Monthly Archives: August 2018

A milestone: An extremely proud moment for me.

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A milestone: An extremely proud moment for me.

Yash, my elder son (Red Shirt) joins the prestigious New York University for M.S. Data Sciences tomorrow, selected through stringent merit criteria.

I have grown up my children with similar principles as practiced by my parents: to become good human beings, to make the world a little better. I hope they justify this aim.

Many of my well-wishers helped me through this difficult journey (Thank you Axisbank Loans😊). I am grateful to all of them from the deepest corners of my heart!

I may not have been the best parent, but I certainly did my best to do whatever it took to be one. There is no career achievement in any field greater than passing on the power and legacy of “Good and Right” to the future generations.

Two things shook me.
Firstly, our society has taken for granted that fathers are secondary, and we were always bombarded through songs and movies and all possible sources that a life without a mother is meaningless. I think mother is synonymous with God, but so was my father for me. But for kids growing up without a mother, such social “prejudices” are quite offensive. In fact, most fathers I know are equally responsible and involved in the parenting of their children.
Secondly, whenever there was an argument between me and kids, I lacked the spouse-support, especially in matters where kids questioned my decisions and thinking. The only way to handle and resolve this was to explain everything logically, and apply the same rules to myself that were applied to them. I grew up!

A personal note: When I mention how difficult it has been to raise kids as a single parent, most people interpret it as a “bad past memory” that I am unable to “get over”. Some ask me to ‘forget it all’. It is like asking me to forget what I learnt while becoming a doctor. I can’t, because it makes me a better doctor to remember everything I learnt and then avoid the negatives.

The kids (like most) have always been a boon and a bliss, the difficulty was not them but with my highly stressful duty, the availability and the time required to be with them. They understood and supported me, compromised and forgave me, we fought and reconciled, cared for each other, laughed and cried together, and I cherished every moment of it all. Only a single parent who has raised two kids while working as a full time doctor will understand the effort. I don’t regret, repent or sadden myself about anything. I am seeking neither praise nor sympathy: just mentioning it for the many doctors who have to struggle very hard to attend this dual career.

If only, I am proud of our survival story. A major part of my struggle was not only to grow up the children well while not letting this affect my duties as a doctor, but to stay alive at all costs to be available for them till they became self sufficient. Uncertainty surrounds us all, but it haunts doctors worst. I did manage to be around till this day. That’s the milestone I refer to.

Of course there were serious readjustments in career (Thank You, Ruby Hall Clinic for standing by and supporting), compromises in personal life and social interactions (misrepresented for choosing to be asocial), but the reward is in this picture!

I seek blessings from you all to help us become the best we can, to make this world a better place.
Dr. Rajas Deshpande

Illegal Heroes

Illegal Heroes

© Dr. Rajas Deshpande

“I was at the disco last night. We danced a lot, I exceeded my ususal capacity of 180 ml alcohol, and had two or three large pegs extra. I must have smoked a little extra too yesterday, I was too stressed”’ said the 30 year old man, who was admitted one afternoon in an unconscious state. He had had a fit in the office that morning. The MRI had shown a large bleeding / haemorrhage in his brain. This illness, cerebral venous thrombosis, is quite common among those who are dehydrated, those who have untreated sinus infections, and among those who take contraceptive pills. If not treated in time, it can quickly cause brain swelling that may lead to disability or death.

Over next three days he gradually improved. Brain swelling started to recede, and he asked for a discharge. Faster and to-the-point care had improved his condition, thanks to modern healthcare. A psychiatrist had already counselled him about deaddiction. When we sent his file for discharge, his mediclaim insurance was declined because this illness was related to alcohol consumption. Immediately, his tone became bitter, his colleagues dissected the case papers asking for justification of each test, each medicine, and also why he was even hospitalised. Gratefulness is often waived off by doctors as a lost quality among saved patients, but it is difficult to tolerate arrogant distrust. We firmly explained him what was done and why.

