Category Archives: free

Medical Profession and Charity:  A Guideline For Medical Students (Speech at a recent Medical Event)

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© Dr. Rajas Deshpande

My dear friends, you will receive many sermons about your responsibility to do charity and social service from those who do no charity themselves. Many who have never done anything worthwhile for the society will remind you of your Hippocratic oath. Beware of these distractors, your social service and charity is your own choice. Thousands of doctors who chose to settle down in the remote place, purely with an intention to serve people, and carried on general practice for over 50 years are now dependent upon someone helping them for their own medical treatment. Neither the government, nor those whom we help reciprocate. Those who lecture doctors about serving the society never answer this simple question: what if a doctor serving the society very well, needs help? Who will help him? The answer is clear. First safeguard your career, reputation, family, home, parents, future and then do charity like a king, confidently, freely and with pride. Professional goals are not the same for everyone.
Some base the entire concept of charity on the low fees, without any analysis of the quality of medical care provided and the outcomes. A patient treated free but wrong, a patient treated at a low cost with a poor outcome cannot be considered charity. “Self-Declaration” of numbers of such patients treated without an analysis of outcomes and patient feedback is nothing but cheap hidden advertisements.
All of us don’t come from the same background: Some families have lived in perpetual poverty, selling off land and compromising quality of housing, clothes and even food to send their children through the medical education. Some must repay their loans, some must attend too many family duties and some just struggle to survive with a middleclass lifestyle. The first thing that we must overcome while doing any charity or social service is the feeling that those who are unable to do it are somehow lesser to us. That discrimination must go. A doctor doing his / her job well is enough charity, they have sacrificed their youth for the society. © Dr. Rajas Deshpande
Let us look at the career options most Indian doctors have.
Medical teachers have already accepted a very low salary compared to what they truly deserve, The average salary of a medical professor in USA and UK exceeds INR 8 lacs per month, working 8 AM-4 PM, with one emergency per week. Although I do not contribute to the school of thought that one must accept the low Indian financial status, at one-fourth salary per month, our medical teachers work three times more than the doctors in the developed world (because in India the staff is never filled adequately) . Still they continue to put in their blood and sweat, training thousands of medical students, working almost 24/7, seeing far more number of patients in OPD, IPD and Emergency. This is the best possible medical social service, nay, charity being done in India, let me first respect and salute this unrecognized social service. This is an ideal premise for those who want to continue to be available for the poor masses, keep themselves abreast of the most modern medical knowledge, and impart it to the meritorious future generations of doctors.
A similar career is working as medical officers in rural / semi-rural areas, where doctors are most deficient. In most Medical Institutes run by the government or municipal corporations, sycophancy and suppression , hopeless bosses, poor administration and heavy paperwork, punishment transfers and bribery are huge limitations for those who want to honestly serve patients. Life isn’t easy in rural surroundings. Right from the lack of basic amenities like water, electricity, good schooling and transport, to a severe threat to personal security by the rampant Political Gunda culture in a superstitious, orthodox community. Who will want to voluntarily expose their family to these? However, if one does have a social standing in one’s homeland, it becomes an excellent option to serve the society. © Dr. Rajas Deshpande
Coming to the non-government career options in medicine, one is either left to private practice as an individual practitioner, which offers a lot of freedom but limited resources, or a salaried practitioner at a corporate hospital.
In the corporate hospital culture, individual charity and social service becomes almost impossible. Contrary to the image created by the media, most of the corporate hospitals actually comply with the mandatory charity, worth crores of rupees every month to those BPL, but the need of our society is far more than that, the demands are never ending. The new doctor who wants to earn a good name and income, but also wants to do something worthwhile for the society as a free service, the corporate culture offers two options: a low-salaried position for looking after the mandatory charity, or working in their low input peripheral schemes. For a beginner, especially a specialist, these are both excellent options . © Dr. Rajas Deshpande
