Category Archives: Social work

Doctor Arrested. Patient Died. Who’s Guilty?

(c) Dr. Rajas Deshpande

“Doctor arrested. Patient died due to a wrong surgery”.

The black headline was shining. There was a file photo of the accused doctor, and angry, crying relatives. Sad and angry, I read through the news that did not affect me directly, yet knowing that every patient who read that news will go further away from their doctor. The already delicate and dying bond will die a little more.

Is it enough to punish this doctor?

Who all is guilty here?

The parents who forced him to become a doctor because they couldn’t?

The corrupt educational boards which allowed leaking papers and increasing marks so the student could get a medical admission? (c) Dr. Rajas Deshpande

The politicians who made it possible for even the undeserving, low-aptitude students (which has nothing to do with one’s caste or religion: it’s more to do with money and power) to become doctors and play with patient’s lives?

The governments who allowed the “Medical Business” by establishment of substandard medical colleges owned by the rich and powerful, to sell medical degrees? The managements of such substandard institutes who chose the “low”quality teachers who agreed to work at low salaries and tolerate all humiliation? The teachers who didn’t care how their student was trained? (c) Dr. Rajas Deshpande

The medical councils which ignored the ‘temporary’arrangements made by such substandard institutes to just ‘Pass the Inspection’, never providing students with adequate education or experience?

The medical policy makers who made theoretical, mcq-type education more important than clinical training?

The offices of law which ignored the repeated applications and complaints of good students from such institutions about incompleteness of educational facilities?

The Universities that allow ‘manipulation’ of medical exam passing under influence of money or power?

Or the politics of allowing cross-specialty practice without adequate training, the ‘jump-over to any pathy’ decisions to please vote banks?

Or the corporate hospitals who prefer such “substandard” doctors because they can work at lowest payments? Aggressive and “market oriented” junior doctors are preferred by many commercial-headed hospitals over those with best academics and clinical knowledge. (c) Dr. Rajas Deshpande

It is indeed a reality that some doctors cannot speak a straight sentence, some cannot spell medicine names correctly, some treat even what is not their qualification skill, and some substitute knowledge with style, overconfidence and sweet talking. At various stages in their career, there are teachers who have tried to correct them, but in these unfortunate times of “pleasing one and all” including students, it is quite difficult to ‘mentally’ train a doctor to be good and perfect.

If only the doctor mentioned above is punished, leaving all others above without correction, then it will be a classic example of example of medical negligence and injustice. It will be like treating only the heart attack without treating the blood pressure and diabetes which cause that heart attack. We know the outcome in such cases.

(c) Dr. Rajas Deshpande

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The Killer ‘C’.. Are You A Victim?

© Dr. Rajas Deshpande.

“I have no life. I depend upon comedy shows to laugh, I don’t remember when I was truly happy anymore. There’s no connection with anyone. Inspite of working a lot and achieving too much, life seems complicated and meaningless at the same time. I have even started forgetting things now”: the 32 year old man was quite distressed when he spoke:

“Can you take a break?” I asked.

He laughed sarcastically.

“Doc, there’s so much competition in my field, that I cannot afford to take a break. They depend upon me for things to be done well. If something goes wrong, it reflects upon my career. If I am not available, I will be replaced”. He replied.

“What are your work hours?” I asked.

“I start from home at about 9 in the morning” he said. I waited for the remaining part of the reply but he didn’t speak. © Dr. Rajas Deshpande

“When do you return?” I knew the answer in his silence. I had heard it one too many times.

“There’s no fixed time” his wife replied, “Mostly after 9 at night, sometimes past midnight. But even after coming home his calls and online work continues.”

“That’s because I have to deal with the Western clients, their timezones differ” he snapped.

“May I speak with the doctor?” the wife asked him, a little insistent.

He nodded, looking down.

