Category Archives: Movie

“Alive Or Dead?”

(c) Dr. Rajas Deshpande

“I saw the news myself. The doctors declared her dead. They took her home. In a few hours, her son noticed her breathing, they immediately took her to another hospital, where she became conscious. Doctors are absolutely careless now a days. All doctors and hospitals work for only money..” the hefty dark man with a large moustache was telling this story loudly to a group of about eight people sitting around him, three of them quite pretty, young and attractive.

“Yes,”replied another, tall and fair, but with a shrill voice: “Doctors have become butchers now. My friend’s father suffered a head injury, and was dead on the spot. But the doctors told us he was alive and kept his dead body on the ventilator for five days, saying that his heart was beating. All for money”.

I was sitting in the cafetaria of our hospital, it was nearly ten at night. I had just attended a call for a patient of convulsion, in the recovery room , where patients are kept for a few hours after major surgeries. . The patient, who had had fits since childhood,had presented with heart failure due to a defective heart valve, and had undergone a major heart surgery to replace the valve just two days ago. He had had another fit. The cardiac surgeon Dr. Ramnath had personally called and requested me to rush and assess the patient. He was quite worried, like most surgeons are after major surgeries. After making some changes to the patient’s prescription, I called up and informed Dr. Ramnath. He was relieved “Thank you, Rajas. Will you please wait in the cafetaria? I would like to have a coffee with you” he had said. (c) Dr. Rajas Deshpande

That’s why I was waiting in the cafetaria, as usual my back towards the world. The group sitting behind me probably wasn’t aware that I was a doctor, or likely had chosen to ignore it.

In the next ten minutes, there followed many anecdotes by various members of that group: that allopathic treatment is costlly yet useless, all doctors are sold to the drug companies, that humanity has vanished from the medical profession, etc.

The most beautiful sign of growing up is not reacting to a certain type of people. I practised it, although rattled with all that I had heard.

Dr. Ramnath walked in. His trademark fast pace and smiling face brightened the small cafetaria.

“Hi, Rajas, sorry to keep you waiting. Much obliged that you could come. I have just seen him. Oh Hi..!” he said, noticing that two people from the group stood up.

“Namaskar doctor! How is our patient? ” asked a person with the moustacheo.

“He is quite stable now, all is well. I will shift him out tomorrow if everything is okay” Dr. Ramnath said.

“Then why did he have a fit? Why didn’t you tell us that could happen?”asked the moustacheo. He had found a gentleman, polite, highly educated doctor replying his questions courteously, this was his chance to misuse it to impress the three PYTs in the group. (c) Dr. Rajas Deshpande

Dr. Ramnath’s smile vanished. “I had explained to the patient’s family. May I know who you are?” he asked to the moustacheo. Even a surgeon has limits to the misuse of patience.

“I am patient’s father’s friend” he replied, his voice on an offended backfoot.

“Please see me in my office by making an appointment”Dr. Ramnath told him.

We went over to another corner of the cafe and ordered our mutual favourite Italian Roast black coffee. (c) Dr. Rajas Deshpande

Two weeks later, the patient came to my OPD for adjustment of the fits medicine. The moustacheo came too. The patient had recovered magically, now living a new life. I told the family so.

The moustacheo was not yet satisfied. He asked many questions. I had most answers. At the end of it, I asked him what he did.

“I work as a commission agent in property deals” he told me.

“If I may ask, how much are you educated, and in which field?” I asked him.

“Oh I left school after tenth standard. Why?” He was offended.

“Can you google?” I asked him.

“Yes” he said proudly.

“Please read about ‘Lazarus Syndrome’” I told him, writing it down on a piece of paper for him.

There are many examples all over the world, where a patient’s heart stops functioning, and doesn’t respond to the usual measures of CPR / resuscitation, but automatically starts beating again after a few minutes, and the patient becomes conscious later. This is called the ‘Lazarus phenomenon’. It happens because of a complicated combination of chemical, electrical and physical changes in the heart, even many minutes after it stops. This has been reported more than 38 times all over the world. However, it is only in India that doctors are beaten up, hospitals vandalised, and the media earns crores by shouting poisonous about this headline. One state government even shut close an entire superspecialty hospital because of such incidence! (c) Dr. Rajas Deshpande

On the other hand, if a doctor tries to keep the patient alive even when the brain has stopped functioning, or the heart is failing, then some of our less educated muscular bollywood heroes cry foul about the entire highly qualified medical profession, that “doctors are keeping dead bodies on the ventilator to extract money” and even slap doctors in the hospital on the screen, to impress their quality of box office. Maybe we must call these “Ëxperts of life and death” in media and bollywood to treat every patient, to perform operations, and even to certify every unfortunate death that may happen in some cases. It is because of this poison spread by these ‘pseudo heroes’ at the cost of the best doctors in the world, that even after the best outcomes at the cheapest rates, Indian doctors have to face the bitterness and wrath of our society.