Coming to the last option: an individual private practitioner, there are many choices but also a stark reality: you are on your own, and on the day that you don’t earn, no one else pays for your innumerable bills. Remember that when you are an independent medical practitioner, you have zero income every day that you don’t work, so a single illness or problem that keeps you home for a month will bring your bank balance to zero. Unless there is an alternative source of income, which is rarely the case with a doctor, this jeopardizes your whole existence. You may be prepared to walk through this, but you will be doing your family a great injustice if you push them into this fate. Look at those who have done the greatest charity upon earth: Bill Gates, JK Rowling etc. They have first earned, secured themselves and their dependents and then returned in plenty to the world. That is the safest way to serve the society effectively and for long.
I know almost everyone in this hall is eager to help the downtrodden, poor and helpless. But there are some things you must first thrash out for yourself. Firstly, do not feel any obligation to copy charity. You can discover your own new ways to serve the needy. Completely ignore those who tell you what should be your financial worth. Once you decide what lifestyle you want, you can chart out how much percentage of your time you can work for charity. You may want to reserve one hour a day or one day every week. Be comfortable, choose what does not become a stress factor, but please stick to whatever you decide.
One hour a day by an Indian doctor means 4-5 free patients a day, that is 30 patients a week, that is 120 patients per month, and 1440 per year. If one consultation is 300 rupees, this way you are giving 4 lac 32 thousand rupees worth service free to the society.
There is a major problem : those who take advantage of free medical service. There already are many affording patients whom most doctors voluntarily see free: relatives, teachers, other doctors and their family, classmates, staff in their hospitals, maids and servants, watchmen, neighbors etc.. There are also others who demand free consultations: administrators, politicos, local heavyweights, ministers and even top businessmen who our bosses accompany. People often say that free service does not have any value, it is not respected, but I will make a small exception here: I feel that the really poor and helpless genuinely respect your free service, remember it for life and place you near God. It is the affluent who are usually thankless for free services, and it is high time that we should stop serving them free, so that we are able to serve the really deserving ones. © Dr. Rajas Deshpande
False poverty/ income certificates, visiting repeatedly for trivial / tiny complaints, daily questioning, become a huge limitation in extending free services openly. Pune teaches you many tricks to identify and deal with such people.
An equal legal responsibility for even the free patients is the law, and a major limiting factor for private practitioners as well as corporates. However careful one may be, every doctor does commit mistakes, and our courts of law are yet unevolved medically, only rare judges are mature enough to understand the intricacies of medical decision making and still rarer doctors understand the law. Look at the big picture: a doctor is treating a poor patient as charity, and unfortunately something goes wrong. The instant conclusion that it was the doctor’s mistake, the sensational news story that follows, and the threat to personal reputation all come to play together. The chance of “Extracting” money from the hospital or the doctor, in case of any complication or death, is considered a lucrative opportunity by many local goons.
A poor young lady with a stroke presented to my free OPD. I found her to have a valvular heart disease with a clot in the heart. We arranged for her free treatment, the best cardiac team in the city operated her free, for a major valve replacement open heart surgery. Everything including all complications was explained, poof on paper. In a month, she developed valve failure, a rare but known complication. The relatives returned with a gang of goons, threatened us in the OPD with dire consequences and legal action. The very family which begged for concessions with folded hands a month ago now spoke of vandalizing the hospital, beating us up. We explained to the patient and family that this is not a surgical mistake, that this is a rare but known complication, and it was still possible to correct it. Fortunately for us, the patient herself agreed for a redo surgery. The cardiac team operated her again, free, and the patient went home walking in a few days, but no one from the family ever expressed any gratitude. We had learnt a precious lesson: do not risk your career for charity or social service, because medical degrees, once cancelled or suspended are almost impossible to get back. © Dr. Rajas Deshpande
My friends, the real richness is that of the soul, and by becoming a Doctor you have already proven all that you need to prove about your soul. Whatever I must earn, I must proudly earn without causing hurt or having to deceive anyone. And believe me, Lord has provided enough for me always. Yes, there was a time when I sat in my hostel room and sung that song “Chaand Taare Ttod Laoon” from Yes Boss . Over the years, the kind Lord has responded to most of my prayers. There is no other profession in which you have such huge opportunity: your charity and service will bring people health and life: so use it freely, every day, always. Just make sure to protect yourself to help others for decades to come, and to pass on this light to the future generations.
Jai Hind!
© Dr. Rajas Deshpande
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Humanity Face / Off

