Monthly Archives: November 2019

Doughnuts, Laddoo, Anyone?

© Dr. Rajas Deshpande

He was so cute and plump as a child, that everyone started calling him “Laddoo”. Soon this became his name. His parents were both hyper-educated, and both owned google browsers, so they studied about parenthood in-depth every day, and decided to provide Laddoo with the best parents and upbringing. They had many fights about how to do it right, but they took care that they never ever fought or argued in presence of Laddoo. They never raised their voice in front of him. Laddoo therefore grew up thinking that any arguments, disagreements or raising of voice was so uncivil and wrong. In a calm, disciplined home, he was being given the best of parenthood as suggested by the best parenting websites in the world.

Laddoo’s parents took care that he could only eat the most fresh and clean, organic food. Laddoo was proud that he did not eat garbage like other children of his age. He often envied those who could eat spicy, oily roadside food, especially the panipuri, kachori etc., but he remembered what his mom-dad had told him about the bacteria and viruses in such dirty food. So he never ate anything like that, but he started developing anger towards those indisciplined kids who could eat and digest anything they wanted. In the midst of beautiful, clean plenty, Laddoo started growing up resentful of everything around him. © Dr. Rajas Deshpande. At home though, Laddoo was always a prince. To encourage free thinking, his parents had decided never to shout at him or punish him. They chose only logical, scientific, calm explanations when he was wrong. Once a maid-servant who was cleaning their home shouted sarcastically at Laddoo: “You call yourself a grown up, can’t you keep your clothes in a little order?” Laddoo’s mom was shocked, she fired the maid immediately. “Such ignorant, stupid illiterates! These slumdwellers have no idea how to raise children!” she commented, patting Laddoo on his head.

“You are stupid, Mom, you and Dad both!” Laddoo shouted, “Why do you stay in India with such people around?” His mom was so thrilled to hear this, that she immediately WhatsApped Laddoo’s words to her friends’ group, adding “Laddoo has become so mature now, he’s speaking exactly what I think sometimes. I am so proud!”. Laddoo was pampered more. All that he wanted was being made available. If he did not get what he wanted, he would throw a tantrum, accuse his parents of cruelty, and write about his parents in his famous blog “Parents and Children’s Freedom”. He had many followers. His parents oozed with pride when they referred to their Laddoo as a “Child Celebrity Author”. His proficiency with cellphones and gadgets was their pet boast.

The thoughts that “I can be wrong, someone else can be better than me, someone else can grasp better, be more intelligent or successful” never crossed Laddoo’s mind. “What I think must be the final word” became his perpetual attitude. If at all anyone was successful in proving his mistake, Laddoo would immediately state how some fault of his parents, teachers or friends led him to commit that mistake. He freely used words that scared elders: abuse, violence, childhood trauma etc. This would usually hush up the matter, and Laddoo always kept on convincing himself and others that everything good that happened in his life was solely due to his own heroic efforts whereas everything bad that happened was the fault of someone else. His parents did not want to ever shake his self-confidence, so they never made an effort to correct him.

Once Laddoo spoke arrogantly and then argued rudely with his class teacher. She was so upset, that she scolded him in front of the class, called him stupid, and gave him a punishment of standing for an hour till the class was over. After returning home that day, Laddoo complained of severe pain in both legs and giddiness. He was taken to the best child specialist, then a neurologist. “There’s nothing major, please take him to a counsellor” they were told. © Dr. Rajas Deshpande.

“Indian doctors really cannot understand a thing” said Laddoo’s father, and sent his reports to Laddoo’s aunt in the USA. The experts there commented that the child may have suffered a mental trauma due to the scolding and punishment by his teacher. Laddoo’s parents immediately filed a police case, wrote blogs against the school and the teacher, and then also complained to the school about the teacher with threats of legal prosecution. It was only after the teacher and the school apologised to Laddoo, that the cases were withdrawn, and his pain and giddiness improved. No teacher ever scolded Laddoo throughout his career thereafter.

Now Laddoo is heading a major company in California. His useless, old parents live in an old-age home, pretending to be happy. They believe that their beloved Laddoo does not see them regularly because of their own parenting faults. They cannot express this to others, they just tell people “He is extremely busy”. Laddoos parents also truly believe that his success in grabbing a great job is the highest achievement of their life.

Laddoo does not have any friends. He only has drink-n-game partners in luxurious clubs. His first wife left him long ago (“She was ridiculously orthodox, she wanted to grow up kids and all”). His second wife owns a company in Washington DC, they meet twice a year. Both of them tell people how they are victims of childhood traumas., especially when they fail competing with those “unruly, ridiculously happy” colleagues. They have decided never to have children so as to compensate for their childhood traumas, bullying by friends, teachers and parents etc. “We cannot afford time for such traditional lives” they mutually agree. They believe, understand and cover each-other’s lies so effectively, that they find it difficult to grasp why others around them cannot accept those.

Laddoo does not like anyone arguing, asking him questions. “Geniuses like me do not owe an explanation to anyone” he says, often freely quoting the likes of Newton, Einstein and Steve Jobs. No one really wants to interact with him now a days. Just as people avoid the spoiled brats of rich fathers, knowing that they are beyond any resurrection, they avoid Laddoo too. © Dr. Rajas Deshpande.

