Category Archives: Filmy

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

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

©️Dr. Rajas Deshpande

A hungry poor man named Atmaram went to a big hotel, had a nice big meal, and told he had no money to pay. He was beaten up and handed over to the police. He was released after a warning and a slap.

Next day he filled up petrol in his bike, and said he couldn’t pay. He was again beaten up, handed over to the police. Then he went to the medical shop, bought medicines and mineral water, ate the medicine, drank water from the bottle, and again said he couldn’t pay. He was now jailed for a week.

Next week his house was damaged by heavy rains, so he went and requested to be allowed to sleep in the house of the chief minister. He was arrested again, thrashed up.

As angry Atmaram shouted at the police, he was beaten up by them, another crime was added to his offences. In the court, Atmaram insulted the lawyers and judges and accused them of accepting bribes and charging too much. The judge punished him extra for his behaviour. Atmaram was angry and threw his shoe at the judge. His punishment was extended.

“You must respect the authority “ the court said.

“But I am poor, I need free food and petrol and medicines. I need sympathy too” Atmaram argued.

“You should have begged and applied for favours and eaten in places that provide charity meals. Petrol, however essential, has the same price for everyone. You can sleep on the footpath, and above all, you are not allowed rudeness and violence because you are poor and needy” The court said.©️Dr. Rajas Deshpande

When released from the jail, Atmaram drank a lot of desi alcohol, had an accident and fractured many bones. He went to the best private hospital, got operated and refused to pay his bills that crossed one lac rupees. When the hospital insisted, the operating doctors were beaten up by Atmaran’s relatives, the hospital was vandalised, the police arrested the doctor who saved Atmaram’s life, the government closed down the hospital, while the media and the society kept villainising the entire medical profession.

The headlines next day reported the sympathy expressed uniformly by wag addicted tongues: some said the entire profession was tainted, some blamed the greed of the doctors, even some doctors desperate for attention shed crocodile tears about the ethics in this profession. ©️Dr. Rajas Deshpande

In the courtroom, during the trial, Atmaram sat facing the doctor, still heavily bandaged.

The hon’ble judge, kind but surrounded by security, told the doctor accused of negligence and malpractice in the court: “You as a doctor carry more responsibility for ethical behaviour upon your shoulders. You should never turn away the poor”.

The doctor, defending himself, asked “but Milord, doesn’t our constitution insist on equality? Why do you yourself or ministers get security but not the doctor? Why isn’t everyone supposed to stick to ethics in every profession including politics, police and judiciary? Why are others exempt? How do you explain beating up of doctors while also saying that the society treated them like gods?”.

There were no answers. The kind court asked if the doctor had to say anything else in his own defence.

The doctor said

“Yes Milord, but the real answers will hurt:

Jealousy against medical professionals across society and many other professions is a reality. Why else will anyone who couldn’t qualify to become a doctor try and teach the qualified doctors what they should do?”©️Dr. Rajas Deshpande

“A culture of exploitation of non-votebank groups

and a complete failure of government healthcare with no one accepting responsibility is well known to everyone, but even judges have no courage to suo motu question this and correct it, even when they see the poor dying”. ©️Dr. Rajas Deshpande

“In a country with never ending poverty, how much free can a healthcare facility provide? For how long? This is already forcing closure of hospitals and exodus of good doctors out of the country.”©️Dr. Rajas Deshpande

“Milord, can you assure that every doctor will get his/ her fees as per his service to every patient, and if the patient can’t pay, that much charge will be exempted from the income tax of that doctor? How else do you except a doctor to meet his needs and dreams? Just because there are millions of poor patients, is the doctor’s life and hard work taken for granted? If there has to be financial sacrifice, why not have everyone contribute to it by creating a national health tax fund for treatment of poor patients? Why healthcare is subsidised only at the cost of a doctor?”

Just at this point, Atmaram, who sat in front of the judge, collapsed unconscious, almost blue black.

The shocked judge requested the doctor to examine him.

“He is no more” said the doctor.

“What could have happened ?” asked the kind but sweating judge.

The doctor told the court about three possible reasons. Two of them were scientific and medical: a sudden cardiac event or a large blood clot in the lungs common after fractures and trauma.

The third non-medical, unscientific cause made the Judge seriously ponder.©️Dr. Rajas Deshpande

“Will this court be now closed down, Milord? Will your efficiency be questioned, will you allow the relatives to attack you and understand their sad situation at the cost of your murder?”

“I understand what you mean” said the kind judge.

Needless to say, the doctor was released without a blame.

Can anyone please solve the mystery of the third non medical, unscientific possible cause of Atmaram’s death?

