Category Archives: medical advances

The Bullet Indian Doctors Bite

The Bullet Indian Doctors Bite
© Dr. Rajas Deshpande

“Her health is fluctuating. We need to admit her in ICU. Why didn’t you bring her earlier?” I asked the daughter of a 75 year old lady who had developed weakness in both hands and legs about two weeks ago.

“Doc, we thought she had weakness due to age, gave her some herbal boosters and vitamins, as we were scared of modern medicine. We hear a lot of bad things nowadays” there was no trace of any regrets in her voice that she was telling me this.

Wish I could tell her all that we hear about the reality of people criticising modern medicine nowadays. But who has that kind of time?

“Can we please treat her at home? She is scared. Also, we have limited finances, my husband is not in town. My daughter has her exams on”. she requested. We often accommodate many requests, but really, our society never stops asking for more than possible. I explained her in detail that not everything can be managed at home, admitted the old lady in ward and gave all instructions to the staff. She had had very low potassium levels, we corrected them. On the second day, she started feeling slightly better.

Third morning, as I continued my OPD, I got a call from the ward. The nurse had a panicky tone “Doc, this patient has become drowsy suddenly since a few minutes. Her daughter is not here, I noticed when I went to check her. Pulse rate is high, no fever, and oxygen levels nomal. But she is breathing faster”.

“Sis, please check her blood sugar and send her blood sodium- potassium levels, and haemogram, I will be there in a few minutes” I said. I called the lab and requested them to process her samples urgently.

The sugar level was low, we gave her sugar and she became alert. In a few minutes we got the electrolyte levels, her sodium was also low, we started the correction.

“I have informed her daughter, she is on the way” the agile nurse said. As much as doctors, the credit of saving lives goes to the millions of active and alert nurses and junior doctors. I went back to the opd, apologised to the waiting patients and started again.

In some time, I received a call again. The nurse was still panicky. “Doc, the patient’s daughter has just returned. She is creating a ruckus here, shouting and abusing. Please come asap”.

I went there again. Indeed the daughter was furious.
“I will post this on facebook, I will write about the hospital, I will sue them. How can they do any tests without my permission?” she went on.

I said hullo to her, stepping between her and the patient nurse. © Dr. Rajas Deshpande

“Why did you do her blood tests without asking me? We had done blood sugars last month, they were normal. Also we had done the sodium and potassium two days ago. You should have asked me before sending blood tests” she went on.

Two angry humans is too much of a mess. I summoned my inner peace. I had done what was good for the patient, I wasn’t scared of anyone. Especially ruckus makers. Her anger was her problem.

“Madam, may I explain?” I asked in a calm voice. Not that I am not short tempered, but I am a doctor.

I told her how some tests need to be repeated, and how there’s no time always to ask permissions by calling relatives. Patient’s life is always more important than the permission of relatives, especially if they are not on site. Sometimes, we need to do tests just based upon suspicion of certain complications. Every passing second increases the valley between life and death, the doctor and nurse must have the fastest brains and actions upon earth. To explain everything to every relative till they grasp and understand is another stupid, idiotic expectation in emergency. It’s like asking a soldier on the border to explain every citizen in the country why he fired each bullet. A medical soldier has to do the best, be medico-legally safe, document everything, explain to the relatives and obtain permissions, and still face anger, humiliation and social media threats, rating scams and attacks on reputation by anyone anytime. All this while having the best intention- saving the patient! © Dr. Rajas Deshpande

“You take fever by a thermometer many times a day – once is not enough as the condition is still persistent. Likewise some tests, even if costlier, need to be repeated. Unless you have written that we do not want any tests, we have to do what we think is good for the patient, that’s our sacred duty” I told her.

She calmed down.

“See, doc, I am sorry, I exploded, I am going through much stress at home due to issues with my daughter and my husband is not supportive. Now that you have explained I am okay with the tests”. she said.

“What about the shouting, the abuse, the insults to allopathic doctors treating you right now, the humiliation of the nursing staff and waste of my time, that caused discomfort and delays to other patients?” I wanted to ask, like most doctors, but we have no time. She wasn’t going to change anyway. Like most of our society.

When I discharged the patient, now walking on her own, the family was still upset, because the hospital did not comply with their expectation of a “discount”. A genuine “Thank You” is extremely rare in Indian hospitals, even when the critical walk home.

Three months fast forward. I received a call from the daughter again “Doc, my mom has become drowsy again, shall we come to the hospital?” she asked.

“Sorry, I am not available, please see another doctor at any hospital of your choice” I replied.