Humanity Face / Off

© Dr. Rajas Deshpande

“Your father in ICU has probably had bleeding in the brain. We need an urgent CT scan” I told the son waiting outside. The old man was admitted late in the evening, although he had had severe headache and weakness on one side since that morning. His son had just returned after a “one-hour” quick meal. Besides flaunting many brands upon his person, he had already told me that he was the vice president of a well known software company.

“Yes, doctor, I am just waiting for the approval from his insurance company.” The son replied. For doctors running in and out of critical care units, the “Cool Calm” of such educated relatives is beyond understanding. Most insurance companies work office hours, approvals come at their own speed, they are least concerned about the patient outcome.

Everything was being kept on hold. Hospitals do not want to proceed with costly tests and investigations unless they are life saving, because most relatives flatly refuse to pay if the insurance company denies approval. The doctor suffers a double blow emotionally: because things are delayed and also because relatives blame only the doctor.

“This is urgent. Please consider making the payments and filing for reimbursement later, so we can make decisions faster” I told him.

“If it is urgent, why don’t you get it done? I will not pay, his insurance company will have to approve” said the son.

I thought about the patient. In the waiting room, the patient’s wife, an old lady, kept praying. I wished she was also praying for a better son. © Dr. Rajas Deshpande. I requested the hospital authorities, and as always, they agreed to help. A CT scan was done, it did show bleeding in the old man’s brain. When informed, the son winced. “How many more days in the hospital?” he asked.

“Usually it takes a week for such patients to stabilize” we told him.

“Can you discharge him? I will arrange for some nurse to give him treatment at home. Just write the medicines he needs” he said. His mother, hesitant, asked “Is it necessary to treat here, doctor? If his health is in danger, we will stay”.

Angrily, the son cut off his mom. “No, mom, this has become a business. They will extend stay even if it is not necessary. If it is only medicines, why does he need to be in hospital?” he asked me.

“Because such patients often develop excess swelling in the brain, or other complications. They can also develop convulsions or lapse into a coma if swelling worsens” I unchained my patience.

“Do you guarantee that those complications will not happen if we keep him here?” he asked.

“No. Only that he can be managed in time, if any complication develops” I replied. There’s no word called “Guarantee” in the medical dictionary. It is only a quack’s favorite trick. © Dr. Rajas Deshpande

“Then why stay here? I have a nursing home nearby, we will go there if there is any problem” the son said, turning his back upon his mother.

The open-secret was revealed soon: the insurance cover that he had bought for his father was minimal, it was over now, and he didn’t want to pay anything from the pocket.

I explained the patient’s wife about the medicines and care, updated her with the warning signs of danger in such cases. © Dr. Rajas Deshpande

“Doc, I am alone at home with my husband all day. My son and daughter in law both work and return late. What will I do in case there is an emergency?” I gave her some contacts near her home, ambulance numbers and doctors.

“Is it okay if she calls you daily to inform the patient’s condition and ask what medicines are to be given in case of an emergency?” the son asked.

“Sorry, we cannot manage patients on phone” I replied.

“Sorry doc, don’t take this personally, but there’s no humanity left in this profession now a days. No one wants to help even an old patient” he commented. I didn’t reply.

They returned in three days, the patient comatose. The brain swelling had increased to dangerous levels. Patient was operated in emergency, saved with a great effort. The son had to foot the whole bill this time. “This is quite unfortunate” he kept saying, reminding me to keep expenses “lowest” because he was paying from his pocket. Finally came the day of discharge. Knowing the questions, I explained them the medicines on discharge.

“Doc, he is a senior citizen. You must give us discounts” said the son.

