Tag Archives: Career

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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“If Only”

© Dr. Rajas Deshpande

Dr. Raina sat devastated in her chamber. Medical tragedies are a part of any doctor’s daily life, but this was cruel, because it was preventable.

A young patient in 20s, Mr. Pandey, was brought to her, with mild headaches. He had started dieting and exercising a month ago, and the entire family was hooked on to some herbal preparations that claimed to confer health without any side effects. His examination was completely normal. The patient and his highly educated parents were extremely anxious. Dr. Raina had explained to them that even if the examination was normal, sometimes headaches may be the only early warning sign of some diseases, and hence she would recommend an MRI of the brain.

“Is it necessary? Does his examination tell you something is wrong?” asked the father.

“His examination is normal, however, in many diseases that manifest only as headaches, one may not find anything wrong upon a clinical examination” Dr. Raina explained.

“Like what? Which diseases?” asked the mother, hardly aware that her anxiety was adding to her son’s distress.

Dr. Raina hesitated. When the patient or family is already so anxious, how can one utter names like cancer, tumor, aneurysm, etc.? If the doctor uses such words, some patients lose their sleep for weeks even if the tests reports turn out normal. A doctor has to be wise enough to avoid worrying the patient unnecessarily. © Dr. Rajas Deshpande

“Well, infections like sinus disease, pressure changes in brain water, and some others which are rare” Dr. Raina said cautiously.

“Any dangerous diseases? How much is the possibility? Can we wait?” the father bombarded.

Dr. Raina controlled her discomfort and agitation. Educated or not, when a patient visiting a doctor talks as if they know better medical decision making than the doctor, the doctor mentally switches off the ‘compassionate involvement of a doctor’ and becomes a ‘legally alert’ medical professional. Questions are welcome, suspicious cross examination is not.

“The possibility of finding anything grievous like clots or tumors is extremely low, but this is usually the standard investigation to complete the evaluation of the case” she replied. She had told them to get the MRI done. They asked if it was an emergency. She said it didn’t appear to be, based upon the normal examination. She wasn’t ‘God’ to see inside the body.

She prescribed the patient some simple medicines for headache, preparing for another round of questions.

“Are these steroids? Are these antibiotics? Do these cause addiction? Do they cause damage to the liver or kidney?” she patiently replied to the family. © Dr. Rajas Deshpande

Why won’t a doctor think of these things when writing a prescription? Do you ask a pilot if his steps while flying are correct? Do you cross question a Judge about how he makes his decisions? Do you ask a soldier fighting with terrorists why he is firing, how many bullets, and in which direction?

The mother checked the medicines and said “Don’t mind doc, but I will first google these medicines and then start in a day or two. We will also think about the MRI”. They left.

Just two days later, the patient was found unconscious in his bed at home. Rushed to the hospital, his brain showed blockage of the venous channels in his brain, that had caused huge bleeding. He was operated in an emergency and was now paralysed on one side. He had also lost speech. The surgeon who operated the patient could manage to save his life with a great effort. The parents were still suspicious about the surgery being wrong. Many opinions were obtained, and it finally dawned upon them that what was being done was the best. The combination of unknown content medicines, low water intake, atrocious dieting and exercise had probably caused clots in his brain, leading to the blockage and bleeding.

One evening, when Dr. Raina was passing by the wards, the patient’s mother stopped her. “He is our only child. Our whole life was woven around him. Will he ever speak? Will he ever walk? Please tell us the truth”.

“We will try, although it looks quite difficult. It may take weeks to see some improvement. But we have seen miracles, let us hope for another” Dr. Raina replied. It was useless to blame anyone now, she refrained from the obvious ‘if only’. © Dr. Rajas Deshpande

They came back in a few weeks after discharge. Now the son was in a wheelchair.

The mother proudly told Dr. Raina: “You know doc, after discharge we took him to a remote village in south India, where he was given special massages and an ancient secret diet. That’s why he is now improving, he has just learnt to say “Aai (mother)”.

