary. Otherwise too, my parents have always insisted that I never entertain any such differences”. I replied. © Dr Rajas Deshpande

“That’s okay, but I admit my prejudice about you has changed,” he said. “If you ever face any trouble, consider me your elder brother and let me know if I can do anything for you”. What an honest, courageous admission! Unless every Indian who thinks he / she is superior or different than any other Indian actually faces the hateful racist in the West who ill-treats them both as “browns or blacks”, they will never understand the pain of discrimination!

As fate would have it, in a few months, I had an argument with a professor about some posting. The professor then called me and said “So long as I am an examiner, don’t expect to pass your MD exams.”

I was quite worried. My parents were waiting for me to finish PG and finally start life near them, I already had a few months old son, and our financial status wasn’t robust. I could not afford to waste six months. © Dr Rajas Deshpande

I went to Dr. SK. He asked all details. Then he came with me to the threatening professor. He first asked me to apologise to the professor for having argued, which I did. Then he told the professor: “Rajas is my younger brother. Please don’t threaten him ever. Pass him if he deserves, fail him if he performs poor. But don’t fail him if he performs well. I will ask other examiners”.

The professor then told me that he had threatened me “in a fit of rage”, and it was all over.

With the grace of God, good teachers and hard work, I did pass my MD in first attempt. When I went to touch his feet, Dr. SK took me to his mom, who showered her loving blessings upon me once again, and gifted me a Hundred rupee note from her secret pouch. © Dr Rajas Deshpande

Like most other students, I’ve had friends from all social folds at all times in school and colleges. I had excellent relations with the leaders of Dr. Babasaheb Ambedkar Association, and twice in my life they have jumped in to help me in my fight against injustice when everyone else had refused. I love the most fierce weapon of all that Dr. Babasaheb Ambedkar himself carried: the fountain pen!

No amount of fights will ever resolve any problems between any two communities, the only way forward is to respectfully walk together and find solutions. Fortunately, no doctor, even in India, thinks about any patient in the terms of their religion or caste. (© Dr Rajas Deshpande). Just like the Judge in the court premises, humanity is the single supreme authority in any medical premises. Blood or heart, brain or breathing are not exclusive to any religion or community. Just like the bigger brain, a bigger heart is also the sign of evolution.

I so much wish that the black clouds of disharmony between different communities are forever gone. The only hope is that our students can open any doors and break any walls, so long as they do not grow up into egoistic stiffs. © Dr Rajas Deshpande

I am proud to belong to the medical cult of those who never entertain any discrimination. A patient’s blessing has no coloured flags attached! Even outside my profession, I deeply believe that the very God I pray exists in every single human being I meet. If at all anyone asks me, I am happy to say that:

My religion, my caste and my duty as a doctor are all one: Humanity first!

© Dr Rajas Deshpande

Neurologist

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विलुप्त चिकित्सक: एक भयंकर घटना.

28378266_1572654156163240_5674072141041150378_nविलुप्त चिकित्सक: एक भयंकर घटना .

© डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट, रूबी हॉल क्लिनिक पुणे.

“सर हम कोंकण से आये हैं” उस पिता ने कहा, “आप से कुछ सलाह लेनी थी और मेरे बेटे के लिए आर्शीवाद भी लेने थे. डॉक्टरी की पोस्ट ग्रेजुएट परीक्षा में मेरे बेटे ने बहुत अच्छा रैंक पाया है. उसे किसी भी विषय में एम्. डी. या एम्. एस. मिल सकता है. अब आप ही बताइये उसकेअच्छे भविष्य के लिए उसे किस विषय में पोस्ट ग्रेजुएशन चुनना चाहिए”.
मैंने उस जीनियस विद्यार्थी को बधाई दी. मेडिकल में कोई भी परीक्षा अच्छी श्रेणी में पास होना बहुत कठिन उपलब्धि होती है. इसके लिए टैलेंट के साथ साथ कड़ी म्हणत भी जरूरी होती है. लेकिन ऐसी बौद्धिक उपलब्धियों को हमारे देश में कोई नहीं सराहता. हमारा समाज सिर्फ बाहरी सुंदरता, बॉडी बिल्डर्स, ग्लैमर, पैसेवाले लोग भाषणबाजी करने वाले तथा क्रिकेट खेलनेवालों को सर आँखों पर रखता है!
कुछ देर उस विद्यार्थी से बात करने पर मुझे ये यकीन हुआ के वह काफी दयालु, शांत, मेहनती और संवेदनशील था. उसका तर्क-वितर्क तथा विश्लेषण निर्दोष तो था ही, पर उसकी विचार क्षमता भी प्रशंसनीय थी. एक अच्छा चिकित्सक / शल्यचिकित्सक बनने के लिए जरूरी सारे गुण इस डॉक्टर में थे. दुनिया में ऐसे डॉक्टर दिनबदिन कम होते जा रहे हैं. मैंने उसे मेडिसिन विषय में एम्. डी. करने की सलाह दी. © डॉ. राजस देशपांडे