“Sorry, the hospital decides the billing. My charges are already minimal”. I told him the truth.

“Just as I said, there’s no humanity left” he looked at his mother and said. It was now the time to chain my patience. I knew the right reply this time.

“Yes, Sir”, I said “ I agree. Humanity is indeed on a decline, but more in your family than in my profession”

© Dr. Rajas Deshpande

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A Habit That Protected Me

A Habit That Protected Me

(c) Dr. Rajas Deshpande

“I cannot bear this. Help me doctor”shouted the Old man fom the waiting room, just as I entered the OPD. There were appointments before him, I requested others to wait, and most of them agreed, although a little upset. I called in the old man. He was accompanied by two of his sons, both probably professional bodybuilders.

He was a known case of Trigeminal Neuralgia, a condition that causes severe, shock like or stabbing, excruciating pangs of pain on one side of the face. This usually brings the patients to tears, and most patients come frustrated, unable to talk or eat, with the telltale sign of their hand covering that side of the face, scared to open mouth even to reply. He had had this condition over ten years now, and was quite stable, usually visiting me once a year. He had last visited only a few weeks ago, smiling and pain free. There were no new findings. He kept on shouting, saying that the pain was unbearable. This was unusual. I asked him if he had done any of the prohibited things that usually increase the pain of Neuralgia: cold drinks, icecream, shaving harshly, exposure to breezes etc. He said he had had an icecream a few days ago, but the pain had only restarted yesterday.

The sons were staring menacingly at me. “How come this has suddenly worsened doc? Is this the effect of your medicines?” one asked. I wondered why they don’t teach simple logic and reasoning in primary schools. Everyone going to a gym must, in my opinion, first be mandatorily taught normal human conversation. Otherwise they speak with their biceps. Not knowing that language, I chose not to reply him. (c) Dr. Rajas Deshpande

He was already on high doses of the medicines that controlled his pain. He also had diabetes, so I could not use the best emergency medicine for such pain: steroids. Once earlier, he had developed severe infection while on steroid, so that was out of question.

I started him on a short course of a strong pain killer. Warning him that he should take it only for three days. “His pain must stop immediately” said the other son, threateningly. “I wish so too. It should subside soon, usually it takes two to five days” I concluded the consultation.

They returned five days later. (c) Dr. Rajas Deshpande

“I am very good now, Doctor”said the old man, “The pain went away the very next day. Thank You”.

Just as I prepared to look at the musclebuckets proudly, the old man said “Doctor I need a certificate that you had advised me bedrest for five days”.

I was almost prepared to write, this appeared a justified request given what had transpired. Curious, I asked him: “But you have your own business. Why do you need this certificate?”

It was then that one of the biceps spoke: “He had a court appearacne in a criminal case on the next day of our visiting you. He could not go to the court. Now the court has asked for a certificate”.

Alarmed, I told them: “I had not advised him rest. I cannot issue a false certificate.” (c) Dr. Rajas Deshpande

They looked at each other. Then the old man said “I request you doctor. My cousin has filed a false murder charge against me and my sons. Please help us. Your certificate will save us trouble”he folded his hands.

Now the secret of why that pain had worsened suddenly had unfolded. This condition is indeed known to suddenly worsen, but when such “situations”coincide with illnesses, a doctor is the easiest to squeeze the arm of.

“But we paid your fees. His pain was actually severe that day. How can you deny us a certificate now?”asked the elder biceps.

Many video clips of daylight, open murders that happen around us daily ran through my mind. Even under the heading of compassion, was it right to help this patient, who was one of the accused? As a doctor, I am not to judge anyone and must purely decide based upon the medical merits of this case.

