Category Archives: Hospital

Distance Yourself, Doctors.
© Dr. Rajas Deshpande

Dear Indian Doctor,
Congratulations on your bravery to face a pandemic without much support or protection. However it looks like once again a lack of funds and scientific PPE availability will be conveniently translated by one and all into “Doctor Bashing” by sermons on call of duty and other emotional yet unscientific logics. Even some administrators who have exposure to screened few, sitting six feet away from everyone are wearing PPE and N95, while appealing doctors to start opds saying there’s no risk. Should one examine a patient without touching? Do we have seven feet long hands? If we are expected to go within 2-3 feet of the patient, aren’t atleast N95 and gloves essential? But logicless arguments only waste time. Always labelled ‘Money Minded Medics’, now when doctors are sitting home, not minding money, everyone wants them to be in the forefront, appreciated by groups clapping from the safety of their homes. © Dr. Rajas Deshpande
But you know what? This has always been, this will always be. Do not expect any major change in social mindset. None of them had merit or patience to study hard for 10-15 years to become a doctor. None of them even knows what sacrifices are required in daily life, family life and personal exposure to fatal conditions on a daily basis. Their tiny grasp is limited to the last visible part: the fees for service. With an exception of honourable few, most cannot understand a medico. Least those who must please and seek attention of majority. And Majority was seldom right as per history. © Dr. Rajas Deshpande. Logic-less mobs are a reality.
Only those among us who shoe lick and toe line will be projected heroes. Most of us are beyond that. It is pathetic that no doctors’ organisations or glamorous bigwigs stood up against some of the major issues concerning fatal risks to our next generations. (DO NOT FORGET THAT).
That’s why writing this: it Is now upto each one of us to fend for ourselves. Stay calm. This is also not a time to argue with administration. Keep concentrating on your own safety while doing the best for every patient. Wear double masks if you don’t have N95. Wear cloth head cap that you can wash. Wear plain spects/ goggles. Use gloves always. If at all you touch patient wash hands thoroughly. Limit examination to necessary. Ask every patient and relative to cover nose and mouth before entering your chamber. If sanitiser is not available use spirit. Leave wallets, purses, bags in your car/ locker. Disinfect your stethoscope, torch and other instruments. Use digital blood pressure machines where possible, if you must auscultate, have the patient turn away face. Change bedsheets and pillow covers frequently. When you leave hospital please wash exposed skin thoroughly. Upon reaching home leave your footwear outside, cover your face and walk straight to the washroom. Change and immediately soak your clothes in detergent plus hot water. Take a thorough wash with preferably hot water, especially washing exposed areas like head. Take your vitamins without fail. Those with high bp and sugars please take rest and leave freely, don’t take your own health for granted. Eat well, stay safe, all of us have to save thousands and thousands for many more decades. Please do not forget that medical practice is far above and beyond one pandemic, covid or not. We must be available to serve all other deserving patients, and for them we must now take the responsibility of our own safety. No one ever stood by doctors’ well being, no one ever will.
Haven’t we always been distanced by the envious, jealous and unscientific? It’s our turn to use that distance and stay away from those. For every patient who deserves us.
All the best.
© Dr. Rajas Deshpande

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

Women’s Day and A Frightening Secret

Women’s Day and A Frightening Secret
©️Dr. Rajas Deshpande

A well respected senior, a social celebrity, walked in with his daughter. Cultured, proud people. Probably highly educated and rich. While he was richly dressed in a traditional Indian attire, she wore a saree. Many phone calls had told me since a day prior that he was very important, and that I must make sure he doesn’t have to wait. They sat down cautiously, the daughter in her late twenties looking at the floor.

“Doctor, my daughter is behaving strangely, she is not speaking normally with any of us, and seems lost since last two months. She has a lot of giddiness and has not slept for many days now. We have seen many doctors, done all the tests advised, but no one has been able to tell us what’s wrong. You see her and tell me if you can help.” Somehow the father was intimidating. I asked the patient her name. The father replied. I asked her about her complaints. He replied again. It is often very difficult to make a woman speak in the Indian scenario. I politely asked the father: “Could you please let her reply?”.