(C) Dr. Rajas Deshpande

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Profit and Loss

Profit and Loss
© Dr. Rajas Deshpande

Case 1:
45 year old man. Many weeks of tiredness, then three days of fever, quack treatment. Developed convulsions, admitted in coma. Blood sugars over 500. The long term past sugar index is very high, suggesting he has had untreated diabetes for months. After stabilizing patient in few minutes, I brief the relatives about critical condition.
His brother asks: Why is his sugar so high? He never had sugar. Is it because of any of the medicines you are giving?
I explain them that he has had high sugars for long, the tests say so. Also that we are giving him medicines to control sugar.
The wife says: “We don’t know all that. I think some medicines have made him unconscious”.
When he was discharged recovered, they fought about the bills saying that wrong medicines had caused delay in recovery. They gave negative feedback because the bills were not reduced to their quotes. “We were duped, we lost so much money” the son kept alleging aloud. © Dr. Rajas Deshpande

Case 2:
Old man, 82. Lung cancer, under radiation. Two episodes of paralysis, diabetes, blood pressure, now has drowsiness since Tuesday. His son and daughter in law come to opd on Saturday evening. The old man needed immediate admission and MRI. I tell them so.
“What is your diagnosis?”, “Exactly why is he drowsy?” “Why admission??” “Exactly what treatment?” “What will be effect of the treatment?” and many such screwing questions (sometimes I wanna ask back: when will you exactly pee next?) later, they went home. In the interest of the life of the old man, I chose not to lose patience.© Dr. Rajas Deshpande

They come back two days later, he had become unconscious.
“Why, doctor, why? He was walking till Sunday” cried the daughter, angrily asking us. “Why can’t you make him conscious? It’s been two days”.
Not only the arrogant tone, but the open distrust was offensive. “What is the exact reason of his unconsciousness?” “When exactly will he become conscious?” “Exactly blah blah?” asked the son, as if he was a Judge, and the doctors were criminals.
I wanted to tell them exactly what they were and where they belonged, but refrained. Patient first.
The treatment was on. Three days later, the old man opened eyes. “He has always had a strong will power. We knew he would recover” told his daughter to us.
Upon discharge, they wrote very bad reviews because the bills were not reduced to their expectation.
© Dr. Rajas Deshpande

Both came for follow up later.
In both the cases, a few years ago, I would have made an effort to spend more time, compromise self respect and continue treating them. Not now. Especially when peacock-fame decision makers decide about the fates of specialist doctors. Now, I tell them to please follow up with whichever doctor they can trust.

What about the probable income from such patients? Let me quote a dialogue that only Mr. Amitabh Bachchan could have delivered, from a film ‘Trishul’ that influenced me much since my college days:
“Zindagi mein kuchh baatein faayde aur nuksaan se upar hoti hain, lekin ye baat kuchh log nahi samajhte” (Some things in life are above profit or loss, but some people don’t understand that)”.
© Dr. Rajas Deshpande

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

The Price Of Love

© Dr. Rajas Deshpande

He tied her to the pole, abusing and insulting her.
Wielding a knife in his hand, he slapped her once more. “You are supposed to be the honest one” he shouted, “I am a man. You were talking with our neighbour. What did you say to him? Did you two fix up a place to meet secretly?” he was trembling with anger.
She looked into his eyes, and replied “Don’t you talk to other women? Doesn’t your mother talk to other men? Do you always talk about that? I was asking him about his sick wife”.
Pulling her by her hair, he said menacingly in her ears: “Look, don’t compare yourself to me. I am a man. You are supposed to be the one who gives up everything for me. Do you think I don’t know how ‘those’ women behave? You have chosen to marry me. I can do what I want”. She didn’t reply. What could she say to a paranoid, suspicious person who had one way communication? The option of violence wasn’t open for her.
As it became dark, his mood changed. He started speaking soft and sweet. He untied her from the post so she could cook. She could not eat well, the humiliation and insults, the allegations and violence wreaking havoc in her mind.
Silence fell upon the dark. The next day’s work awaited her at dawn, so she skipped the sobbing and tried to sleep.
“Make love to me” he ordered. She tried to comply.
He raised his voice “It should come from the bottom of your heart. Don’t pretend. Love me madly, deeply, and let it show in your action”.
Silently, she replied “I can’t. The only one thing that could have made me truly love you was true love from you too”. © Dr. Rajas Deshpande
This is the current scenario between the society and the good medical professional today.
Take for granted that the whole medical profession is one’s slave. Make allegations at every possible opportunity. Be suspicious and paranoid. Hold a doctor guilty for any news anywhere without logical enquiry. Make them overwork under the sacrifice tag. Disrespect them, beat them up, ask them questions as if talking to criminals. Presume every other doctor and every big hospital is a fraud.
Then, when one has a health problem, expect them to be truly, deeply compassionate, loving angels who will do the best because they are married to their principles of being good and kind to everyone.
If you expect the doctor to be truly nice and kind and compassionate to you, to make best decisions for you, ask yourself if you deserve that. No amount of money will buy you a doctor’s love and respect, no amount of hateful criticism or threats will compel your doctor to be compassionate.
A doctor’s real fees is the respect and trust you place in him / her. No amount of money is worth the value of your life. Pay with suspicion, threat and disrespect, and you destroy the compassion you truly deserve.
The doctor-patient trust is a coin with two sides, one side cannot be blank.
© Dr. Rajas Deshpande

