Category Archives: Humor

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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Which Is The Best Festival Upon Earth?

Which Is The Best Festival Upon Earth?
Dr. Rajas Deshpande

“Happy Diwali” said Mr. Abdul as he entered with a box of sweets in the OPD.

Over five years ago he was admitted with a complete paralysis, and had fully recovered as he had reached the hospital within two hours of the onset of paralysis. Since then I had received his Diwali hampers without fail.

A happy gentleman who liked to make funny sarcastic comments (maybe Pune effect), he made me smile every time. “Your fees has increased, doctor, but my feelings of gratitude for you will not change” he said now, silently laughing: “Every Diwali I remember that I was admitted on the Laxmipooja day, and our family was worried if the specialist doctors will be available. My wife was praying that there should be some specialist doctor to attend my case all the way from home when I became unconscious” he recalled. Dr. Rajas Deshpande

Indeed, he was admitted on the auspicious festival day, the junior resident doctor had activated the stroke code, our team had rushed in. I was already in the hospital to see a VIP leader whose headache usually worsened on holidays and then many specialists had to be called in to ego-massage his headache. So I could see Mr. Abdul immediately, and explained to his family that his condition was critical, that there were risks of complications in the first few days. Uncertain with the new doctor, they requested that I talked to their family physician Dr. Feroz. I did.
This is but natural, and there was no reason to feel offended with the anxieties of a serious patient’s family. In the age of trustless relationships where couples check each other’s cellphones like detectives and parents and kids question each other’s intentions, it is hardly possible that a serious patient’s family will blindly trust a new doctor. Even some doctors distrust new (not senior / junior, but the one being consulted for the first time) doctors. The only possible solution is an understanding doctor who takes this in stride, refuses to be offended, and acts in the best interest of the patient, taking an extra step to make the worried family comfortable. There are indeed some who never trust anyone whatever one does to satisfy them, but that is their own cross to carry, one should simply ignore the ugly trait. It is well known that those patients who do not trust any doctor suffer worst, as they don’t take anyone’s advice seriously. Dr. Rajas Deshpande

Three days later, as Mr. Abdul recovered, the family breathed in some confidence, and started believing all that I explained, without having to involve their family physician. Since then, although I have advised that he does not require to see me now, and instead he can follow up with Dr. Feroz, Mr. Abdul visits me every six months for a check up. His wife calls me Rajabhai, a name I would not have allowed anyone to call me with, but couldn’t dare tell this to her!

This is a pretty standard picture across India, most of even the poorest recover well from strokes, accidents, burns, infections, fractures, heart attacks and various other emergencies if they reach hospital in time. While people all over the world wish happy festivities to each other, take holidays, revel and eat and enjoy, while leaders give long festive speeches from their farmhouses to please various voters according to mob IQs, it is the professionals like doctors and servicemen like police, military, etc.who slog and run to save lives. They forget family and enjoyment to be available for those who suffer. The perpetual thankless will immediately say “but this is a choice you made”, but not understand that this choice was made to be respected, to earn well and to save lives, not for the society, the skimpsters and politicians to take advantage of. To see the sick and crying, angry people, to witness death and disability on the very days that your family expects you to be happy with them is not something one can easily come to terms to, and this is lifelong, not a five year term with long vacations. Dr. Rajas Deshpande

The fact that millions of critical patients are attended well during the most auspicious festivals: Diwali, Eid, Christmas, and all other religious festivals included, is conveniently forgotten once the festivals are over, and then the mudslinging about medical professionals starts, with the long speeches advising doctors to work harder with lesser expectations. Dr. Rajas Deshpande

“Doctor, this is not about Diwali or our religions” Mr. Abdul said while leaving, “this is to continue the tradition of humanity. There must be so many patients who can be with their families this festival, because some doctor worked hard to save them. This is my token of respect for those doctors”.