She replied in single words, mostly yes or no. She appeared to have given up. It is indeed tough to deal with such ‘mentally closed’ patients. I obtained her permission for a clinical examination and found nothing abnormal.

“Are you stressed ?” I asked what was inevitable now. ©️Dr. Rajas Deshpande

The father repied promptly: “There’s nothing to stress about, doctor. She works as a lecturer at a prestigious institute, we are quite well off, and although we want her to marry soon, she refuses to meet anyone. We are okay with that too, we are in no hurry. I dont think there’s any stress here. She just needs to be mentally strong. She has lost her will power”.

At this point the daughter looked up at her father, begging him to stop.”I have done whatever you asked. I came to every doctor you took me to. I am not weak. Please stop all this now, I will recover in few days”. I sensed something wrong here. I asked her if she wanted to speak in privacy and confidence, offering a nurse to attend instead of her father. Her father was visibly annoyed at the suggestion, and terribly surprised when she said yes. With a firm face, she said “Can I speak with the doctor alone for a few minutes, Baba?”. Her father walked out. ©️Dr. Rajas Deshpande

“Doc, I don’t know what to do. I am in a terrible situation. As you see, everyone is scared of my father, so no one tried to speak to me in privacy prior. To be able to trust you, I need your word that you will never tell my father about this discussion. If you cannot keep that word, it is best that I don’t speak with you about my problem”. This was a common request. A doctor’s first loyalty is to his / her patient. I reassured her that whatever she speaks won’t go beyond me, and also told her that she should be completely honest and open, that I was not here to judge her but to help her.

She paused, embarassed. The stress and shame of what she was going to say reddened her face. She sipped some water and took a deep breath.

“Okay doc. Five years ago, I was in love with a classmate of mine. He is from a well known politician’s family, and we were very close. We were planning to marry after a few years. He had alcohol frequently, but had promised me he would stop after marriage.”

She paused again, now tears in her eyes. “Please don’t misunderstand doc, but like all other lovers of our age we exchanged naked pictures and video clips. We also recorded some of our own, making love. As my father often checked my phone, I deleted everything immediately. I told him too to delete them, but apparently he stored them. After a few months I found out that his alcohol addiction had become worse, and he was going around with another girl, so I stopped seeing him immediately. He never cared, and he married someone his parents had chosen”.

“However, three months ago, out of the blue he called me and asked me to meet at his home as his wife had left him. I refused. Now he is threatening that if I do not meet him he will upload my nude pics and videos on the internet. Their’s is a very strong and rich political family, I know he can do anything and get away with it. You just met my father, you can imagine his reaction to this. My family is proud of me, but they will never accept or forgive me for what I have done. I feel ashamed, but there’s nothing I can do about it now. I am loved where I work, my students look up to me as a teacher. All is on the verge of being lost for me now. I feel like I should permanently disappear. I don’t know what to do” and she let out all the sobs she had held for months.
©️Dr. Rajas Deshpande

This wasn’t new to me. While virtual exchange of ‘love’ in form of nudity and self recorded sex between couples is a reality of current times, it strongly contrasts with the social preparedness for it. Our society is not only orthodox, but shamefully, violently critical of anything that offends their cultural tastes that vary from family to family. An exchange of such nudity between couples in love is their personal choice and preference, no one should feel offended by it. However the dilemma of its correctness arises when situations of such blackmail as mentioned above create catastrophic consequences.