“Doc, we had a love marriage. He was not like this at all. He was full of life and vigor. He made everyone smile and had hundreds of friends. Now he has no friends, but even with me and our daughter, he gets hardly five minutes every day. On weekends he is so exhausted mentally to interact that the schedule is almost set: visiting mall, watching a movie, eating out and coming home tired again, immediately to sleep. He gets irritated without any reason. He was so attached to our daughter, she was his life, but now even she avoids playing with him. Even enjoyment has become mechanical” both of them became tearful.

Then, lowering her voice, she continued “Dr. Rajas, this is embarrassing, but who else can I tell this to? You are like family to us, so I will say it. We had a great sex life earlier. Now he seems to have lost all interest in me. We have lost our physical bonding just because of lack of time. And now we are losing the mental connection too, as he has started becoming quite forgetful” she completed. © Dr. Rajas Deshpande

They were the second couple today with similar problems.

Excessive work hours, traveling long distances, continuous multitasking without resting the brain and body and eating junk have become the lifestyle for not only most software engineers, but almost every doctor, sales and marketing person, and most other careers in India.

The concept of “minimal salary” and “maximum work hours”, so vehemently fought for by the human rights organizations around the world, seem quite unrelatable and impractical in India: not only competition, voluntary overwork, unrealistic financial expectations and unemployment, but a social tendency to “shove this phenomenon under the carpet” has led to a country of human robots who cannot connect with other humans.

India is an exploitation hub since decades. Cheap manpower is our famous boast. And the worst part is that they are thrown away instantly the moment their productivity is less than excess, or when someone cheaper can replace them. Years of loyalty, honesty, hard word had zero meaning in corporate world. You are just another table with an assigned process. © Dr. Rajas Deshpande. Be it secretaries, clerks, employees, students, teachers, or labourers, the message by the employer is loud and clear: work as told or go. We have many others to replace you. Eight hours of work with two hours of travel every day is itself very taxing, add two more hours of work and on is misusing body and brain both. Health is not on the cards here.

5-6 hours of sleep has become a norm with most of the above categories. For a normal brain, 7-8 hours of sleep is essential. Whatever one may hear about geniuses sleeping less, chronic lack of sleep does cause damage in the brain, that manifests as irritability, personality changes, forgetfulness and less mental efficiency.

Years ago, gymming at the Athletic Club in London ON Canada, I met an old man in the locker room. After the initial ‘Hi’, he asked me what I did. I replied that I was a postgraduate doctor, now a specialty fellow at the University. He said “Oh I did my career in health too”.

“Were you a doctor too?” I asked.

“No. I did many jobs, whatever gave me happiness and satisfaction, but I made my career in my own health. For decades now, I have eaten only healthy food, cooked for myself, taken good sleep, read a lot, traveled the world, played with kids and of course gymmed: not to show off my muscles, but to keep fit. I am ninety two now, healthy, and most importantly, happy”. © Dr. Rajas Deshpande

I told him I envied that lifestyle.

“It’s a choice, doc, and a sacrifice too. If you want health, you must give up anything that is against it. I had great job offers, but they did not go with my choice of a healthy life. Now I think I was right. I don’t have too much money, but I am happy and healthy. I had many friends with millions in their bank accounts, but they are either dead or can barely walk”.

I told that couple this short story. They appeared to understand.

“I will start working upon this, doc” said the husband.

One aspect of human evolution should be good mental and physical health. However we are going backwards. People have developed funny concepts: that muscles and physical stamina alone is health, that less weight is the best health etc. We meet many who diet excessively but piss of everyone they meet as they are continuously irritable due to hunger. Mental and physical health shows upon a person’s face: peace and happiness are its prime components. These are impossible without bonding with your family, ensuring adequate sleep and rest, and opting for stress-free career choices.

As for now, the ‘Killer C’ called career is turning out to be the biggest life- killer at least in India.

© Dr. Rajas Deshpande

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The Light Divine

(c) Dr. Rajas Deshpande

The lady in the ICU appeared quite disturbed and shaken. Bewildered, she kept looking at her husband’s face, wiping her tears and his forehead with a corner of her saree.