Many good doctors have exhausted their patience and will to be kind and compassionate due to such incidences happening every day. Now most are concentrating on patients who have better common sense and manners, politeness and willingness to understand the use and limitations of modern medicine. Money is the last thing a doctor can think of, but sadly it is the first and only thing that most relatives think about. While treating the patient, the first thing- patient’s life – has not remained the priority for most hospitals, it is now the safety about medico-legal aspects and reputation. A wise doctor has to learn how to balance in between.

Doctors in India must bite many such bullets every day!
© Dr. Rajas Deshpande

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The Story of a Deadly Brain Aneurysm..“Doc, was the treatment delayed?”

The Story of a Deadly Brain Aneurysm..
“Doc, was the treatment delayed?”

© Dr. Rajas Deshpande

“Doc, was the treatment delayed?”
The angry husband, Mr. Mane asked in a calm voice but the accompanying relatives had a menacing look upon their faces.

The patient, his wife Mrs. Sujata 35 years old, was brought unconscious two days ago, in a comatose state, at about midnight. I was out of city, so my colleague Neurologist rushed to the hospital and started treatment. We were constantly in touch, within an hour Sujata’s scans were completed, and she was shifted to a critical care unit. She had large bleeding in the brain, and was already beyond a possibility of surgical treatment.

About five years ago, she was diagnosed with an aneurysm in the brain. It is a defect in a blood vessel which balloons out as its walls become thinner and may rupture suddenly, causing either instant death or bleeding in the brain, many a times huge. This diagnosis needs immediate treatment, the right words that describe its risk are: “This is like sitting on a time bomb, not knowing when it is set to explode “.

Many patients do not have much symptoms besides headaches or minor neurological issues usually found on examination by a neurological expert. There are many NeuroIntervention specialists in India since last two decades, who can reach the balloon via a catheter/ tube and close the balloon/ aneurysm so the risk is eliminated and patient cured. Sometimes neurosurgeons are required to operate if the aneurysm has a wide base, and close the connection between the balloon and the artery from which it arises, by an open surgery. © Dr. Rajas Deshpande

Five years ago, we had informed all this to Mr. Mane and Mrs. Sujata. Like many educated patients nowadays, they obtained multiple opinions. Almost all doctors had told them what we had told. However one retired allopathic doctor, now quite old, and one non-allopathic practitioner told them “It is not necessary to do the surgery. Doctors these days advise unnecessary costly treatments”. They started some vitamins and health boosters. © Dr. Rajas Deshpande

The couple decided to wait. The came for follow up once after two years, we told them it was better to operate, but they said “We met our neighbour doctor, he is very senior, and he said that there’s no danger in waiting. I think he knows, see, nothing has happened in two years.. we are happy as it is!”

After that they did not follow up. They had even stopped allopathic medicines. They had come now, when she was beyond any possibility of rescue.

When after a day we told the family that she was brain dead, they asked the question above: “Was her treatment delayed?”.

After explaining to them that everything was done faster than even the best centers in America would have done, they calmed down.

Out of curiosity I asked Mr. Mane: “What did your neighbouring Doc say, the one who had advised to not operate her?”

“Oh, he was very kind. He said nature is cruel and anything can happen anytime to anyone. He arranged for an ambulance too for us.”.

Mrs. Mane didn’t make it, we all felt very sad that a young life that could have survived was lost to a wrong advice. Many doctors who do not specialise in certain complicated and advanced branches of medicine often try to please the patient by giving them an advice that attempts to impress the patient by saying what they want to hear.

It is true that sometimes surgeries are wrongly advised and performed, hence the social confusion about trust. There’s only one way out- explaining the patients and giving them credible websites to refer to, referring them to another specialist who is qualified in that branch. Some trust-less patients will still pay with their health and life. © Dr. Rajas Deshpande

If such cases go to the courts of law, challenging the speed and/ or efficiency of treatment, the honourable courts should consider delays and decisions at every step beginning from the day of onset of symptoms, the delays in visiting doctor, specialist, performing advised tests, obtaining another opinion if advised and getting the prescribed treatment in time. Just holding the doctors and hospitals responsible for not being able to rescue the patient at the last stage is not justified.

