Tag Archives: Administration

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

Carefully calculating the dose and mixing it with the intravenous fluid with precision, I told the kind old lady: “I am starting the medicine drip now. If you feel anything unpleasant, please tell me.”

Through her pain, she smiled in reply. Her son, my lecturer Dr. SK, stood beside us and reassured her too. He had to leave for the OPD, there already was a rush today. “Please take care of her and call me if you feel anything is wrong” he said and left.

Dr. SK’s mom was advised chemotherapy of a cancer. It was quite difficult to calculate its doses and prepare the right concentration for the intravenous drip. Just a month ago, my guide Dr. Pradeep (PY) Muley had taught me how to accurately prepare and administer it, so when Dr. SK’s mom was admitted, he requested me to do it for her too.

The drip started. After a few hours, I noticed that her urine bag needed emptying. The ‘mausi’ supposed to do it was already out for some work. Any resident doctor in India naturally replaces whoever is absent. So I wore gloves, requested a bucket from the nurse, and emptied the urobag into it. Just as I carried the bucket with urine towards the ward bathrooms, Dr. SK returned, and offered to carry it himself, but I told him it was okay and went on to keep the bucket near the bathroom where the ‘mausi’ would later clean it. © Dr Rajas Deshpande

Once the drip was over, Dr. SK invited me for a tea at a small stall outside the campus. He appeared disturbed. He said awkwardly: “Listen, please don’t misunderstand, but when I saw you carrying my mother’s urine in the bucket, I was amazed. You are a Brahmin, right? When you were away, my mom even scolded me why I allowed you to do it, she felt it was embarrassing, as we hail from the Bahujan community. I am myself a leader of our association, as you already know”.

I knew it, to be honest. His was a feared name in most circles.He was a kindly but aggressive leader of their community, but always ready to help anyone from any caste or religion, to stand by anyone oppressed, especially from the poor and discriminated backgrounds.

“I didn’t think of it Sir! She is a patient, besides that she’s your mother, and I am your student, it is my duty to do whatever is necessary. Otherwise too, my parents have always insisted that I never entertain any such differences”. I replied. © Dr Rajas Deshpande

“That’s okay, but I admit my prejudice about you has changed,” he said. “If you ever face any trouble, consider me your elder brother and let me know if I can do anything for you”. What an honest, courageous admission! Unless every Indian who thinks he / she is superior or different than any other Indian actually faces the hateful racist in the West who ill-treats them both as “browns or blacks”, they will never understand the pain of discrimination!

As fate would have it, in a few months, I had an argument with a professor about some posting. The professor then called me and said “So long as I am an examiner, don’t expect to pass your MD exams.”

I was quite worried. My parents were waiting for me to finish PG and finally start life near them, I already had a few months old son, and our financial status wasn’t robust. I could not afford to waste six months. © Dr Rajas Deshpande

I went to Dr. SK. He asked all details. Then he came with me to the threatening professor. He first asked me to apologise to the professor for having argued, which I did. Then he told the professor: “Rajas is my younger brother. Please don’t threaten him ever. Pass him if he deserves, fail him if he performs poor. But don’t fail him if he performs well. I will ask other examiners”.

The professor then told me that he had threatened me “in a fit of rage”, and it was all over.

With the grace of God, good teachers and hard work, I did pass my MD in first attempt. When I went to touch his feet, Dr. SK took me to his mom, who showered her loving blessings upon me once again, and gifted me a Hundred rupee note from her secret pouch. © Dr Rajas Deshpande

Like most other students, I’ve had friends from all social folds at all times in school and colleges. I had excellent relations with the leaders of Dr. Babasaheb Ambedkar Association, and twice in my life they have jumped in to help me in my fight against injustice when everyone else had refused. I love the most fierce weapon of all that Dr. Babasaheb Ambedkar himself carried: the fountain pen!

No amount of fights will ever resolve any problems between any two communities, the only way forward is to respectfully walk together and find solutions. Fortunately, no doctor, even in India, thinks about any patient in the terms of their religion or caste. (© Dr Rajas Deshpande). Just like the Judge in the court premises, humanity is the single supreme authority in any medical premises. Blood or heart, brain or breathing are not exclusive to any religion or community. Just like the bigger brain, a bigger heart is also the sign of evolution.