“Thay are all jealous about me, my genius, my success” Laddoo thinks. His wife agrees. Both of them spend their time at home and work blaming the whole world, showing people down, being bitter to the happy ones, and repeating the stories of how they suffered in the past, how they struggled through those imaginary problems and how heroic they have been to reach where they are now. They compliment each other like the two halves of a doughnut.

I meet such Laddoos and doughnuts (men and women) everywhere now a days. They are frequent among Doctors, Patients, Engineers, Lawyers, Businessmen etc., but also very common in big offices, major posts in the governments and managements, professors, judicial offices, ministers and even among rulers.

Do you meet any?

© Dr. Rajas Deshpande

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Robodoc

© Dr. Rajas Deshpande

“The doctor wasn’t even replying. He didn’t answer my questions” the patient, an angry lady, told me about one of my colleagues. The patient’s husband sat besides her, expressionless.

I reviewed her case in detail. She had had varying complaints for over four years, mostly severe pain at various points on her body. When a patient has symptoms (complaints) grossly disproportionate to the signs (doctor’s findings), there always is a suspicion of ‘exaggeration’ or ‘lying’. This can happen involuntarily due to stress, depression or anxiety, or voluntarily usually for seeking attention. She had seen many specialists, and had received strong doses of almost all types of pain killers and other pain control medicines, still her response after every course was ‘zero relief’. That was definitely suspicious. I looked at her husband. He appeared tired and aloof, reluctant to participate in any discussion. I had to make him talk.

“Is she stressed? Have you noticed any change in her personality?” I asked them the question that usually opens the dreaded can of worms.

“I am fed up, doctor” said the husband, “She needs continuous attention. Since our marriage four years ago there’s never been a month when we did not visit a hospital. All doctors tell her to go to a psychiatrist, but she refuses. The moment I return from office she starts complaining about her health. I don’t know what to do now, I feel I am better out of my own home” he avoided looking at her.© Dr. Rajas Deshpande.

His wife started crying, and in a shrill voice, shouted at me “Why are you speaking with him, doc? I am your patient, speak to me. No one believes me. I am suffering so much!”

I assured her that I was going to help her sort out the issue. Once she calmed down, I was able to explain to her the way stress affects human mind and body, and that it was possible to get well soon. I told her that being stressed was not a “psychiatric illness” but an overworked, burdened state of mind that needs attention, and that it can often be cured by speaking with the right person. She asked me many questions. As a special case, I made an effort to reply to each one of them, even the irrelevant ones, sometimes repeatedly. She agreed to visit an excellent counsellor colleague of mine. She drastically improved in a month after the counsellor worked upon her. However, she came back with new complaints within two months. She visited me twice more, and each time cried a lot, then when I pacified her, asked the same long list of questions mixed with new ones.

My sympathy and compassion started waning. I have promised myself never to be rude to any patient ever, and I religiously follow that. Yet my patience was wavering now.

The more compassionate, patient, sympathetic a doctor becomes towards the patient and their family, the more it is taken for granted and misused. The doctor is then expected to be an unending source of “psychological support”, mentoring and motivating, and a punching bag or a cry-to teddy bear. While in a healthy doctor-patient relationship this compassionate attitude is natural and welcome, many doctors do not know when it starts growing upon them and stressing them out. It is not easy to listen to a continuous flow of medical symptomatology especially wrapped in negative emotions. While positive outcomes do bring back life into a doctor’s motivation to do better and more, this expectation to be a listener of all sorrows until the storyteller is satisfied is unnatural and impractical. It tells upon the doctor’s health. This is now happening in almost all specialties, and wise doctors are learning to separate patients into “whimpering, chronically-dissatisfied-with-everything storytellers” versus patients with genuine medical, surgical and psychiatric issues. © Dr. Rajas Deshpande.

To concentrate upon what can be corrected, to treat what is possible should be the right priority, and here’s where a doctor’s compassion, sympathy and patience are best employed. To expect a doctor to resolve issues like ‘Swabhav’ (inherent nature) of a human being is wrong. A doctor also cannot solve the root causes of stress like poverty, unemployment, interpersonal incompatibility, overambitious, over-expectant personality or attention seeking. Many patients and families expect the doctor to resolve ‘every minor issue’ related to ageing, refusing to accept that resuming complete normalcy of health is impossible after a certain age, especially with some medical conditions. Doctors can guide patients, but cannot accompany the patient and family to fine tune every minor issue.© Dr. Rajas Deshpande.

Few paranoid, suspicious, accusative, aggressive patients and the types mentioned above have now made it necessary for the doctor to be extremely aware and alert, cautious, and to some extent emotionally aloof from the patient at least in the initial phase. Every word has to be spoken with caution. This “Robotic Doctor” or “Robodoc” is actually becoming a sad reality in the Western world where every medical consultation is considered a potential chance of litigation. A careful doctor avoids getting trapped into emotional exploitation. While this may upset some patients, much of the educated class is still happy with a proper professional consultation, diagnosis and treatment rather than only a compassionate sweet talk. Given the Indian scenario where patients are driven emotionally rather than scientifically especially in the illiterate and financially challenged echelons, a doctor needs to be better equipped for avoiding misuse of his / her compassion and sympathy, as it also converts readily into a permanent source of rewardless stress. This is unhealthy for doctors.

This is one reason ‘Robodocs’ are on a rise. A sad truth about an essential evolution in the medical profession across the world. The only thing that can change this is individualising patient care.

© Dr. Rajas Deshpande

Please share unedited.