Leave aside a few wrong ones, but most surgeons only advise a surgery after deeply thinking about all possibilities, risks and outcomes. Sometimes even when the outcome is uncertain, they must operate. At such times their reputation and career is at a stake, because every mistake is nowadays amplified into a media blast. Still they think about what’s the best for the patients, and try to do their best. Surgeries and procedures, even the costliest, are the cheapest in India since last thirty years- surgeon’s fees are still lowest in all branches, and if we consider the medicolegal and media risk and a violent mobs backed by some politicos, actually the doctor is at a high risk during every major surgery. © Dr. Rajas Deshpande

A doctor is not a merchant or politician to sweet talk to the patient and give them a pleasant but wrong advice and jeopardise their future just to “retain the customer“. This is a noble profession where sometimes strongly worded and unpleasant solutions are essential to save the patient. To expect all the patients and relatives to understand complicated medical concepts and treatments (which takes even brilliant doctors years to grasp) is comical.

We sincerely hope that our society recognises the huge stress every doctor goes through, every day, trying to do their best for patients.
We also wish that the law, politicians and media note that it is often the delays before admission that kill the patients than those after.

© Dr. Rajas Deshpande

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Who Are You?

Dementia: The Brain Killer.

© Dr. Rajas Deshpande

“Just a month ago dad / mom was alright, but now replies in a word or two, appears disinterested in anything. He / she was very lively and active earlier, we are surprised that now they just sit without doing anything, usually staring out of the window, and have to be reminded for everything – food, bath and even who we are’. These words alert every doctor about dementia- a disease that is extremely scary, because the brain is slowly dying. The person suffering with this illness, if not attended in time, can deteriorate permanently and fast, forgetting even oneself, without knowing that this is happening.

What if your own brain forgets you? What if you start to complete fail to recognise your own family, children, friends, not only their names but even their faces, how much they mean to you? Worse, what if in fact you start thinking that they are after your life? Impossible, you think? Welcome to dementia, a devastating disease of the brain that shatters many of our conceptions about ourselves and the world around.

Human brain does a lot more than thinking, speaking, memorising and walking. Born nearly empty, with only basic animal instincts, it then starts filling the memory cells with whatever information is fed to it- name, caste, religion, country, culture, food habits, and also the preaching of dying for one’s own religion or country. While acquiring different skills, it starts comparing self with others, instils the cultural concepts of loving or hating others, discriminating, superiority, and even the wish for equality found in some evolved cultures. Whatever we learn and the emotional make up of our minds, is a stored data in our brain.

Add the bittersweet experiences, the eternal exposure to a mostly self-centred world and our insights, all these make up the personality of each individual, even the ego of being that person, and the addiction of thinking ‘me first’ – all of it is in fact ‘stored data’ in the cells of the brain. There’s also information necessary for communication and social interaction: from days of the week to awareness of day and night, where we are, people and environments around us and so much more.

What happens when these brain cells start dying, degenerating? All this starts fading, and the brain starts having large gaps in these storages about everything, including self. This disease starts slowly, and unless someone is having daily meaningful conversation with the patient on a daily basis, it is missed for many initial months, because the regular, hi-hullo type of conversation is preserved till late. Even the most brilliant minds start making notes and reminders, often forgetting where they kept those. They appear withdrawn, lost in thought, and often have difficulty remembering names, relationships and directions- like not knowing where the washroom is. Some of the most disciplined and cultured may also start using vulgar abuses, have spells of rage, and may accuse their beloved spouse / children of having affairs, intentions of harm and stealing. Some take off clothes in public, misbehave, leave home and get lost outside. All this because the stored memories of “What not to do” is also being lost with brain cells dying. There are many types of dementias other than Alzheimers. Some are treatable if diagnosed early.

The loved ones of such patients are usually shocked and devastated, not only with the diagnosis, but with the revelation that in many cases this is permanent. They usually think that it must be age, stress or some anger that led to this, but their frustration is usually vented at the doctor when they realise that things are progressive. Visiting quacks in various pathies who exploit hope and frustration, the patient is subjected to much experimentation, abuse and even cruelty like tying them down, beating them up, etc., thanks to our superstitious society. The real tragedy is the waste of precious time- because starting the right treatment may some parts of memory longer, and reverse some types of dementias.

The right counsellors, psychiatrists or physicians recognise the disease easily and refer the patient to a qualified neurologist in time. Certain dementias due to deficiencies of thyroid hormone, Vitamin B12 etc. and depression are reversible to a fair extent, while others may require lifelong treatment with a neurologist. If started early with the right medicines, many cases improve and sustain for months to years.

Many cases of dementia are unmasked when patients undergo surgeries, hospitalisation. Patients with dementia get scared and confused in new surroundings, change of familiar places or absence of near and dear ones. They may have many psychiatric manifestations, and even become aggressive. The most emotionally draining thing is their paranoia and accusing spouse of infidelity.

