Tag Archives: Buddhism

“Why Don’t You Marry Her, Doc?”

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Dr. Rajas Deshpande

“Sir, she cannot walk, she is paralysed below chest since last few days. Her husband doesn’t care, he has abandoned her. She has no money or insurance for tests or treatment. I want to help her, I don’t know what to do” I told my junior consultant, who was having his coffee break with senior consultant and the departmental secretaries. He looked at me in a nasty way, and said “Why don’t you marry her?” and they all laughed aloud. However, although my professor smiled with them, he asked me to get the patient’s papers.

She was a case of Multiple Sclerosis, in her early thirties, and had lost ability to walk. Her sensation below the waist, control over urine was also lost. This ghastly illness of the brain and spine often cripples the young. In many cases, when such disability develops, divorces follow. The world as we doctors see it is far more cruel, deceptive and dangerous than most illnesses humanity knows. She was left with a small daughter and no income. © Dr. Rajas Deshpande

I felt insulted, but I was in a foreign country. The junior consultant was known for his sarcastic humour and enjoyed impressing women around him, often at the cost of others, like so many dwarfs who take advantage of their chair to achieve what they otherwise cannot. I chose to ignore him, and got the papers to our boss, who called a colleague to enrol the patient in one of the upcoming research trials. That would ensure her free tests and medicines for a few years. I told her the good news. She started sobbing, then handed me a note written by her:
“I am killing myself as I have nothing left except my daughter, I cannot look after her with my disability. I have no complaints against anyone. Please look after my daughter”.
In some time, after she stabilised, she said “Doc, I had come prepared to kill myself today. My daughter is sitting in the cafeteria. If you had not told me what you did just now, believe me, I was planning to drive my wheelchair off the roof today”. © Dr. Rajas Deshpande

We called her 10 year old daughter from the cafeteria. Little did the cute child know how lucky she was to see her mother again that day.

That evening, my boss, the senior consultant, took me out for a dinner. Once the red wine loosened strained faces, he started to speak: “Rajaas, I know you are kind and you want to help others. I know you feel for your patients. But I must caution you, don’t get carried away. Your job is clear: to listen, to advise the best line of investigations and treatment, to explain, and to compassionately guide. Don’t carry too much weight upon your shoulders”.
“Why, Sir?”I asked politely, “I feel inner peace when I walk an extra mile to help my patient. How can that cause me any harm? Didn’t this lady survive just because you helped her today?”
“Because it is a never ending burden. To be able to effectively help everyone coming to you, you must have too much money and too much time. Doctors seldom have either. I lost a lot of time and money, to realise that this cycle never ends, that newer and more people need your help every day, all your life. I almost went bankrupt, collapsed and quit under stress. Then I realised that I must limit this so I could serve them best the next day”. © Dr. Rajas Deshpande

It felt like dry reasoning at that moment. However, boss continued to help patients beyond duty whenever I asked him. Over years, I realised how correct Boss was!

My dear british colleague Dr. Mindy was trying to help a patient through her divorce, I accompanied her. As the patient opened up, she revealed to Mindy that although she enjoyed marijuana, her husband was involved in the sale of other illicit drugs, and that was one reason that she wanted to divorce him. Dr. Mindy involved a counsellor to help her out. However, after they decided to patch up their marriage, the patient told her husband that she had confided in Dr. Mindy. The husband came over and politely threatened her to keep all the information only to herself, otherwise be prepared for dare consequences.
We all spent many a restless nights after that.

Emotionally disturbed, helpless patients, those who are treated unfair by family often depend upon a kind doctor. They get quite restless at times, worry a lot and then expect an immediate hearing and resolution from their doctor. From suicide threats to blackmails, there are messages that pour in once that channel is opened. This sometimes wreaks havoc in the doctor‘s life, because being disturbed affects clinical practice and decision making. The small time left for self and family is thus shot dead. A patient who becomes emotionally dependent upon the doctor can turn into a nightmare for the doctor. Over years, I learnt to balance this, going out of the way only for the few truly deserving patients.

Thousands of patients have survived just because their doctor emotionally supported them in time, otherwise they would have died of lack of will to carry on. No one ever credits the doctors who become emotional back-ups for their patients: a service that costs them time and stress, without any income. That is unfortunately considered a “duty” of the doctor, to be kind and available at bad times, but to be forgotten in good times. © Dr. Rajas Deshpande. Many actually think that good words, compliments and “a satisfaction of serving” should be sufficient compensation for the doctor. Nothing fully compensates, although kind words do sometimes make one feel good.