PS: I know the word “exaggeration”. Learnt it from some movies and TV shows that criticise doctors.

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Targets and Doctors: A Fatal Flaw

Targets and Doctors: A Fatal Flaw
© Dr. Rajas Deshpande
“What will you become when you grow up?” a common question heard in childhood. Always weary of doing the routine and fond of a little spice in life, I had kept a list of answers to surprise and occasionally shock the questioner uncle / aunt, based upon the spontaneous dislike they generated by other questions and general behaviour and replied something like “It’s a secret” or “It depends upon when in future” etc. There is no better revenge than vagueness for some. In the moment when they paused to react to that vague answer, I would make an innocent face and ask “What was your percentage when you were my age?”. Then the explanations of how things were more difficult and in general marks were lower back then were very entertaining! Curiously, those uncles / aunties did not ask me further questions. Target hit.
© Dr. Rajas Deshpande
For the better and polite class of grown ups, I had the standard answers that my parents would like: Doctor, Scientist etc. The real answers were too “out of the league” for the culture I grew up in then. One thing was sure: the big-eyed respect that the words “I want to be a Doctor” evoked from the listener was sure better than any other response.
Somehow the wish to become a doctor caught hold better, probably because of parental influence. Once I completed MBBS, I loved the actual interaction and started realising the enormous satisfaction potential that the skill generated. The ‘high’ of vast complicated knowledge sharpened daily by experience was superior to the ability of a non-medico to understand or praise it. It was an autonomously growing satisfaction.
Then came the thought that I want to learn more. There are better skilled people, who could treat better than me. Getting admission to MD Medicine was very difficult, there was no question of paying in private colleges as we could barely even afford the govt. medical college fees. A lot of somersaults later, I got admission. There was an explosion of medical knowledge and wisdom suddenly, and there was no choice but to comply. Good and bad patients, good and bad teachers, good and bad friends, good and bad times were all drowned by the prime necessity and survival technique of every genuine doctor: Study!© Dr. Rajas Deshpande
Ego is greedy. Mine too. After MD, there was a desire that I want the highest specialisation: DM. More battles. More scars. All worth the title. With that degree, it felt like I have won the world.
At that time if anyone had said I worked for a financial target, I would have declared a war.
Many more steps in education later, I woke up to the naked reality: however good a specialist you become, you have to either have your own multicrore hospital, or work at someone else’s. Basic medical practice is far different from specialty practice, which requires more time, more investigations, intensive care and complicated treatment strategies / surgical techniques.
When one joins a private hospital, one realises this more intensely: there really are good and bad specialists. Some are very thorough in their academic base but cannot convert that in good patient outcomes or numbers. Some are very sweet and courteous with patients but they lack proper skill, knowledge or experience. The spectrum is wider than one can imagine. Obviously like in every profession, some think of earning more money as their primary aim.
Anyone who owns a hospital must invest many crores of their private money, directly or via bank loans. Sometimes the govt. helps in reducing the cost of land. But in each case, the maintainence cost of any hospital runs usually in lakhs to crores, more with each bed added. Intensive care beds are the costliest investment.© Dr. Rajas Deshpande
When the owners of any hospital invest crores of rupees, they have targets to return their loans., to maintain the expenses that run in crores again: right from 24/7 failproof electricity and water arrangements to the availability of medicines, stents, catheters etc. in the hospital premises. The nursing, reception, helper, technician staff (in most major hospitals, the staff runs in thousands) must be engaged in three shifts, and paid in time commensurate with other establishments/ professions.
The only help that comes from the govt. is initial subsidy in land / water prices. There are no tax relaxations for any hospital/ staff. 20% of all services and beds are reserved for the poor. (If anyone has doubts that the poor-reserved services are not utilised, they can verify with the charity commissioner any day). On top of this all govt. employees must be seen at pathetically low rates, and even that amount is usually pending to be paid for years if not decades.© Dr. Rajas Deshpande