It is essential to counsel and train the family and caretakers about how to handle such patients. One needs to detach emotional interpretations of patient’s behaviour and treat them like a child. One must never force such patients- to eat, sleep, exercise or do something against their wish (unless of course if they intend to harm self or others). One must also refrain from continuously correcting them, teaching them logic and reasoning, or asking them things they cannot remember.

Who Are You? Is an extremely difficult question to answer. Whatever you are, it exists only in your brain. Take good care of it. Stay away from negative emotions of hatred and discrimination. Don’t compare yourself with others. Practice equality in its true sense, it brings calm. Eat healthy, stay happy and active. Include almonds, walnuts, fresh fruits and vegetables in your daily diet. Control blood pressure, sugars and cholesterol levels.

Avoid red meat, butter, fatty and fast food. Avoid unknown medicines.

Many consider deceit and lying as “essential diplomacies” for success, and happily sacrifice precious personal relations in a quest to succeed for money and fame. Guess who helps us when we forget who we are. Preserve your relationships, speak your mind to your close friends, near and dear ones. Share your feelings, express your desires. Shed egos and reach out to people you like, make up with them. Do this today, because tomorrow it may be too late.

© Dr. Rajas Deshpande

Neuroloigist

Pune, Mumbai.

9922753753

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Thirty Years of Suffering and One Tablet of Gratitude

Thirty Years of Suffering and One Tablet of Gratitude
© Dr. Rajas Deshpande

At the age of 18, he started noticing difficulty in falling asleep because of a weird pin-prick like sensation in his calves. He ignored it initially, but later in a few months it grew so severe that he could not sleep. Then started a nightmarish phenomenon of sudden squeezing sensation on the legs, sometimes with other abnormal and disturbing symptoms like gnawing pain, pulling and jerky movement of both legs. A little massage initially helped, but within minutes, symptoms returned, and now came up to his thighs. Many a nights, he could not sleep at all.

Lack of sleep worsened his daily performance, and he started getting irritable, confused and often very depressed because of the ongoing symptoms. There were phases of relief without any apparent reason, but the problem almost always returned with more severity. He went from one doctor to another, was told he had nerve problems, muscle fatigue, deficiency, and even psychological issues. Various tests done did not show any abnormality. In the last few years, his symptoms spread over to his hands and became so severe that he could not sleep at all. He tried many medicines from many pathies but had no relief. Then he started having suicidal thoughts.

That’s when Dr. Lakshman Sathe of Dodaich arranged for a video consultation with me for Mr. Rajendra Badgujar, now 50 years old, resident of Sindkheda. As any learned neurologist will have guessed from the description above, I concluded that Mr. Rajendra was a severe case of a rare disease called “Restless Legs Syndrome”. Although rare and more common in women, this extremely troublesome condition is now increasingly recognized in Indian population. This usually is caused by a genetic predisposition, but may also be associated with certain other medical conditions including iron deficiency. The most common complaints are ‘restlessness’ of legs, due to weird squeezing, pricking sensation or jerky movements. Very good treatments usually in form of tablets are available, but most of these tablets have serious side effects if incorrectly used. Also, only if the diagnosis is accurate and not associated with any other related conditions, patients respond well.

Mr. Badgujar, who had suffered for nearly 30 years, had complete relief within a week of starting the new medicine, and is now not only having sustained relief with only one tablet, but has also slept blissfully over last two months. Still, that is not the reason for my article. This poor man travelled to Pune for 9 hours, daring the CoViD pandemic, with his family, only to personally say thank you to me. This single tablet of gratitude calmed my restless mind instantaneously!

Most neurologists can readily diagnose and treat this condition in the first or second visit itself, sometimes a few tests may be required. If the patient reaches the right specialist for various medical conditions, not only is he /she relieved at the earliest, everyone saves a lot of money and we can thus contribute to improve the reputation of our noble profession.

©Dr. Rajas Deshpande
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PS: Every qualified neurologist can diagnose and treat this condition effectively.

Beyond Those Valleys and Mountains..The Story of a Doctor That Media Won’t Tell.

Beyond Those Valleys and Mountains..
The Story of a Doctor That Media Won’t Tell.
© Dr. Rajas Deshpande

Just after admission to a medical college, Rohan noticed that he had a twisting movement of his right hand. He was diagnosed with a common condition called “Writer’s Cramp”, which is sometimes disabling and resistant to treatment. He started changing posture and position of his hand to be able to write well and somehow continued his studies. His complaints kept fluctuating. His father, a primary teacher, passed away when he was in the second year of Medical School. His mother somehow managed with the tiny pension they received and Rohan completed his MBBS.