I had not advised him rest. I declined their request for the certificate. Angrily, the trio left my room, and on the way out, in the waiting room, loudly enough for other patients to listen, the old man said something derogatory about all doctors being heartless looters. Every new patient who walked in that day had a question mark of suspicion on their face, it took me extra effort to wipe that away in each case. (c) Dr. Rajas Deshpande

Whether it is addiction to pain killers or sleep medicine, whether it is false certificates or deceiving the medical insurance companies for claims, many patients abuse their doctors’ compassion and services. Some doctors fall easy prey to such tactics, some do it for money. Majority refuse to contribute. It is this majority that such “demanding”patients always cry against.

The doctors who help such people with such causes not only endanger themselves, but may in fact add disgrace to their profession, because it is these same patients who tell others how any doctor can be fooled, or bought with some money or threat.

As fate would have it, one of the sons came to visit me the very next month, for his wife. As I examined her and then wrote a prescription for her, I enquired about his father.

“Oh he is alright now. We got a certificate from one of our relative who’s a doctor” said the son, smiling shyly: “That’s why I brought my wife to you.. I know you will do only the right thing”.

I could only thank my teachers who had tattooed that habit upon me, and taught me that only good begets good. It is a habit that has protected me always.

(c) Dr. Rajas Deshpande

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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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“Why Don’t You Marry Her, Doc?”

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Dr. Rajas Deshpande

“Sir, she cannot walk, she is paralysed below chest since last few days. Her husband doesn’t care, he has abandoned her. She has no money or insurance for tests or treatment. I want to help her, I don’t know what to do” I told my junior consultant, who was having his coffee break with senior consultant and the departmental secretaries. He looked at me in a nasty way, and said “Why don’t you marry her?” and they all laughed aloud. However, although my professor smiled with them, he asked me to get the patient’s papers.

She was a case of Multiple Sclerosis, in her early thirties, and had lost ability to walk. Her sensation below the waist, control over urine was also lost. This ghastly illness of the brain and spine often cripples the young. In many cases, when such disability develops, divorces follow. The world as we doctors see it is far more cruel, deceptive and dangerous than most illnesses humanity knows. She was left with a small daughter and no income. © Dr. Rajas Deshpande

I felt insulted, but I was in a foreign country. The junior consultant was known for his sarcastic humour and enjoyed impressing women around him, often at the cost of others, like so many dwarfs who take advantage of their chair to achieve what they otherwise cannot. I chose to ignore him, and got the papers to our boss, who called a colleague to enrol the patient in one of the upcoming research trials. That would ensure her free tests and medicines for a few years. I told her the good news. She started sobbing, then handed me a note written by her:
“I am killing myself as I have nothing left except my daughter, I cannot look after her with my disability. I have no complaints against anyone. Please look after my daughter”.
In some time, after she stabilised, she said “Doc, I had come prepared to kill myself today. My daughter is sitting in the cafeteria. If you had not told me what you did just now, believe me, I was planning to drive my wheelchair off the roof today”. © Dr. Rajas Deshpande

We called her 10 year old daughter from the cafeteria. Little did the cute child know how lucky she was to see her mother again that day.

That evening, my boss, the senior consultant, took me out for a dinner. Once the red wine loosened strained faces, he started to speak: “Rajaas, I know you are kind and you want to help others. I know you feel for your patients. But I must caution you, don’t get carried away. Your job is clear: to listen, to advise the best line of investigations and treatment, to explain, and to compassionately guide. Don’t carry too much weight upon your shoulders”.
“Why, Sir?”I asked politely, “I feel inner peace when I walk an extra mile to help my patient. How can that cause me any harm? Didn’t this lady survive just because you helped her today?”
“Because it is a never ending burden. To be able to effectively help everyone coming to you, you must have too much money and too much time. Doctors seldom have either. I lost a lot of time and money, to realise that this cycle never ends, that newer and more people need your help every day, all your life. I almost went bankrupt, collapsed and quit under stress. Then I realised that I must limit this so I could serve them best the next day”. © Dr. Rajas Deshpande

It felt like dry reasoning at that moment. However, boss continued to help patients beyond duty whenever I asked him. Over years, I realised how correct Boss was!