Her husband, Mr. Mohan Vitthal Kadam, was critical, he had also gone completely blind suddenly and paralysed. While working as an electrician with a company in Jejuri, he was often noticed to have high blood pressure inspite of taking regular treatment with his family doctor. One day at work, he suddenly had a severe headache and went completely blind. Terrified, his colleagues rushed him to the nearest hospital. His blood pressure had shot up far above the dangerous levels. The local doctors gave him emergency treatment and sent him over to Pune. That’s why I had come to the ICU.

I introduced myself politely to his wife, and asked her the details. Sobbing intermeittently, she told me what all had happened. I examined Mr. Kadam. His BP was still high, but not in dangerous zone anymore. He was confused, unable to speak clearly. His left side was paralysed too. He pointed towards his head, indicating that he had a headache. His MRI showed many areas of his brain damaged due to high blood pressure. The areas which control the visual information coming from the eyes were damaged heavily. His brain was swollen dangerously. He could need an emergency surgery.

This condition, known among doctors as “Cortical Blindness” is a common but griveous condition: the patients eyes and the nerves are intact, they actually can see and carry the images to the brain, but the visual areas in the brain cannot see / read that information, because they are dead or injured. I informed this in simpler words to Mrs. Kadam.

“Will he ever see me again? Will he see our kids? How can he live the rest of his life with such blindness?” her questions came mixed with sobs and tears. I had very few answers, but I told her I was hopeful of a recovery. “We will first concentrate on reducing the swelling upon his brain, so we can avoid surgery” I told her. Their son came over and attended his father alternating with his mother. Mr. Kadam ‘s brain swelling gradually reduced, surgery was no more required. His BP was well controlled in two days. His paralysis also improved, but he still was completely blind.

Once he could understand the situation, he asked only one question: “Can I see my wife and children at leaast once in life again?”.

“We will try, I am hopeful” I replied. We had started with all the supplements that help recover brain damage. When he was discharged after ten days, he was still not able to see anything. He returned today.

“After we went to our village, many people told us to abandon allopathic treatment and go for secret herbal medicines and magical remedies. Somehow, myself and my wife decided to have complete faith in what you had told us. We continued your medicines and kept praying. The only light in my life then was the trust I had that I will get better. After two months, I could suddenly see a light bulb at night in our home. I immediately called my wife and told her so. Then onwards, there was a gradual improvement. I tried every day to see the faces of my wife and kids. In another two weeks, I could see them again That was the happiest day of my life.”. Mr Kadam became emotional. “Doctor, my company offered me a substantial sum as disability compensation, but I did not want money. I only wanted to see my family. Now that I can, I came here to thank you. Now I can even read a newspaper…but the darkness of being blind was far less hurtful than the thought of never seeing my dear ones again.. I cannot forget that. Thank you again, You are God for us” Mr. Kadam said.

I told him that I was just another doctor, that we were both cared for by the same God, that any qualified doctor would have done the same. I had not done anything extraordinary. But it is difficult to control a grateful patient.

“No doctor, we believe that doctors are God’s hands specially made to treat patients” he persisted.

I could only thank him. Thousands of doctors all over the world, all across India, do this every day, and receive blessings and gratitude that fills up their hearts with a joy that cannot be described.

Now I think there is a reason why Mr. Kadam came today. Many good and bad things happened in 2018. While making resolutions for the incoming new year, I was thinking once more what is most important in life. Mr. Kadam provided with many answers to that question. What matters is gratitude for what you have, especially health, gratitude for your family, and the ability to help others through their darkness. Who except a doctor is better placed to help others with health and life? Whatever other resolutions a doctor may make, one of them remains a universal favourite: ’ Let all my patients improve, and live happily a long life. Let me make every effort for that.’