थोडासा कतराते हुए उसने कहा, “सर मैंने हमारे फॅमिली डॉक्टर को एक गुंडे राजनितिक से बुरी तरह पीटते देखा है. जब उन गुंडों ने हमारे डॉक्टर की पिटाई करते हुए उनके बीवी-बच्चों के सामने उन्हें अश्लील गालियां दी, तब उनके बाकी पेशेंट इस घटना का वीडियो ले रहे थे, बजाय के उस डॉक्टर की मदद करें. डॉक्टर साहब अपनी फॅमिली के साथ शहर छोड़ गए , पता नहीं कहाँ. अब मैं पेशेंट्स से संपर्क वाली किसी भी ब्रांच में नहीं जाना चाहता”.

मैंने उसके पिता से अनुरोध किया: “आपके बेटे में एक बढ़िया चिकित्सक होने के लिए आवश्यक सारे बेहतरीन गुण मौजूद हैं. हमारे देश को, सारी दुनिया को ऐसे डॉक्टरों की कड़ी ज़रुरत हैं. ये जरूरी नहीं के वह आपके शहर में या भारत में ही प्रैक्टिस करे. कृपया इसके बारे में सोचिये, अच्छे डॉक्टर आजकल नहीं मिलते. अगली पीढ़ी के बारे में भी सोचिये”.© डॉ. राजस देशपांडे

उस व्यथित पिता ने कुछ देर सोचकर कहा, “पता नहीं सर, क्या करें. जब इसने कहा के ये डॉक्टर बनेगा, तो इसकी माँ और हमने सोचा की ये बहुत लोगों की सेवा करेगा, बहुत लोगों की जान बचाएगा. पर जब हमने अपने हो फॅमिली डॉक्टर को एक बदमाश राजनितिक और उसके साथ वाली भीड़ के हाथों पीटते देखा, तो हम समझ गए की इस देश का डॉक्टर कितना मजबूर और असुरक्षित है. हमारे फॅमिली डॉक्टर को तो लोग भगवान मानते थे, पच्चीस सालों से सारे गांव के लोगों की उन्होंने सेवा की थी, पर जब एक गुंडा और उसके साथी उन्हें पीटने लगे, तो उनका किया सारा अच्छा काम एक मिनट में सारे भूल गए. उनके मार खाते वीडियो वायरल बने, मीडिया ने उन्हें सारे देश के सामने जलील किया. हम नहीं चाहते हमारे बेटे को कभी ऐसे लोगों से उलझना पड़े. अगर इसकी जगह बेटी होती, तो उसे डॉक्टर भी नहीं बनाते, क्योंकि हमारे देश में एक स्त्री डॉक्टर को न ही सिर्फ ऐसे गुंडे सताते हैं, पर उनको दोगनी मेहनत भी करनी पड़ती है. ये हमरा इकलौता बेटा है, हम चाहते है के ये हमारे पास ही भारत में रहे”.

फिर उन्होंने पूछा: “वैसे अगर इसकी जगह आपका बेटा होता तो आप क्या सलाह देते?”

इस सवाल से मेरे दिमाग में एक विस्फोट-सा हुआ.
मेरे माता पिता ने, शिक्षकों ने तो मुझे हरदम अच्छाई, ईमानदारी और सहिष्णुता की राह चलना सिखाया था. अगर मेरे बेटे डॉक्टर बनते, तो वे भी यही सीखते, बहुत अच्छा डॉक्टर बनने की क्षमता उनमे थी. ये भी सोचकर मेरा दिल दहलता है के कुछ ही सालों में अच्छे डॉक्टर करीब करीब विलुप्त होंगे. अगली पीढ़ी को अच्छी वैद्यक-सलाह मिलना नामुमकिन होगा. पर फिर भी, मैं अपने बच्चों को डॉक्टर बनाना नहीं चाहता था. ये अलग बात है के मेरी हालत, जिन कठिनाइयों का सामना मैंने किया उन्हें देखकर मेरे बेटों ने खुद ही अलग राह चुनी, पर मैंने भी कभी उन्हें डॉक्टर बनने के लिए प्रोत्साहित नहीं किया. हर पिता चाहता है उसकी औलाद एक अच्छी और सुरक्षित जिंदगी जिए, मगर भारत में एक डॉक्टर के लिए ये मुमकिन ही नहीं. मैं नहीं चाहता के मेरे बेटे सालों कड़ी मेहनत करके लोगों की जान बचाते हुए भी गुंडे-मावली तथा राजनीतिकों की दहशत में अपनी ज़िन्दगी गुजारें. मैं नहीं चाहता के अनपढ़, गँवार लोगों की बनी कमिटियां उनकी तनख्वाह तय करें. मैं अपने बेटों को मुफ्तखोरों के वोटों के भिखारी राजनीतिकों की जंजीरों में नहीं बांधना चाहता. © डॉ. राजस देशपांडे