Many women (and I am sure even men) face threats of their privately exchanged nudity being exposed. This rampant blackmail that extorts anything from money, sexual favours etc. to various other compulsions are a nightmare turning into a reality now. Although the cyber-crime cells admirably track down the culprits, the victims still go through a lot of humiliation till then. Many victims do not know where to get help, and women’s organisations, NGOs need to reassuringly come forth with plans that ensure complete privacy and confidentiality of the sufferer. What offends most is the callous allegations of cheapness, wrongdoing , shame and derision with which our society criticises the victim. Some people and many in media actually take a perverted interest in exploring private nudity and sex, as if looking for certificates of their own piousness in someone else’s ‘moral adventures’. ©️Dr. Rajas Deshpande

I told my patient that we could help her, and handed over the case to a female counsellor who is well versed with such cases. Although she has proper connections in the cyber crime department, usually this is not required, as the threatening cowards usually come to their knees oncethey know that the victim has someone’s support. The last I heard, the matter is resolved.

Stronger laws to respect privacy, stronger punishments for those who use such threats to their ex-lovers and a social revolution to accept the realities of today and reassure the victims rather than shaming them are essential. A complete ban on reporting of such cases as “Spicy News”in media is awaited.

On this Women’s day, I humbly bow to the higher gender, the mother and the sister, the wife and the best friend called woman. Only what a man learns from a woman makes him the man that he is, and in that, she is the teacher: of patience, of modesty, of hard work and sacrifise, and the soul of true love.

©️Dr. Rajas Deshpande

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P.S.
Partly Imaginary story.
I truly respect a woman’s freedom, and her ability and right to defend it. My views above are to express that respect. I am not a socio-cultural legal expert and certainly not a moral judge. Never mean to offend anyone.

Doctors and Religion?

Doctors and Religion?

Abdul Majid, (middle) my classmate, stayed across my room in the boys hostel, all 5 years of MBBS. I have never seen him sleeping or eating. Whenever we saw his room door open, he was either studying or offering prayers. I have often borrowed his luna moped to go for a tea in late nights. He comes from a very humble family, and had always been among the toppers in every batch: MBBS, MD, and then DM. We have attended many cases together before he finally settled in Aurangabad and made a big name for himself. I have not seen a more hardworking doctor than Dr. Majid.
Ateeq-Ur-Rehman (Right) is another such brilliant doctor, coming from my small town called Nanded, who has scaled highest levels of education in India with sheer merit, and has now settled as a successful Neuro-Intervention specialist in Hyderabad.
While I treat hundreds of Muslim patients who come with complete faith and trust without thinking about my religion, Dr. Majid and Dr. Ateeq have also served thousands of patients from all religions including Hindus, who have complete faith and trust in their ability and acumen.
Whichever religion, state or country a doctor may come from, there never is any thought about religion or caste when we treat patients. Humanity, compassion and Scientific logic is the ground upon which medical science is based. There’s no place for any discrimination, racism or even enmity. Thousands of doctors from all religions: Hindu, Muslim, Sikh, Christians, Buddhist, and many others treat millions of
Indian patients every day. We doctors take pride in rising above all differences, thinking of all humans as one and equal, and in the trust that our patients show in us, irrespective of our names and external appearance. Inside, every doctor, whichever religion or country they may belong to, represents only one principle: the desire to do the best for those suffering.

I am proud to belong to this medical culture and tradition of unity.

© Dr. Rajas Deshpande

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An Interview With a Neurology Legend

An Interview With a Neurology Legend

Dr. Satish Khadilkar

MD, DM, DNBE, FIAN, FICP, FAMS, FRCP (London)

Dean and Professor and Head, Department of Neurology,

Bombay Hospital Institute of Medical Sciences, Mumbai.

He is a living legend, one of the best neurologists anywhere, a stunning example of what an ideal doctor should be like.

He needs no introduction to those in the medical world: he has carved his golden name in global neurosciences with his passion for Neurology and especially NeuroMuscular diseases, pioneering this specialty in India. I am grateful to Dr. Satish Khadilkar for agreeing to guide us all.

Q: How does it feel at the top?

A: Grateful to life!