Thank you. Mr. &. Mrs. Kadam, for allowing me to share this story.

(c) Dr. Rajas Deshpande

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“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

The Other Side Of Life

(c) Dr. Rajas Deshpande

“Wear your helmet” said my grandma, as I kicked my scooter “and don’t argue”.

I could have argued with the POTUS, but not with my grandma. I had come to my uncle’s house to visit my grandma, with the additional attraction of eating the delicious Diwali snacks she made. I wore my helmet and scooted back as fast as I could. My duty started at eight PM in the ICU, and the resident doctor who was on duty had warned me that she had to be with her in-laws for her first Diwali with the new family. All icu beds were full, one patient was intermittently gasping, unlikely to recover, and three others were fluctuating.

Firecrackers, lighting, happy people in new clothes were all around, yet out of mind. I parked the scooter outside the ward and ran in.

“Thank you thank you” said my predecessor, and explained me the cases and ongoing treatment.

When at the bed of the patient who was intermittently worsening, she told me “Listen he’s on dobutamine drip, we don’t have it, I have borrowed two ampoules from the medical shop outside. I will pay him later. His family has no money”. Many critical drugs were not available in the icu, a common problem even today across India.

She left.

Behind the ICU building, a political party was celebrating the festival in a pandal, with repeated announcements of its achievements. Loud lewd music was playing, less irritating than the dramatised loud repitition of the party leaders’names. (c) Dr. Rajas Deshpande

Three more heart patients came in, but the ward beds were full, there already were twelve patients on the floor. This is a common scenario in almost all government hospitals across India. We begged the ward resident doctor to help us, and he agreed to shift three of his patients to the floor. The heart patients were taken on the beds outside ICU, and their medicines were started. We struggled at every step. The student nurses, enthusiastic and energetic, virtually carry half the weight of the doctor’s work upon their shoulders. (c) Dr. Rajas Deshpande

A municipal councillor walked in drunk, and started abusing the ward resident doctor for shifting “his”patient to the floor bed. Aggressive and drunk, his language was more offensive than his personality. We tried explaining to him that there were critical heart patients, but he insisted that his patient be taken on the bed. We then requested a stable young patient, who agreed reluctantly to go to the floor bed.

While this was being done, another old man was rushed in, his bronchitis/ asthma had worsened due to the excess pollution, a common problem in modern India. He was too late, his ambulance had been held in traffic. Already blue-black, he could not be saved inspite of frantic efforts. There were no relatives with him, we completed the paperwork and sent him to the mortuary.

In a few minutes, the fluctuating icu patient had a cardiac arrest. Loud noises of emergency carts, glass ampoules being broken open, and panicked cries filled up the ward. Starting CPR, we tried best to restart the silent heart. Such moments are beyond prayers, the doctor’s heart appeals through his hands, a dead patient’s heart. After a few minutes, the best sound in the world- that of a heart beating again- could be heard. Fingers crossed, we restarted his life-supports and gently informed his wife about what had happened. She was sobbing violently. I went to the doctors’ room to wash my hands.

It was then that the political pandal music could be heard again. (c) Dr. Rajas Deshpande

“Our party has made this big decision. You will all have to pay a little extra, but we will give you a modern, advanced, beautiful India. We will make more advanced satellites, bridges, we will buy the best fighter jets in the world, more bullet trains and bigger statues shortly. We are already ranking very high in the world, we will continue to grow. The only major problem in India is other political parties” the speeches were heard loudly, with proud shouts of joy and claps from the pandal.

At about 5 AM, things settled down enough to sip some water. The nurses had made tea for themselves, the incharge sister Mrs Joseph lovingly ordered me to take a quick break and have a cup of tea. She read my face. (c) Dr. Rajas Deshpande

“Doctor, I have been in this government hospital for nearly thirty years now. Nothing changes, whichever party comes to power. No one cares about the poor patients or their life. We need millions of doctors and nurses more, we need beds, equipment, so many more medicines, but we have to keep begging to the government as if we need it for personal use. Hundreds of patients die every day due to lacknof Medical care, because they cannot get beds, medicines or critical care. I was fed up long ago and wanted to quit. I had excellent offers from middle east and even UK. But I thought, if I left, who will look after these poor patients?”. She was to retire shortly.

