Tag Archives: Doctors

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

© Dr Rajas Deshpande

Neurologist

Pune

Please Share Unedited

The Overdose of Medical Advice

The Overdose of Medical Advice
© Dr. Rajas Deshpande
“If the doctors want to go to a five star hotel, they must pay for it” said someone recently in a headline.
Well yes, like any hardworking honest professional, even a doctor may want to go to a five star hotel occasionally, and have a good time, especially given the sadness that surrounds his / her profession. There is nothing that prevents me as a doctor from wanting to go to a five star hotel once in a while, and I do not feel guilty about wanting to live a good life. Earlier, I was happy to attend some great lectures by the world’s best doctors brought to India by the pharma industry (because the government never can), now I will just pay for myself.
Whether a five star meal comes from the profit of pharma industry or the hard work of doctor’s fees, there will be objections for sure. The problem is not the five star meal, the problem is elsewhere. So the different ministries can officially host super luxurious parties on different religious / non religious occasions to woo voters via the taxpayer’s money (and the media will describe the Biryanis and Gulab Jamuns in paragraphs), but the doctor must never eat a free luxury meal!
Many non medical professions, industries, financiers, film industry people, bankers and builders host dinners / other events at five star hotels, and many government officers / ministers attend them. Do they all pay for themselves? Just because a minister attends a five star dinner, he cannot be presumed to be doing a hidden favour to some industry, likewise, a doctor attending an academic event cannot be presumed to be doing a favour to any pharma. © Dr. Rajas Deshpande
It is doubtless that some doctors may have misused this facility and overspent. But the huge advantage: giants in the different medical fields from the developed world coming and educating the doctors in India will be greatly sacrificed by such limitations.
Given the social envy and jealousy against the doctors now rampant, it is probably an inevitable but unfair step by some organisations recently to ban pharma sponsorship of certain medical events at five star hotels. It is also a good initiative to reduce drug prices. But then, can the same organisations and even the federal bodies show the same guts and ban following malpractices too:
Open sale of undergraduate and postgraduate medical seats all over India, that creates funds worth trillions, benefitting even some in the highest offices of the country? Where does this money come from, and where does it finally go? Are we innocent enough to presume that the patient is not ultimately paying for this? © Dr. Rajas Deshpande
Under the medical consumer protection act, is not the government required to make all the facilities of healthcare available at all government hospitals in our country at subsidised rates? It is argued that taxpayers are paying for the education of medical students who enter medical colleges by merit, which is wrong, because the taxpayers are actually paying for good health facilities at the said hospitals. But most of the hospitals / medical centres run by the government are understaffed and run far below acceptable conditions. How many government health set ups have been evaluated for accreditation by standard bodies, and what are the results?
The insurance companies and corporate hospitals have held the private doctors prisoners of their atrocious conditions, and even the paying patients are being provided a substandard service, thanks to a total absence of any willingness to question any of this on the part of administration.
The demand and supply of “Cheap everything” in medical profession has now gone to such a dangerous extent, that substandard staff, incompletely qualified professionals, low rate medical instrumentation and quality of service, and above all, ineffective / low quality medicines have become a horrific reality already, even at some corporate hospitals dominated and dictated by the insurance sector.
They are giving people what they want: Glittering Cheap Healthcare. It is so surprising that the patients are happy with only this one quality of service and drugs: cheapness. The day that our society will understand that like anything else, good healthcare will cost more and will obviously involve more profit-making, our health scenario will improve. © Dr. Rajas Deshpande
The IMA, while trying to play safe and readily making rules like banning sponsorship, should take a firm stand to fight against the one sided war waged upon the medical profession by some.
Written in a state of perfect peace, not frustration.
Because I am not sold out to the desire to be liked by everyone, especially those against doctors.
© Dr. Rajas Deshpande

“I Swear”

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

“Eureka”

photo-09-09-16-12-12-22© Dr. Rajas Deshpande

Half day OPD today. Diwali morning. Busy busy rush.

Push ups. Weights. 30 minutes on treadmill at 7 Kmph. Feel the rushing blood. Check out a muscle or two in the bedroom mirror. Count the packs in certain position. Feel the pride of this sweat too.

For some curious reason, take your smartphone to the shower. Not only because you are a doctor, but plain simple addiction. The idiotic fear that the world will stop functioning without your supervision. It doesn’t. Or does it?

Enter the steamy hot shower feeling like a superman. Start philosophical excursions in your mind finding simplest solutions to everything. Under shower meditation is the supreme spiritual ritual of the day. Not because ‘the world cannot see your tears’, but because the world is altogether absent here in the shower.

This new shampoo is great, just takes some more time. Wait.

The phone rings. I will not pick up. I will just see who it is.

Oh my God!

It’s that Professor of mine, known for never calling anyone, never socialising, and in general being a “limited edition”, generally sarcastic. If I do not pick up his call, he won’t call again, and probably will never pick up my call again. Doctors have bombastic egos, the senior the more. He is over 80 now, and still studies a lot. © Dr. Rajas Deshpande

Pick up the phone. (Thank you Apple for making it waterproof). Come out in the bedroom dripping.