In the health pyramid, ‘top’ really means ‘more useful’! And there are at least three parts to being useful: providing service, teaching and conducting research. Indeed, I am grateful to life for having provided me with the opportunities to be useful to colleagues and disease sufferers in all the three spheres.

Q: What are the most essential qualities that a doctor must possess?

A: As mentioned above; service, teaching and research are the three main pillars of medical careers. Each of these requires different virtues. Service requires patience, availability, affordability and the capacity to empathize with the sufferers. Teaching requires clarity of ideas and the ability to be inspirational to the new entrants and younger colleagues. And research requires an analytical mind to understand questions, be unbiased to design experiments in search of the answer.

Depending upon which field you choose, relevant qualities will need to be enhanced. In my mind now, as I have gone on, service has emerged as the noblest frontier for the medicine man. So the essential qualities are compassion, knowledge and the desire to help.

Q: What do you suggest we do to improve the clinical sense among newer generations of doctors?

A: Simple answer: bedside clinics by masters of clinical medicine and shadowing them to see how they utilize the limited resources.

Q: How do you deal with the ever widening knowledgebase while effectively practising as one of the busiest practitioners in the country?

A: Knowledge is of two types, one to know it yourself and the other, to know where to find it! In the present times; we have moved on to the second mode. The great thing about this era is that knowledge is freely available. We only need to develop the ability to design the search to get rapid answers to our questions. There are courses available to this effect.

While this is true for problem-based daily issues, in one’s own area of interest, one has to acquire all the manuscripts and threadbare them, assimilate them and understand them, for deeper knowledge.

Q: How do you handle the incessant negativity which doctors face while dealing with so many incurable conditions and gradually deteriorating patients?

A: Negativity in the doctor’s mind stems from the perceived personal inability to help or to provide solutions. Doctors need to appreciate that their role is limited to being knowledgeable helpers. If we keep in mind the inadequacies of medicine as a science and our restricted role, negativity is less likely to take roots.

Q: What is your take on making holidays, vacation compulsory for doctors to overcome stress?

A: Personally, I do not see the need to take holidays, as my daily work itself is a never ending holiday! I do not remember taking a holiday in last three decades. The better you gel with your work, less it stresses you and less is the need to break.

Having said that, as our work relates to human life, we have to make sure that we take adequate rest and are “on the top of our game” for the hours that we work, as our shortcomings can have consequences.

Q: What advice will you give about handling family responsibilities and duties to the new generation doctors?

A: Human relationships take very long to build and only one indiscretion is enough to undo these. So, in relationships and family, equal attention needs to be given, as you would in your profession. In today’s competitive India, we tend to take the family granted and actually end up doing the least for those who matter most!

It is best to think of this early on while planning the professional career.

Q: What best can be done to stop the exodus of doctors from India?

A: Talented Indian doctors need to be appreciated by the society and the health system in India. System needs to be more humane and responsive to the doctors’ needs. Doctors also need to understand the process of medicine, its goals, trials and tribulations. Till this happens, we shall see movement to greener pastures, where this process has evolved better.

Q: Your guiding thoughts for future Indian Doctors?

A: Let us all remember that we are in medicine to help suffering people. That is the core of medicine. We are healers and scientists. If we don’t veer from this ideal and have patience, all material wants and requirements will automatically fall in place. So to understand medicine, one must never forget that this is the noblest of all professions. I have chosen its nobility as a guiding principle for myself. I found my solace in drowning myself deep in the vast oceans of knowledge about neuromuscular disorders and using it in the service of suffering multitudes.

©️Dr. Satish Khadilkar & Dr. Rajas Deshpande

The Dictators in Hospital © Dr. Rajas Deshpande

“Let my father die. It’s ok. I will not take him anywhere. I don’t want anyone else to treat him” said the 60 year old son loudly. His old father who could listen and understand the conversation, but could not speak or move due to a paralysis, just closed eyes. Tears emerged from the corners of those closed eyes.