Thousands of excellent doctors and nurses, pharmacists, and oher hospital staff carry on caring for poor and desperate patients in government and even private hospitals all over India, they are paid peanuts, are exploited inhumanly, yet keep working through festivals and celebrations, away from their families, with a smile upon their face. Right now, millions of critical patients are being attended by thousands of doctors, nurses and other hospital staff without thinking about salary, rewards, medals, sweets, new clothes or any form of celebration. The only medical festival is a saved life.

This post is to stand up and say a heartfelt “Thank You” to these doctors and nurses who are spending this Diwali with their patients.

(c) Dr. Rajas Deshpande

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A Good Doctor’s Daughter

© Dr. Rajas Deshpande

We sat inside her home, not able to speak. It was a Sunday. The doorbell rang. My classmate Siya looked at me, indicating with her eyes to please answer it.

Siya had lost her father that early morning. We had just finished the last rites and returned with that feeling of emptiness of life which prevails at such moments. Her father was a successful pediatrician, known for his excellent diagnosis and humanitarian approach. He had passed away at a very early age due to a rare cancer. He had kept working till the day he was admitted. His devastated family was staring at a long dark tunnel.

I went and opened the door.

“Doctorsaab hai kya? (Is the doctor home?)” asked a man in his thirties. Behind him were his wife and a son, about ten years old.

“No” I replied, but his wife immediately said: “Please, my son is his patient since last ten years, he has fever since last three days, we must meet the doctor”.

I requested him to please clear the door, shut it behind myself, and whispered to him: “Doctorsaab passed away early this morning”.

They looked at each other.

“How?” the husband asked.

“He had a cancer, he had some sudden complication” I replied.

After a pause. The husband asked “ Can you suggest some good pediatrician nearby?”

I did, and they went away. © Dr. Rajas Deshpande

There was no word of feeling sorry for the doctor who had treated their son for ten years. Not even a formal gesture of condolence. Their child wasn’t very sick either, to skip the basic courtesy. For the next few days, I was at their place on and off, and somehow expected that man to return to express some form of condolence or gratitude. It never happened.

Then over a period of years, the truth gradually dawned: that this is normal. No one comes back to ask a dead or retired doctor’s family if they need any help.

Another young colleague of mine, a diabetologist, passed away recently. He had done phenomenal social work, treating many patients free, and even arranging for many patient’s education. Every time he referred a poor patient to me, he called up, requested me to see the patient free. We all gladly did. We had many common patients who followed up later with me, after his death. Unfortunately none of the patients who he had called about ever expressed anything beyond “He was a good doctor. Now I go to this doctor”.

I wonder how many of these patients will ever realize that every time this doctor had seen them free, he had taken a share of what his own children would have inherited, and given it to that patient.

I am a fan of Ayn Rand. I believe that it is nobody’s duty to help me, and that I should rely only upon myself. But unless this stands on both sides, it becomes meaningless. While the expectations from every doctor are expressed in heaps, when it comes to rewarding the good results “blessings, satisfaction of saving a life and good wishes” are conveniently considered enough. I sincerely doubt whether the future generations of doctors will be able to buy their petrol with blessings and satisfaction. © Dr. Rajas Deshpande

Why is the compulsion of “courteous, polite speaking” only applied to the doctors? Why cannot our society learn the same? The idiotic claim (often supported by some media legal officers) that ‘a patient is in distress and so doctors must accept the anger, impolite behavior, violence or abuse’ is so stupid and meaningless! Will a judge ever accept such reactions by an angry criminal? By the way, if the patient is stressed, is the doctor also not stressed for years? Is the doctor then allowed to misbehave? If the doctors can learn courtesy, why cannot others?