Whether a patient is “Dead or Alive”? Everyone in India other than qualified doctors seems to know better!

(c) Dr. Rajas Deshpande

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The Poverty Vow

(c) Dr. Rajas Deshpande

Long day. Came home. Ritual steamy hot bath to wash away the hospital feel, followed by steaming hot dinner. Switched on jazz, and I picked up the pasta. Heaven descended upon my tongue.

“How perfect this moment is!” I thought, and that’s where I was wrong. The phone rang.

“Sir, 18 year old buy, had fever since a day, took some tablets, became unconscious, now comatose. Vitals are stable, although he is coughing occasionally. No past history significant. Poor family, cannot afford treatment. Father is a labourer. What should I do?”

“Get him into the ICU, intubate if required and stabilise. Arrange for an MRI”

“OK Sir, but Sir they don’t even have a deposit. They had first gone to the government hospital, but as they were not happy there they have come here”. (c) Dr. Rajas Deshpande

“We will work something out. I am on my way” I replied.

In an hour, after examining the boy and seeing his MRI and other tests, we concluded that he had viral encephalitis. The standard medicines were started.

The boy’s father, an obvious poor slum dweller, was in a state of shock. The mother, sobbing, told me the history. I reassured them. When I explained the diagnosis and treatment they asked some questions.

“We don’t understand anything, we are illiterate and poor. Do anything Sir, Just save my son, Sir” the father folded his hands together. Private hospitals have a quota for free patients, but usually it is always overloaded. I requested the hospital management to please make this a free case, they accepted.

The next day, the child opened his eyes. On the third day he started responding. I was quite elated to have his mother speak with him. However, his respiration was still shallow, and blood presure very low. His heart rate was fluctuating due to the effect of viral infection. He was still critical. I spoke to his parents twice every day, specifically reassuring them. Poor patients must never feel that they are not equally cared for. (c) Dr. Rajas Deshpande

That evening, as I attended my patients in the OPD, the patient’s father came in, requested that he wanted to have a word. He came in with six other people. None of them could possibly be poor, given their get ups.

“Yes?”I asked.

The patient’s father looked at the giant next to him. “You ask” he said to the giant.

The giant, chewing his gutkha, askked me “What’s wrong with his son?”

“I have explained them thrice”I replied, “he has viral infection of the brain. There’s a lot of swelling upon his brain”.

“How come he is not improving? His BP was normal when he came. He did not have any heart problems. Now you tell us his heart is not functioning well” asked another medical superstar with white linen and gold teeth. (c) Dr. Rajas Deshpande

“Yes, this happens commonly with viral infections” I replied, feeling hopeless. How to teach complicated medicine to this pure- muscular class? I wondered.

“But you said he had infection in the brain. How come now he has it in the heart? Is the treatment wrong?” Asked someone similar among them, in a tone nastier than medical examiners.

I looked at the patient’s father. He was looking at the ceiling, deliberately avoiding eye contact with me.

“Listen, Sir”, I told them, “Your patient has viral infection, it has primarily affected the brain, but involvement or dysfunction of other organs is well known with such infections, this is not something new to us. We are on guard, dealing with the situation. Nothing is wrong about the treatment, in fact his brain swelling has improved, and he is conscious now. Ask his mother” I looked at her.

“I don’t know” she said, “we don’t find any improvement in my child. Nobody tells us anything”.

“Haven’t I explained you and his father patient’s condition every day?” I asked. They did not reply.

The white linen gold teeth spoke again: “We want a report. We want to show the case to another doctor”

That was a relief. I gladly wrote them a report. They went doctor-shopping all day. They returned next day. Almost everyone had asked them to continue the same treatment that we had advised, except some desperate non-specialist telling them to shift the patient immediately for a surgery at his hospital. Even our gold-toothed medical superstar understood that it was wrong! (c) Dr. Rajas Deshpande

“We will continue treatment here only. But our patient must survive” came an open threat.

”I will do my best, but I cannot guarantee you anything. You may please transfer the patient under the care of any doctor of your choice” I told them.

“No no, you continue to treat him.But if anything goes wrong, we will file a police complaint. We will ruin this hospital”said one of them.

I am allergic to threats. I don’t allow them twice from the same source in my life. How could any doctor guarantee that there could be no complications? How could I say that the patient could not react to any medicine in such a critical condition? If every patient could have guaranteed improvement, what’s the need for a doctor?

“I am sorry, I am planning for a leave next few days. I won’t be able to see your patient. I have requested our management to transfer your case to another doctor” I told them.

There was a movie “Teesri Kasam”in which the lead character, at the end of the movie, vows never to help the character of the lead actress in the movie, because the very wish and effort to help her has shattered his life, caused him regret. Most Doctors are now being forced to take such a vow. Urban Poverty is not so simple and innocent in a hospital as it appears to the media and society. Whether it is the roadside rowdiness of slum dwellers who roam around with weapons or a maid’s drunkard husband in civilised society, we all understand the misuse of poverty status well anywhere outside hospital, but somehow when this happens in a hospital, the blame is automaytically pinned upon the hospital or the doctor.