Add to this the profiteering that the medical insurance companies have created: on one hand twisting the arms of private hospitals to provide specialty medicare at bare minimum rates, while on the other hand declining many deserving patients medical coverage due to idiotic reasons.
In this scenario, the last thing that a corporate / private hospital can afford is a non-performing specialist, whose salary runs in lacs of rupees every month (which is what that cadre deserves).
Most corporates / private hospitals are aware of this, and usually support a budding practitioner till his practice picks up. After that, the least he / she is expected to do is to maintain that level of practice or increase it, returning the investment that the hospital has made in his growth. The provision of a furnished room, electricity, washroom, cafeteria, parking, staff and salary to a non-performing or underperforming doctor is not affordable for every hospital.© Dr. Rajas Deshpande
This generated the word “Target”, which was quickly coloured villainous by many. Which financial endeavour can be run without setting financial targets? If anyone is naïve enough to think that all hospital owners will invest their hard earned crores for charity and leave the returns to fate, they must get examined by a qualified practitioner. If the hospital cannot generate enough profit money, there won’t be any growth in medical technology. If they cannot repay loans, the hospital will be confiscated by banks.
Many hospitals of excellent doctors have closed down because they could not sustain the charity they attempted. Indian poverty and healthcare need is beyond the capacity of even the govt. to cope up with, so to expect a private company / doctor / hospital to provide free / concessional high quality continuous medical care to everyone can only be a fool’s dream. This applies to the MRI centers, diagnostic facilities, labs, physiotherapy units etc. where multiple crores are invested.
Some hospitals realised the potential of profit making in this “Target setting” and turned greedy. Mostly good specialists do not stay at such hospitals. Even if most hospitals pinch most doctors to achieve certain numbers, not every specialist works to achieve that target. I know many who would rather keep their ethics and be good clinicians, still staying in the lesser favourite class of management, rather than selling their ethics to shine among the administrators.
The notion that “Every specialist in every big hospital is working to achieve targets by deceiving the patient” is a fatal flaw developing in the mind of our society . Fatal because this also generates fear of going to the right specialist or reaching too late for them to be able to save life.© Dr. Rajas Deshpande
If I cannot afford a Mercedes, I will drive the car I can actually afford, rather than blaming and maligning the entire car industry. Many other cheaper, equally safer options are available for travel.
The problem is, everyone wants the best, highest class of super specialty medical care in luxurious set-ups, at the price list of a sarkari dawakhana. Most doctors who studied in govt. hospitals know that the quality of doctors is very good there too, but if we give that option to the patient, they say “No, not in sarkari” because they want to avoid long lines and “general population treatment”.
As the doctor is the only responsible face that the patient sees in the hospital, many obviously end up thinking that every penny they pay is going to the doctor, at least in percentage. Many will be surprised to know that a doctor usually gets less than 10 % of the total hospital bill as his fees in most cases.
Few will understand that the real “Target” that most doctors work for is to do good to the patient, to save lives. Millions of successful treatment and surgical outcomes from the corporate and other hospitals are a proof of this.
© Dr. Rajas Deshpande
Dedicated to the private hospitals started with the aim of making available specialty medical care for the society and caught up in unfair, unjust allegations because everyone wants free healthcare.
PS: There are greedy doctors and hospitals, like in every other profession. This article is not about them. It is wrong to advise patients unnecessary procedures / tests to achieve financial targets. This article is to explain to the society that target setting is essential for any hospital where recurring investment in new technology and maintenance is also the responsibility of the owner.
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The Sweetest Pinnacle Of Life