It is so funny that even the great politicians who keep on throwing mud and blood upon each other, use basest language of threats in public day in and day out advise doctors about how they should learn courtesy, humanity and communication.

Siya has now become a successful practitioner. After her father’s death, she wasn’t helped by the government, society or the patients that her father treated. The family had to compromise a lot to complete education of all the sibs.Yet she became an excellent doctor by her own wish, her own conviction and continues to be praised by her patients for her courtseys. After all, she is a good doctor’s daughter!

But her smile, when her patient compliments her, is hollow.

© Dr. Rajas Deshpande

Please share unedited.

He woke me up again!

All through MBBS and MD, living in the hostel, one rarely had time for eating. The eternal aim was to keep awake, alert and running task to task 24/7. That needed a constant supply of stimulants: namely a tea that could bring you back from hell, and a visit to the pan-shop for You know what (bad habit, never mean to encourage, quit a decade ago).

But who had a steady supply of money? Most of us were dependent on the tiny money orders which vanished in a week, and then we depended upon the kindness of the tea-stall and pan-shop owner.

Mangesh Tea Stall at Jubilee Park, run by Inder, Gajanan and Ravi was our eternal hope and den, like that of thousands of doctors passing out from GMC Aurangabad. They fed us with snacks and tea for weeks/ months, trusting that we will pay back. Most of us did. Yet there were times when harsh and sarcastic comments were necessary to remind us of the payments due.

But the grandness of these souls was that in spite of themselves being so poor, they never ever denied to serve us snacks, tea and smokes, even when we weren’t able to pay for long. The stacked up bills must have been such a burden for them, yet they always said: “You doctors have such a heavy duty.. it’s ok”.

It was so necessary to visit them today after 20 years and say “thank you” for standing by us, supporting us in our pauper times!

The day was made again, when Inder made the same “back from hell tea”, and reminded that there’s a lot of work to finish yet!

He woke me up again! This reminder of how grateful I should be for all that I did not have then but have received now is so powerful!

©️Dr. Rajas Deshpande

Left to Right: Ravi, Myself, Inder, Gajanan, Dr. Shrinivas Gadappa.

Hon’ble Babaji’s Medical Interview

© Dr. Rajas Deshpande

A long fleet of luxury cars entered our big hospital. Sirens and whistles, security guards brandishing their AK 56s. and shouts of humiliation for the common men and women suddenly filled up the scene.

Hon’ble Babaji had arrived. A vacuous smile and blessing hands greeted one and all. Babaji was known to cure one and all with his blessings, secret medicines, chants, touch, and even exercises. There was nothing he didn’t treat, so he was the ultimate superspecialist with highest experience and cure rate. No deaths were ever reported among those millions treated by Babaji.

I was in the ward with some of my colleagues, a junior doctor then. The most reliable pleasure in the life of junior doctors is pretty, beautiful and handsome colleagues to work with! Rare exceptions with extreme merit are of course there.© Dr. Rajas Deshpande

A rich businessman and senior minister was admitted in emergency with a heart attack last night. Doctors had performed an emergency angioplasty, barely in time to save his life. Highest offices in the country had warned doctors to ‘do the very best’ for him, till the time he could be flown out of the country for the most advanced treatment. After the meeting of money, influence and power, we got a chance to request Babaji for a small interview to guide us inexperienced doctors. Looking at some of the prettiest faces among us, he gracefully consented. Here are some excerpts of the interview for the benefit of mundane, inexperienced new generation doctors and junta:

Doctor A ( looks OK): Namaskar Babaji! Can you tell us where you studied this art of curing all the illnesses?

Babaji: Beta this is the inheritance of generations, bestowed upon those who perform some secret rituals, it took me many years in the forest to learn it all.© Dr. Rajas Deshpande

Dr. Me ( looks ugly as you know): But Babaji, did you have patients to treat in the forests?

