Tag Archives: Corruption

Hon’ble Babaji’s Medical Interview

© Dr. Rajas Deshpande

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Babaji smiled proudly and got up.

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

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

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

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

© Dr. Rajas Deshpande

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

The Medical License to Kill

© Dr. Rajas Deshpande

The five year old girl stopped breathing. Her father shouted in a state beyond panic. With a fear of a death worse than his own, he choked upon his own shouting. It was about 4 AM. The dozing relatives of other patients in the casualty woke up startled.

The intern doctor Anu tried to insert a breathing tube in the child’s throat, but the right sized tube wasn’t available. Dr. Anu shouted at the nurse to wake up the medical officer on duty. She couldn’t: he was deep asleep, being drunk. The child started getting blue. The heartbeats became feeble. Another nurse ran upstairs, and literally dragged the junior doctor in the ICU to the casualty. He struggled and managed to insert the tube somehow, and with the breathing bag, artificial breathing was started. The child stayed unconscious, but the heart beats were heard well now. There were no beds in the ICU, so they managed her there itself, in the casualty.

Two hours later the medical officer woke up. Unclean and unkempt, stinking of alcohol and sweat and yet careless about it, he was usually seen roaming in the hospital with swollen red eyes, talking usually about the only three things so called “Men” talk about. In hating him, many diversely thinking junior doctors united. There were complaints about him: nurses, junior doctors and patients had all written to many authorities about his drunken demeanor, ill behavior, swearing and abusive language, and even a violent attitude: he was known to slap attendants, drivers, assistants, and throwing instruments in the operation theater. © Dr. Rajas Deshpande

Dr. Anu not only hated him, but was scared of him too. She hesitantly reported what had happened in the night. “We tried to wake you up Sir, but couldn’t” she said cautiously, just like all brave girls who cannot hide what they dislike. He laughed in the style of a famous ‘Manly’ hero of the times. “Such small things keep on happening in big hospitals. Don’t worry. If I wake up for every emergency at a government hospital, I will myself die. I am doing the duty for five medical officers alone. You must accept death as a part of your daily life. Don’t get emotionally involved in patients. Some will die, we can do nothing about it”. Then, without even visiting the child once, he left, as his duty hours were over. © Dr. Rajas Deshpande

The disgust and anger that flooded Dr. Anu came out in the form of tears. She went to the nurses room and sobbed. She had not dreamt of becoming a doctor like this: helpless and suppressed. The nursing Superintendent, a motherly lady, patted her. “It is good that he didn’t wake up at night. He doesn’t know even the simple procedures. He would have probably harmed the child more in that drunken state. The only thing you can do now is to quickly learn all the life saving procedures that you can, and then don’t be dependent upon anyone else to save lives”.

“I want to complain against him. How can a doctor sleep when a child is dying during his duty?” Dr. Anu asked.

The Nursing Super smiled in shame.

“My dear, who will you complain to? This drunkard is the son of a ruling minister. They own a private medical college themselves, many come to him to get medical seats there, so they have friends and defenders in almost all high offices. Whoever questions anything about him, faces not only the ire of his father’s political goons, but suffers at many other levels to. Do you think people don’t know his addictions and ill behavior? But when the government protects him, what can anyone else do?”.

Then, as Dr. Anu stared in vacuum, the Super told her one of the most beautiful pearls in medicine: “There are some bad doctors dear, but that’s where you come in. Your responsibility increases. Learn to be strong, learn to compensate for what others cannot do. Such sick doctors who pass out without learning, who come drunk to the hospital and mistreat patients are a curse to our profession. We can’t change them. The lesser number of patients they see, the better it is for everyone. You compensate for them by becoming better”. © Dr. Rajas Deshpande

The day forever changed Dr. Anu. Providence, as always, had rewarded her for her efforts in saving the child’s life only a few hours ago.

The sad fact still remains: that some students are not trained well. Some do not have the capacity or wish to become good doctors while some are ‘pushed’ by money and power. These are the people who have learned the most deadly Indian trick: to find a political godfather who protects them from anything you do, Feed his wallet and ego, lick him all over, and then retain the ‘license to medically kill’. Please check out how many ministers and political bigwigs own medical colleges, and how many use these as ‘power channels’ to make undeserving doctors, and one can easily know where the problem lies. This by no means suggests that only the doctors from private colleges are bad, there indeed are ill behaved and drunkards among doctors passing out from govt. colleges too. The point is that they are protected by some. To first satisfy all vote banks, then collect the multicrore moolah for admissions and then create yet another channel of corruption: Eligibility test! This is a nightmare for the truly willing and deserving merit holders. About this aspect of the matter, no politician ever speaks. Who protects the Medical admission scamsters? Why do not our courts act suo moto, knowing that so many lives will be at risk with doctors produced via scams? © Dr. Rajas Deshpande. The saddest part is that many corporate hospitals look for such doctors who are also financially recklessly aggressive, and then make them compete with the good and ethical doctors.

Today on the occasion of Gandhi Jayanti, many “trumpet tongues” will be heard speaking through their hats about the Mahatma. Introspection and truth are the beginnings of even knowing the Mahatma. The criminal corruption networks which produce bad, ineligible doctors by the force of money and power must go! These are the very doctors who bring a bad name and a shame to our profession. Many a good things in the profession, saving a million lives every day and sacrifices made therein bt thousands of good docs all become a waste because of such few bad doctors. Let us all stand united in improving ourselves, giving up what’s not the part of a good doctor.

