Monthly Archives: May 2019

A Doctor’s Meditation

©️Dr. Rajas Deshpande

Religion and medicine should never be mixed. Yet it is extremely necessary that a good doctor understands the mindset of a patient, especially a frightened, disturbed patient, and holistically plan the treatment rather than just writing a prescription for an ailment. To calm the mind of an irate patient, it is necessary that the doctor has that ability and self restraint, acceptance and compassion. A doctor who thinks in terms of religion and has a resultant bias can never understand patients even from his own religion as there’s no single path in any religion.

Science has to think of human body and mind only logically, with a sharp reasoning and on the basic presumption of equality. Genes may differ across races, but their numbers, function and dysfunction are the same across the human species. Racism is a serious disease of human mind. ©️Dr. Rajas Deshpande

I have always lived a parallel, isolated life to evolve mentally to be able to understand myself better. Only if I understand myself, my fears, my wants, necessities and my preoccupations, my expectations from others and my thought processes well, will I understand other human beings- in my case, the patient. This inward journey makes me a better doctor than knowledge, experience and information alone. This understanding is superior to even medical and social wisdom.

To achieve this, I have kept acquiring insights and inspiration from various religious texts and their translations, commentaries on religion and philosophy across cultures, and of course many scientific analyses of human mind. This of course comes after the dedicated time reserved for studying scientific medical sites and texts on a daily basis. ©️Dr. Rajas Deshpande

One prominent requirement of today’s doctor is to advise on meditation as many patients seek that from their treating doctor. I cannot advise something impractical or anything which I have not found myself to be useful. Researching this, I came across a beautiful article written by an army officer about the essence and technique of meditation. He had suggested this book above as an ‘Ultimate’ commentary on the science and practice of meditation. It has nothing to do with religion, it is an effort to delve into the depths of human nature. I reiterate, when I go to the hospital (and outside my home in general), I don’t see myself as belonging to any religion. I truly believe in the equality and beauty of every human being. Starting to read this immensely complex book today, hopefully it will help me and my patients too.

©️Dr. Rajas Deshpande

“Dev Borem Korum” (Thank You)

(c) Dr. Rajas Deshpande

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

“Hullo, Mr. Clement? I’m Dr. Rajas”

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

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

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

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

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

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

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

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

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

(c) Dr. Rajas Deshpande

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A Rare Case, Rarer Diagnosis

©️Dr. Rajas Deshpande

He lost his ability to walk. He had to give up working. He was carried around by family members. His spine had to be operated. Still he couldn’t walk. He didn’t lose hope. He kept smiling, searching for treatments. His legs had become completely stiff like wooden logs, and they jerked violently even with the slightest movement, even if someone touched them. He couldn’t separate his legs apart. He had to use pain killers that would cause acidity, and muscle relaxants that caused lethargy and drowsiness. All this usually depresses most patients, and some lose their patience with life.

But not Mr. Dnyaneshwar Patil. He was tougher than his problems.

“I never thought my illness was anyone else’s fault. I didn’t want to exploit sympathy by complaining about my troubles. I decided to accept my illness to fight it better. I wouldn’t tell my family about my suffering. They were always ready to help, but I changed my lifestyle and needs to suit my condition. They had their life too, I did not want to make it bitter with my troubles” said Mr. Patil, a school teacher from a small village Takarkhela in Jalgaon, recalling his struggle.

His son Girish told me “Baba never raised his voice or got angry with us. Even when there was extreme pain and disability, he chose to take rest and keep smiling. He continued to do what he could, and only needed our help when he couldn’t even stand up”.

After over eight years of this agony, Mr. Dnyaneshwar Patil had another major problem. His disc in the lower spine slipped and caused immense pain. The stiffness and pain in his legs worsened, it was impossible for him to move. He underwent a spinal surgery. That relieved his pain and he could resume some movement, but his earlier woes continued.

Two years ago, one of his blood tests revealed that he had an extremely rare disease called “Stiff Person Syndrome”. Due to a defect in the immune system, there was damage in his spinal cord, which caused the stiffness in his lower body. He was given controlled doses of steroids under supervision to reduce the activity of his immune system. There was a dramatic improvement: now he walks comfortably without assistance, and has resumed his full time job of a teacher.

Today he had come for a follow up. When I asked him permission for sharing his story of amazing courage and hope, he smiled and said “Every patient must understand that they must accept the illness first to be able to fight it. One must never lose hope. I found an answer after over 8 years of not knowing my diagnosis. Some doctors had told me that my problem was psychological, that it was due to stress. I knew it was not, so I did not give up. The reward of my hope is that I can walk today”.

We often get to learn from our patients. Hope is indeed an amazing prerequisite of a good life. We congratulate Mr. Dnyaneshwar Patil for his exemplary grit and pray for his best health always!