Dr. Raina did not reply. There was no cure for the disease of faithlessness in the society that she worked for.

© 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 Full Stop and The Comma

The Full Stop and The Comma
(c) Dr. Rajas Deshpande

A panic struck voice shouted on the other end of the phone: “Doc, This is Neerja. My husband suddenly cannot remember anything. Not my name, not even the kids. I am rushing him to the hospital. Can you please see him now?”.

Mrs. Neerja Dev was my old patient, under treatment for migraine. Actually it was late and I was done for the day, but when faith and trust calls, a doctor cannot say no. I drove back to the hospital.

Her husband Mr. Alok, a young and handsome software engineer in his early thirties, was placed in a big multinational. He was his company’s blue-eyed beloved, groomed for a long-term high flying career. His salary much exceeded that of the President of India. I had met him earlier, when he accompanied his wife. Quite brilliant, he had an arrogant attitude to go with his achievements. Neerja had often complained in privacy that she had a lot of stress as her husband worked excessively, had too much responsibility upon his shoulders, and growing up two daughters was left to her. “He loves me and the kids, but he has no time to spend with us” she had often complained.
“There’s cut-throat competition in the software industry, I need to work hard to be where I am” Alok had replied curtly whenever the topic came up. (c) Dr. Rajas Deshpande

I reached the hospital and examined him. Indeed, Alok was blank. He could just answer his name, and yes/ no to some questions, but he could not even complete a sentence. As he struggled to find words. Neerja was devastated, and could not stop crying. Their sweet daughters, aged fourteen and seven, boldly waited outside the casualty.

“Did he have fever? Did he take any new medicines? Did he fall down? Was he fasting?” I went on with a long list of questions. Nothing should be left to chance, every bit of information must be collected for an accurate diagnosis. There were no clues from the history. His pulse, heart, and blood pressure were normal. He was able to move well, and had normal sensation all over the body.

We rushed him into the MRI. Alok had many large white spots all over his brain in the MRI, a condition that is called “demyelination”. This usually happens in young patients after viral infections. Some other abnormalities in the immune system can also cause this. I explained the situation and its uncertain outcome to Neerja.

“There is no threat to his life right now, but we cannot comment anything about the recovery”. I concluded.

“What now? Will he recover at least enough to remember me and our kids? What will we do?” She broke down again.

“High dose Steroids may help some patients, but this treatment may increase his blood pressure, sugar levels, and also his chances of developing an infection. Are you ok with this risk?”

“I will leave it all to you. I cannot understand anything now.” She replied.

We started the injections of high dose steroids. His heart rate, blood pressure and sugars were continuously monitored, fluctuations treated promptly. The ward doctors, nurses stayed upon their toes, informing me every hour about him.

Friends from his company and even his boss visited. The boss just asked how long it will take for him to recover. “You know, we have deadlines and our clients need to be informed” he said.

After three days, Alok started to gradually recognise family and friends. In about ten days, he spoke well, and even started understanding what had happened. He was shocked.

“What about my job? Can I work from the hospital? They are dependent upon me. My boss has immense faith in me. Many high end projects need my supervision” he asked impatiently. (c) Dr. Rajas Deshpande

As controlled mental activity is good for recovery of brain functions, I allowed him to work from his hospital bed for an hour or two.

The next day he was all depressed: “Doc, I cannot remember many things necessary for my work. I cannot afford this. Please don’t tell anyone from my company. How long is this going to take? Will I ever completely recover?”

I wished I could reply, but I had no answer. Every doctor is frustrated when explaining uncertainty about outcomes.

“This is going to be a long process. I cannot say how much recovery is possible or how long it will take” I explained to him. His wife and friends requested my permission and sent his reports to various specialists in the developed world, and were reassured that the ongoing treatment was correct. Finally, they accepted the situation.