I so much wish that the black clouds of disharmony between different communities are forever gone. The only hope is that our students can open any doors and break any walls, so long as they do not grow up into egoistic stiffs. © Dr Rajas Deshpande

I am proud to belong to the medical cult of those who never entertain any discrimination. A patient’s blessing has no coloured flags attached! Even outside my profession, I deeply believe that the very God I pray exists in every single human being I meet. If at all anyone asks me, I am happy to say that:

My religion, my caste and my duty as a doctor are all one: Humanity first!

© Dr Rajas Deshpande

Neurologist

Pune

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Homoglobin

Homoglobin

© Dr. Rajas Deshpande

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

Many hilarious and abrasive retorts came to my mind:

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

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

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

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

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

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

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

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

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

“No” me.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

© Dr. Rajas Deshpande

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“Do you want a broken leg, Doctor?”

“Do you want a broken leg, Doctor?”
© Dr. Rajas Deshpande

Three days after he suffered a paralysis, after having tried Voo Doo, Herbal and some other medicines, an old man of 80 was shifted to a big private hospital once he became comatose. The three sons accompanying him didn’t even touch the comatose patient, they didn’t even care about whether he was covered properly or not.
His Blood Pressure was too high, and he turned out to have a bleeding in the brain, untreated till this moment. His brain was swollen badly.

Every private hospital has free mandatory beds for poor patients. This family was asked about their preference and eligibility. © Dr. Rajas Deshpande
“We will pay everything. Don’t worry about the money. He should get the best room and facilities” his son said. They signed the necessary documents about knowing the critical condition of the patient, charging schedules, willingness to pay etc.
Then the sons came to me and said “We don’t care about the money, doctor, but he should get completely cured”.
This was expected, experience teaches a doctor about relatives as much as about patients.
“He is 80 years old and critical. At this stage I cannot guarantee anything. Complete recovery looks impossible, partial recovery may be hoped for if he responds well to standard treatment” I replied.
“But we will pay anything you want” the younger son said.
I involved the PRO, a lady who had far better patience than myself dealing with attitude and arrogance. Explained them once again, and left after the patient was shifted to our Neuro Intensive Care Unit. © Dr. Rajas Deshpande

The patient improved in five days. Started to speak a few relevant words. Out of danger, shifted to Deluxe Room as requested. The only person who ever attended the patient was a 15 year old grandson, mostly the patient was left alone.
The sons had by then submitted some documents claiming a BPL “Below Poverty Line” status, but those were found to be false. A fake letter in the name of charity commissioner was also attempted. The hospital PRO reminded the patient’s sons about the pending bills regularly.

It became clear that none of the three sons who earned well themselves wanted to pay for their father’s treatment. They had continuous fights amongst themselves, the only thing they agreed upon was not wanting their father. The request “He must get completely cured” was not because they wanted his health, but because no one wanted to take home a disabled father to care for years.

The hospital took a stern stand. The bills had exceeded two lacs rupees, nothing was paid. This indeed was burglary with blackmail.

After repeatedly asking to meet the patient’s sons for another three days who did not pick up the hospital calls, I told the attending boy very carefully to please remind his parents to settle the pending bills, also reminding him that nothing in the treatment will wait or change because of bills.

In two hours I received a call. It was a local Municipal Councilor.
“Doctor, do you want a broken leg? Are you a doctor or a businessman? How can you speak about money to a small boy? Just keep on treating. We will do something about the bills through our MLA. If you speak about bills again, remember, there will be news about your hospital on every channel”.