During internship his left hand started to become weak, he had numbness in some parts of the hand, and could not move two fingers. It was quite painful too. He came to us for his nerve damage. His worried mother had a hundred questions, fears and tears in her eyes. Studies showed that one of his nerves was severely damaged. There are very few reasons why this can happen in young patients. Diabetes, faulty Immunity, Genetic Diseases are common, but upon investigating, Dr. Rohan was found to have the most dreaded cause for his nerve damage: Leprosy.
Dr. Arjun Mapare started treating him for Leprosy.

I reassured them and we started on an unpredictable journey. I explained him the schedule of medicines and advised to continue his leprosy treatment.

Doctors get infected with dangerous diseases every day. However nerve damage especially in the hands endangers entire career of a doctor, and if treatment is not started in time, many develop lifelong disability. Nerve diseases are extremely troublesome, recoveries are rare, delayed and difficult in many.

Dr. Gajanan Bhalerao, my super energetic colleague known for his physiotherapy expertise took the challenge and worked up a strict plan which Dr. Rohan followed. He kept on working after permission from his leprosy expert.

Where there’s no light, faith guides us. Patience is a rare quality. For a few months we did not see much change, but we didn’t want to give up. Beyond those valleys and mountains that scare us, is the Sunrise.

Today, Dr. Rohan visited after many months, completely recovered from leprosy, and told us that his hands have full functionality, his nerve functions were normal and he was able to move his fingers well. His writer’s cramp in the other hand bothers him sometimes still, but what’s a doctor who can handle problems? There are hundreds of such passionate young medical students fighting through adversity right now in India, because they have a common aim- neither money, nor fame, it’s the wish to treat the sick and suffering, to save lives.

The credit of his recovery?
To Dr. Hansen who discovered leprosy bacteria, those who discovered its treatment, those like Baba Amte who spent life fighting the stigma of this disease and the thousands of specialists in urban and rural India who treat this every day …. and some thought Covid was all that’s important!

Dedicated to the memory of Dr. Baba Amte, worthy of Bharatratna and Nobel Prize both!

© Dr. Rajas Deshpande

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Photo:
With Dr. Rohan (Name Changed) and
Dr. Gajanan Bhalerao

The Hurt Passion Of A Doctor

The Hurt Passion Of A Doctor
© Dr. Rajas Deshpande

The recent picture of our favourite cricketer Mr. M. S .Dhoni exhausted and fatigued on the field caused a lot of concern, and we wish him best health with many more years on the field. The passion with which he plays is inspiring, we all love and respect him just like we have loved and respected Mr. Sunil Gavaskar, Mr. Sachin Tendulkar, Mr. Anil Kumble, Mr. Virat Kohli and many other greats that the Indian cricket has produced.

By the age of 40 or so, most of the heavyweight sportspeople usually retire from a competitive life and take over other, less tiring jobs. They have spent their entire youth in working extremely hard, with untiring efforts to perfect their craft. The fields of both sports and films are unforgiving, and exceptional talent is required to make it to the top. On the plus side however is the recognition, fame, and money that follows success.

Where does a doctor stand then?

While we cannot compare any two professions given the different client-base and frustrations of each, we can definitely draw some parallels. Competing intellectually starts from school for every doctor, innumerable hours in studying, applying the best mental effort to performance, and overcoming all temptations of a light-heartedly enjoying outside world are just basic compulsions if one has to excel at least in India. The extreme competition for medical admission is worst in our country.

However, that’s just the beginning, and the real struggle starts after one joins medicine: exhausting timetables, extra work and duties, unending patient loads of an hygiene- illiterate society abandoned on health front by its own government are the basic premises. Add expectations of immediate cures and filmy, miraculous recoveries with best recommended World-class internet treatments but with “Indian Compulsions” of charity treatment by doctors from their own pockets, and a never-ending game of moral-ethical looting, compassionless exploitation begins. In the midst of all that mud, a doctor must still keep studying to be abreast of all the modernities of his science, keep a calm mind and be polite and good to even the worst behaved.