© Dr. Rajas Deshpande

PC Aniket Yadav

When Money Rained In Our Hospital

When Money Rained In Our Hospital

©️ Dr. Rajas Deshpande

On a beautiful September midnight, I was studying in the medical college library, as the exam term had started. It was that pre-exam phase when the futility, cruelty, and stupidity of exam system hurts most, and new poetry starts stemming in one’s brain when trying to study difficult medical concepts. But that night was a pleasant exception. My gorgeous tall colleague with curly hair was besides me in the library. She had come in from a famous private hospital in Mumbai for studying with me (seriously), and I was drenched in the pleasure of her company, because we got along very well together. We divided topics, studied and taught each other, the whole process made learning Neurology so much more beautiful! She was brilliant and madder than me in her attempts to “know everything”about what we studied. ©️ Dr. Rajas Deshpande

At about 2 AM, we went out for a small ride on my Yamaha RX100 to Dadar station, where a tea vendor on a bicycle used to serve a tea that could possibly wake up dead brains. It was raining lightly, and the whole atmosphere was filled up with a sort of Kenny G’s ‘Songbird’. She sat huddled behind me on the bike, as we sipped tea in the silence of that atmosphere. It was more beautiful than anything we could speak.

Just then, the cellphone rang. I was on call, there was some emergency. Thanks to the RX100, I reached hospital campus in nearly three minutes. I dropped my friend at the library, and went towards the casualty. There was a huge crowd. Many patients were being brought in, some severely injured, some unconscious, most bleeding, crying and shocked. The atmosphere was filled with anger and wails of relatives frantically seeking medical help for their patients. Manyresident doctors from different specialties were trying to deal with the situation.

A building under construction near the hospital had collapsed. Over 8 labourers sleeping there had died, many were badly injured. Sirens kept sounding as ambulances brought new cases. Just then, a different siren sounded, with a lot of police whistles. A local elected politician had come in his red-light car, surrounded by bodyguards. The seniormost doctor was summoned by the authorities acompanying the politico. ©️ Dr. Rajas Deshpande

“Make sure everybody gets the right treatment. Don’t let any complaint arise. Keep mum, we will provide all the help you need” the Politico told the casualty in charge.

“But Sir we do not have enough beds or staff to handle this. Many will need blood, antibiotics which we have long ago requested but we havent received yet” the casualty in-charge said.

“Just shut up and give a list of what is required right now, we will arrange. Make sure that media is not allowed inside the hospital” said the Politico.

Then he gestured his assistant, who opened a bag and pulled out bundles of 1000 rupees notes. The politico went from bed to bed of the injured and the dead, placed one note in the hand of the patient or the relative, and whispered “I am with you. Don’t worry. We have ordered the hospital to treat you completely free. If you need anything please tell me directly. Don’t speak with anyone else”. If anyone spoke angrily, a few more notes were thrusted in their hands.

One elderly labourer, whose son was unconscios and bleeding with a head injury, started shouting “They killed my son. We had told them that building was unsafe. They forced him to stay there. I will go to the police”etc. The politico’s assistants took him aside, and whispered something in his ear. He returned sobbing, but he did not shout anymore. ©️ Dr. Rajas Deshpande

The next day, there were headlines. They covered the pictures of the rubble of the building, the dead bodies, the injured, the shocked relatives, and the patients in the hospital. They wrote praises about how the local politico rushed and helped the victims, again with pictures. There was no mention of the efforts made by the doctors who had saved many lives that night. But what was most shocking was that there never was any mention of whose building it was, who was responsible for the gross neglect in safety precautions, who owned the construction. Many had died, many were injured, but there was no blaming anyone. A case was apparently filed with the police, but no labourer came forward to complain. Money chokes many a throat, poverty sometimes desperately seeks that choke.

Thousands of people, especially the poor and helpless, die in India almost every day due to the gross inadequacies and negligence of many authorities: transport, travel, aviation, road safety, building construction, food quality, school health are areas where there are glaring blunders sometimes costing people their lives. Traffic accidents are conveniently blamed upon drivers. Unclean food, drugs being licensed are a horrible reality. Mosquitoes and malaria, dengue cause hundreds of deaths every month. Yet no press is seen “investigating” where to pin the blame. No court orders suo moto enquiries in traffic accidents of bridge / construction collapses that kill many. Railway accidents are considered an ill fate. Those victims who raise voice against this probably face the threat of never receiving the compensation or financial aid. ©️ Dr. Rajas Deshpande

Except when someone dies in a hospital, however serious they may have been. Then the whole world knows who to blame, punish or exploit. If a doctor or hospital had committed a mistake, the headlines would be totally different. The names of doctors who spent a lifetime saving lives would be painted in black within a moment, they would be labelled villains and murderers!

I could only meet my friend three nights later. When I told her the details of how money rained, she uttered a word about that politico. A word that was shocking, but perfect. I told you, we got along very well together! Of the many beautiful nocturnal rides and adventures in my life, the memories of that one night when money rained in my hospital come back to haunt me everytime I read of a new tragedy that kills people due to someone’s fault. What happens later is still the same though. Nothing has changed.

©️ Dr. Rajas Deshpande

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