Like most doctors nowadays I have learned to master personal opinions and emotional responses, especially with ill-behaved patients, but this was beyond me. Not because he had shouted at me, but because he had just stabbed his father’s heart. Loudly, so that the patient could hear, I said “I think your father should feel better soon, let us see what we can do”. Then I gestured the angry son to see me out of the room. Two other men accompanying him came out and towered upon me.

About five days prior, this son had come to me with his father’s reports. The patient was admitted at a rural hospital. He had severely compromised heart function and his heart rhythm was abnormal. This caused formation of many blood clots in the heart, which went to the brain blocking blood vessels. One such large blockage had caused paralysis and inability to speak. © Dr. Rajas Deshpande

I had asked the son not to shift the patient, as the treatment started by the rural physician was accurate, we had to just wait and watch. Still, they had brought the patient in an ambulance, travelling for over 4 hours. Naturally, the patient had worsened , becoming drowsy. His heart rhythm was dangerously worse. He was unable to swallow, there was a big risk of his saliva/ mouth secretions going to his windpipe blocking his breathing.

Whenever a patient has problems out of a specialist’s expertise area, it is mandatory that an opinion of the concerned specialty expert be obtained. I asked the best heart specialist I knew to see the patient, and also a small ENT test to see if we could initiate training for swallowing. Our physiotherapists were already working upon his hands and legs gently.

However, the son (a retired govt. officer from a very respectable post) and two others attending the patient created a big scene when my junior doctor visited the patient. They started shouting and cursing that by calling other specialists we were just “increasing the bills”, and that they did not want anyone else except me to see the patient, not even the junior doctors. © Dr. Rajas Deshpande

My assistant physician called me in panic and updated about this, asking me to immediately act to deescalate the situation. Although there were many patients waiting to be attended in OPD, I had gone to this patient’s room. I explained to them that the patient needs to be seen by a heart specialist too, as his heart condition was very delicate. I also offered them to choose any specialist or hospital they wanted, if they were unhappy here, but they could not waste time as the patient was critical. That’s when the son shouted that he would rather let his father die than be seen by any other specialist.

When they came out of the room, their body language and general disposition suggested aggression. I tried to politely reason with the son that any specialist cannot sit with the patient 24/7, that junior doctors and other specialists as required will have to be called in for the best care, but they declined. The efforts of our medical superintendent and best patient coordinator went in vain. © Dr. Rajas Deshpande

“We will not allow anyone except Dr. Deshpande in the room. Our patient must get better” the son said loudly.

“I will see him till he is under my care, but I cannot guarantee any outcomes” I told them. “Let’s see” he said. He did sign the document informing about criticality of the patient.

No doctor should treat patient under pressure, duress or threat in the interest of the patient. I went to our medical director and requested that the patient be transferred under some other specialist. The hospital offered them freedom to choose, but the relatives declined. “We have come here for Dr. Deshpande, he will have to treat the patient alone” the son said. The hospital decided to take a call next day after a meeting.

That evening as I finished the OPD, I wondered how the patient was. However much angry I may have been with the relatives, the patient was more important than my anger, pride or anything else. I went to their room and checked the patient. He opened eyes and smiled. I asked him his name, and he replied in a husky tone. He was speaking now!!

The next day again, the relatives refused to transfer the patient under someone else, and I kept the treatment on. The trustless atmosphere was quite volatile, and if something had gone wrong, things would have taken an ugly turn. In the next three days, the patient spoke well, and even accepted some sips of water. His hand and leg started moving too.

“Can we take him home now?” the relative asked on the fourth day.