Alok followed up every month. After first three months his company fired him. His boss who he treated like God, refused to even meet him, and did not reply to his emails. For him Alok was dead. Word spreads. Although recovering fast, Alok did not get any new job. Neerja took up a job, and they divided the housekeeping chores and babysitting among themselves.

The family is now far less stressed, the kids are far more happier now because their father spends more time with them. At a lower income, they have reached a higher happiness bracket. The kids took every effort to jog their father through the past memories,and that has helped him recover faster. There is no higher medical stimulus for recovery than love. (c) Dr. Rajas Deshpande

Yesterday, all of a sudden, Alok came over with a box of sweets, and a greeting.

“I have decided to start my own business. I feel confident now. I may have lost some bits of my brain, but my heart is still strong enough to dream big. I have decided to turn this full-stop into a comma. But this time I have decided that I will first reserve time for my family and then work hard. It is because of them that I am back. I just came to thank you for standing by. My daughter has made this greeting for you “.

The sweets were of course delicious, but the greeting hand-made by his daughter moved me.

It said: “Thank you, doctor, for giving back our papa his dearest family”.

(c) Dr. Rajas Deshpande

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Be A Woman!

©️Dr. Rajas Deshpande

A major part of the pride of being a doctor is the freedom from any discrimination between humans. Every woman or man, from any religion or country is equally important, and also equally cared for.

Yet as a doctor I have often witnessed women being stronger than men when life presents any calamities, however explosive. Women are probably more emotionally destroyed with a traumatic event, yet they pick themselves up and fight like a mother for whoever they choose to stand by and protect. And we know, a mother makes a strong army! Any patient cared for by a woman heals faster, be it a nurse, a sister, servant, daughter, wife or mother, be it a girlfriend or just a woman without any relation. In any family, it is usually the women who keep the bonds of humanity and culture alive. We have so many biases about cultures and how women are treated, but it is an unfortunate fact: that women do things men find impossible. Hence the title, Be A Woman!

We often hear from working men in the metropolises how they cannot bring a parent in wheelchair to the hospital as it would be a lot of trouble and time.

Ms. Eshrak (a psychologist) and her sister (a bank employee) brought their mother on a stretcher all by themselves, all the way from Cairo, Egypt, to Pune India, in a hope to see her walk again. To travel to another country without knowing anyone there wasn’t their biggest problem. Reaching India from the war-torn middle east is a nightmare, but once they reach, local Indians, especially police officials are very cooperative in helping out especially patients coming for treatment to India.

They found a friend in a local Arabic student Mr. Ashraf Olafi, and had him search my clinic (I am sure any good qualified neurologist could have treated them equally well!). Their mother, suffering from Parkinsons Disease, walked after many months today, so they came with the two greatest gifts for their doctor: a smiling gratitude and blessings. Of course they brought a material token!

What better proof can there be of women not being dependent upon men? If only we recognised how incomplete and incompetent humanity would be, without the strength of women!

To artificially write about gratitude for women in one’s life and to thank them superficially to impress press and public has become a fashion, few do it from their heart. I pity those “high flying, successful” men who boast about how they respect women and consider them equal, while their wives are in fact taking care of their home and children, opting for hugely compromised careers. The truth is, a man, however strong, is always indebted to some woman!

Be A Woman!

That should always have been the correct slogan..

©️Dr. Rajas Deshpande

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

A Thumb Impression Of Our Society

© Dr. Rajas Deshpande

As the highly educated family: patient, his wife and daughter stared at my face, I bought a moment of thought by continuing to write instructions. Although the intensity of what I was going to say would affect them now, I knew what the future held a difficult and mentally traumatic, draining corridor they would have to go through in coming years. How to say this? I felt sad. Even after decades of experience, no doctor feels comfortable telling the patient or relatives about a bad or incurable diagnosis. It is a curse we must shoulder. Because someone must say it, someone must sympathize and stand by the patient and family, someone must face the anger and frustration of a family that was till yesterday living in the comfort of good health, completely oblivious to the fact that things may go wrong anytime with anyone. . © Dr. Rajas Deshpande

“You have a type of Parkinson’s disease with dementia. The Parkinson’s is causing your slowness and stiffness, and the dementia is causing the memory loss and change in personality. It is good that you have come at an early stage, we will be able to prolong lifespan with a better quality of life. With your cooperation I think we can do the best possible for the patient. I will give you some links to read from. Please read them and meet me again next week, I will be happy to answer all your queries, doubts and concerns”.