However, what caused worse hurt to me was some of my own colleagues who made fun of me and many other doctors who went out of their way to help patients. “Impractical, unnecessary, worthless, drama”, and so many other adjectives are used by colleagues and even seniors/ some teachers for doctors, students, residents who walk an extra mile to help their patients. I was extremely fortunate that I met some good teachers who supported my efforts without mocking me, and I continue to meet students who carry on this noble trait forwards.

When I was leaving, the junior consultant came over for the farewell too, and told me in too many words how I must learn to be “Practical”. I gave him a reply that one teacher with advanced genius had taught me years ago, for people who do less themselves and advise others a lot. This reply saves a lot of time and energy, my teacher had told me, and its beauty is that people don’t even understand that you are saying ‘those two useful words’ when you reply like this:

I just smiled at him.

© Dr. Rajas Deshpande

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The Zen Of a Doctor: An attempt of honest meditation

The Zen Of a Doctor
An attempt of honest meditation
© Dr. Rajas Deshpande

I am now tired, mentally fatigued, I want to recover to joy. I do not want to lie to myself.

I love treating patients, resolving their health problems. I love the feeling of their recovery. I love the gratitude that comes my way. I am proud of this ability to be compassionate, to harbor empathy and to understand and fight suffering of another human being. I am proud, that money is not on the top of my priority lists. © Dr. Rajas Deshpande

But now I am tired of the whining: not the whining of suffering, for that is mine to destroy happily, but the whining by choice of adopting an extremely stressful, dirty, unclean, unhealthy lifestyle, not preparing to change, not preparing to pay for health, and then blaming it all upon a doctor. Women openly suppressed by husbands and large families, children tortured by parent’s whims, men exploited by their own desires and careers, and an orthodox, superstitious society where the most literate and educated believe in sometimes poisoning themselves with unknown medicines, and then have the audacity to question a qualified doctors’ intentions in writing a prescription. © Dr. Rajas Deshpande

They want everything of the best quality, from panipuri to cars, and are willing to pay extra for every luxury, while expecting that only healthcare must come free, and the very doctor whom they cannot trust, cannot tell the truth to, must treat them with best empathy and honesty, give them enough time to ask unnecessary questions and doubts, and then should waive off the fees out of sympathy. © Dr. Rajas Deshpande

I am also tired of the corrupt practices in medicine, and the hopeless scenario that everyone rather tends to believe that the doctors are all corrupt (some indeed are, but so are few in every profession, shut up pseudo Einsteins of argument!) rather than seeing the open markets established by uninhibited corporates who are seen hand in hand with the administrators, some pharmaceuticals and some in power. Corruption by those in high places, that ranges from producing some of the worst quality, inexperienced doctors, to dispensing lower quality everything just because they have understood this trick: people fall for low cost anything, even health. Such a disaster that people do so many unnecessary tests under the “Health Check” scams themselves, but when the doctor advises even one test, suspect him / her of wanting more money! © Dr. Rajas Deshpande

I refuse to be exploited. I can only change myself, not the world. Hence this meditation.

I want to live a good life: not full of gold and diamonds, but of joy, health and inner peace. Of independence, financial as well. Of my own choice and preference, not what the society decides for me. I want quality time for myself and my family too. © Dr. Rajas Deshpande

I do not want to be a busy doctor irritated and shouting at everyone: I would rather earn less and guard my composure. Those who cannot respect this will be given a chance to understand, but only once.

I will continue to stay highest in my principles. I will refuse to compromise on the quality of healthcare I want to practice, just because someone wants a cheaper, faster but less ethical alternative, less correct choice. I will see less number of patients and rather spend enough quality time with each of them, and charge them higher as per time and expertise, rather than hurrying through.

I will choose to encourage trust in my patients with my own behavior and words, but if I realize they are still trustless and question my integrity, I will refer them to their choice of another specialist, because I want to retain my best peace of mind for my next patient.© Dr. Rajas Deshpande

I will not take the extra effort to explain everyone why I do what I do, my duty is to be honest to myself and my God, my patients. I have limited time, now and in life, and I will expect that faith, trust and a level of basic intelligence (that has nothing to do with education) will enable everyone to see clearly that I mean well. That is my promise to myself: I will always mean well to my patients, and offer them my best. That should never preclude my own happiness. This will enable me achieve my inner peace so essential for a doctor.

I feel better with this already.

© Dr. Rajas Deshpande