Then come home and see pictures of compassion for celebrities. No we do not envy the celebrities. We love them as much as anyone else. We just hate the hypocrisy that our people have created: that if you choose a career in medicine, you are far less likely to be loved, whatever you do, however hard you work, and even if you lose your life. The whole government machinery which rushes to wish celebs and click selfies with them on every tiny occasion cannot have the list of doctors who died treating covid patients! Has anyone seen any selfie of any minister with the doctors who saved their lives from covid?© Dr. Rajas Deshpande
There are thousands of young and old doctors in India, this very moment, working in covid wards, more exhausted and tired than any cricketer in the world. They cannot retire: 99 percent are so financially dependant on their daily income or monthly salaries, that they have silently accepted the tyrannous, cruel policies of various governments to inhumanly exploit them. They are on the verge of death due to exhaustion, and some are already having thoughts of ending it all. Over 500 have died. But the very same society has no compassion for these exhausted doctors, it has abandoned the very heroes who have stood between them and death. Their salaries are pending, they have to buy their own masks and kits, and thousands are estranged form their families for quarantines.

A society that browbeats doctors and hospitals to convert compassion into acceptance of non-payment of bills (as if doctors do not have basic compassions and humanity that everyone else has!) has money to queue up in restaurants, bars, liquor shops, malls, and bet millions on cricket matches is still completely ignorant about the exhausted doctor. We can build everything else as development agenda, but India can not invest in doctors. It can have the most modern aeroplanes and bullet trains, but it cannot pay its doctors.

The young doctor is now rethinking. Many have chosen to change their preferences and not become a doctor. Most doctors do not want to push their brilliant children into this chasm called ‘medical practice in India’: a dark, exploiting, thankless, violent and vulnerable machinery to suck out the blood of the most brilliant minds of our generation. The most important part of becoming a doctor is to reduce suffering and save lives. No one, however rich, becomes a doctor with a mindset to earn out of the dying and suffering.

That very passion to save lives is being insulted, mocked, and widely abused by our great nation today. I will continue to write to my students, to the next generation doctors to please preserve this passion: that is the most beautiful part of your soul, and please do not let it be scarred by an unevolved, regressive and exploiting society that we live in. Take care of yourself. We have a mission to save lives, without thinking whether they deserve to be saved or not. We will shortly also devise strategies to end this exploitation.

© Dr. Rajas Deshpande

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The Future Girl and Her Message


© Dr. Rajas Deshpande

At about 7 PM, I was about to finish the OPD at Ruby. One last patient was waiting, I could see her in the waiting hall outside.

My N95 was on since 10 AM, and I hadn’t had an opportunity to drink even water since I entered hospital at noon. Fatigued, thirsty and heavy-headed, like most doctors today.

‘This isn’t fair’, I was thinking, ‘I don’t deserve this torture after so many years of hard work. This pandemic seems unending, this stress is piling up on my mind and body now,. The world seems to have come to an inhuman standstill’.

The last patient walked jauntily in, a young girl of 27, her eyes smiled excited. She’s been my old case of epilepsy since last three years. She works in a virology research set up, and had told me six months ago that she’s working on Corona. Her parents are working as labourers in a local government factory.

“How are you?” I asked, mustering a smile she couldn’t see.

“All fine Sir, no fits at all. I just came to share a good news. An American University has liked my virology work and offered me a job for three years. I am leaving in three days. I will begin a new life, I have decided to spend it for virology research. I just came to say bye to you. I will of course keep in touch, but I will miss you there” and she touched my feet.

“God bless you. Stay safe at all costs. I am sure you will reach great heights and win a Nobel. Don’t forget your parents. Let me know if you need anything anytime “. I said what I could.

I was happy and sad at the same time. Happy for her career leap, and sad that such a brilliant scientist was leaving India.

I was startled that she had shaken away my fatigue and the pandemic rust that was accumulating on my mind. A sign of youth, she had taken the burning world around her as an opportunity rather than being cowed down by it. She was going to wear a mask almost all her career life, and the thought didn’t seem to affect her. She had accepted the reality faster than anyone I knew. A mind made for the future, she was travelling to the US (she has reached now) at a time that the world was locked down.

The world hasn’t come to a standstill, I realised. It is picking up. It will thrive again and boom in few months. Till then I must keep all negativity away. Till then I must do whatever it takes to survive and live the best life possible even in a pandemic. She had unknowingly come to deliver that special message before she left.

She left teary eyed and yet with a smile. My tiredness was gone. My spirits felt rejuvenated, I was grateful that she visited. Like every doctor who gets up and puts on his mask every morning for seeing their patients catch on with their life again.

© Dr. Rajas Deshpande

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The Good News: ‘Life Is In Brains’

Last three years we were planning a beautiful, comprehensive and patient friendly, “All under one roof” Neuroscience set-up at Ruby Hall Clinic.