Jai Hind!

Mahatma Gandhi ki Jay!

© Dr. Rajas Deshpande

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The Deadly ‘Vegetable’

The Deadly ‘Vegetable’

“How is my mother, Doctor?” The smiling politician, a tower of patience, surrounded by his impatient bouncer cronies, and a drooling doctor, asked me at the door of the critical care unit.

I examined the patient, a case of a large bleeding that had caused severe damage in the brain. Inputs were whispered in my ears by the cautious doctors of the unit. The poor lady had been treated by many excellent doctors in Mumbai and Delhi, as the family of that politico had that free facility. However, she had stopped the blood pressure medicines as some “Herbal Baba” had criticized them on National TV. © Dr. Rajas Deshpande

“She is conscious, but cannot understand or respond at all. Her heart is beating well, blood pressure is holding up, and her breathing is fine too. She can move her hands and legs, but it all appears meaningless movement. This may last for weeks or months, and in some cases, even permanently”.

The ‘doctor’ with that group authoritatively asked “That means she is a vegetable now?”.

“The correct word is ‘Vegetative’, the medical condition is called ‘Persistent Vegetative State’, and I cannot say as of now if this will be persistant. There are some chances of recovery” I replied with a carefully acquired masked face.

“Is there anything we can do anywhere in the world to make her brain normal again? I can take her to the best centers in the world” said the Politico. The drooling doc came forward again. His desperation to be significant was almost killing him. “Are there any medicines that can make her recover faster? We can afford anything” he asked.

I knew the exact words to reply him with.© Dr. Rajas Deshpande

“No Sir. Just as you cannot shorten the period of pregnancy, you cannot convert it to three months in the best of the hospitals , however rich you may be, the recovery of brain happens at its own speed. The medicines that can help her are already on”. This usually stops further discussion in that line, it did.© Dr. Rajas Deshpande

I went to the cafeteria to cool down. I couldn’t understand whether it was the tail-wagging doctor or the politico with ‘everything exists to serve me’ attitude that irritated me more. A cyclone of the big picture started rising in my mind.

The state of our “Government run” healthcare, is more or less the same: Vegetative. Big plans, big declarations, more investment, more land and buildings, more equipment, all surfaces, especially during elections. But the brain: good doctors in the system: is dead. No good healthcare system can be created or run by those appointed without merit, without quality. Thousands of huge set-ups declared and erected by the various governments are lying vacant, or serving far below their purpose because there are no good doctors/ technicians in most. The last battalion holding the flag of good healthcare: good medical teachers in medical college are on the verge of extinction. Best of the government-run hospitals and services are often reserved for those in power and their families. The shameless orders for “reserving ICU beds and ventilators, operation theaters etc.” for a patient known to a politician are a daily affair, they least care if someone else without an influence dies.© Dr. Rajas Deshpande

Appointments of drooling, medal-hungry shoelickers on various key medical posts has crippled the system. The real poor and deserving are thrown from one window to another to submit documents and applications to claim the benefits that they deserve.

The whole blame of a this deadly “Vegetable” healthcare is cunningly shifted upon those who refuse to work as ‘personal servants’ to the government, those who go into private practice, and private hospitals. Now almost all doctors complete their bonds, yet there is a gaping hole in the system that cannot retain specialists for long. Only the compromised, beginners, and failures stay for long in adverse, sycophancy based, low-cost environments. The very politicians who say “Don’t worry about money” when asking treatments for their own family, accuse the doctors of being “greedy”, when they leave govt. services.© Dr. Rajas Deshpande

The simple solution, the recovery of the brain, i.e induction and retaining of good, meritorious, non-shoe-licking and highly qualified specialists in the government-run healthcare departments and set-ups will probably change this scenario. But this looks impossible, now that even many doctor’s organisations have started losing their autonomy, self respect, to fall in line with the glorified slogans and to lick the bottoms of those who run such failed healthcare systems. The addictions to blow up any tiny good news, modify data to appease masses, hide the blaring failures, deficits and corruption in the healthcare have become a norm, and even our society seems to be ecstatically happy to just hear loud speeches of big plans rather than facing ground realities.

Indian Healthcare run by various governments, except for very few honourable exceptions, has become a brainless “Persistent Vegetative Healthcare System”. A ‘deadly vegetable’, for the understanding of the drooling docs. Unless someone sane and responsible in healthcare department acts quickly, we will lose this healthcare battle.

© Dr. Rajas Deshpande

PS: During the writing of this article I received over 20 phone calls from patients, and 12 of them dropped, cut, hanged. This is our technical progress. Before we send men in space, can we deal with this?

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Illegal Heroes

Illegal Heroes

© Dr. Rajas Deshpande

“I was at the disco last night. We danced a lot, I exceeded my ususal capacity of 180 ml alcohol, and had two or three large pegs extra. I must have smoked a little extra too yesterday, I was too stressed”’ said the 30 year old man, who was admitted one afternoon in an unconscious state. He had had a fit in the office that morning. The MRI had shown a large bleeding / haemorrhage in his brain. This illness, cerebral venous thrombosis, is quite common among those who are dehydrated, those who have untreated sinus infections, and among those who take contraceptive pills. If not treated in time, it can quickly cause brain swelling that may lead to disability or death.