As always, I told Mr. Abdul that I was immensely grateful that the superpowers gave me this opportunity to be a doctor. I meant it. Dr. Rajas Deshpande

I often imagine: what if I was born with too much money, son of a rich father, with no worries for earning and no limits on spending, I would so much love to roam around the world in luxury cars and jets, among beautiful people (you understand), enjoying life to the brim, without caring for any suffering around me. In that case, I might have been very happy probably, but I won’t have respected myself as much. Even the most junior, newest recruit of a doctor is far superior to anyone who has chosen to cunningly ignore the suffering around, speaking big words and doing nothing about it.

Therein lies the best festivity in life: being a doctor, with an ability to abolish suffering and avert death.
Dr. Rajas Deshpande

Happy Diwali to all Patients, Medical Students, Junior and Senior Doctors, Resident Doctors, Nurses, Technicians and wardboys, Hospital staff and administrators, and to everyone who cares for others, showing it in their actions.

Advise Doctors What To Do?

 

For the hypocrites who don’t do anything to correct their own profession (almost every profession has immense corruption), but think they have the right to criticise other professions. Criticising the most intellectual profession of doctors irrespective of one’s own credibility, effort, contribution, or even intellect, has become an ugly fashion.
Here’s the answer:
(C) Dr. Rajas Deshpande

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Homoglobin

Homoglobin

© Dr. Rajas Deshpande

“How much is your experience, doc? Have you ever seen any cases like this?” she asked. She was accompanying her father who had Parkinson’s Disease, quite common all over the world.

Many hilarious and abrasive retorts came to my mind:

‘Do you ask such questions about the pilot or driver when you board a plane or bus? , Do you ask such questions when someone absolutely inexperienced is made a minister of important portfolios like health, defence, environment etc.?’ If you can have faith in them, why cannot you trust your qualified doctor?© Dr. Rajas Deshpande

However, being on the doctor’s side of the table, I could not allow myself losing patience so easily. I chose the most professional answer, forcing a smile: “I am practicing since 25 years, over 15 as a Neurologist, and I have seen over two lac thirty thousand patients till now. Almost every Neurologist sees an average of 30-40 patients per day”.

When the rural / illiterate populace asks these questions innocently, I am never offended, but if it is the literate suspicious kind who treat manners and etiquette as an ‘optional’ part of communicating with the doctor, I feel just like when someone spills my ice-cream. It is difficult to connect with a paranoid literate, however hard one tries.

Apparently satisfied with my experience, she shot her next google bullet: “Can this happen because of his low Homoglobin? I read it on a blog.”

“The correct term is Hemoglobin”, I told her, “and its low level does not cause Parkinson’s”.

It was over 45 minutes since they entered, I had replied to every point on the question paper that they had prepared from a Googlesearch syllabus. The next patient must be already angry now, I thought.© Dr. Rajas Deshpande

“How can you be so sure that this is Parkinson’s Disease? What’s the proof?” Fired she.

“There are many diseases where there are no proofs of diagnosis, some can be proven, most are based upon the doctor’s clinical judgement. Sometimes quite costly tests are required to prove what is an obvious diagnosis. You are welcome to obtain a second opinion” I replied.

“Can his Parkinson’s be the side effect of the knee surgery done eight years ago?” She.

“No” me.

I now issued a DNR (Do Not Resuscitate) order for my gasping patience.

Most doctors know the simplified versions of how to explain the patient in layman language about the common diseases/ disorders. Every type of case requires a lot of reading and actual handling / treating to gain insights about that condition, something that is impossible to explain exactly to the patient / relative, especially because they do not know the basic concepts, organs, their functions etc. What even the brilliant medical students take repeated readings and many case studies to understand well, cannot be simplified enough to explain to all and sundry.© Dr. Rajas Deshpande

Add to this: every patient even with the same diagnosis is different, needs an individualised approach, and no google guidelines or statistics can replace the doctor’s wisdom in making a treatment decision especially in complicated cases. To make the most accurate decision and to explain it is a doctor’s duty, but the understanding quotient of the patient or relative cannot be the doctor’s responsibility. Medicine is so complicated, that even the most experienced doctor in the world cannot say he knows everything about any single medical condition.

The more you attempt to educate some literates, the deeper in a quicksand you enter. Because they are not satisfied with the fact that the doctor is making the best effort to educate, but look upon this as an opportunity to question the knowledge and wisdom of the very expert whose opinion they are there to seek!