Do I have time, energy to waste, filing a police complaint? Will it be any use at all? © Dr. Rajas Deshpande

In no other industry, not even in govt. offices, will anyone be given anything on credit: even for a paper worth five rupees. Even the poorest of the poor cannot get free food or travel in private industry. But the entire private medical care is expected to go on working in ‘credit’ mode, for everyone who claims to be poor. Emergency is understood, and no hospital or doctor thinks about money in case of emergency. But once emergency is over, those who cannot afford a private hospital should go to a government hospital. A private hospital needs too much investment per bed, and anyone who questions this can please sponsor one bed in any ICU for a poor patient, see for themselves what the actuals cost.

Who will even address this Burglary and Blackmail that happens everyday in every private hospital in India?

There should be an online portal by government / police for doctors and hospitals to report patients dumped by family, families who refuse to pay, those who use threats and intimidation anonymously. Then the ‘other side’ of this story will be clear.

© Dr. Rajas Deshpande

“I Swear”

I Swear
© Dr. Rajas Deshpande
 
“Have you forgotten your oath, doctor?” asked the Hon’ble minister to Dr. Prasad.
 
The fat elderly reporter accompanying the Hon’ble minister laughed. “We must teach these doctors a lesson” he said.
Being a doctor, good language and behavior is essential. So Dr. Prasad swallowed the immediate reaction that had sprung to the tip of his tongue, one that involved references to some passionate human interaction.
 
He then smiled.
“Sir, did you attend any school?” he asked the Hon’ble minister innocently.
The Hon’ble minister was offended. He had not had a respectable academic record. © Dr. Rajas Deshpande
“What does that mean? Do you know who you are talking to?” the accompanying reporter raised his voice.
“Yes, I know I am talking to a patient. A human being with the same organs as me, but not the same merit or intentions” said Dr. Prasad.
 
Before the cunning reporter and the Hon’ble minister could formulate a reply, Dr. Prasad continued:
“Sir, all over India, for ten years, everyone who has attended any school has recited every morning, the National Pledge. That is our promise to our beloved nation. Let me remind you of some sentences in that prayer:
I shall give my parents, teachers and all elders respect and treat everyone with courtesy.
To my country and my people, I pledge my devotion.
In their well being and prosperity alone lies my happiness.
Tell me Sir, are all politicians, ministers, media persons, businessmen, lawyers, and other professionals following this oath that they have recited every day for ten years? If yes, where does violence come from? Not only in hospitals, but in every other home, against children, against womenfolk, against even the elderly”.© Dr. Rajas Deshpande
 
“But you are a doctor, you have taken an oath to serve” said the defiant Hon’ble, expert in the art of diverting discussions.
 
“No, Sir”, replied Dr. Prasad firmly, “I have not taken any oath to tolerate violence or abuse, or to risk my own life or limb. I have not taken any oath to feed with my blood and sweat the deficient and perpetually corrupt healthcare systems. I have not taken any oath to be nice and kind to attacking, drunk, abusive or irresponsible people who enter the hospital with an almost dead patient at the last moment and then expect the doctor to perform miracles. I have never taken any oath to treat Judges and Ministers and Rich VIPs above the poor, really deserving patients. I have not promised anyone that I will neglect my family or my own health”.
 
“I have only taken an oath to honestly treat the sick with dignity, not thinking about money. That most doctors do, some who fail are common in every field. My oath is to help a patient recover. If I fail, try me in a court of law. Send me to a court that understands law better, and appeals people not to be violent, tells governments to protect everyone against violence, rather than asking doctors to tolerate violence as a part of their duty. It is exactly as backward as like asking a wife to tolerate her husband’s atrocities as a part of her duties”. © Dr. Rajas Deshpande
 
The restless tail barked again: “But the public pays for your education”
 
“I beg to differ, sir. No one is obliging anyone by paying for doctor’s education. The country needs many more thousand doctors. And we pay taxes too, to be protected. People pay taxes for a good and cheap healthcare system, please give them that, rather than them having to depend upon private hospitals. A doctor is just a small component in healthcare. Don’t blame him for expecting the same protection that every citizen expects. The infrastructure and policies are pathetic, and an intelligent taxpayer will one day understand that the doctors are not taking home any money as their alms. Everyone knows who gets richer with taxpayer’s money, Certainly not the doctors”.
 