Over next three days he gradually improved. Brain swelling started to recede, and he asked for a discharge. Faster and to-the-point care had improved his condition, thanks to modern healthcare. A psychiatrist had already counselled him about deaddiction. When we sent his file for discharge, his mediclaim insurance was declined because this illness was related to alcohol consumption. Immediately, his tone became bitter, his colleagues dissected the case papers asking for justification of each test, each medicine, and also why he was even hospitalised. Gratefulness is often waived off by doctors as a lost quality among saved patients, but it is difficult to tolerate arrogant distrust. We firmly explained him what was done and why.

“We will pay your bills, we will claim the insurance later, but you must change your notes, remove alcohol and smoking from his papers” said the patient’s brother.

“We cannot change the case notes, it is illegal. Also, we have already sent copies to the insurance company, a standard procedure. You are not obliging us by paying the bills, we have provided healthcare service that saved your brother, who was about to die due to alcohol consumption” we replied.

Within an hour, a local politician, an elected member, who came in his Range Rover with his personal armed bodyguards and human doggies, started his anti-medical show that had drama, emotion, tragedy, threats of violence and revenge and everything else but truth and honesty. He spoiled the day for everyone involved, caused disruption of hospital work for over six hours, and left with a threat of “burning down the hospital soon”. When our PRO asked him whether he wants to pay the bills of this patient to help them, his reaction was the hallmark of a true politician: change of topic to how the medical profession has lost its reputation.

Almost every doctor, every hospital in India is being threatened and pressurised by our own lawmakers at almost all levels into changing facts, writing false details, extorting concessions for the rich and poor both, only to increase their own vote banks at the cost of the healthcare industry. Most politicians, many government officers instead of financially helping the patient, ask the hospital to treat free or cut off bills.

How legal is this authority? If a politician writes to a court or lawyer or hotel or an Airline to waive off fees/ bills of a poor person, will they ever? Why are the doctor’s services and hospitals taken for granted here? How sad that such illegal means make pseudo-Heroes in our country!

Everytime the politicos pressurise a doctor or a hospital to treat their paying cronies free or concessional, some other truly deserving patient suffers because hospitals, small or big, can only do a certain level of charity. How fair is it to deny healthcare to the deserving poor just because they cannot flex a political muscle? This phenomenon is ruining the whole purpose and concept of charity healthcare measures all over India.

Aren’t these elected members responsible for the disgusting state of the civil and government hospitals and healthcare all over India? That is their domain of authority. This is like messing up one’s own home and family and requesting the one with a better home and family to pay and comply for one’s own needs. How shameful is it for the elected members of different parties to have to send people, especially the poor, to the private hospitals, because their own set-ups are failing perpetually? Empty posts, inadequate staff, poorest funding, non-availability of quality technology and medicines and red tapism have created massive monuments of the healthcare failures of different lawmakers all over India, and these are the very people who come threatening to the hospitals of burning them down! Hear this, any Milord?

If the honourable Prime Minister and Health Minister invite feedback from every patient leaving every civil and government hospital, the gravity of this situation will be understood better. Many repairs “at home” are required before “the neighbours home” is raided. We as doctors and hospitals must together request these authorities and offices to protect us from such daily insults, extortions and exploitation.

The very next day, an old man, a retired Indian Military officer, was expressing himself in the OPD with tears in his eyes: “Ye desh ka kuchh nahi honewala (This country cannot progress). People here, at all levels, want corruption, legal escapes to save money, and will elect anyone who throws them petty bits. Votes are bought for such favours as alcohol, gifts and cash. Sycophants rule, criminals are seen hand in hand with some rulers. Who do you think will get elected with such means, saints? You can guess what progress we expect if the lawmakers are first in line to break laws..”

There was nothing more sinister I heard that day. I am worried about the healthcare in my beloved country. God save the future generations from such illegal heroes!

© Dr. Rajas Deshpande

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The Greater Squint

The Greater Squint

© Dr. Rajas Deshpande

“Why didn’t the doctor tell us? Is it allowed for the doctors to hide such information? I will sue him” the angry mother kept shouting as she cried. Her husband told her to calm down.

“I know the other doctor well, I will talk with him today. He must have his reasons” I replied.

“No doctor, we don’t want you to talk to him about this” said the father.

Their fifteen year old brilliant daughter had developed mild headache and occasional giddiness. They had first read blogs about these symptoms, and after trying out various “natural” remedies and lifestyle changes, visited their family physician. He had started with the routine medicines for headache, and advised them to visit a specialist if the symptoms persisted for a week. As the headache didn’t subside, they visited a specialist. His notes indicated a normal neurological examination, and some higher medicines for headaches and giddiness. After a week, the girl developed a squint, double vision and slurred speech suddenly, and was unable to walk. She was brought to our emergency, her MRI of the brain showed multiple sites of infection including the lower part of the brain. Although most infections are treatable, those in the lower part of the brain (called brainstem) are extremely dangerous, and can cause even coma or death. This part has all the vital centers of the body, controlling heart rate, blood pressure and respiration. © Dr. Rajas Deshpande

When I explained this and advised admission for further treatment, they had panicked. That is when the mother had lashed out at the earlier doctors.

After admitting the child, the father came back.