Specialty Clinics for Multiple Sclerosis, Parkinson’s Disease, Epilepsy, Vertigo, Stroke, Brain Tumors, and all neurological investigations will be available here, on this floor. Also Neuropsychology, Speech Therapy and Counsellor for family members dealing with difficult illnesses.

My dynamic CEO Mr. Bomi Bhote has long dreamt of a world-class Neuroscience department at Ruby Hall.
“Give our society something to remember you for” he said often. I have tried my best to design this fully new Superspecality Neuroscience Department. After many meetings and many precious inputs from Dr. Purvez Grant, Dr. Manisha Karmarkar (COO), and Dr. Rebecca John, and the blessings of senior Doctors like Dr. Ravi Gulati, MD Dr. Sanjay Pathare we added one stop troubleshooting and convenience so that patients do not have to roam around.

Mr. Iqbal Chaney, Dr. Abhijit Rokade, Mr. Shailesh Kelkar, Mr. Avro Chatterjee, Mrs. Nilofer Shaikh, Mr. Tushar Patil, Ms. Ansha and so many others contributed to the efficient beauty of this set-up.

One item on the top of my bucket list thus ticked off: giving Pune, Maharashtra and India a Neuroscience Department to bank upon. This is just the beginning.

© Dr. Rajas Deshpande

Doctor 2025: What Happened After The Pandemic?

© Dr. Rajas Deshpande

The whole family was happily relishing desserts after a sumptuous dinner, when Mr. Shah suddenly went blank. His eyes rolled up, and he started having violent movements of his body. His daughter Amira shouted “Mom, call the emergency ambulance number” and tried to comfort her father who was now in a full blown convulsion, blood oozing from a corner of his mouth with froth.
The ambulance came with paramedics. Its driver handed Mrs. Shah a cellphone: “Please enter his Aadhar card and Insurance policy number, we will take care of everything” he said.

They collected a drop of blood, which would give all the necessary information about the patient. A video scanned the patient and recorded history and legal statements of the family members.
The sugar level was high.

“Was he given sweets? asked the paramedic.
“Yes” said Mrs. Shah.
“Did you take permission from the government? He is a diabetic, sweets are illegal” the paramedic said.
Amira pulled out a big pink note from her purse.
“Listen, please delete that video. Please take another clip, Mom doesn’t know, I will speak” she said. The attendant agreed. His salary had been halved since the pandemic.

They reached the nearest hospital in few minutes. The nurses hooked the patient with various tubes and told the relatives to wait in a counselling room. The patient appeared stable now. “This is really cool. India has made such great progress” Amira said to her sweating mother.

After a few minutes a Doctor on the TV screen greeted them, and explained them that Mr. Shah had developed bleeding in his brain. Interrupting the doctor, Mrs. Shah, sobbing, asked if her husband will be out of danger. Amira too, very anxious, asked many questions. The doctor replied very pleasantly “Just after this video call, you will see a video of all the likely things that can go wrong in your patient’s case. You will also be provided interactive links like a telephone menu, to ask any questions you want, the answers are scientifically standard. All treatment and billing is standardised”.© Dr. Rajas Deshpande.

In a fit of anger, Amira loudly asked “But doctor, we want to see you and speak with you. When will you visit the patient?”.

Smiling, the doctor replied “Oh! Sorry, but we abolished that practice long ago. We don’t directly meet thee relatives now. For every patient, we give you the diagnosis and condition, all the information is made available on the internet, you can read for yourself.”

Mrs. Shah took out the Bramhastra “But we are paying your fees. You must answer and explain to us. You must be available for the patient all the time”.

The Doctor’s smile now became distant and curt.

“No madam. The law requires that I see the patient every day and treat him / her well, which I will continue. The insurance company and the hospital to whom you pay require me to visit the patient only once in 24 hours, which I will do. I am supposed to inform you, which I just did. You are paying the hospital and the insurance company for my services, from which they both cut some amount and pay me, you are not buying my time or me. You are free to request to change the doctor, or for a second opinion at an extra cost. The government has now made it mandatory to treat the patient at the hospital that they will decide, unless you are a special category. There is nothing like personal care now, everything is standardised by the ministry. We have a PRO who can assist you with searching all the information you need”.

Amira, wiser to the world, asked directly, in a cautious, lower pitch “Doc, what can we do to get your direct services? We can pay anything you want. We want you to personally see my father, make all the treatment decisions, and we also want to speak with you daily, in person. Do you have a private hospital? Please, I beg of you, have some compassion”.