“We will pay your bills, we will claim the insurance later, but you must change your notes, remove alcohol and smoking from his papers” said the patient’s brother.

“We cannot change the case notes, it is illegal. Also, we have already sent copies to the insurance company, a standard procedure. You are not obliging us by paying the bills, we have provided healthcare service that saved your brother, who was about to die due to alcohol consumption” we replied.

Within an hour, a local politician, an elected member, who came in his Range Rover with his personal armed bodyguards and human doggies, started his anti-medical show that had drama, emotion, tragedy, threats of violence and revenge and everything else but truth and honesty. He spoiled the day for everyone involved, caused disruption of hospital work for over six hours, and left with a threat of “burning down the hospital soon”. When our PRO asked him whether he wants to pay the bills of this patient to help them, his reaction was the hallmark of a true politician: change of topic to how the medical profession has lost its reputation.

Almost every doctor, every hospital in India is being threatened and pressurised by our own lawmakers at almost all levels into changing facts, writing false details, extorting concessions for the rich and poor both, only to increase their own vote banks at the cost of the healthcare industry. Most politicians, many government officers instead of financially helping the patient, ask the hospital to treat free or cut off bills.

How legal is this authority? If a politician writes to a court or lawyer or hotel or an Airline to waive off fees/ bills of a poor person, will they ever? Why are the doctor’s services and hospitals taken for granted here? How sad that such illegal means make pseudo-Heroes in our country!

Everytime the politicos pressurise a doctor or a hospital to treat their paying cronies free or concessional, some other truly deserving patient suffers because hospitals, small or big, can only do a certain level of charity. How fair is it to deny healthcare to the deserving poor just because they cannot flex a political muscle? This phenomenon is ruining the whole purpose and concept of charity healthcare measures all over India.

Aren’t these elected members responsible for the disgusting state of the civil and government hospitals and healthcare all over India? That is their domain of authority. This is like messing up one’s own home and family and requesting the one with a better home and family to pay and comply for one’s own needs. How shameful is it for the elected members of different parties to have to send people, especially the poor, to the private hospitals, because their own set-ups are failing perpetually? Empty posts, inadequate staff, poorest funding, non-availability of quality technology and medicines and red tapism have created massive monuments of the healthcare failures of different lawmakers all over India, and these are the very people who come threatening to the hospitals of burning them down! Hear this, any Milord?

If the honourable Prime Minister and Health Minister invite feedback from every patient leaving every civil and government hospital, the gravity of this situation will be understood better. Many repairs “at home” are required before “the neighbours home” is raided. We as doctors and hospitals must together request these authorities and offices to protect us from such daily insults, extortions and exploitation.

The very next day, an old man, a retired Indian Military officer, was expressing himself in the OPD with tears in his eyes: “Ye desh ka kuchh nahi honewala (This country cannot progress). People here, at all levels, want corruption, legal escapes to save money, and will elect anyone who throws them petty bits. Votes are bought for such favours as alcohol, gifts and cash. Sycophants rule, criminals are seen hand in hand with some rulers. Who do you think will get elected with such means, saints? You can guess what progress we expect if the lawmakers are first in line to break laws..”

There was nothing more sinister I heard that day. I am worried about the healthcare in my beloved country. God save the future generations from such illegal heroes!

© Dr. Rajas Deshpande

Please share unedited.

The Greater Squint

The Greater Squint

© Dr. Rajas Deshpande

“Why didn’t the doctor tell us? Is it allowed for the doctors to hide such information? I will sue him” the angry mother kept shouting as she cried. Her husband told her to calm down.

“I know the other doctor well, I will talk with him today. He must have his reasons” I replied.

“No doctor, we don’t want you to talk to him about this” said the father.