“Doctor, I must make a confession. My wife is quite anxious, and she was crying when we saw the last doctor. That’s why the doctor didn’t tell her everything, but asked her to wait outside and informed me that there were such dangerous possibilities as cancer, tumor or infection, and that an MRI was necessary. I requested him not to write that on paper, thinking that my wife will panic. She is very emotional. That’s why we waited for a few days, thinking that things will improve. Please understand us, doctor”. I reassured him, and treatment was started.

The inflow of blatant allegations against allopaths/ modern medical practitioners is now so wide and strong, that this has sensitized some of the best doctors. Some have started to entirely avoid mentioning the tests required for a complete evaluation of a condition, knowing that if the doctor advises any tests, the only interpretation in our society is that those are for earning more money.

“Patients themselves do so many tests and take so many medicines without consulting a doctor. But if we advises any tests, the immediate allegation is that we want to earn more money. That affects our practice. So shall we still advise tests?” asked a colleague during a recent seminar. © Dr. Rajas Deshpande

The answer is a definite, loud yes. The duty of a doctor, besides being well qualified, skillful and compassionate, is also to boldly state fact and possibilities, advise the best investigations and treatments to every patient, poor or rich, VIP or AAP, and write these all on the patient’s case paper. The workup / investigations advised should be according to the global best practice guidelines. Poverty and illiteracy are neither the faults or responsibilities of a doctor, and like other professionals or even some governments, a doctor cannot provide “low grade” service to any poor patient. From the eyes of a doctor, even a penniless beggar should get the same advice about tests, medicines and surgery that the Prime Minister of the land gets. If ministers can go to corporate hospitals or even abroad for treatment, every citizen should also be sponsored for the same benefits by the same administration through the same funds, without preaching the doctors to do more “charity”. Otherwise we are a hypocritical society. © Dr. Rajas Deshpande

Whether to do those tests or not, where to do them is the patient’s choice. Whether to take the advised medicines is also upto the patient. The doctor may suggest the best place, request concessions, and if the patient is poor, suggest options to get financial help or refer to charity. But the quality of medical advice should never change. The only exception is an accusative, angry patient who is making paranoid efforts to find faults with everything that you do. One may politely decline to accept such a patient.

If the treating doctor has not advised all the tests necessary for the evaluation of relevant diagnostic possibilities, he/ she may be found guilty of negligence. To avoid advising tests just to please the patient would also be a moral crime. One must also refrain from crossing over to other specialties and advising tests before referral to the right specialist. Some “pretending to know everything from every specialty”, doctors advise various tests incorrectly, and even attempt treatments out of their expertise without a working diagnosis. . Such dangerous doctors may add to the woes and defamation of the profession. © Dr. Rajas Deshpande

The girl above is improving, although her balance is off, and she has developed t a squint. Most likely her squint will never improve. She is missing school for over three months now. She will now onwards live a compromised life: incomplete education, compromised marriage and the condescending Indian society where shame of physical disability like squints and lisps, slurring and imbalance are the essential components of most enjoyed comedies.

However, her squint is far lesser a problem than the one that our society has, against doctors.

© Dr. Rajas Deshpande

PS: Many people comment often that “Doctors should introspect”. I do not know how many of these people introspect about their own habit of finding faults with others before self. But the article above is an honest attempt to do so.

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The Goddess Of Humanity

The Goddess Of Humanity

© Dr. Rajas Deshpande

When I entered the hospital today, little did I know that I would meet someone who changes lives by example.

Then I met Mrs. Jasmine Govindji Majethia. A lady far superior than most men I ever met, a spirit with an energy to defeat ten ripped-jeans-teenagers, a soul that can only belong to a saint in any religion!

At the age of 80, Mrs. Jasmine Majethia is working 24/7, traveling alone all over India to help patients with Thalassemia get treatment in time, to generate awareness among people and even medical community. She has been doing this for over 30 years now. © Dr. Rajas Deshpande

This morning I had received a call: “Hi. I am sending an old lady to your OPD. She has done a lot for the society. She has had some episodes of unconsciousness recently” said our Pathology chief Dr. Mrs. Nita Munshi, always out to help others full throttle.

Mrs. Majethia told me that her tremors were long standing, but recently she had had some episodes of unconsciousness. It had all started after a stressful event related to one of her Thalassemia kids.

“I cannot sit at home. I have so much to do. Tell me what tests are required, tell me what medicine I should take, but I want to continue my work” the lady had an authority difficult to match. I followed her orders.

Born and raised in Calcutta, married in Mumbai, she finished her family duties and joined the LTM Medical College Sion to work as a liaison officer with Dr. Lokeshwar, who invoked her interest in Thalassemia. Witnessing the plight of children with Thalassemia and their parents, she decided to make it the mission of her life to stand up for them. She established PATUT (Parents Association Thalassemic Unit Trust) to help the affected families with financial and other support for treatments. This Goddess of humanity has thus saved many a lives, roping in doctors, hospitals, trusts, friends, rich and poor donors to help this cause.

“Zero Thalassemia Birth Rate in India by 2020 is the mission of my life. I am not ashamed of knocking doors and asking for help because it is not for myself.” said the lady with a steel resolve. © Dr. Rajas Deshpande

“There’s hardly anyone who can resist helping her cause. She is like a gentle pinch of conscience for those who have excess, to help others” said Dr. Munshi.

Thalassemia affects over 40 million people in India and kills thousands every year, it can easily be prevented with simple precautions. Even countries far backward than India have rules that make Thalassemia screening legally mandatory before / during pregnancy, and thus prevent any child births with this condition (“Zero Thal Birth Rate”). However, lack of awareness and screening, apathy on the part of our governments has continued to increase the burden of this disease in India. The treatment is extremely costly in some cases, and out of reach for most common Indians.