The Doctor paused with a sad face, then said in a more personal tone “ I am sorry mam, all private healthcare has been abolished in India. . Many relatives attacked and injured doctors, most spoke in an abusive, rude manner, many wasted our precious time with illogical, repetitive and absurd questions. So the unnecessary was eliminated . During the pandemic of 2020, doctors were abused by our society so badly, that many died, many left either the profession or the country. Now the number of doctors is very low, We have a wild, abusive society that swings between begging for compassion and free treatment to violently attacking doctors. So all hospitals are now controlled by the government, and all doctors just follow the treatment recommendations set by the government. Even the brands and quality of medicines, stents, instruments for each patient are decided by the government, according to that patient’s category”

Mr. Shah’s condition was worsening day by day. Once every day, Amira received updates about her father via a lengthy SMS, with advertisements of big business houses, who had access to every data in the country. Nothing was private anymore.

Amira asked the PRO one day “What happens to the poor patients who don’t have money?”

The PRO smiled in disdain. “There are special insurance schemes and different stadium-hospitals for them. They have the same system, but low cost everything, including medical staff. Those who cannot afford even basic insurance are sent a CD of patriotic songs and motivating sermons. After the pandemic, this has emerged as the most cost effective way of healthcare.”

“What if I want to take my father outside India for treatment?” asked Amira, now fed up with all the robotic answers. All human touch in medicine was lost.

The PRO looked at her in awe. “Are you in Politics? Are you super-rich like celebrities? Because taking someone out of India for medical treatment is reserved only for them, or those who have special links”.© Dr. Rajas Deshpande

Every morning, Amira and her mother went to a temple and prayed. One day, Amira asked the doctor: “Doctor, what if this was your father. Would you do the same?”

The doctor replied “Mam, My father died because I was posted in the pandemic ward. He was a high risk case but I did not get exemption. I think I am already doing far more for your father than I did for mine”.

On the fifth day, Mr Shah woke up. In a week’s time, he was scheduled for a discharge. Arguing about the hospital bills or complaining about the treatment with the insurance company or the government was now considered anti-national, so she carefully remained silent and paid all the bills, right from that for the first drop of blood collected at home and the ambulance. The pandemic tax and GST almost doubled every bill. Everything was authentic and standardised.

On the day of his discharge, a political leader came over, and a picture was taken with Mr. Shah. “Recovered due to the untiring efforts of the party and the government” said the newspaper the next morning.

On the way home, Mr. Shah told Amira “That doctor was fantastic. When will we see him again?”

Amira replied “I don’t know. The government will assign a doctor for you to follow up now”.

Mrs. Shah looking far away, said “At the temple every morning, I prayed for two things: for your health and for return of the good old days of personal relations with our doctors”.

© Dr. Rajas Deshpande

Please Share Unedited

Much of this is happening right now. This is the foreseeable unavoidable future.

My Best (And Last) Effort For Indian Healthcare.

My Best (And Last) Effort For Indian Healthcare.
(c) Dr. Rajas Deshpande

Are you fed up of the medical scenario in India?
Neither patients nor doctors are happy.
Society and Government have expectations but no answers to basic questions.

Healthcare must reach everyone, including the poorest, but it cannot be a charity at the cost of the doctor.

Junior doctors, Interns, Medical Students are exploited and harassed by one and all, many have not been paid. They have no voice. Private medicare is on the verge of collapse, gun to its head.

Worst, Doctors are pathetically divided due to various reasons, hence being exploited at all levels.

Are you a doctor, willing to change this? It is possible.

Do you accept the principles of ethical medical practice, with ethical and scientific patient care as the first goal?

Are you willing to give up religious, political, regional and language discrimination and pharma sponsorship, if you can still get the same secure, clean and ethical income?

Are you willing to stand by every other doctor in India, irrespective of their religion, political affiliation, state, city, irrespective of whether they are junior or senior?

Are you willing to fight for your own and our collective dignity, safety, and human rights for all doctors and patients?

Are you willing to care for the poorest of the poor with the same dedication as for the best affording, if there is no exploitation of your skill and time?

This is possible.

We have great expectations from the younger generation whose blood can still boil, who can still roll up their sleeves, and who can dream of a great future where both the doctor and the patient can be smiling.

I am willing to be in the front seat.

Do you want to start a revolution?

Join my facebook page only if you are a doctor and agree to all above.

https://www.facebook.com/UnitedDoctorsAcademyIndia/

Any political/ religious/ discriminatory activity will permanently disqualify.

Only those with medical council registrations should join.

Let Us Work Together For A Great Indian Medical Establishment.

(c) Dr. Rajas Deshpande