Angry Babaji: No. To learn this secret art you do not need to practice upon patients like your medical science. Once we know, we can directly cure everyone.

Doctor B (stunningly beautiful, common crush): Babaji, can you tell us how you treat a case of open head injury?

Babaji (with an gracefully sexy smile): Come beta, sit here, so you can hear me. We first hold some leaves hard pressed against the wounds to stop bleeding, then pray for the patient with some internal healing chants. We then call the relatives and explain them how futile and fragile life is, and ask them to accept fate. Usually they do. Some rare ones take such patients to hospitals. There too, some die and some survive. Those who survive mostly do because of the prayers. You can come to our place if you want to know how to treat all types of emergencies. We have even made some dead alive!© Dr. Rajas Deshpande

Doctor C (Meritorious. That’s all.): Babaji, there are so many poor patients dying in so many government hospitals, in small villages, everywhere. There are so many hunger deaths too. How come you and your chelas are never seen working your magical powers for such poor and needy patients? In the same time that you visit a businessman, minister or appear in a TV interview, you could treat and cure hundreds with the power you claim to have.

Babaji (red): You will not understand, because you do not have faith. Next question.

Doctor B: Babaji, you and your drug company earn in multiple billions. You are a saint yourself, and do not have material aspirations. Then where does all this profit go? Are you secretly using it to help treat poor and downtrodden?

Babaji (drinks water): There are many charities we do, but one must not tell others what charity they do. We submit the reports to the government. I am getting late, beta, it is my prayer time.

Doctor A: Just one more question, Babaji.. it is said that you cure diseases like cancers, AIDS etc which have no medical cures. Is that true?

Babaji (winks one eye): If you ask me in front of media, I will say no. Because I do not like too much attention and fame. But if you come to our place, you will see the miracles that our ancient formulas and personally researched products can make. They are all FDA approved and safe. Millions have been cured. We treat everything!© Dr. Rajas Deshpande

Babaji smiled proudly and got up.

As he walked in the lobby, many poor patients and their relatives who tried to touch his feet were pushed away by his security. Only pausing to answer questions by TV channels, posing holy, Babaji disappeared in his luxury car.

I went back to the room of the rich senior Minister to record his blood pressure. He was on the phone, talking to someone “Yes, yes, Babaji just confirmed his plan to buy another aeroplane. I have promised him that you will design the customized interiors for his new plane. Come over tomorrow”.

Then, as I recorded his notes, I politely asked the rich minister “Sir, why didn’t you go to Babaji first when you had chest pain?”

He replied what most Indian Politicians, Media personnel, and many Judicial experts feel: “You are too inexperienced about these things, Doctor”!

© Dr. Rajas Deshpande

Please share unedited. Any resemblance to any human being or animal is deeply regretted and unintentional. Praying for better logic and reasoning in all human beings.

The Parceled Sandwiches

(c) Dr. Rajas Deshpande

Entering the hospital that morning, I was wondering if I could finish early and go for a relaxed dinner with a friend who was visiting. Iwas in an excellent mood when I entered the hospital at about 10 AM. That’s when I heard the noise.

In the entrance lobby, there was a group of men, women and children, wailing, crying, shouting, pulling their hair, beating chests, and throwing their hands and legs around lying upon the floor. Few of them were shouting loudly “All doctors are looters. They robbed us and still killed the patient. How can our patient die? Catch them. Kill them. Burn the hospital” this was accompanied by abuses that cannot be mentioned. The security staff and PROs were patiently trying to tell the violent relatives that there were other patients and relatives, that there were women and children around, but the most vulgar of the abuses continued.