But who among the vote-mongers will speak against the majority voting bank?

(c) Dr. Rajas Deshpande

Profit and Loss

Profit and Loss
© Dr. Rajas Deshpande

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

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

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

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

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

The Music Called Life

The Music Called Life
© Dr. Rajas Deshpande

“What prize do you want”? My father asked me after I finished my tenth standard exams well.

I was desperately awaiting that question, knowing him well.

“A Sony Walkman” I replied almost instantly. I got one, the most basic Sony model, and lost myself for weeks in the stereophonic effects, collecting songs and recordings that had best quality. Right from the scratchy sound at the beginning, made by the record player needle-tip on the record disc, to the realization of different soundtracks on right and left, with separate sounds of each instrument. One favorite hobby was to select and follow only one instrument from the whole orchestra throughout the song.

Besides the music of MJ, Madonna, Beatles, the Indian stereo effect songs were a pleasure too. Ye bambai shehar haadson ka shehar hai (Kalyanji Anandji) and Pag Ghungroo Baandh, Thodi si jo pee lee hai (Bappi Lahiri) had the best stereo effects from the headphone. Kishore Kumar, Lataji, Lionel Richie, Cliff Richard, and Bee Gees became addictions. The collection grew enormously.

A cousin returning from the USA bought himself a Bose audio system, I was 18 then. I remember arranging the exact angles of the speakers, all directed towards one single chair at the center of the room, then taking turns to listen to “How Soon Is Now” (The Smiths). The strong wish that I must own the best music system for myself, make a music room in my home dawned that day, and is still thriving within me.

Much later, on a birthday, returning after ward work, I found a huge parcel at my hostel door, and the watchman told me that a fan had left it there. I had told some friends how I loved “Experiencing music”. Opening the box, I found the most advanced 8 speaker Panasonic music system, the home theatre one. That was one of the best gifts I ever received. The effectiveness of listening to music as a treatment for one’s negative moods is beyond question. I feel that good singers , those healers of soul, are better doctors than many medical degree holders,as their love songs and happy songs cure many a sad minds. © Dr. Rajas Deshpande

Recently when I listened to great music all the night with a very precious friend, a beautiful soul who understands that each instrument and even the voice of the singer has a different expression, other than the lyrics, who can feel music imprinted upon blood just as I do, I realized what I was missing in life. With this friend, the hear beats of life have become stereophonically audible again to me!

Technology has started drowning music into sounds, taking out meaning to be replaced by sound effects, we have almost lost the appreciation of the intricate fineries of meaningful music. The true feeling of listening to music is much like being underwater, if at all to compare: unless you drown yourself in it, you don’t feel it right!

Talking to patients, students, colleagues, this thought grew into a major revelation: we are losing our fineries not only about music, but also about feeling out other people: near and dear ones as much as strangers, both can have so much more meaning than the “bodies and words” that men and women have become now! There’s so much beauty in almost every human being who dares to preserve individuality without either copying anything or looking down upon anyone else.

An alert, feeling, self-aware mind that dwells upon the here and now is the best song nature has ever sung to me: and also the highest state a human mind can achieve. Unfortunately, we are lost in the digital-technology jungle, and take pride in either losing ourselves, escaping or running away from ourselves, or searching ourselves outside our own conscious reality. © Dr. Rajas Deshpande

I have decided for now: that I want to live this music experience without compromising: I want to to feel every bit and piece of the music that life brings to me, through songs and their lyrics, through the rains and the sun, through eyes, touch and silence, and above all, the resonance that it generates within me.

Only Love can match the beauty of good Music.

For the music called life is never sad, and I want to always walk towards a happy inner peace.

© Dr. Rajas Deshpande

Bravo! Aarya Ambekar

Bravo! Aarya Ambekar

A few years ago, my mother would often call me and my kids to watch especially this cute little girl Aarya Ambekar sing in SaReGaMaPa. Sweet and humble, expert at winning hearts that she is, we all loved her innocent smile and super perfect ease in singing like a pro. Inspite of being a celebrity with lacs of fans, her humility is so natural that she herself messaged me that she loved to read my articles (her father DrSamir Ambekar is a mutual connection). A celebrity herself complimenting spontaneously is an unforgettable moment!

She has worked very hard from a very tender age to maintain her singing “Sadhana” under the guidance of her mother. Waking up at 3.30 every morning just to practice music for over a decade is dedication par excellence. No wonder she has won so many prestigious awards!

This singing wonder is now lifting a curtain to display her new talent: her movie “Ti Sadhya Kay Karte” releases tomorrow. Gruelling hard work has gone into the making of this film which directly relates to almost all of us through a delicate subject in our hearts: First Love.

I wish her the best and pray for immense success of her efforts with her team.

@aaryaambekar @tisadhyakaykarte