Their fifteen year old brilliant daughter had developed mild headache and occasional giddiness. They had first read blogs about these symptoms, and after trying out various “natural” remedies and lifestyle changes, visited their family physician. He had started with the routine medicines for headache, and advised them to visit a specialist if the symptoms persisted for a week. As the headache didn’t subside, they visited a specialist. His notes indicated a normal neurological examination, and some higher medicines for headaches and giddiness. After a week, the girl developed a squint, double vision and slurred speech suddenly, and was unable to walk. She was brought to our emergency, her MRI of the brain showed multiple sites of infection including the lower part of the brain. Although most infections are treatable, those in the lower part of the brain (called brainstem) are extremely dangerous, and can cause even coma or death. This part has all the vital centers of the body, controlling heart rate, blood pressure and respiration. © Dr. Rajas Deshpande

When I explained this and advised admission for further treatment, they had panicked. That is when the mother had lashed out at the earlier doctors.

After admitting the child, the father came back.

“Doctor, I must make a confession. My wife is quite anxious, and she was crying when we saw the last doctor. That’s why the doctor didn’t tell her everything, but asked her to wait outside and informed me that there were such dangerous possibilities as cancer, tumor or infection, and that an MRI was necessary. I requested him not to write that on paper, thinking that my wife will panic. She is very emotional. That’s why we waited for a few days, thinking that things will improve. Please understand us, doctor”. I reassured him, and treatment was started.

The inflow of blatant allegations against allopaths/ modern medical practitioners is now so wide and strong, that this has sensitized some of the best doctors. Some have started to entirely avoid mentioning the tests required for a complete evaluation of a condition, knowing that if the doctor advises any tests, the only interpretation in our society is that those are for earning more money.

“Patients themselves do so many tests and take so many medicines without consulting a doctor. But if we advises any tests, the immediate allegation is that we want to earn more money. That affects our practice. So shall we still advise tests?” asked a colleague during a recent seminar. © Dr. Rajas Deshpande

The answer is a definite, loud yes. The duty of a doctor, besides being well qualified, skillful and compassionate, is also to boldly state fact and possibilities, advise the best investigations and treatments to every patient, poor or rich, VIP or AAP, and write these all on the patient’s case paper. The workup / investigations advised should be according to the global best practice guidelines. Poverty and illiteracy are neither the faults or responsibilities of a doctor, and like other professionals or even some governments, a doctor cannot provide “low grade” service to any poor patient. From the eyes of a doctor, even a penniless beggar should get the same advice about tests, medicines and surgery that the Prime Minister of the land gets. If ministers can go to corporate hospitals or even abroad for treatment, every citizen should also be sponsored for the same benefits by the same administration through the same funds, without preaching the doctors to do more “charity”. Otherwise we are a hypocritical society. © Dr. Rajas Deshpande

Whether to do those tests or not, where to do them is the patient’s choice. Whether to take the advised medicines is also upto the patient. The doctor may suggest the best place, request concessions, and if the patient is poor, suggest options to get financial help or refer to charity. But the quality of medical advice should never change. The only exception is an accusative, angry patient who is making paranoid efforts to find faults with everything that you do. One may politely decline to accept such a patient.

If the treating doctor has not advised all the tests necessary for the evaluation of relevant diagnostic possibilities, he/ she may be found guilty of negligence. To avoid advising tests just to please the patient would also be a moral crime. One must also refrain from crossing over to other specialties and advising tests before referral to the right specialist. Some “pretending to know everything from every specialty”, doctors advise various tests incorrectly, and even attempt treatments out of their expertise without a working diagnosis. . Such dangerous doctors may add to the woes and defamation of the profession. © Dr. Rajas Deshpande

The girl above is improving, although her balance is off, and she has developed t a squint. Most likely her squint will never improve. She is missing school for over three months now. She will now onwards live a compromised life: incomplete education, compromised marriage and the condescending Indian society where shame of physical disability like squints and lisps, slurring and imbalance are the essential components of most enjoyed comedies.

However, her squint is far lesser a problem than the one that our society has, against doctors.

© Dr. Rajas Deshpande

PS: Many people comment often that “Doctors should introspect”. I do not know how many of these people introspect about their own habit of finding faults with others before self. But the article above is an honest attempt to do so.

Please share unedited.