The Sweetest Pinnacle Of Life© Dr. Rajas Deshpande

To many students who are lost in their search for the right aims and goals in life, who trusted me enough to ask that question, I have suggested that they imagine what they actually want in their life at its Pinnacle.

Success, riches, fame, awards and accolades, a legacy, achievements are all good to show and leave behind oneself. The truth is far more than that. Love and care, affection and respect in one’s evening of life is what everyone deserves, but few are fortunate to achieve. For what good is s life that spends its aged years in desolation, isolation, despair of an uncaring, loveless family one has sacrificed much to bring up well?

Hollow words of “show- love” and “pretend care” are commonly employed everywhere, especially among the rich, educated and culture-claiming pundits of humanity.

One experience I have is worth sharing: that the poorest of the poor, like the farmer in the wheelchair here, are cared for with far more genuine love and affection than many. This family collected alms and help to get him to India, and never asked for any concessions, free treatment etc., always saying they were willing to do anything for the happiness and health of this grandpa. His son standing by his side is an illiterate farmer, but is caring for his father . quoting proudly “He brought me up!”. There is no smell of “I am obliging my parent” in his behaviour.

I have met hundreds of Arabic Muslim patients who care for their parents, sons and daughters equally well, willing and with total faith in the treating doctor. It does not change with their financial status. They insist on the parents staying with them, ask questions about their food, exercise, medicines, happiness and comply strictly with the given instructions.

They naturally do not know the words “Culture, Rights, Medicolegal, Elderly care, Nursing Homes, Mercy Killing etc.”. Rarely have I seen them unemotionally “okay” with a bad diagnosis of a parent.

This old man, in my personal opinion, is one of the luckiest human beings upon earth!

© Dr. Rajas Deshpande

Thank you, Mr. Naser Ali, Mr. Abdul Hakim Mohd. Al Malahi, Mr. Majdi Jamil Aiselwi, Mr. Ahmed Anwar Aqlan!

Critical

Critical
© Dr. Rajas Deshpande

“Code Blue” someone shouted.
There were sounds of rushing, muffled sobs and wails, metal trolleys banging walls and glass syringes being broken open.
He rushed fastest, asked the relatives to wait outside.
“What’s wrong with him?” insisted the patient’s brother on knowing.
“His heart has stopped. Please wait out we don’t have time”.
The nurses had positioned the patient and started the CPR.

The ugliest sound in the world: the desperate rocking of the bed during a cardiac massage, was heard outside the cabin. The high pitch beeps of the defibrillator followed by the thuds of a body due to the electric shock initiated prayers even in the hearts of strangers. The relatives of other patients in the ICU waited outside their cabins, watching the faces of those who were crying. Those who could not bear the sight went inside their cabins. © Dr. Rajas Deshpande

He went on doing the CPR, knowing that the patient was young, and may still respond. The risk of this highly fatal disease to himself and the nursing staff was taken for granted: there is no time to “dress up” for CPR. He was simultaneously ordering the injections to be given. A male nurse took turns and helped him with the cardiac massage.

It is exhausting. Giddy after some time, he looked at the watch. It was about half an hour since the event. Almost nil chances now. He asked the nurse to continue, and came out to inform the relatives.
“He has had a cardiac arrest. We are trying, but it looks difficult” he informed the patient’s brother.
“Why? How come?” the brother shouted as the rest of the family gathered. © Dr. Rajas Deshpande
“We have been informing you many times. He has been critical. His lungs were not functioning well, his brain has many TB tumors, and his kidneys have been shut due to infection for a long time. It is called multiorgan failure”.
“We don’t know all that, doctor. Save him” said the brother.

Young patient. Fever since over three months. Avoided seeing allopaths for over a month. Diagnosed as multidrug resistant tuberculosis, one of the worst and most difficult diseases to treat. By the time they reached the proper specialist through all the “money saving” channels, it was too late. Almost all Government Hospitals have experts and facilities to treat MDR TB, but somehow people think it is below their dignity to avail of services at Govt hospitals.

The ICU doctor came out after a while. “We are sorry, he could not be revived” he sadly told the relatives.

Then there was a shriek, as the patient’s brother held the doctor by his collar, and slapped him. Exactly the style of Akshay Kumar from some movie. A lady doctor tried to stop the brother, but was held by the women in the family and bestowed with blows and abuses. The security, who had allowed the relatives on humanitarian grounds, regretted it, and desperately tried to control the relatives. © Dr. Rajas Deshpande

In an hour, they all left.

He washed himself. There was no time to cry, complain, register a case or go to TV channels or press. There were 22 other critical patients in the ICU, and he was in charge. He had to forgive, forget, digest it all. And then there was a perpetual expectation of the society to “understand” the misbehavior of the bereaved.

In a few minutes, another gasping patient came in on the same bed. A young girl with continuous convulsions. He rushed and intubated her, stabilised her. He talked to and pacified her panicked parents. © Dr. Rajas Deshpande

He had forgotten the slaps, the abuses and the blows he received a few moments ago. Like filmstars who slap qualified doctors on the screen and earn crores for that “entertainment”, he did not deserve a palatial bungalow and luxury cars, but as a life saver who saved hundreds every year, he was doomed to an asylum walled by expectations, criticism, abuse and overwork. Saving lives was “just a duty” not deserving respect or rewards.

The stress that comes from handling daily CPRs, saving lives and declaring deaths for years together cannot be acted by any of the Tom Dick Harrys on screen. Most of them are not even intellectually equipped to perceive the education, hard work and traumatizing effects of daily deaths and allegations that a critical care doctor faces.

While exceptionally literate and mature film personalities like Mr. Amitabh Bachchan and Ms. Lata Mangeshkar have always praised the doctors and spoken highly respectfully about them, most other “Muttonshop” artists have only exemplified their own jealousy about the highly educated doctors, trying to show them down one way or another.