“Good Morning Sir!”

“It’s nearly afternoon, Rajas. Good afternoon! Do you have internet access right now?” Prof.

I am always proudly connected.

“Yes Sir”.

“Okay. You had referred a patient to me. It’s about him” he told me the name.

Yes. I had referred him a case I had doubts about. Things were quite odd, I had never seen a neurological condition like that. I just hope it is not something I missed, otherwise Prof. will skin me alive on phone!

“I examined him. I presented him to our Neurological society, and we concluded that this is pretty rare. There are only two such cases diagnosed with such findings till now. One is in 2004, and the other in 2012. Open your net browser, I will tell you the references”.

Wipe hands dry. Open the net. Check the references. “Yes, Sir!”

“He is going to need some more tests to confirm this condition. He cannot afford. I have written a letter for him to show to his employer, they may sponsor. Or we should look into charity. He will come to you, send me all the reports. Then maybe we will report this”. © Dr. Rajas Deshpande

“Yes, Sir”.

“Okay. Bye”.

Thank God there was no skinning! I must complete reading the reference right now! Done.

Standing there, dripping all over, I realised how much I enjoyed the “Fun” in learning, What a feeling! Eureka!

That whole day, my spiky hair may have offended many who met me, and I had no explanation. Most patients graciously forgive their doctors’ weird appearances, sentences and even some spurts of absent minded stupidity, the senior the more.

Once this very Professor was to be the internal examiner for my senior batch, and I was supposed to present him cases to be selected for the final DM Neurology exams. Terror reigned. Our best case was a Huntington’s Disease patient, and I had studied day and night the whole prior week about that and other cases. © Dr. Rajas Deshpande

He sat in the ward side room.

Trembling, I called in the patient. The patient walked in about four steps till the examination bed, and sat upon it. It was less than ten seconds that the patient was in the room.

Just before I opened my mouth, Professor said plainly “Huntington’s is too short a case for DM. Keep him in reserve. Get the next case”. I felt like being shot before even entering the battlefield!

This professor was my examiner too, for my DM final exams. His genius was scary, his comments deadly. Just as I came out after the final viva, I received a money order sent by mom. As I stood counting the money outside the exam ward, this Professor came out. Looking at me counting the money, he smiled big. © Dr. Rajas Deshpande

“Already planning a party haan?” he kept his hand upon my shoulder.

Frightened, I explained that it was just a regular money order from home.

“You will need extra money this time” he said and walked away.

My heart turned into a boombox.

My palpitations stopped only when someone told me after two hours that I had topped the exams. The whole world paused in my mind to salute three years of extreme hard work, the run of umpteen sacrifices: that of youth, food, sleep, life, enjoyment, relationships, and everything that is “normal human need”.

Of all the qualities that make a genuine doctor, the Nerdiness is probably the most undervalued one. What a doctor appears to speak or write or decide on the spur of the moment is actually the product of years of study, research and hard work, with umpteen experiences that add to the thinking process. © Dr. Rajas Deshpande

It is this same Nerdiness that saves many a doctors from the depression and other mental stresses that their life offers on a daily basis. I love reading my subject at least two hours every night, and I know many doctors who are “lost” in the quest of knowing more and more. All the humanity, compassion, social service, charity, respect and earnings on one side, it is sometimes only this “thirst of knowledge” that makes us forget the umpteen festivals, celebrations and other happy things of life we keep on missing.

Like the soldiers on the border, thousands of doctors spend their Diwalis and Christmases and Eids and Baisakhis in hospitals, tending to the care of the sick and suffering, drinking the poisons of allegations and anger. One sure-shot medicine for this is studying.

For their Festival of Lights is in the service of the suffering, and their celebration is saving life. The fire comes from their quest for knowledge. They burn colourfully to make others smile again!

Happy Diwali to all the Patients, Doctors, Medical Students, Nurses, Paramedical staff, Pharmacists, Medical Representatives, Technicians, Wardboys, Reception and other staff, Mamas, Mausis, Security staff and all those who are connected to the healthcare industry!

© Dr. Rajas Deshpande

“Get Out, Doctor! You Are Finished!”