Mrs. Majethia spoke with the passion of a revolutionary: “So many doctors all over the country, like your colleagues Dr. Vijay Ramanan, Dr. Nita Munshi and Mrs. Trupti Thanekar always help me in my cause, whenever I request help. But the sad part is that there is almost no health awareness in our country. Even if we offer free treatment, many parents do not avail of it until it is too late and the case gets complicated.”

“Yet I like to think that God has given me in excess than what I need. Even Life. It is my duty to give some of it to those who are unlucky. I tell myself that God has selected me to do this work, because I can.” Such simple words, yet so powerful in their meaning! I really wish that she must receive best of the National Honours and medals for her work.

Every now and then, some insurance agent gives me plans to retire early and still earn well. Some tell me how people make retirement plans by age 40. Until now, I didn’t find exact words to tell them that many of us do not want to retire, that I wanted to work till my last breath. This lady was the answer, the literal personification of the words I AM MY WORK.

Across the cultures, there are Gods and Goddesses of Beauty, Fame, Love, Sport and Affluence. Rarely do we hear of a God of Work or Goddess of Humanity. In Mrs. Jasmine Majethia, I found the Working Goddess of Humanity.

My highest respect to this lady, one of the most inspiring women I ever met!

PS: She agreed to record a short message for everyone including doctors, please click this link in my comment below this article to listen to her divine voice.

© Dr. Rajas Deshpande

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Victim? Dr. Reena’s story

Victim? Dr. Reena’s story

© Dr. Rajas Deshpande

“I am being victimised, Sir! I have tried to do my best, but my senior has developed some prejudice against me and has started to find faults with everything I do. I don’t know, I feel suicidal sometimes” the resident doctor Reena said, breaking down. She was into medicine, one of the toughest branches for post graduation.

This was a difficult situation. It is very well known that some seniors and teachers do take advantage of the situation to mistreat and misuse their students or subordinates. It is also well known that both men and women in every profession, including medicine, have strong gender biases and favouritism. Sycophancy is so essential in India, that I wonder sometimes whether an official bachelors / masters “Chamchagiri” (sycophancy) certificate will be necessary before people are selected for their jobs.

I gave her some instructions to ignore words and minor incidences, and concentrate on doing her official duties with concentration. I also counselled her about how to handle egoistic, arrogant seniors. She was supposed to follow up next week.

That weekend, I met a colleague of mine, Dr. Anand, in the coffee shop. There was no OPD, it being a Sunday. We sipped coffee in the canteen, telling each other funny stuff about other colleagues. Medicine provides great entertainment too, in the form of various types of doctors, and we start with ourselves usually. © Dr. Rajas Deshpande

Just then, another doctor came in, Dr. Anand invited him to join us and introduced me to him as Dr. Ashwin. “Ashwin was my junior resident” said Dr. Anand, “and one of the most brilliant students. He’s a wiz. He wanted to work for the downtrodden, so he has continued to work at the govt. hospital after his MD. Most dedicated! That’s why most girls around us liked him and we all envied him”. It is rare for Anand to praise someone this much, I was quite impressed and happy.

But Dr. Ashwin appeared quite disturbed. Dr. Anand asked him if he was ok.

“No, yaar. I am facing a big problem. There’s this girl in my unit, who has made my life hell. She has filed complaints against me to the dean, my name is all mud”.

“Complain against you?” said Dr. Anand, truly surprised “Even your wife never complains against you”. He was trying to lighten up the mood. © Dr. Rajas Deshpande

“Yes. But you know how heavy our PG duties are. This girl, besides being lousy and careless, refuses to finish her work, constantly looks at the watch and doesn’t want to be corrected. How can we tolerate carelessness in medicine? There are patients in the ICU and this lady keeps busy with her cellphone! I gave her a warning that I will complain, but instead, she went ahead and complained that I was harassing her, implying serious charges. Fortunately my wife and the dean understand the situation, but you know some people in the campus would rather see me down. I don’t know what to do. I am thinking of resigning”.

“Can you share her name?” I asked, cautiously. The guess was correct. It indeed was Dr. Reena.

“I tried to talk to her, I requested her to call her parents. Apparently she has grown up as a pampered child, her parents refuse to even think that she can be wrong. They started complaining that their daughter didn’t get enough rest and good food, that she has always been a super genius kid and how many a times even her teachers could not understand her genius”.

Now the picture was clear, with the other side of the story revealed.

There indeed is, nowadays, a rampant tendency to play a victim, especially to cover up for one’s own failures, inadequacies and lethargy. Children who allege that their failures are either because of their parents being over disciplined or completely negligent, boys who hate their parents and refuse accepting that they fell short of hard work and dedication because of too many diversions, girls who sometimes lie about “sexual abuse”, and employees who underperform only to blame it upon a racist / pervert / prejudiced boss are classical examples when stress factors are analysed well. There was one girl who alleged abuse by her step father, just to tell me minutes later that it was probably her imagination, and that she didn’t know if it was a dream! It was her mother who then revealed that the girl had always used that ‘dream reality’ sequence whenever she wanted something and was refused. © Dr. Rajas Deshpande

There indeed is rampant true victimisation in all these areas, and one must always stand by the victim. But the overflow of sympathy that drowns sense and reasoning (thank you, media and some movies!) must always be avoided. Differentiating ‘true’ and ‘pseudo’ victims is never easy especially because there always will be the social biases. Most Indian men unfortunately truly look down upon women, most seniors think that juniors cannot be more intelligent, parents often mentally overpower logic when dealing with kids etc.. Still there indeed are many who hide behind the “victim” tag, just to take advantage of the sympathy and protection it offers, using it to hide their own negative side. A lot of people use suicide threats, false complaints and other pressure tactics to emotionally exploit and threaten others. When this happens in a workplace, it poisons the whole atmosphere. There is indeed no protection for the true victims here.