“As for your allegation, respected reporter sir” said Dr. Prasad calmly to the tail, “You are educated, you have a responsibility to heal social ills, not widen the bleeding wounds and survive on that flowing blood. There are so many good examples of reporters / media persons who bring immense good to our society. The ability to sit in one’s chamber with all controls, and bark at everyone, manipulate speech cunningly, distort facts pretending to be holier than others, while your seat is dipped in hidden honey is not reporting”.© Dr. Rajas Deshpande
 
“Doctor, you have too much ego” said the angry Hon’ble.
 
“No sir, intolerance to stupidity is not ego. Every religious ceremony, every professional oath makes us repeat the good we must do, including a minister’s oath of office. . Very few actually do it, but everyone thinks it is only the doctor who must follow his oath” said Dr. Prasad.
 
He then checked the Hon’ble Minister and wrote him a prescription that included weight reduction and abstinence from alcohol.
 
Without a Thank You or a payment, the powerful duo left.
 
“I swear” said Dr. Prasad, smiling to himself, “I will never give them the joy of taking it lying down”.
 
That is the basic oath of every self respecting human being.
 
Jai Hind
© Dr. Rajas Deshpande
 
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Goodbye, Doctor

Goodbye, Doctor
© Dr. Rajas Deshpande

“Screw this satisfaction. Dump this happiness. Can you try to understand that I am fed up of both?” said Dr. Sahil. He was one of the busiest and most respected specialist in our town.

Surprised at a superspecialist doctor friend speaking this, still impressed by his ability to identify and speak the truth about himself. I let him go on.

“There’s no guilt. There’s no regret. I have done my best since school. Topped everything. I did not feel the extra effort: I finished graduation, PG and Super PG by merit alone, that too without having to make a great effort. I have practiced over 15 years now. I did some research, but don’t enjoy the kind of research that goes on in Clinical medicine now. I have practiced with all my heart, and all my time. Now I don’t want to. Repetition kills me, and I cannot see anything but that now”. He paused.

We shared the best bond between two humans: mutual respect with no curtains. Either of us didn’t feel the necessity to modify speech for political correctness or covering up naked feelings.

I replied: “I understand. But we always thought that we need to save lives, give back to the society. So many will benefit with your genius”. I realized just as I spoke, there was something hollow about that. Or did he just uncover a mirror in me?

Sahil was as calm as a meditating saint. “I don’t feel so. Nobody’s saving lives. We use scientific knowledge to try and treat the medical conditions we see, try to comfort the suffering with our kindness, and earn our bread under the continuous threat of something going terribly wrong. I have studied for fifteen years, and served the society back for more than that.”

We sipped our coffee in silence for some time. Hans Zimmer’s ‘Discombobulate’ was playing at that time in my chamber. Coincidences are too much sometimes. That heavenly symphony of all disconcerted instruments played by the expert musicians is one of the best things in human history I think (link below).

He smiled at the music. “I did not promise anyone to spend an entire lifetime doing what I don’t want to do anymore. I respect the gratitude I received, although it was rarely pure and sustained. I am sure many better than me will replace me and continue to treat patients who need care. I have never felt respected or accepted in the society, it was always with the caveat of ‘not all doctors are good’ that the people who I served looked at me, not the other way round.“

He became serious. “I don’t want now to work hard all day and night, be serious all the time, and step up my already busy schedule to reprove my abilities again and again. I am fed up of having to prove my worth and abilities to those who I do good to. When almost every illiterate as well as the educated questions my intentions, I don’t think anyone deserves an explanation. Half my time is spent now explaining the patient what is good for them, why they must do the tests and take the medicines, how I cannot predict all side effects or complications and be held responsible for them. I became a doctor to treat people, not to cover up for their suspicious ignorance with my knowledge and time”.

Somewhere deep, I understood him. But the ego of a doctor: that we have “accepted” the responsibility to serve prodded me to argue with him. I said so.© Dr. Rajas Deshpande

“Who are we serving, Rajas?” He asked. “Society? Government? People? To what end? Where do you see this service either recognized, rewarded, acknowledged or reciprocated?. Then again, where does it all end? The line of unaffording poor is unending, the complaints of affording are mounting, and I seldom get a peaceful night’s sleep, inspite of a clear conscience. I will retire without enriching my own life”.