जो विचार मैं अपने बेटों के लिए करूँ , वही अगर मैं उनके बेटे के लिए नहीं करूँ तो ये तो पाखंड हुआ! हर अच्छा डॉक्टर अपने हर पेशंट के लिए ऐसे ही तो निर्णय लेता है.

मैंने उसे वही बताया जो मैंने अपने बेटों से हरदम कहा : “जिस काम से तुम्हारे मन को ख़ुशी मिले, ह्रदय में शांति बानी रहे, तुम्हे खुद के लिए और अपनों के साथ गुजरने के लिए वक़्त मिले, जिस काम से अच्छी कमाई तो हो, पर कोई और आपकी कीमत नहीं तय करे ऐसा काम, ऐसे विषय में पोस्ट ग्रेजुएशन चुनें. समाज सेवा के तो बहुत अवसर मिलेंगे, एक अच्छा इंसान होने की मिसाल आप बनें, भले किसी भी विषय में हो”. मैंने उसे दो पोस्टग्रेजुएट विषय भी सूचित किये, जिनमे ये सब संभव था.

ये सच्चाई अब हमें स्वीकार करनी होगी, के अच्छे डॉक्टर अब विलुप्त हो रहे हैं. डॉक्टरों की संख्या बढ़ते हुए भी आजकल पेशंट एम्बुलेंस में सफर करते हुए रास्ते में ही मर जाते हैं, क्योंकि अच्छे दवाखाने भारत के लगभग सभी घरों से दूर हैं. कुछ अनाथ तो सरकारी दवाखाने का भी खर्चा नहीं उठा पाते, जो घर में ही तमाम हो जाते हैं.

उस पिता ने बेटे से मेरे पैर छूने को कहा. जब उसने मेरे पैर छुए, तो मुझे अपनी ही सलाह की उदासीनता काट गयी. अपने महान डॉक्टरी पेशे का मैं कभी भी अवमान नहीं होने देना चाहता. © डॉ. राजस देशपांडे

“देखो बेटे, मैं ये बात अपने उसूलों के खिलाफ कर रहा हूँ. मैं भी जूझ रहा हूँ इस बात से!. पर आप एक अच्छा चिकित्सक होने के बारे में ज़रूर सोचो, भले ही आप किसी और सुरक्षित देश में अपना व्यवसाय करो. अपने माता-पिता को भी आप अपने साथ ले जा सकते हो. आप खुद की ख़ुशी के लिए जो भी पर्याय चुनोगे, वो अच्छा ही रहेगा, पर एक उत्कृष्ट चिकित्सक या शल्य चिकित्सक बनना हर किसी के बस की बात नहीं, इसके लिए असाधारण टैलेंट आवश्यक तो है ही, पर एक दुर्लभ विशेषता आपके व्यक्तित्व में होनी चाहिए, जो बहुत कम डॉक्टरों में पाई जाती है. मुझे आशा है आप इसके बारे में सोचोगे”.

मेरा शुक्रिया अदा करके जैसे ही वे दोनों बाहर निकले, एक युवा युगल अपने शिशु को लेकर अंदर आ गया. माता पिता की गोद में वह बेखबर शिशु खुश था, मुझे भी उसने एक मीठी-सी मुस्कान दी. उस मासूम नन्ही जान को ये अभी पता नहीं था के मैंने उसके भविष्य के लिए एक कीमती तोहफा अभी अभी बनाया था!

© डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट, रूबी हॉल क्लिनिक पुणे.

ज़रूर शेयर करें

The Extinction of Precious: A Medical Horror Story Happening Right Now!

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The Extinction of Precious:
A Medical Horror Story Happening Right Now!
©️ Dr. Rajas Deshpande

“Sir, we have come from Konkan”, said the father, “to seek your advice and blessings . My son has passed the medical postgraduate exams with national rank 30. He wants to decide which branch he should choose”.