My dear british colleague Dr. Mindy was trying to help a patient through her divorce, I accompanied her. As the patient opened up, she revealed to Mindy that although she enjoyed marijuana, her husband was involved in the sale of other illicit drugs, and that was one reason that she wanted to divorce him. Dr. Mindy involved a counsellor to help her out. However, after they decided to patch up their marriage, the patient told her husband that she had confided in Dr. Mindy. The husband came over and politely threatened her to keep all the information only to herself, otherwise be prepared for dare consequences.
We all spent many a restless nights after that.

Emotionally disturbed, helpless patients, those who are treated unfair by family often depend upon a kind doctor. They get quite restless at times, worry a lot and then expect an immediate hearing and resolution from their doctor. From suicide threats to blackmails, there are messages that pour in once that channel is opened. This sometimes wreaks havoc in the doctor‘s life, because being disturbed affects clinical practice and decision making. The small time left for self and family is thus shot dead. A patient who becomes emotionally dependent upon the doctor can turn into a nightmare for the doctor. Over years, I learnt to balance this, going out of the way only for the few truly deserving patients.

Thousands of patients have survived just because their doctor emotionally supported them in time, otherwise they would have died of lack of will to carry on. No one ever credits the doctors who become emotional back-ups for their patients: a service that costs them time and stress, without any income. That is unfortunately considered a “duty” of the doctor, to be kind and available at bad times, but to be forgotten in good times. © Dr. Rajas Deshpande. Many actually think that good words, compliments and “a satisfaction of serving” should be sufficient compensation for the doctor. Nothing fully compensates, although kind words do sometimes make one feel good.

However, what caused worse hurt to me was some of my own colleagues who made fun of me and many other doctors who went out of their way to help patients. “Impractical, unnecessary, worthless, drama”, and so many other adjectives are used by colleagues and even seniors/ some teachers for doctors, students, residents who walk an extra mile to help their patients. I was extremely fortunate that I met some good teachers who supported my efforts without mocking me, and I continue to meet students who carry on this noble trait forwards.

When I was leaving, the junior consultant came over for the farewell too, and told me in too many words how I must learn to be “Practical”. I gave him a reply that one teacher with advanced genius had taught me years ago, for people who do less themselves and advise others a lot. This reply saves a lot of time and energy, my teacher had told me, and its beauty is that people don’t even understand that you are saying ‘those two useful words’ when you reply like this:

I just smiled at him.

© Dr. Rajas Deshpande

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The Changing Blood Group

The Changing Blood Group

(c) Dr. Rajas Deshpande

“He is sinking” shouted Dr. Siya.

The casualty registrar rushed to the bed, checked the vitals. Pulse very fast. Blood Pressure very low. Lips and nails white, hands and feet cold. The young man, unconscious, was on the verge of death.

“He must be bleeding inside. Get an urgent sonography of his abdomen”said the registrar to Dr. Siya, and call the blood bank. He will need at least two units of blood urgently”.

It was Dr. Siya’s first week into internship, she was thrilled with the idea of actually saving lives. At the young age of 22, she was witnessing death almost every other day. Along with that she was amazed to see the darkest sides of human nature: the potential of humans to hurt each other: via rapes, accidents, murders, fights. She had decided to not let this affect her attitude, and to continue to try and save every life she could.

That late night, this young man of about her own age was brought in unconscious by someone, who had just dropped the patient in the casualty and left without leaving any identity of himself. “I found him lying unconscious on the road. I don’t know anything else about him. I am just doing my duty, I have a train to catch”said the stranger and left. The patient was reeking of alcohol. He had a visible head injury. A quick CT scan had revealed minimal bleeding due to a small skull fracture. He also had had bleeding from wounds from his hands and legs, they were sutured. The patient had no identity marks, wallet or cellphone. The policy of the hospital was to provide basic treatment and shift the patient to the government hospital. The police station was already informed. Treatment was started.

Dr. Siya requested two units of blood. The blood bank called. They had only one unit of the blood for his blood group. The registrar had the same blood group, and like many doctors working in the emergency departments, he went down to donate blood.