They try and catch words and cross question as if it is a legal argument.

“You said swelling: show me where is the swelling?” most common question.

“Well, it is called Inflammation in medical language, there is no accurate translation for that word even in Hindi, hence we commonly use the word swelling. It may not be a visible swelling”.© Dr. Rajas Deshpande

It is not always the fault of doctor’s ability to communicate, it is often the over-expectation that one can understand everything. It is laughable that even those some whose life is a mess, who are failures in their own chosen paths try and argue about medical diagnosis and decisions with highly qualified doctors.

However profound a doctor I may think I am, there are so many things I do not understand: politics, finances, many people’s behaviour, mathematics, government, etc., and I am ok without ith not understanding most. However I do not have the audacity to ask an expert in these fields / professor / CA whether he / she has enough experience.

But with a doctor, these liberties are becoming rampant now.

“I think he has convulsions because of his spondylosis” one halfpant+crocs combo tried to punch a new hole in my knowledge recently.

“Let me decide that” was all I replied, rather than explaining how he was beyond wrong.

The shorter you keep it, the sweeter it remains. I would rather save and use my time for those worried, panicked patients who have enough faith in my abilities, who understand mutual respect, and who will have at least this insight: that the doctor knows best how to treat patients.© Dr. Rajas Deshpande

Of course I am aware that there are some doctors too, who initiate rude conversations, do not respect simple etiquettes, and are quite difficult to connect to. Most patients even when offended by rude doctors, kindly choose not to react although they carry home a bitter feeling. Every medical student, every doctor must be taught in the earliest parts of internship about the code of etiquette and mutual respect while dealing with any patient, and only then expect the patient to follow it too.

Coming back to this lady, I wrapped up the session by telling them to follow up after a month.

“Can he continue to take his three large pegs of rum every night? He cannot sleep otherwise” she asked.

“In my 25 years of practice, I haven’t met anyone whose health improved with alcohol. Do please google that.” I gave her the dose she had begged for.

© Dr. Rajas Deshpande

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G-Bhai, The Suicidal Intellect.

G-Bhai, The Suicidal Intellect.
© Dr. Rajas Deshpande
 
G-Bhai is an extraordinary genius, and all that he lacks in the matter of manners, culture, and grooming oneself to a neat and clean appearance is compensated for by his superb analytical abilities and internet access. He was so engrossed in Google all the time, that he was nicknamed G-Bhai by his family.
 
A few weeks ago, he went to his boss, who owned one of the biggest profitmaking multinationals upon earth. The boss was absorbed in his divine meditation about new tricks to lay off more IT personnel in pursuit of that greatest human achievement in today’s world: moolah. G-Bhai, who believed in complete equality, sat cross legged in front of his boss, and scratching his beard, told his boss where all the boss and the company could improve. © Dr. Rajas Deshpande
The boss, amused by free entertainment, asked G-Bhai where he learnt it all.
“Internet” said G-Bhai, and showed some Googled statistics to his boss.
“Thank you, you are fired with immediate effect” said the boss
.
G-Bhai wasn’t affected at all. With his oversized grey T shirt, jeans, slippers and laptop that connected him to all the internet data, he was still the king.
 
He thought of adventure, and went to the Indo-Pak border. The firing and shelling was full-on. He met an Indian soldier who asked him to hide in his shelter. The soldier, who had spent all his life upon the border, was prepared to even die for this citizen, so gave away his helmet to G-Bhai.
G-Bhai was intensely searching the internet, wearing the soldier’s helmet.
“Don’t fire the gun like that” told G-Bhai to the soldier. “This website says the right way to fire is with the gun aimed at oneself”. The soldier ignored him and continued to defend the border. Just as he held a hand grenade to be thrown, G-Bhai held his hand. “Let me search first if you are doing it correctly” he said. The soldier, now in defense of his own life risked, slapped G-Bhai tight and asked him not to interfere. © Dr. Rajas Deshpande
 
G-Bhai proceeded to write a very critical review of that soldier, saying that in his opinion, all the soldiers were doing it all wrong.
 