I remembered my favourite author Richard Bach’s view: “The simplest questions in life are also the most difficult ones to answer”.

My lawyer friend, Advocate Shrirang Choudhary, had time and again pulled me out of civil hospital Nanded. I had this habit of ‘living’ inside the hospital, beyong the 12 hours duty. I would just go home to take a bath and one time meal, then return and stay to assist every consultant I could: there was such a sense of fulfillment in learning!

Shrirang would pull me out, we went to the riverbanks and he ensured that we talked for a few hours anything except medical world. “You will kill yourself if you spend all your life in the obvious negativity that is the milieu of any hospital. There’s more to life than being a good doctor. Treat yourself to the immense beauty life has to offer. You have only one lifetime, and limited active years”.

I realized how much I had wanted to pursue a career in poetry, music, philosophy and adventure. It was with such ease and passion that I had given up all of it, proud that I will be saving lives. Now after 15 years of practice I saw another valid viewpoint.

“You get used to the satisfaction and happiness, the challenges and the victories in healthcare. I can understand that some may enjoy the repetition of the same for umpteen years: in fact an entire lifetime. But can you please also understand that to me it feels like an artist who paints only one big picture or sings only one song in his entire lifetime?”

I knew what he spoke about. I was suffering the same, but had avoided to think of it.

“Do what you want in your spare time. Reduce practice. You must take a break” I suggested, “A long break.”
To lighten up the mood, I added, “Although people will immediately say that some pharmaceutical sponsored your holiday and fun”.

“I wish I cared what people thought” he smiled, “And I don’t want to run away. I don’t want to do anything half hearted. I want to walk out gracefully. Like a saint or a seer walking out upon the world and going to the Himalayas. Why is that more respectable than a doctor wanting not to be a doctor?”
I did not have an answer.
© Dr. Rajas Deshpande

Dedicated to those who understood this post.

Hans Zimmer’s Discombobulate music video:

(https://www.youtube.com/watch?v=R89UGKuyodk&index=2&list=FLHqY_yEsrcQFcedWLQUF2Pg)

Stop This Anesthesia

Stop This Anesthesia
© Dr. Rajas Deshpande

“Why so Doctor? Why cannot my child be like others?” asked the angry mother.

Just as I started to reply her, the patient: a 23 year old boy, went into a flurry of jerks. His body stiffened up, his eyes rolled up, and his face turned blue. He was already on the examination bed. Me and my student tried to support him there. We activated the code blue, just in case.
But the fit stopped. The boy came to, gradually. The nurse cleaned the bloody froth from his mouth. Heart rate and BP were normal now. Patient remained confused.

The mother, silently sobbing while patting his head, showed me the many large scars upon his face, head, and elsewhere. “He falls down many times every day and often injures himself. Can you imagine, doctor, what a mother’s heart feels to see her child bleeding every day?” © Dr. Rajas Deshpande
It was a case of hypoxic brain damage. The child was born in a village, the labour was prolonged and they could not reach a bigger hospital in time. If they had facilities, the child would have been normal today. Since birth, the child had had mild mental retardation and convulsions resistant to many medicines, They refused a surgery. I tried to counsel them. In many cases, we can control fits with a good combination of different medicines. But that takes time over a few months.

“We are farmers, doctor. We cannot stay home all day, we need to work to earn. The medicines are all so costly. I can sell everything to treat my son. But please tell me this will stop” the father’s voice was quivering.
It is easy to expect a doctor to detach himself emotionally from the patient, but then it is also like denying the patient empathy and understanding so crucial to their wellbeing.
“I will try my best, and I feel we can control the fits with medicines. Also, I can arrange for free medicines for your son whenever you cannot buy them. Never worry about my fees, I will be happy to treat him free. But make sure that his doses are never missed.” My teachers spoke through me.