I congratulated the genius. Passing medical entrances with high merit requires great talent. It does not earn the glamour, claps and appreciation of stage and limelight, for we live in a society that only worships looks, muscles, bhashanbazi, financial success and sports (sorry, one sport. Even if someone wins a world gold in any other sport than cricket, they go home in an auto rickshaw when they return to India!).

Speaking with the boy, I realised that he was very sensitive, compassionate and had an excellent logic and reasoning. Besides having a calm bearing, he was also a hard worker. A perfect blend for becoming a great physician or a surgeon, in a world that is fast losing able clinicians. I suggested him to prefer Internal medicine.© Dr. Rajas Deshpande

They looked awkwardly towards each other. The boy garnered some courage to speak.

“Sir, I saw our family doctor being beaten up by a local politician, his clinic was ruined. He was humiliated in the worst language in front of his wife and children, and instead of protecting him, other patients in his hospital kept on recording videos of the incident, which later became viral. He left, we don’t know where he went. I cannot ever think of directly dealing with patients now. I want to choose a non- clinical or para-clinical branch.”

I appealed to the father: “Your son has a great potential and matching talent to become a good clinician, we desperately need many more. It is not necessary that he practices in your own town or even in India. The whole world needs good doctors. Please think about this”.

The father, a simple teacher from a primary school, thought for a prolonged moment. His eyes reddened up.
“I don’t know, Sir. When he said he wanted to become a doctor, his mother and I always thought that he will become a saviour, running around saving people’s lives. We were never interested in only money. But the day that we saw our own doctor being beaten up by a crowd and the local politician, we realised how helpless a doctor’s life is. We knew our doctor for over 25 years, he was like a God for many in our town. All he did in 25 years became a zero in a few minutes, thanks to a hooligan politico and his crowd. We don’t want our son to ever face that. If we had a daughter in his place, we wouldn’t even have made her a doctor, women as doctors suffer a lot more trouble and get no returns, sometimes even from their family. And this is our only son, we want him to stay in India near us.”

Somehow I didn’t want to give up convincing him, he was an ideal candidate for becoming an excellent clinician.© Dr. Rajas Deshpande “Think of the future. Hopefully there will be better laws, he can also consider working in bigger, safer hospitals if he is scared”.

“What would you advise your own son if you were in my place, Sir?” asked the father.

He had bombed my mind.
I was trained by parents and teachers to always do good, be compassionate and kind. My kids had a potential to become great doctors coming from this background. I worry a lot about the extremely critical condition of deteriorating healthcare standards and reducing number of good clinicians that is destined to cause a havoc in a few years. Still, honestly, I did not wish upon my children the insecurities and threats I face. I don’t want them to live under the perpetual fear of being vandalised, defamed, tortured by over-expectation and punished by committees made up of politicians and medically inexperienced judicial experts. I won’t want their lives, work hours and remunerations to be dictated by a corrupt bunch living for votes of free mongers.© Dr. Rajas Deshpande

It would be hypocrisy to advise someone else what I wouldn’t choose for myself. That’s how a doctor makes the best possible decision. With a heavy heart, I advised him what I always advised my children:

“I agree. Please choose what suits your heart most, what gives you fearless happiness in your work and also leaves you with some time for yourself and your family, ensures a good income and is not dependent upon jealous people’s expectations of what you should do and for what price. You have so many options for social service other than becoming a clinician. I am sure you will stay a good human being all your life.” I suggested him two para-clinical branches that offer good scope.© Dr. Rajas Deshpande

The world indeed will have to suffer the gradual extinction of good clinicians. We need many more excellent doctors in para clinical and non clinical areas too, but the face of the profession is the clinician, and we certainly, desperately need many thousand more. It is a fact that in spite of increasing number of doctors, patients still die travelling in an ambulance to reach good healthcare far away from most homes in India. Many federal orphans who cannot even afford government healthcare die at home.© Dr. Rajas Deshpande

The father asked his son to touch my feet. As he did so, the melancholy of my own advice bit my heart. I couldn’t let down the flag of my noble profession.

“Listen, dear. I am speaking this against my own convictions. I am struggling. Think about becoming a good clinician and practising in a safe country, take your parents with you. I will be happy whatever you finally decide, but not everyone has the ability and talent to become a good doctor, it is rarest of the rare traits.”© Dr. Rajas Deshpande

They left. So did a part of my hope for the future of good healthcare.

When the next couple walked in with an infant baby in their hands, I looked at the smiling baby, and forced a smile. She didn’t know it yet, but I had just bought a precious gift for her.

©️ Dr. Rajas Deshpande

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