The stunned wife started sobbing. The husband closed his eyes in agony. The daughter, unable to speak, held her father’s hand. Offering them some water and coffee, I explained the daughter instructions about the medicines, tests to be performed, and asked them to see me next week. I wanted to spend more time with them, but the relatives of a critical patient in ICU were waiting outside for me.

“Dr. Rajas, my husband has been a brilliant scientist. He loves reading, writing and intellectual interactions. In fact that’s why we fell in love back then when I was his student. Intellect is his life. We will both die if that is taken away from us”. It was then that I looked at the lady carefully, because till now my mind was occupied with the patient. A very graceful, intelligent, upright and hence beautiful face, the one that tells stories about the highest culture and upbringing that there is. The grey hair added to the loving kindness of her expression. Intelligent Humility, that one element often absent from so many beautiful faces, was abundant upon hers. Somehow I remembered my mother.© Dr. Rajas Deshpande

“I understand, mam. Things are not so bad as of now, and we are still in the evaluation phase. I can give you a better idea about the future once I see the results of all the tests.

It was then that the daughter spoke: “Doctor, I am in India for only the next week. Can we complete the workup before next week, because I cannot postpone my travel back to the US. And yes, I want the best to be done for my father. ” the daughter said.

“Ok” I said. I have now come to accept the socio-cultural changes.

They came next week, the diagnosis was confirmed, I counseled them.

Then I explained the medicines and other care to the patient’s wife.

“Did you understand it well, mom?” asked the daughter, “because I will not be able to help you with this everyday”. The mother replied with her kind smile.

Three months later, the patient came back, with the daughter and her husband.

‘Doc, mom passed away with a sudden heart attack a month ago. She never told us she had any complaints”.

This happens so often: that when a family member is affected, everything revolves around their health, and the warning signs of caretaker’s disease are ignored till the last moment.

“Dad has become worse now. He doesn’t eat well, doesn’t speak with us. . We tried to encourage him to make new friends with his old age home society, but he doesn’t want to interact with others, he has always been stubborn. We have arranged for a caretaker, but dad doesn’t talk to him either.”

Looking at the patient, I realized how much emotional support he needed at that moment.

“I am sorry to know about your mother. Such a nice and kind lady!” I said.

“Thanks, doc. But now you must help us. Please help us find a good old-age nursing home for dad. I cannot stay back. We can pay well”.. she had a hint of “please let us get this over fast” in her speech.

“You said you wanted to do the best for your father. The best would be for you to be with him in these days, talk with him, connect him back with life for whatever remaining awareness he has left. There’s no other person upon earth that he will ever connect with, so this becomes your responsibility”. She knew the truth well, for she broke down. “I know doctor, but I have my family to look after. I cannot take my father with me. I am sorry”.© Dr. Rajas Deshpande

She visited again with the patient, before leaving for the US. A bank officer and a lawyer accompanied them.

“Dr. Deshpande, I need a certificate, my father cannot sign, and is in no condition to think coherent now. So we want to get his banking and legal formalities about our property completed with thumb impressions. I need you to authenticate dad’s thumb impression”.

The old man printed his thumb impression in my presence. Somewhere within, I knew he was violently crying although he must be hiding it just so that his daughter doesn’t feel bad while leaving him.

That Thumb impression, Decoded, was in fact the stark face of today’s society.

© Dr. Rajas Deshpande

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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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