“What after my death? Who will care for him? Who will bring him medicines? Who will ensure he takes them?” said the hefty man, and broke down. The proud feel it most difficult to declare their agonies. He tried to hide his face. The father and the mother sobbed on either side of the patient, who wasn’t yet alert enough to grasp it. © Dr. Rajas Deshpande
“There are some help communities and groups for epilepsy patients. We will enroll him into one. They will arrange for his medicines. I will also introduce you to some pharma companies who will give him free medicines as required”.
Then, pausing to realize the unasked question, I replied “And after me too, my students, colleagues or most doctors I know will never decline to treat him free. You just have to show them this note” .
I made a small note of such a request. I have never known any of my students or colleagues refuse to see a deserving patient free.

The tension in the room was melting. The parents had stopped sobbing. A possibility of hope and reassurance destroys the worst of darkness. The father folded his hands in gratitude, but couldn’t speak. The patient had a glass of water and they left.
But my mind was on fire again. Who’s guilty here?
Shall we blame fate for the blatant failures of a system? © Dr. Rajas Deshpande

Why didn’t their village have facilities to ensure good delivery? Why wasn’t it possible for them to reach bigger hospital in time? Who is responsible for millions of children who develop lifelong preventable illnesses just because of a cruel lack of healthcare infrastructure? Patients with heart attacks and strokes and cancers die everywhere everyday, unable to afford treatment or to reach hospitals in time.

In a country that needs serious improvement in almost every area of healthcare infrastructure, the whole focus is being directed at the repeated exams for doctor’s requalification.
Do we need it at all in a country that is grappling with critical shortage of doctors, and where we are promoting every other pathy to allopathy with a six month training? We need many care homes, support systems for patients who cannot afford medicines. Many more ambulances. Many more hospitals in remote areas, Many more qualified doctors to work there while being able to afford a dignified life.

But the only decisions being made are about more exams for truly qualified doctors: why? This tranquilizer to divert attention from the main issues that need correction is the worst treatment possible for Indian Healthcare. © Dr. Rajas Deshpande

Doctors are never defined by the examinations that they pass, being a doctor is far more than passing qualifying examinations. But who will educate those who never bothered to pass any dignified exams?

Just before inducing the anesthesia, the patient is told “You will feel sleepy now. Everything is ok. Take a deep breath”. With complete faith, the patient goes unconscious. It is the doctors who ensure he / she returns safe. Some rare unfortunate patients never know that they will never wake up, because there are things a doctor cannot control.

That unfortunate patient is just like the Indian Society today.
How qualified are the healthcare policy decision makers?
© Dr. Rajas Deshpande

Please share unedited. Let the society know what is critically essential.

Sirs, Madams, Soldiers and Slaves

Sirs, Madams, Soldiers and Slaves
© Dr. Rajas Deshpande
 
“Who will face the bullets on the border if everyone starts arguing?” shouted the officer.
He was a municipal corporation deputy chief in a metropolis. I was representing a students’ union for resident doctors, and we were demanding two major changes: that our salaries be deposited in a bank (hundreds of resident doctors, wardboys and other staff were supposed to queue up within the first three days of every month, in front of the accounts office to collect monthly salary, some could not because their duties did not allow them), and that the libraries be kept open 24 hours, as our work hours were never defined, and rooms being shared, it was not always possible to study in hostels. The demands were many years old, nothing had moved.
But this time we had decided to use a new weapon: Strike. © Dr. Rajas Deshpande
Sensing trouble as we had recently carried out a successful strike, the deputy chief blasted his arguing lethargic assistants who resisted every change: the hallmark of most administrations.
That’s when the deputy chief shouted upon them and ordered to comply immediately.
“Yes, Sir” they said. The next month, both these things changed in all Municipal hospitals. Threat had achieved what the system would never have allowed to happen.
 
Few years later, studying in Canada, almost every boss or senior I met insisted that we call him / her by name, and not Sir / Madam. “It stinks of slavery somehow” said a professor whose thinking affected me profoundly. © Dr. Rajas Deshpande
“Why are so many brilliant Indian students so intimidated to openly argue, come out with suggestions or put forth a contrary opinion in front of their boss?” he once asked me, “I don’t think respect can be placed above logic. So I think fear must be involved”.
 