I know of some friends who spend a sad, spoilt day even when they see a funeral passing by. The doctor has to face it every day, still carry on dealing with money savers, skimpy, arrogant, abusive and violent relatives reaching the hospital at the last moment. He has to garner a calm and control possible only with great effort. This tells upon the doctor’s mental and physical health. Being blamed and held responsible for someone’s death (this has become rampant now: to presume that all deaths are someone’s fault) in spite of trying hard to save them is something no film star, judge or minister will ever understand. Very few doctors are able to enjoy a genuinely stress free happiness in their personal life.

Of all the doctors suffering today because of the illiteracy, poverty and defective policy-making in India, the critical care and casualty doctors are the worst sufferers. My heartfelt tear and salute to their unending suffering for humanity. Also a strong appeal to the press, law authorities and the government to ensure that these highly stressed doctors are not assaulted, unnecessarily criticized or abused.

Just imagine a world without casualties or Intensive care services. That is a choice which doctors still retain.

© Dr. Rajas Deshpande

Dr. Madhu

 

© Dr. Rajas Deshpande

Blue-Grey eyes, fair pink face and curly hair. Tall, thin, agile and always happy. Boyish demeanour. Life of the moment. Most unmarried resident doctors swooned  over her , and most married ones secretly admired her. Her name was Madhu. She studied neonatology, and often baby-talked to those who  tried to be macho around her, making a chutney-pulp out of their muscular egoes. She stayed in the room next to mine, with another girl, a resident doctor from surgery.

We often shared the late-night breezy balcony on the 12th floor, overlooking the secretive city lights, when we sat in different corners studying, reading, writing or just thinking things over.

My shyness (really, I swear!) probably was quite noticeable, as once late after midnight, she asked me if I would like to share the tea that she and her roommate were planning to make. My roommate Dr. Vinay, who was studying besides me, said yes before I could. “So this is why you study here late night” he winked at me, as I made vigorous attempt to not blush and defend my non-involvement in the whole issue.

I became good friends with Madhu. She was from Madhya Pradesh, her parents were middleclass teachers like mine. She was engaged to be married to a handsome postgraduate businessman from her own community, staying then in the UK. ‘Don’t tell anyone yet, I want to declare only after I pass my MD’ she warned me with big eyes and a beautiful long finger wagging at my nose when she confided this. With the busy residency, there was no scope for any further interaction beyond the customary midnight tea-talk where we shared our joys and woes. But we waited for and enjoyed those moments.

Her roommate, the surgery girl, was very attractive too. However, she used to be mostly quiet, often sulking, and in general appeared unhappy. Once she was crying, so I asked Madhu if we could help her some way. “No”, Madhu replied,  “She has problems at home, she married early after MBBS, and now her in-laws are insisting that she has a child. Her husband is an engineer and says that he wants to avoid late pregnancies, he wants two kids minimum. She has two more years to finish MS, she knows having a kid will affect her learning, and we don’t have leaves as you know, so she will skip a term”. Complicated. Many female doctors go through the hell of this twin task: high-demanding duties in career and life at the same time. Perpetual shortage of doctors precludes any leaves, and many families do not support women’s careers whole heartedly. Some girls do it all with a smile, some collapse, often compromising on their career.

© Dr. Rajas Deshpande

One black morning brought the bad news: the surgical resident, pregnant, returning home early morning after a heavy emergency night, lost control of her car and hit a pole, died on the spot.

Nobody can be held responsible in our great legal system for this death except herself.

Madhu was devastated. Myself and Vinay accompanied her in her sleepless and horrible nights, there was no question of being able to study. After three such sleepless nights, she went home for a week. She returned with the determination of studying better, she had to complete her MD to be able to marry sooner. Our routines returned to a clouded normal again. Madhu’s legendary smile was scarred.

After about two months, she started coughing. One day I found her having high grade fever, so reported this to her HOD, and got her medicines and some food. Vinay and I attended her for next two days till her parents arrived. Many tests were done.

On the third night of their arrival, at about 1 AM, her father came to the balcony where I was studying. He was a tall, bald, fair and intelligent man. “Madhu asked me to talk to you”, he said, “will you please keep this confidential?”.

Scared to the core and praying in my heart, I reassured him that I won’t disclose anything to anyone.

He started to sob violently like a child. He strangulated a wail, covering his mouth tightly with his hands. In broken short sentences, he told me that Madhu had developed tuberculosis of the lungs.

“Is that all?” I asked and realised this might be very impolite. “I mean, is there anything more than that too? “ I rephrased my question. “No, but what will we do now? We are destroyed. Why should such a sweet fairy like my child suffer this?”.. A father crying for his daughter is unbearably painful.