Next time when Dr. Reena came to visit, I told her how I chanced upon the doctor who was “troubling” her. As expected, she cried and defended her stance, but after some gentle coaxing, when I reiterated that the actual problem must be dealt with, she agreed to have a meeting with Dr. Ashwin. I called in a female counsellor too, and in a few meetings, we could sort out the issue.

Medical career is, difficult, it is important to do every single thing perfectly and with utmost care and concentration. No one else can ever replace the life-saving responsibility of a doctor on duty. A doctor who isn’t fully attentive to everything about every patient can be dangerous.

Dr. Reena agreed to go by the duties allotted and improve her performance, while Dr. Ashwin reassured her that he had nothing personal against her, that she could always compare her duties and performance with her other batchmates. He also told her that now onwards he will mind his words better. She withdrew the complaint.

Dedicated to those such who have had this horrible experience.

© Dr. Rajas Deshpande

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The Higher Suffering

© Dr. Rajas Deshpande

Stuck in the heavy traffic due to rains, I tried to remain calm. The cellphone kept on ringing, patients who were waiting, those who wanted appointments, those who were to catch their ride out of station anxiously asked when will I reach. Some lost patience and raised voice. In addition, there were calls about the patients admitted in the hospital: critical decisions to be made, idiotic questions by insurance companies to be replied to. There were huge processions, the traffic was diverted, without any arrangements for ambulances. Impatient, aggressive and violent people is a reality on almost all Indian roads now. No one cares for law on the road. You are at the mercy of anyone who chooses to pick up a fight with you.

There were some issues at home too, the cook had called in sick, we had to do some emergency cooking. That had delayed my start.© Dr. Rajas Deshpande

At last, an hour late, I reached the OPD, and entered running. Faces with controlled anger greeted with cultured politeness. Prepared for bitter comments, I called in the first patient.

This was a free patient, she did not need a follow up. But being free, she visits almost religiously every month, whenever she has a fight with her husband. Sometimes, when the only guaranteed compassion is from a doctor, it can be misused. However, as I was late, I decided to respect their patience, and told them to visit a counselor. Nevertheless, my irritation heightened, that this added to the wait of other patients.© Dr. Rajas Deshpande

I certainly am impatient with meaningless waste of time, and sometimes the traffic, the sudden changes in schedules due to someone’s irresponsible behavior, and misuse of compassionate services bring me to the edge of a reaction. This was one such moment. My face must have become grim.

The next patient walked in, an elderly gentleman with Parkinson’s disease. He was accompanied by his wife. They were supposed to come back three months later, but had followed up early. I examined him, found him quite stable neurologically, but the usual twinkle in his eyes was absent. Even his usually smiling wife appeared lost. It must be the traffic, my late arrival or something likewise, I thought, and curbed my curiosity to ask them. Today was heavy and behind schedule, I must wind up fast. Yet, as I explained them that everything was stable and alright, that they need not worry, I noticed the unspoken uneasiness in their body language. A little reluctantly but keeping up with the expectation of my own heart, I asked them: “You look quite disturbed and stressed. Is anything the matter? I am sorry I came late today”.

“No, no doctor, it’s not that. But yes, he is stressed and disturbed said the wife, and looked inquisitively towards her husband. ”Shall I tell him?” she asked.

Looking down, hiding his face, the husband nodded.

“Doctor, we lost our only son ten only days ago. Someone killed him on the road. Some drunk goons dashed his car from behind, and when he got down to check the damage, they attacked him and hit him on the head with some rods. He was lying on the road for a long time, and by the time police took him to the hospital, he was gone. We came to know after a few hours. He was our only child, an engineering scholar who had returned to India with great dreams .”

The lady was silently weeping as she kept her emotions in control. The patient was sobbing, I called the receptionist to get a glass of water.© Dr. Rajas Deshpande

“We have done so much for our town and the society” said the patient, “but now I feel it was all useless. No one is safe even on the roads. We see so many rules and laws broken, so many violent and aggressive people that it has become difficult to question anyone even when they misbehave”.

I had no words to pacify them. What can pacify the parents of a dead child, that too a victim lawlessness?

The receptionist called “Sir, the next patient is shouting” she said.

“Five minutes” I requested her.

“You are busy, doc, we will leave. But I brought him here only because he feels better when he meets you. Once you reassure him, he will feel a little secure. Even I feel better when I see you. Otherwise we sit at home just staring at each other’s sunken souls. We have no relatives”.