It was nearly midnight. The fate of the life of a young man depended upon what the junior doctor did just then. There was no one to sign any consents, the protocol was to inform the hospital’s medical director and obtain consent for emergency transfusion or procedure. Dr. Siya finished the formalities, obtained the permission, and started the transfusion. If the patient had reacted or something went wrong now, they all feared, there will be a havoc in the media: that they had let an unknown patient die because they wanted money!

Dr. Siya kept on managing the show. The angry and disturbed relatives of other critical patients kept on taunting her, speaking rude and reluctant to complete simple formalities and paperwork.

The sonography was thankfully normal.

Just as the first unit of blood was over, the patient became conscious, and revealed his name. He was quite shaken with the surrounding, but told in broken sentences about his friend’s number and address. He revealed that while returning from a party, his bike was interrupted by a bunch of goons, he had fallen down, they hit him upon the head and left with all this belongings.

The friend was called, and came in. He revealed that the patient was used to smoking weed and drinking alcohol in huge quantities. They were staying in the hostel of a famous college.

The second blood unit was started, and in a short while the patient threw a convulsion. He was immediately given injectables for controlling the convulsions, he slept off with the effect.

His parents arrived early next morning.. The shocked mother was consoled and explained about the situation by Dr. Siya. The elderly father, like all fathers, equally shocked but being a father unable to cry, kept mum, just holding hands of the boy.

When the patient woke up again, the father came to Dr. Siya, and touched her feet. Too embarrased, she told him that the registrar had donated blood for the patient. The father went and thanked the registrar, again trying to touch his feet.

As Dr. Siya had finished her night duty, she prepared to leave. “Beta, Will you come soon please?”asked the tearful mother to her. “Yes Auntie, I will be back soon. Don’t worry, he is ok now”she reassured and left.

On her way back her genius young mind tried to look at the situation sitting upon her shoulder, the little third person that resides within each one who has a conscience. That booze and weed was easily available to youngsters in almost all Indian hostels, that even educated people rode bikes without helmet, that crimes were happening almost everywhere that injured and killed people, that law and order was a laughable term in many parts ofthe country, that there was no government mechanism in place to provide emergency medical / paramedic support ambulances to raod / traffic accident victims: which one is the most responsible cause, when patients like these died? Who is responsible?

She reached home, told her proud parents what had happened, that she had helped save a life. Her mother folded her hands towards the sky, said “God, let my daughter save many lives everday”.

While having the breakfast, her father turned on the TV. A famous but ill educated political leader, in his mind-and-other- organs blowing speech in Karnataka, was explaining the illiterate public how all Indian doctors charged in excess, how they were only after money, how everyone except himself was the enemy of the millions of patients surviving from critical heart attacks, accidents, strokes and other diseases. All patients getting better all over te country was only thanks to himself and his government!

Dr. Siya’s father laughed bitterly. “Next time you need blood for any poor or unknown patient, call him” he said.

Dr. Siya replied, laughing “That kind of ëver changing blood group doesn’t match anyone, it is useless for any patient, Papa”.

(c) Dr. Rajas Deshpande

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New Medical Criminals

New Medical Criminals
© Dr. Rajas Deshpande

“Doctor, Will My Dad Survive?” asked the anxious son.
“Very unlikely, we are trying our best though” said the desperate doc.
The highly qualified son had brought his father late night on a Friday, over 24 hours after he had developed a paralysis. Patient’s blood pressure was high, and heart status was fluctuating. An urgent MRI was advised.