Happy for many reasons, but mainly the fact that the patient had improved, I discharged the patient. I had learnt my lessons. © Dr. Rajas Deshpande

Adamant, unreasonable and illogical demands by patient’s relatives jeopardising the patient’s life is a huge medical problem in India. Illiteracy, political interference, goonda culture and media support make such horror stories a routine reality. The law still expects the best patience and non-reacting approach of medical personnel, with the onus of saving lives still upon them under this pressure. Innumerable instances of harassment and humiliation of nursing staff, especially women go unreported. Relatives, especially politically connected, behave like dictators in any hospital, threatening one and all. Unless this culture ends and doctors are at a freedom to do their best for every patient, medical care in India will always remain inaccurate, incomplete and purely financially guided rather than scientific or even legal. Doctors can actually file a complaint or take legal action in such cases, but they are too many, and no doctor has time for such legal courses. In the best interest of our patients’ lives we go on forgiving and tolerating such abuse. Because neither law nor administration wants to correct the causative factors effectively.

© Dr. Rajas Deshpande

Neurologist Mumbai/ Pune

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Take me for granted

©️Dr. Rajas Deshpande

Neurologist

Pune/ Mumbai

“Is your food more important than the patient?” asked a angry voice on the other end of the phone.

It was a Saturday night, about 11 PM, and I had already had a tough day. I had not had time for even lunch, my head was hurting already. I had known the patient for over five years, her husband wanted to “discuss something” urgently. I had requested him to call next day, honestly mentioning to him that I was on my way for dinner. That’s when he asked if food was more important than patient.

“No. Food is not important than the patient”, I said, “Please tell me.”

“Listen doc, today after dinner me and my wife had our usual walk in the society, when we met a neighbour who told us about a new herbal treatment for neurological patients. He said it worked like magic in paralysis cases and the cure was guaranteed. He had some extra bottles, but it is very costly. So we decided to call you and ask”.

“What is so urgent about it?”I asked.

“Not urgent, but we were both very excited and anxious, so we decided to call you and ask” He replied. I told him that that they were free to try anything they wanted, yet cautioned him to check the contents and then alone take any medicine.

I wasn’t angry.

The next morning, I had to visit a government office. There was a huge queue. By noon, as the queue extended, the officer got up and with a calm face went for his lunch, displaying a a sign “Lunch Hour”. I wasn’t angry.

©️Dr. Rajas Deshpande

I remembered the time when I had to visit a minister, a bigshot political leader for some issues about resident doctors. We had to repeatedly call for appointment, it was cancelled many times, then we were made to wait for hours, securitymen surrounded the elected representative, considered a public servant. Then at six he suddenly got up and left, quoting an urgent meeting. I wasn’t angry.

Because as a doctor I am perpetually alive to the fact that people take me for granted. That they will misuse compassion, avail of my private time for trivial reasons without feeling any guilt or compensating for it. That they will expect me to be sympathetic even with arrogant, abusive and blatant liars who treaten me with assault.

Because big ministers and political leaders who have a checkered past and disrepute of lying can openly make allegations that tarnishes the image of all doctors in the eyes of our “Election Elite Public”. Blanket allegations by many that accuse all doctors of indulging in malpractices and foreign tours or worse, ‘asking for women from pharma’ have become common.

Don’t these people know that thousands of most successful doctors in India are in fact women, and it is such a huge insult to those as well as the glorious careers of many thousand other medical professionals who live a life of an ideal doctor, who have trained millions of medical students successfully in that tradition?

©️Dr. Rajas Deshpande

More than half of those in the parliament must have been successfully delivered by a qualified doctor, and most of them must have had their children brought up/ treated by expert doctors. Most politicos must be under the treatment of some or other specialist, so that they can work well, still they have this habit of “Attention seeking” by trying to disgrace the whole profession of best qualified people of their own country.

What ingratitude!

The other day I also saw a video of some sermon in some village, making fun of doctors and specialists. The religious speaker, who could have easily qualified as a stand up comedian, and had no clue what a doctor does and why, was making cheap fun of doctors. What was more alarming was the way public was laughing and clapping, thousands of them! I wondered how many of them, their family members were treated by some doctor, and how many of them remembered it. I can understand and enjoy jokes and fun. But this was maliciously criticising an entire profession of highly educated people serving India 24/7, inspite of the hate and paranoia that surrounds them, that too by a person without any medical background or qualification! Many comedians have actually gone beyond “graceful” and “quality” comedy to cheapest low levels to criticise doctors. Hope they meet good doctors who avoid head traumas at least when their children are born!