That was a bitter eye opener to me. They had chosen me to be their lifeline in the worst times of their life, and here I was, thinking about my worries, my time, and the inevitable small happenings that block the path of every working person every day. I had momentarily ignored the fact that I must still enter the hospital with a smile, push behind myself all the negatives that pull me down. For every patient here to see me comes with a hundred fears and a thousand expectations, the least I can do for them is be compassionate and reassuring, whatever may have happened till that moment.© Dr. Rajas Deshpande

“You may see many patients in a day and listen to their troubles, doc, but you are the only doctor your patient meets in a long time. I don’t know about you, but we always feel good when we see you”. The wife added.

Yes, I had heard that earlier, in my teacher’s cabin. Once a patient develops trust in his / her doctor, they look upon the doctor as one of the most reliable resource for courage, compassion and troubleshooting, even beyond the expertise of that doctor. As doctors, we must never forget this, and stand up tall above all our personal problems to be the supermen and superwomen, the Messiahs, the Saviors that we are expected to be. Law and some idiots do push a stick in our wheels, but then the patient is far above both. A patient’s suffering is always far above that of any doctor.

I stood up, held the patient’s hand, and reassured them: that they do have a relative here in Pune. “According to the Pune tradition”, I said, “one should offer tea only when the guests are half out of the door, but I will make an exception today .”

Having them sit in the next empty room, I proceeded with the OPD. Ordering tea for everyone in the OPD waiting room, I stole a few more minutes to calm the ruffled souls of those two, and asked them to see me again, whenever they wished.

As I returned late after dark, even through the rainy night, a sweet moonlight made the raindrops glow. Just like every doctor brings back the smiles to the burning hearts of their patients!

© Dr. Rajas Deshpande

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

©️Dr. Rajas Deshpande

A hungry poor man named Atmaram went to a big hotel, had a nice big meal, and told he had no money to pay. He was beaten up and handed over to the police. He was released after a warning and a slap.

Next day he filled up petrol in his bike, and said he couldn’t pay. He was again beaten up, handed over to the police. Then he went to the medical shop, bought medicines and mineral water, ate the medicine, drank water from the bottle, and again said he couldn’t pay. He was now jailed for a week.

Next week his house was damaged by heavy rains, so he went and requested to be allowed to sleep in the house of the chief minister. He was arrested again, thrashed up.

As angry Atmaram shouted at the police, he was beaten up by them, another crime was added to his offences. In the court, Atmaram insulted the lawyers and judges and accused them of accepting bribes and charging too much. The judge punished him extra for his behaviour. Atmaram was angry and threw his shoe at the judge. His punishment was extended.

“You must respect the authority “ the court said.

“But I am poor, I need free food and petrol and medicines. I need sympathy too” Atmaram argued.

“You should have begged and applied for favours and eaten in places that provide charity meals. Petrol, however essential, has the same price for everyone. You can sleep on the footpath, and above all, you are not allowed rudeness and violence because you are poor and needy” The court said.©️Dr. Rajas Deshpande

When released from the jail, Atmaram drank a lot of desi alcohol, had an accident and fractured many bones. He went to the best private hospital, got operated and refused to pay his bills that crossed one lac rupees. When the hospital insisted, the operating doctors were beaten up by Atmaran’s relatives, the hospital was vandalised, the police arrested the doctor who saved Atmaram’s life, the government closed down the hospital, while the media and the society kept villainising the entire medical profession.

The headlines next day reported the sympathy expressed uniformly by wag addicted tongues: some said the entire profession was tainted, some blamed the greed of the doctors, even some doctors desperate for attention shed crocodile tears about the ethics in this profession. ©️Dr. Rajas Deshpande

In the courtroom, during the trial, Atmaram sat facing the doctor, still heavily bandaged.

The hon’ble judge, kind but surrounded by security, told the doctor accused of negligence and malpractice in the court: “You as a doctor carry more responsibility for ethical behaviour upon your shoulders. You should never turn away the poor”.

The doctor, defending himself, asked “but Milord, doesn’t our constitution insist on equality? Why do you yourself or ministers get security but not the doctor? Why isn’t everyone supposed to stick to ethics in every profession including politics, police and judiciary? Why are others exempt? How do you explain beating up of doctors while also saying that the society treated them like gods?”.

There were no answers. The kind court asked if the doctor had to say anything else in his own defence.

The doctor said

“Yes Milord, but the real answers will hurt:

Jealousy against medical professionals across society and many other professions is a reality. Why else will anyone who couldn’t qualify to become a doctor try and teach the qualified doctors what they should do?”©️Dr. Rajas Deshpande

“A culture of exploitation of non-votebank groups

and a complete failure of government healthcare with no one accepting responsibility is well known to everyone, but even judges have no courage to suo motu question this and correct it, even when they see the poor dying”. ©️Dr. Rajas Deshpande

“In a country with never ending poverty, how much free can a healthcare facility provide? For how long? This is already forcing closure of hospitals and exodus of good doctors out of the country.”©️Dr. Rajas Deshpande

“Milord, can you assure that every doctor will get his/ her fees as per his service to every patient, and if the patient can’t pay, that much charge will be exempted from the income tax of that doctor? How else do you except a doctor to meet his needs and dreams? Just because there are millions of poor patients, is the doctor’s life and hard work taken for granted? If there has to be financial sacrifice, why not have everyone contribute to it by creating a national health tax fund for treatment of poor patients? Why healthcare is subsidised only at the cost of a doctor?”

Just at this point, Atmaram, who sat in front of the judge, collapsed unconscious, almost blue black.

The shocked judge requested the doctor to examine him.

“He is no more” said the doctor.