Then he went to the court and tried to teach the lawyers how to argue, and the Judges how to analyse cases and deliver judgments. He showed them multiple websites from which they could learn law. “We are all equals, why are you sitting so high?” he asked the judges and tried to sit on the Judge’s chair.
After six months in jail, upon his release, G-Bhai went to the police commissioner to teach her how to deal with crime and criminals, based upon internet searches from different countries. He came out limping, and refused to tell anyone why. © Dr. Rajas Deshpande
 
Due to excess stress, his health worsened. He went to the best of the doctors. He demanded that he wanted a complete check up to reach the most correct diagnosis. He was advised tests. He researched the internet and did only the tests he thought were necessary, because he thought all doctors were corrupt. He reached a very reputed doctor with the test results. The 70 year old doctor examined him, checked the reports and told him: “You are a failure in your own life, you have excess stress, and are unable to handle it. You are jealous of everyone who is doing well, and therefore you have developed a complex that everyone who does well is either corrupt or wrong. Go home, exercise, find your own life and deal with yourself” When he tried to show the experienced doctor what internet said, the doctor smiled and asked “Did you also net-teach your parents how to make you?”. © Dr. Rajas Deshpande
 
G-Bhai then went to many doctors in many pathies. Then he researched and tried many home remedies. But his health kept on worsening. He was very upset and started a blog of criticizing that all the doctors. Here, for the first time in life, he discovered success: he was an instant hit, because there was a huge population who agreed with his views. There are more buyers for poison than for wisdom in this world.
 
But unfortunately by then, his kidneys failed due to experimentation with various medicines and various pathies. Now he is undergoing dialysis and posts his anti-doctor articles from the dialysis ward. The old doctor recently visited him with his flock of medical students, and spoke with empathy to the bitter G-bhai, who tried to show the old doctor some more internet references about his treatment.
 
The old doctor then told his students: “This is what I would call a suicidal intellect”.
© Dr. Rajas Deshpande
 
 
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Allopathy? Oh, No!

Allopathy? Oh, No!
© Dr. Rajas Deshpande

“Doctor, I don’t believe in Allopathy. There are so many traditional remedies that work wonders. We heard of this treatment where you eat certain flowers, and they cure everything, even cancer and AIDS.”
“Doctor, we hear that there are cures to many diseases, but the pharmaceuticals and doctors want people to be ill for longer, so the right treatments are hidden, and only useless costly medicines are prescribed.”
“I don’t want any medicines that cause side effects. I am allergic to almost every allopathic medicine”.

One standard answer:
“Then why are you here today?” © Dr. Rajas Deshpande

We live in a world brimming with superstitions and claims of all kinds. From parents killing a girl child to dowry deaths, from voodoo to sophisticated five-star magic healers, we have it all in our society.

Add education and a degree (not mandatory), add internet, and one becomes the King or Queen of personalized wisdom. Now one can question anything except one’s beliefs and random internet claims. Even years of training and scientifically proven facts, good or bad.

From scorpion bites to poisons of different kinds, from heavy metals in overdose to drinking one’s own pee, there are claims of cure that have been refuted by authentic scientific research, but then the easiest thing to question and suspect today are scientific knowledge and a doctor’s integrity and training, no matter how little one has studied medicine. Just as most hospitals struggle to fight infections, people happily drink urine: mostly studded with some of the deadliest microorganisms known. The fact that many children have died of Urine therapy does not seem to affect the popularity of this myth. By this logic, a person with kidney failure who is not urinating should become immortal! But only the proponents of this therapy will be able to tell why kidney failure patients die within hours of not passing urine. © Dr. Rajas Deshpande

I had a classmate who would blindfold his eyes and cross a live railway track, to prove his courage. Whenever someone questioned his safety, his pet answer was “I have done this many times, nothing has happened”.

It stands to reason (again a doubtful criteria in some communities: why base arguments upon reason when there’s superstition?), that if you believe that all Allopathy is a hoax, you have a complete freedom to stay away from it all your life; that at least will save the Allopaths some burden and free them from the daily sins they are so presumed to commit by treating with a hoax science! May be one can wear brass badges that say “I don’t want Allopathic treatment, don’t take me to an Allopathic hospital even if I am serious”.