©️Dr. Rajas Deshpande

You cannot and should not make fun of militarymen. That never means there cannot be anyone wrong in themilitary / army. But there’s a system to deal with that, it is not open for politicos, temporary ministers, and self proclaimed godmen / women / artists to criticise the military. The guilty must be punished, whether in any profession or service, and it should be done legally, and others should stop speaking about it. This should apply to the medical profession too. There indeed must be some doctors who are wrong, they must be dealt with, but we do not go out and blame everyone from other profession!

The most common allegation is about doctor’s handwriting. Well, if you have the guts and patience to listen to over 50 crying/ complaining people every day, while writing for them a “Scientific” list of medicines, which can save life or kill, without committing a single mistake, for decade after decade, then you are welcome for a handwriting challenge with doctors. Google the word “Scientific” and see how much of your speech is scientific before you speak abut doctors! For government hospitals, the daily patient number crosses 150 per doctor. Every prescription is a huge liability. If the chemist can read it and others cannot, who is illiterate?

©️Dr. Rajas Deshpande

I have seen the most artistic and best handwriting by doctors at all levels: students to specialists. Indeed, some doctors may have a bad handwriting, but in a country that has many illiterate leaders, some who never completed school or college, a society with one of the highest illiteracy rate in the world, it is such a paradox that they all have such a unity when laughing at doctors who write 40-200 pages every day, each page bringing back someone or other from suffering to relief, from death to life!

No amount of a leaders’ loud and chest thumping speech will ever save a patient from a heart attack or paralysis. No amount of comedy will take off the ventilator of a comatose patient in critical care unit. No poetry in beautiful handwriting will safely deliver a child. No political leader can stay awake in a casualty to treat a dying poor found injured on the road. All Doctors do this.

Still, I am not angry, because I have come to accept the fact that Indian society hates their most meritorious, studious children: the doctors.

Take me for granted, I am all yours.

For now.

An Indian Doctor, happy with his purpose of saving lives, reducing suffering of Patients from across the world, too busy to stand up and waste my anger on cheap attention seekers.

©️Dr. Rajas Deshpande

Neurologist

Pune/ Mumbai

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Young At 98. Secret?

Young At 98. Secret?

©️Dr. Rajas Deshpande

A few months ago I had received an emergency call for a stroke case. The resident doctor informed me that the patient was a lady of 98 years. Her basic tests were normal.

Worried, because stroke is a dangerous diagnosis at any age but more so at that age, I ran to her room as soon as I reached the hospital. A group of her worry-faced relatives waited outside her room.

I entered the room and introduced myself to the patient. She got up.

“Namaskar! How are you doctor? My name is Champadevi Gupta” she said with a big smile and such gusto that I wondered if she was the right patient.

“I am ok, thanks. What happened today?” I asked her.

“Nothing much. I had some giddiness but my children worry so much about my health that they rushed me here”.

Although her examination revealed only mild signs, her MRI had shown a small block in a blood vessel supplying a crucial area of the brain. I explained it to her. She laughed aloud again “I feel okay now. When you feel ok, let me go home”.

She was discharged next morning.

She came in thrice after that, every time walking in with a big smile, lighting up everything around her, keeping her hand upon my head and sumptuously blessing me, inviting for a meal at her home.

Today she came with her youngest son. She is as fit and fine as any young teenager, only happier and more content.

“She has always been like this: happy and content with whatever life brings, in good and bad times” her son Satish told me, “we are 5 brothers, we all look after her, but she still lives alone near my home. She is like a treasure and source of life for all of us”.

Indeed. A laughing, smiling, truly happy, positive and content person is probably the most precious form of human being, and so rare now, that sometimes I want to tell those running behind one thing after another, killing themselves every day: “Look at this lady’s face! This is the secret of a good life, the best health and happiness”.