I walked past the abusive crowd and met my resident doctor in the ICU. The first case was that of an old man who had had a fall a week ago, but was treated at home for the first three days. Three days later, the old man had suddenly become unconscious, and on admission was found to have a large bleeding in his brain. If not operated within minutes, he would have died. Our neurosurgeons rushed in and operated him with a huge risk. Now he had just started responding, but was still not fully conscious. (c) Dr. Rajas Deshpande

“Why is he still unconscious, doc? Was the surgery not done correctly?” the son asked.

“We have repeatedly told you Sir, the delay in admitting your father has caused a lot of damage in his brain. We cannot predict when and how much he will recover. The surgery was done to prevent imminent death. In my opinion, he is steadily improving. ”I explained again.

One after another, different faces of suffering and allegations, pain and expectations kept mounting and in a few hours it became difficult to feel happy. I am seriously not the type who can keep a perpetual meaningless smile upon my face without actually being happy. However, I must keep calm and smiling, because the next patient will be coming in with a lot of hope, expectation and fear. I did my best.

But my hope of having a relaxed dinner with the friend was gone. All I wanted now was to go home, take a hot shower and try and kill the negativity that was cluttering my mind. The wails and cries of the crowd were still noisy in my heart. “Who must have died? What must their family be going through? What about their children and spouse? Was this preventable?” I was curious. (c) Dr. Rajas Deshpande

The casualty called. A young girl had come with fits. Her old farmer parents had brought her. Stabilising her, and completing the examination, I asked questions to her father. With teary eyes and folded hands, he told us “We have no one and nothing left. Please do something”. Reassuring him, I messaged my CEO, who graciously allowed to treat her as a free case. I started writing notes.

“What was the ruckus in the morning?”I asked the resident doctor standing besides me.

“Oh that!” he replied “That patient was admitted for a head injury two weeks ago. He drank too much alcohol, and his bike had slipped. We admitted him as an emergency, and treated him on compassionate grounds as he was comatose. The relatives were well aware about the poor outcome. We did everything we could. I don’t know why they reacted so. Someone told me that the local politico wanted to extract some funds from the hospital”. This was not unknown, but loss of life does cause unexpected reactions, the doctors and the hospital staff bear the brunt.

Many patients were treated that day, many came cured, many went home happy, many expressed gratitude. But the fact remained that I was unable to forget the wailing family and the accusing son of the ICU patient. Am I supposed to smile and be happy for those cured and improving, or am I supposed to feel sad about the death and suffering I see every day? The emotional highs and lows that happen in every doctor’s day are too wide, too heavy and dynamic. It is not easy to forgive and forget bitterness, thanklessness and paranoid accusations on a daily basis for years, and keep smiling in between. (c) Dr. Rajas Deshpande

My friend called. “Rajas, I am standing outside your hospital. Come let’s have a quick bite. My bus leaves in anoter one hour” she said. We entered the nearest restaurant. Her witty words indeed relaxed me somewhat, and she ordered soup and sandwiches, knownig my favourites. As the steamy soup eased my throat, I started telling her about my day. My cellphone rang.

“Is that you, doctor Deshpande? Do you remember my father Mr. Ramakant who you were treating? He passed away today. We were supposed to come to you three months ago, but as I was out of India, I couldn’t bring him. He had stopped all medicines”.

I winced. Mr. Ramakant was fairly healthy, happy and stable on medicines, they were told never to stop the treatment. How should I react?

“Very Sorry to know” I said.

“That’s okay doctor. My problem is that no doctor is giving a death certificate for him, as he had not seen a doctor since long. We need it for the funeral. If I come to you now, can you please write a death certificate for him? I will pay your charges” he said.

“Sorry, someone has to examine him and issue a certificate. Please call your neares doctor home, or take thepatient to the nearest hospital” I told him. As I kept away my cell, I avoided looking at my friend.

“What happened?”my friend asked. Looking at my face, she sensed it.

“Oh. Sorry” she asked the waiter to parcel the sandwiches.

Both of us knew that neither was going to eat them.

(c) Dr. Rajas Deshpande

Please share unedited. Please let the society know what a doctor’s day is typically like.