While some Allopathic doctors do use medicines injudiciously sometimes, it is seldom with an intention to cause harm, no doctor thrives on a bad reputation. Everyone wants their patient to get better.

Those who do believe that doctors are only after money, that Allopathy is just another deception, that most treatment choices that doctors make are selfish, they are welcome to never enter another hospital again in life. There are umpteen non Allopathic therapies from magic to music that are claimed to cure every ailment that Allopathy cannot.

Is there nothing better to do in your life than to visit places that you don’t believe in? Do you get a high questioning a doctor’s scientific knowledge while being unable to question your own unscientific hearsay myths? © Dr. Rajas Deshpande

God forbid, but next time someone is sick and dehydrated, down with a pneumonia that stops breathing, has a heart attack, or bleeding from a head injury, please call that friend who suggested that scorpion stings heal everything. May be he can help.

What will happen if children are not vaccinated? What will happen if all Allopathic hospitals are shut down?

Stand outside the discharged patient’s section in any Allopathy hospital, you will hear daily stories of returning from death’s clasps. From polytrauma to cured cancers, from patients recovering from a paralysis to stopped hearts beating again, Allopathy brings life to most. Have some respect for what science has achieved!

Allopaths should stop wasting time arguing with those who continuously belittle Allopathy and sing praises for the unscientific. Use that time for saving lives of those who need you better. The easy answer is: “Yes, you may drink your pee or pet a poisonous scorpion if you enjoy its bites for your health”. Reserve the social education for those who understand logic.

We don’t believe that science needs permissions to be accepted. What is proven goes through rigorous scrutiny and is then marketed. But then again, this is expected to be understood by only those with a certain mental education, reasoning ability and logic, those who are not carried away by every myth they hear.

As for the rest, may your faith and belief alone heal you.
© Dr. Rajas Deshpande

PS: There are some traditional remedies that help some medical conditions. That does not refute the benefits that Allopathy has brought to mankind.

“If I don’t set an example, who will?”

photo-23-02-17-18-56-00“If I don’t set an example, who will?”
© Dr. Rajas Deshpande
One fine late morning, a phone call woke me up. “Hullo?” I used the trained professional cautious voice that does not encourage further conversation, hoping to not let go of the sleep stage.
“Good Morning. I am Rashmi Shukla, Commissioner of police, Pune. May I speak to Dr. Rajas Deshpande?” the lady on the other side said.
My heart missed one middleclass heartbeat and performed five higher class somersaults. Sleep ran away like a signal jumping two wheeler pursued by a traffic cop.
“Yes mam, speaking” I sat up in bed.
“I want to show my aunt to you. When can I get an appointment for her?”
This was unusual.
Usually most bigwigs just walk in without any warning and want to be seen immediately. Some soft-threaten an appointment via their secretary. Some come with the hospital owners, some hassle the boss to get the doctor rush for them whenever they want. There even are netas and officers (not only police) who ask doctors to “hurry up” with the patient in the chamber and see them first. If you make them wait, your boss usually would remind you many unpleasant things in chaste English.
So, about this call, I felt very respectful.
“Anytime you want mam. What time is convenient for you?”
“You say doctor, you people are always so busy. I will arrange my schedule accordingly”.
“4 PM today?” I asked
“Ok. We will be there” she said.
At sharp 4 she came with her aunt and waited patiently for their turn. Inside the chamber she behaved like a common citizen, and politely narrated the details of her aunt. She listened to the instructions and prescription details, and asked a few questions. She made me laugh with some puns too. Then she thanked me and left. We kept on reading about many new initiatives and improvements she implemented in Pune.
When she followed up today, again with similar polite call for appointment and then a punctual visit, I told her how admirable and respectable her politeness and etiquette was, and how rare it has become among the highly placed.
She smiled: “Doc, If I don’t set an example, who will?”.
Huge Respect, Commissioner!
May all police and government officers be like you!
Then when I requested her permission to write this and also for a a pic, she said “If you don’t smile in the photo, I am going to have you arrested immediately”.
Thank you, Mrs. Rashmi Shuklaji, Commissioner of Police, Pune, for making a common doctor like me feel great again about my choice of this profession!
© Dr. Rajas Deshpande