It is so sad that we are evolving into a “Want more” type of materialistic, selfish, disconnected world with misplaced icons! I was amazed at the willing, involved enthusiasm with which this lucky lady’s children cared so well for her! Incidentally, I had had a tough argument with my teenager kid that morning and had left home in a slightly bad mood. After meeting Champadeviji, whose eldest son of over 80 years still visits her regularly, I was relieved. Parenting is a long term, never ending activity, and may be my own stresses of being a doctor were also distressing my kids sometimes.

As I told her that she was fine and need not visit me for another year, she held my hands, hugged and blessed me, and with mock-anger said “Now if you don’t come to my home I will come to yours without telling you “.

I am now in a true dilemma.

©️Dr. Rajas Deshpande

Diagnose This Indian Disease

© Dr. Rajas Deshpande

“Doctor, we had gone to the UK” the patient’s husband was telling me, “What an advanced world that is! Extremely clean and very systematic! People are so well mannered, everyone is respectfully treated. So many facilities… and there’s no pollution at all! I think that world is at least thirty years ahead of us.”

His wife was an extremely complicated case of a subtype of Parkinson’s disease, under my treatment for over three years now.

“I agree”I replied, and I meant it, although it somehow felt sad about it.

“By the way, doc,” he continued hesitantly, “while we were there our son had taken an appointment with the best Neurologist there. Actually we had to pay 250 Pounds, but we thought we could use the opportunity to get a second opinion. We met the doctor there and showed your papers. He checked the patient and advised us to repeat all the tests. He confirmed the same diagnosis and asked us to continue the same medicines given by you, and said there’s nothing more to be done. I am sorry, we completely trust you, but our son insisted on a second opinion. Now we will continue to follow up with you”. © Dr. Rajas Deshpande

I smiled and replied “I am absolutely not offended. A second opinion is a patient’s right and we all exist for the patient. I am happy that the neurologist there has agreed with the current diagnosis and treatment. The only problem is that you had to pay twenty three thousand rupees just for that one consultation ”.

“That was only for the consultation, doc! We paid separately for all the tests” his voice picked up.

Almost every patient who seeks medical care and treatment in the advanced world has experienced that things are easier, faster and cheaper in India when medical treatment is concerned. While Indian doctors may be equal to those in the western world, the technology definitely lags behind because of the red-tapism and taxation, the expectation of charity (and thereby socio-political misuse) from every investment. © Dr. Rajas Deshpande.

While the Western world is decades ahead of India, most medical specialists in India is at par with the western world, and are available at a far lower cost to almost everyone. Faster appointments, much faster turnout of investigations and reporting (probably the best in the world), diagnosis and treatment is something every Indian and especially administrations should be proud of. It takes months to get appointments with the specialist, for MRIs, and for treatments too in most cases outside India, so many from the advanced world actually travel to India for medical treatment. The costs are extremely high in most world, so are insurance premiums, and doctor’s salaries.

All the credit of this medical advance in India goes to the private medical practitioners and institutes, corporate hospitals. Yet most Indians speak in derogatory terms about them. Deliberate attempts of fault finding, accusations of greed and malpractice by politicians, society and media, allegations about medical colleagues by the dissatisfied, unsuccessful practitioners and seekers of quick fame, and an environment of perpetual mistrust and legal action has really made practising difficult for many Indian doctors. Still, we have the best turnaround time and accuracy at lowest costs. Some day someone sane in the administration will hopefully realise this.

When I handed over the prescription to the patient, the husband winked at me “Doctor, I am a pensioner old man. My son made me spend for all the medical in UK, as he had no insurance cover. Can you give us some senior citizen concession?”

Like every Indian doctor who accomodates every Indian patient, I did!

What do you call the condition where you do your best for someone, but the expectations of more never cease at the other end?

© Dr. Rajas Deshpande

Neurologist

Pune/ Mumbai

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