“I will get the MRI done outside, I have a friend who gives me concession” said the son, and returned with an MRI after three hours, it did show a big clot in the patient’s brain. The son had insisted upon admission in the ward instead of a critical care unit, saying that his father “did not appear critical” to him and his family. “You want to admit in ICU because that will increase the bills. I know” he had bluntly told the doctor. The doctor had asked him to sign the refusal to admit in critical care, then sent the patient to the ward. Routine treatment for stroke and blood pressure was started, and tests sent.
“I will also get the medicines from outside the hospital, I have a pharmacist friend who gives me concession” he had told the doctor. © Dr. Rajas Deshpande

Early next morning, the father developed chest pain, and the cardiologist advised immediate stenting, as he was developing a block in the heart. . The son had insisted on using the cheapest stent. Although the angioplasty went well, the patient developed a bleeding in the brain, a complication known in stroke cases. He became unconscious. As the bleeding caused increased swelling and pressure upon the brain, a neurosurgeon was called in to decompress the brain (take off a small portion of the skull bone, to relieve pressure upon the brain). The surgery is usually safe, but the condition in which it is done is usually ultra-critical, thus risk to life is high. The son asked for a guarantee for a good outcome, and was explained that there cannot be any guarantees in medicine. He then refused the surgery, saying “I have read that surgeries are done without necessity by scaring the patient”.

Within hours, the patient’s brain swelling increased to the level of almost a certain fatal outcome. In the evening the son said he was willing for the decompression surgery, it was almost too late. The Neurosurgeon still operated him late night to make a last attempt to save life. After the surgery, the father was shifted to the recovery room. © Dr. Rajas Deshpande

It was here that the son had asked the doctor: “Will my father survive, doctor?”.
The doctor politely replied: “Sir, you have all the reports, you know what is his medical condition, so you can now google search and also ask your political leaders through their famous apps what will be the outcome, what is the next step”.

“But you are the treating doctor, you know better. You are like God for us” said the desperate son.

The doctor uttered the only two words that the doctor would want to use after hearing this:

“I Wish”.

Every Tom, Dick and Harry in the government and in the Media has become a critic of the extremely overburdened Indian medical profession made up of some of the best doctors in the world. Those who cannot run their own govt. hospitals well, cannot provide quality heatlthcare to the taxpayer, those who have corruption seeping through almost every office they own, those in whose authority (read govt. hospitals) hundreds of patients die helpless without care, compassion or treatment, those who suspend peons, ward boys, nurses and doctors for deaths that result from inadequacies like lack of essential facilities at hospitals owned by the govt., are out telling the world how Indian medical practitioners are corrupt, instead of praising how they shoulder what the govt. fails to recognize as its own responsibility: healthcare for the majority.

There are bad doctors, bad diagnostic centers, and bad pharma companies, protected by politicians and working on ‘lowest quality-lowest price’ principle. There indeed are “profit sharing set ups”. Among these, if a good doctor / specialist advises the patient to go to a particular doctor or lab or choose a particular brand, the patient automatically presumes that that the doctor is looking for extra money. So most doctors now tell the patient to “go wherever they want” for specialist consultation or tests. © Dr. Rajas Deshpande

When I must refer a patient to someone, the only thought in my mind is to offer the patient the best: because the patient’s trust is most important for me. This is how most doctors think, every doctor wants to make a good reputation, which is impossible without also good outcomes. I need to be able to discuss and be comfortable with that specialist, so we can plan best for the patient. If a suspicion about financial misappropriation looms over everything that a doctor does, it is difficult for any doctor to work. There must be accountability, but for both: the treatment and the doctor’s time, energy and skill. The doctor must be able to choose the best for the patient and the patient should have more trust in the doctor than the rumors. .

The last person who should play with trust and faith in other professions is a politician.

The patient did not survive. Neither the leaders who spoke lose and caused paranoia to affect the outcome, or the son who delayed admission, the pharmacy that sold cheapest drugs, nor the family that refused a life saving surgery had any blemish upon their reputation.

It was easier for all of them to blame the doctors who tried hardest for the patient.
© Dr. Rajas Deshpande

Thank You Dr Nusli Ichaporia for the technical assistance.

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

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

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

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

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

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

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

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

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

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

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

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

© Dr. Rajas Deshpande
Neurologist, Pune.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट
रूबी हॉल क्लिनिक पुणे

जरूर शेयर करें.

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

© Dr Rajas Deshpande

Neurologist

Pune

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