“Tuberculosis is curable if treated correctly, there is no need to worry at all.. I am sure she will improve. We will show her to Dr. Karnad” … We were all very proud of Dr. Karnad’s abilities and knowledge.

© Dr. Rajas Deshpande

“ He has seen her today and started treatment. I am not sure if we should inform her department and her fiancé. This news spreading is not good for her”. His dilemma was genuine.  They decided what most middle class people do: have faith in the power of good and honest. They informed her department, and had her fiancé talk with Dr. Karnad.

She went home. There she developed liver failure due to the anti-tuberculous drugs, a common side effect. Treatment was delayed for another two months. After six months she returned. Her fiancé had broken the engagement while she was in liver failure phase. He had married someone in a haste after that.

She kept studying and working hard. We often went to the mess together for dinner.  She had lost her shine, more due to her broken engagement than her illness and medicines. She who always talked with such passion about her fiancé never mentioned him again ever.

When I once asked her if she still felt hurt, she said “Yes, it hurts beyond my ability to bear. But what hurts more is the thought that I was about to marry him”.

She was eventually free of all medical problems, but decided not to marry. She passed well, went to a developed country, and is practising quite successfully there. In a recent email, she wrote: ‘One spell of an infection, and the whole concept of humanity, human behaviour changed for a doctor like me.  I wonder what it does to the illiterate and poor. I know, but I feel scared to pin the blame here. I wish I had grown up in the developed world where I practise now’.

Many female doctors have to bear the brunt of social, familial and cultural expectations, pressures, insults, humiliation and sacrifices while studying the extremely demanding science of medicine. They lose their happiness, give up simple pleasures of life just to be able to cope up with their wish to serve humanity, at the cost of their own life. They are any day superior to their male counterparts, as they also shoulder the toughest responsibility: being a mother, while being a doctor. Unrewarded, unrecognised, and many a times not even acknowledged, they stand tallest in the fraternity, taller than any material or scientific achievers!

My highest respects to them.

© Dr. Rajas Deshpande

 

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The Bollywood Hospital

The Bollywood Hospital

© Dr. Rajas Deshpande

“You are invited for the inauguration of The Bollywood All-or-None Good Doctor’s Ultimate (BANGDU) Hospital” said the card. I was ecstatic, because now I could meet the so-claimed best experts in the field of medicine, the Bollywood heroes who “create” and advise the screen doctors, and know best about medical profession. This was also my lifetime lucky chance to learn about new methods of medical practice yet to be discovered by the actual medical professionals practicing all over the world, like conducting heart transplants only by using cellphone batteries and delivering babies using toilet vacuum pumps over Skype after graduating in engineering, which all the Medical councils seem to approve without hesitation.

My good friend with emotional incontinence (uncontrollable crying / laughter) Mr. ‘Arun Khar’ (Mr. A) was to be the medical director of this hospital, because usually he declares himself the perfect and best at the outset, and everyone else has to be compulsorily less smarter in his shows, movies or whatever else he does. As I wished him a good evening, he reminded me that I should now call him ‘Dr. A’ as the Bollywood Medical University has conferred upon him the superspecialty degrees in all medical and surgical branches within one year of joining the course because he was too smart: in fact, he showed me the special “Oversmart of the Century” certificate conferred upon him by the BMU.. There was one more reason that he was chosen the boss: he had also produced huge number of patients via his work, in the field of violent revenges and other human injuries so essential to improve other human beings.

The crowd was overwhelming, as the public and some TV channels were very excited that the “Real Good Doctors” from Bollywood with Godly qualities were now available for their free and most accurate miraculous treatment, there was no possibility of any patient dying. Unless of course they wanted to shoot for some movie, where the script demanded that the patient died. The hospital was decorated by the best imported designers in artful colours, live orchestra played beautiful tunes stolen from the western musicals, but the theme was Indian (sorry, Desi). The ambulances standing outside had turbo and nitro modes, and their sirens were created by the best South Indian Music Directors, in the “Karuna Rasa” (nectar of compassionate pity). The paramedics and ambulance drivers were said to be trained by the best Hollywood stunt masters. Each ambulance was also equipped with praying priests from at least four different religions.

So it came that Dr. A started showing me around.

“This is out Casualty in charge Dr. Mithun Coconut”, he said as we entered the casualty, introducing me to a sickle-wielding man who was threatening all the casualty doctors. “He has already killed three doctors today for not saving the dead bodies of our innocent film stars who were fighting gang wars with guns, bombs and knives since their childhood”, Dr. A proudly hugged Dr. MC. They both wiped their eyes after taking the right pose in front of the camera.

Dr. MC then explained the relatives of a critical patient of brain tumor, by showing them an X-ray film of pelvis on the view box. How artistic and meaningful!