“What could have happened ?” asked the kind but sweating judge.

The doctor told the court about three possible reasons. Two of them were scientific and medical: a sudden cardiac event or a large blood clot in the lungs common after fractures and trauma.

The third non-medical, unscientific cause made the Judge seriously ponder.©️Dr. Rajas Deshpande

“Will this court be now closed down, Milord? Will your efficiency be questioned, will you allow the relatives to attack you and understand their sad situation at the cost of your murder?”

“I understand what you mean” said the kind judge.

Needless to say, the doctor was released without a blame.

Can anyone please solve the mystery of the third non medical, unscientific possible cause of Atmaram’s death?

(C) Dr. Rajas Deshpande

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The Changing Blood Group

The Changing Blood Group

(c) Dr. Rajas Deshpande

“He is sinking” shouted Dr. Siya.

The casualty registrar rushed to the bed, checked the vitals. Pulse very fast. Blood Pressure very low. Lips and nails white, hands and feet cold. The young man, unconscious, was on the verge of death.

“He must be bleeding inside. Get an urgent sonography of his abdomen”said the registrar to Dr. Siya, and call the blood bank. He will need at least two units of blood urgently”.

It was Dr. Siya’s first week into internship, she was thrilled with the idea of actually saving lives. At the young age of 22, she was witnessing death almost every other day. Along with that she was amazed to see the darkest sides of human nature: the potential of humans to hurt each other: via rapes, accidents, murders, fights. She had decided to not let this affect her attitude, and to continue to try and save every life she could.

That late night, this young man of about her own age was brought in unconscious by someone, who had just dropped the patient in the casualty and left without leaving any identity of himself. “I found him lying unconscious on the road. I don’t know anything else about him. I am just doing my duty, I have a train to catch”said the stranger and left. The patient was reeking of alcohol. He had a visible head injury. A quick CT scan had revealed minimal bleeding due to a small skull fracture. He also had had bleeding from wounds from his hands and legs, they were sutured. The patient had no identity marks, wallet or cellphone. The policy of the hospital was to provide basic treatment and shift the patient to the government hospital. The police station was already informed. Treatment was started.

Dr. Siya requested two units of blood. The blood bank called. They had only one unit of the blood for his blood group. The registrar had the same blood group, and like many doctors working in the emergency departments, he went down to donate blood.

It was nearly midnight. The fate of the life of a young man depended upon what the junior doctor did just then. There was no one to sign any consents, the protocol was to inform the hospital’s medical director and obtain consent for emergency transfusion or procedure. Dr. Siya finished the formalities, obtained the permission, and started the transfusion. If the patient had reacted or something went wrong now, they all feared, there will be a havoc in the media: that they had let an unknown patient die because they wanted money!

Dr. Siya kept on managing the show. The angry and disturbed relatives of other critical patients kept on taunting her, speaking rude and reluctant to complete simple formalities and paperwork.

The sonography was thankfully normal.

Just as the first unit of blood was over, the patient became conscious, and revealed his name. He was quite shaken with the surrounding, but told in broken sentences about his friend’s number and address. He revealed that while returning from a party, his bike was interrupted by a bunch of goons, he had fallen down, they hit him upon the head and left with all this belongings.

The friend was called, and came in. He revealed that the patient was used to smoking weed and drinking alcohol in huge quantities. They were staying in the hostel of a famous college.

The second blood unit was started, and in a short while the patient threw a convulsion. He was immediately given injectables for controlling the convulsions, he slept off with the effect.

His parents arrived early next morning.. The shocked mother was consoled and explained about the situation by Dr. Siya. The elderly father, like all fathers, equally shocked but being a father unable to cry, kept mum, just holding hands of the boy.

When the patient woke up again, the father came to Dr. Siya, and touched her feet. Too embarrased, she told him that the registrar had donated blood for the patient. The father went and thanked the registrar, again trying to touch his feet.

As Dr. Siya had finished her night duty, she prepared to leave. “Beta, Will you come soon please?”asked the tearful mother to her. “Yes Auntie, I will be back soon. Don’t worry, he is ok now”she reassured and left.

On her way back her genius young mind tried to look at the situation sitting upon her shoulder, the little third person that resides within each one who has a conscience. That booze and weed was easily available to youngsters in almost all Indian hostels, that even educated people rode bikes without helmet, that crimes were happening almost everywhere that injured and killed people, that law and order was a laughable term in many parts ofthe country, that there was no government mechanism in place to provide emergency medical / paramedic support ambulances to raod / traffic accident victims: which one is the most responsible cause, when patients like these died? Who is responsible?

She reached home, told her proud parents what had happened, that she had helped save a life. Her mother folded her hands towards the sky, said “God, let my daughter save many lives everday”.

While having the breakfast, her father turned on the TV. A famous but ill educated political leader, in his mind-and-other- organs blowing speech in Karnataka, was explaining the illiterate public how all Indian doctors charged in excess, how they were only after money, how everyone except himself was the enemy of the millions of patients surviving from critical heart attacks, accidents, strokes and other diseases. All patients getting better all over te country was only thanks to himself and his government!

Dr. Siya’s father laughed bitterly. “Next time you need blood for any poor or unknown patient, call him” he said.

Dr. Siya replied, laughing “That kind of ëver changing blood group doesn’t match anyone, it is useless for any patient, Papa”.

(c) Dr. Rajas Deshpande

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