Naked Cavemen, Einstein and Calvin Klein

Naked Cavemen, Einstein and Calvin Klein
© Dr. Rajas Deshpande
Lower courts give judgements. Higher courts change them. Higher courts give judgements, other benches change them. Government fights with courts. All of them work less than 8 hours (few exceptions) and have sumptuous vacations. Judges without medical training will decide about medico-legal cases. But any of them do not require exams to improve performance or to deliver better in spite of huge backlogs. © Dr. Rajas Deshpande
Almost in every government office, in most departments controlled by them, bribery is a rule rather than exception. Piles of files do not move, pensioners die without pension and farmers commit suicides. But the concerned authorities who work 8 hours per day do not need any corrective courses or exams to assess their performance, to compare where the developed world is today.© Dr. Rajas Deshpande
In most of the healthcare facilities run by governments, there are severe deficiencies: no appointments of doctors, no proper salaries, no facilities or backups, no security, and worst of all, no vision. But the people who are responsible for making these policies do not need any training, assessment or exams. The very people who want youngest generations of doctors to provide world class medical services to rural India do not want to change their decade old failing policies.© Dr. Rajas Deshpande
The thousands of practicing Babas, Gurus, Quacks who are officially seen tied up with the highest of the land and bash the allopathic and scientific medicines spreading poison in the society do not need any exams to preach or practice. The lawmakers who do not ban tobacco, alcohol, helmetless driving, the people who eat unhealthy and mistreat themselves or family do not need any exams. The transport offices that issue driving licences to unfit drivers do not need training or exams.
We see many military men and out of respect treat them free. They are so patriotic that they seldom expect anything in return from the country. But they often relate how bad the conditions are for them and their families. There is a crop of people who quote the military sacrifices as if it was their own credit! Those who are responsible for the upgradations in facilities for the military personnel do not still need any exams.© Dr. Rajas Deshpande
There are deaths due to hunger and malnourishment. But the ones who are in a position to change this by making right laws do not need any exams. Illegal buildings are erected, labourers die when they collapse, but the concerned professionals do not need exams or assessment.
547 extremely responsible and respected representatives who waste the public money in daily crores over a month due to ego issues, not being able to come together in the interest of the nation to resolve issues, blaming it all upon each other do not need any exams to assess their performance.
But the actual allopathic doctor, who has stood highest merits in all exams, stayed on the top of the competition to earn his / her degree late in life, all of whose exams had 50 percent as passing limit as opposed to 35 percent in all other professions, who has sacrificed family life, sleep and food for over 10-15 years just for learning, who works almost 24/365 and solves health problems on a daily basis, updates his / her knowledge with CMEs, stays in touch with the latest and delivers it to the poorest of the poor with equal affection, carries the country’s failed healthcare upon his / her shoulder is not good enough for them! Now they want the allopath to appear for exams lifelong, suspecting that his / her knowledge is still not enough good for them, even after the CMEs.© Dr. Rajas Deshpande
If the millions of doctors are forced to give exams repeatedly all their life, they will happily do so (for they are not afraid of exams). But this will take away billions of doctor-hours out of service (exam leaves) in an already failing healthcare system, will tax the patient more, will open up new channels of corruption and another universe of chaos will add itself to India. Who cares? The ruling mood seems to be ”Patients will die, patients will pay”.
The current CMEs are world standard, do not tax patients, and enough effective. But our system seems to want “better than the developed-world class of doctors”.
This is like the stone-age naked cavemen asking Einstein and Calvin Klein to appear for yearly exams to stay updated for serving them.
© Dr. Rajas Deshpande
PS 1: The nicer you are, the worse your troubles. Doctors must unite upon an apolitical platform to fight stupid laws being proposed.
PS 2 For those who are not able to think beyond medical malpractices and corruption, please make an effort to understand that there are other issues in medical practice, and this post is not about money.
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The Price Of Love

© Dr. Rajas Deshpande

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

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

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Targets and Doctors: A Fatal Flaw

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