I was curious about the blood bottles hanging upon each wall, ready to be transfused, labeled “Lost son 1, Lost Mom 3” etc. When I asked about it, Dr. A answered with a trademark cunning smile: “That is our creative idea: so we don’t waste time in blood grouping etc., we can readily transfuse blood when the lost relatives are here. We are so advanced, we even have emotional singers sitting in the casualty specially for that occasion”.

“These are our Operation theatres”.. he showed me two rooms with green and red bulbs over the door. We entered the first room. It was empty. “This is our ‘Director’s cut’ OT… Different genius directors invent different medical / surgical procedures, like cutting the heart and keeping it in the freezer till the hero kills the villain, hero holding his totally cut head for days so it fits back, conducting online deliveries etc… we have reserved this OT for such emergencies. You routine doctors will never be able to match us!”.

The second operation room had specialized music systems to adapt to the patient’s heart rate and criticality. It automatically started to show the patient’s life in flashback and played songs sung by either his / her parents or fiancé in the past, so their heart would restart. “The doctors and anesthetists are very well trained here to look frightened and concerned into each other’s eyes and sweat heavily when the patient goes serious. We have three specially trained “tears of joy” nurses who smile a curiously contorted smile when the patient’s heart restarts. The lighting also adapts to the situation” He described.

Then we went to the ICU.

The moment we entered, someone karate-chopped my neck and hit me on the head. As I regained consciousness, Dr. A introduced me to the ICU in-charge: Dr Akkha Kumar. I had heard the name earlier: He was world famous for his work: killing all those who were living and saving all those who were dying. “Why did you hit me?” I asked, hiding behind Dr. A. He looked at me angrily and said “This is my style.. I assault all qualified doctors, govt. officers etc. to prove that I am better than them. Do you understand?” He asked, pointing a gun at my forehead. “Yes, Sir”. I said.

A nurse came running “Dr. Akkha sir, the patient has had a cardiac arrest.. they are resuscitating him”.. Dr. AK jumped over three beds and thrashed the doctors who were trying to save the arrested patient: “You idiots.. his heart has stopped.. Khattam… Don’t treat this dead body now..”.. “But sir, she’s young, and may survive..” said one young doctor… “Bang”. He received a bullet in his forehead. “My Style, remember?” asked Dr. AK to me. Some people came in and actually performed a pooja and aarti upon him for his human values: after all killing and violence was such an easy solution to all problems, which the likes of Gandhi and Einstein had missed!!

In the next room, there were many elderly ladies. “We even provide these praying and crying Moms to our patients at discounted rates. They have a degree in emotionally blackmailing the doctor, and the only way our patient’s will start talking again, however critical with whatever diagnosis.” Explained Dr. A.

There were sounds of loud music coming from the auditorium next door. As we entered it, we saw the ever clever and strong  Chunabhai MBBS: whose famous radical theory of providing “alcohol and sex” to all dying patients had caught the fancy of our times. The old methods of religious recitals and soulful things were so bland for the dying! How could sex and alcohol not make them happy in their last days? These were the only things one could want in life, especially when dying young with grievous illnesses! Chemotherapy, Radiotherapy, Counseling.. were old treatments. How innovative and mind-blowing!

“Is it all free?” my natural question.. “Yes, for those who watch our movies. You must show the tickets for entry in this hospital. Those in emergency can buy tickets for our shows in the multiplex on the top floor.. we thought of everything.. medical charity is our aim”. “What is your first response when an emergency arrives?” I asked Dr. A innocently.

He smiled his famous “Ain’t I cutely great?” smile, and said: “Just see”.

In a few minutes, an ambulance rushed in. Dr. A was at the forefront with his team. What a hero!! The patient was apparently having a heart attack.

They made a circle around the patient. Dr. A and his team removed their shirts. Some wardboys came with buckets and mugs. Some others rushed in with a huge water pipe. The orchestra opened with loud drums, to which they all danced: “Jab Life ho out of control … Toh Hoton ko karke gol.. Seeti bajake bol… Alll Izzz Welllll (Basically a hindi song meaning when Life gives you the raspberry, just say All Is Well to yourself till situation resolves!)” .

As the music drowned the patient’s voice, I saw the relatives and TV channels line up to get the autographs of these greatest doctors upon earth!

(c) Dr. Rajas Deshpande

PS: Purely an imaginary story. No truth at all. Any resemblance to any human, animal or non living entity or event is purely a perversion of reader’s imagination.

PPS: For all the criticism of medical profession they show, whenever the b’woodians need to show a hero / heroine intellectual, he / she is a good doctor automatically. This post is for the real good doctors!

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