That set me thinking. It was true. From the parents who directly start slapping children for questioning them or talking about issues like sexuality, to the teachers who misuse their authority to suppress students by threats, failing in exams and scarring their CVs, we had grown up in the dual pressure system: cultural limitations that prevented thinking out of box, and intimidation by fear of humiliation and failure: from both family and teachers. There were rare honorable exceptions: teachers and parents who encouraged to think free.
 
What happens when someone in India argues against the prevalent system? First ridiculed, then refuted, threatened and often destroyed or outcast by the system whose malfunction he / she has questioned. From judiciary to journalism, from schools to parliament, and from doctors to labourers, his/ her own people question his / her sanity or intention. © Dr. Rajas Deshpande
 
No wonder we have mastered the British art of establishing a foolproof slavery system.
 
Look at the scientific and literary outputs. Look at the productivity and innovation. A country that boasts of geniuses is happy to play the role of “cheap intellectual labour”, proudly flaunting the business, outsourced to it primarily for low costs, as an achievement. These super-talented brains in business or in any other field must only walk the narrow path, at the speed of one of the slowest systems, limited by humungous paperwork, red tapism, favouritism and corruption. . Public condemnation and humiliation await those who differ in their opinion.
 
What happens when one follows all the rules of argument in such a system?
 
Suppose a soldier tired of his heavy duty without adequate food complains about it to his superior, what is the typical answer he will get? Is it too difficult to imagine what will happen to his career? How many are the chances that a military superior, a government officer or your own boss will say “You are right, my dear, I am sorry you had to face inconvenience, we will correct this immediately” and do it? Sorry. We grow up with incessant reminders of how we are second to, under, helpless, and lesser than the people we work for, including our administrations. © Dr. Rajas Deshpande
 
We live in a fool’s paradise. We like to stay hidden behind the fears of our little sins and mistakes (who doesn’t commit some?) being exposed, our socio cultural apple cart being upset and our perpetual orgasm with comfort zone being threatened.
 
When the hallmarks of slavery: calling everyone “Sir” or “Madam”, standing up, bowing, compulsory greeting, applauding and agreeing without pausing to think or argue are so perfectly blended with cultural traditions of respecting the elders, we create a foolproof prison for thought. It is indeed a mystery why a country which has so many elders, and so many respectable people, is yet to be at the top in any field! Do all these “Sirs and Madams” truly behave or achieve to match that respect?
 
A country where seniority, relation, political strength and connections, nuisance value, money and age surpass all other intellectual criteria of leading and promotion by merit, do we really dream of becoming number one in the world? © Dr. Rajas Deshpande
 
Every genuine intellectual, artist, scientist (and there will be many who will throttle up their throats to praise the existing system for obvious rewards) will dislike being tied down by limitations. The ones who have spent their youth standing up and saluting “Sirs and Madams” have had their time. It is high time we start thinking of the youth and the future generations.
 
When I returned from Canada, I had changed. I knew I could not change the system, but I could definitely change myself. I have since then never expected or insisted anyone calls me “Sir”, respects me out of context, or stands up / greets me. I prefer people, even students calling me by my name, and it has never taken away the affectionate relationship we share. I have always encouraged my children, my students and the scanty number of friends to be completely free in their thinking, to think of the whole world as their home and humanity as their culture, to politely argue without arrogance or spite, and to accept what is right without thinking who said it. Those who presume that “uncontrolled freedom will always go in wrong direction” confuse between misuse of freedom and non adherence to civil duties.
 
This small contribution to eradicate slavery of thought was one of my many duties towards life.
 
As for the soldiers on the borders of any country, who just “take orders from people sitting in air-conditioned offices, to face bullets,”, let us at least gather some courage to stand up to the sacrifice they make in the name of their country, and try to realize the meaning of this precious word : Freedom.
© Dr. Rajas Deshpande
 
PS:
Only for free thinking intellectuals.
Please share unedited in the interest of future generations.