“Get Out, Doctor! You Are Finished!”© Dr. Rajas Deshpande
“Doctor, it’s this way or highway. We have many from your specialty in the waiting list. Do you accept to go by our policies or do you want to resign? Mind well, if you disagree, we will see to it that your name is blacklisted in every hospital in this city”.
As Dr. Sumeet stood there thinking, one of the administrative doctors, always a first class bottom licker, commented “These days doctors are like W*****, throw money at them and you get them to do anything you want”.
One junior doctor, still hot blooded, walked away. Dr. Sumeet asked that medical superintendent to mind his language. There was no reply. The bosses had really enjoyed the comparison, and while eating their pistachios at the hands of their secretaries, laughed aloud.
Dr. Sumeet felt devastated in that super luxury office, among the administrative officers and his own senior doctors from that hospital. He had returned from Germany a year ago, and joined this corporate hospital that was recruiting specialists. They had also offered him a decent salary, and accepted his condition that no patient will be sent back from his OPD for lack of money. © Dr. Rajas Deshpande
However, he had had to face a lot of jealousy and hatred from his senior doctors as he was looked upon as a competition. This is extremely common in India, and however stifled, a major truth. But no one ever stood against the bosses of corporate hospitals, so they had to accept his appointment.
The same corporate also owned other industries, namely Gold, Cement, Cloth, Petroleum etc. They were a “closed” community, all in the administration belonged to a particular caste. This hospital was another of their ‘profit oriented investment’, and did really well as most of the public can easily be fooled by the words “Free, Concession, Accreditation, World Class etc”. Medical illiterates (read general public) are really taken for a ride by healthcare advertisements of corporate hospitals.
Few months after Dr. Sumeet joined the hospital, the CEO changed, and another “extremely loyal invertebrate profitmaker insider” came in as the new CEO. From prehistoric period, he was considered as the best pet of that corporate family. The new CEO started by applying all the labour and profit criteria of cement industry to this hospital. If anyone argued, his famous dialogue was “If Sirjee (the owner of the corporate) wants, he will make the sun rise from the west. You are not aware that his reach is beyond the highest in India”. Anyone who uttered a word against any policy was isolated, humiliated and finally thrown off. Various allegations and ‘proofs’were easily furnished by a dedicated ‘execution panel’.
The new CEO changed the conditions that were accepted when Dr. Sumeet had joined. He was now given a target that his patients have to increase by 25 percent every six months, so should his tests, surgical referrals, etc. Free cases were cancelled. Many doctors spoke in private about this, but no one wanted to lose their job, as it is very difficult to get attachments in multispecialty hospitals. © Dr. Rajas Deshpande
As Dr. Sumeet had argued, he was given this ultimatum. He appealed to the senior doctors in that room, most of them looked away. Some told him they had always warned him not to be ‘over-smart’.
“I will reply in three days” said Dr. Sumeet and left the room.
He had nowhere to go. He had shifted his family to this new city and his children were already adjusted in their school. He had chosen this city after long deliberation, and had recently bought a flat with a loan, so he needed a stable income. His parents were teachers, he did not have the kind of money required to make his own hospital. All his friends had one answer: “Adjust “. He decided to plead once more to the management, to allow him to provide free consultation to really poor patients, and to continue a contract not based upon income generation. © Dr. Rajas Deshpande
Next morning, as he entered the hospital, one of the servants (being from the inner caste, his title was ‘General Manager’) came to see him with a huge grin upon his face. “The CEO sahab has asked you to empty your belongings by afternoon. This office is given to another doctor”.

He went to the CEO, who refused to see him.

The same medical superintendent came out.

“Doc we do not require your services any more. Get out, You are finished” he said.

“Why?” asked Dr. Sumeet. “I want an explanation”.

“We have many reasons. You do not fall in line with our policies. You are insubordinate. Also, some staff say you are having an affair with another doctor in the hospital. We also had a complaint about you yesterday from a patient”. © Dr. Rajas Deshpande
The complaint was obviously custom-made, and there was no way to argue about the affair allegation. Medical staff working together in an extremely orthodox country has to face those allegations very commonly. How such allegations disqualified him as a doctor was beyond him.
There was no argument now. He was escorted by security team out of the hospital, in full view of many specialist doctors (his friends), patients (treated by him), and others, but no one had a word to say. After he came out of the campus, one doctor friend accompanied him home silently.
He wrote to many senior doctors. There were no replies. He wrote to the medical councils. There was no reply. One senior member of the medical council told him in confidence: “ All the Medical Council rules are only for doctors. Medical councils in India have zero control over private hospitals, especially corporate hospitals”. IMA and other doctor’s bodies are clueless and directionless about the open exploitation, humiliation and destruction of doctor’s careers, especially new-coming specialists. In a country devoid of specialists, it is paradoxical that so many specialists are continually fired / thrown off / made to leave corporate hospitals which take advantage of the competition among doctors. Sadly, the doctor community, with too many self-proclaimed geniuses, has failed to unite and protect itself from this corporate onslaught. It is pathetic to see some greedy doctors competing to see each other down. © Dr. Rajas Deshpande
His practice was super-specialised and required a multispecialty set up with inpatients. There are very few government set ups in India like those. The rules, conditions in most govt. hospitals are idiotic, age-old, and the payments are laughably low. Also, the govt institutes are mostly headed by you know whos.There are indeed some charity super-specialty set ups, but most are religion / cult / faith based.
Dr. Sumeet decided to work it out his way. The corporate hospital which fired him made sure that his name was defamed in every possible way, they left a many pronged negative feedback everywhere. © Dr. Rajas Deshpande. There is no remuneration for the career murders of the intellectuals in every field in India, caused by two-faced systems run by invisible hands.
Gradually, he picked up, losing years of his career. He found out a hospital that respected his wishes to treat the poor free, and did not insist on numbers.
The complete ignorant and irresponsible stance of senior doctors when someone wrongs the junior doctors, the complete lack of any control over the policies of corporate hospitals by any medical council or governments, and the impotent stance by many a doctor’s organisations has spread the healthcare-toxic corporate medical culture all over India.
Doctors should at least make directories and online lists (maybe anonymous to begin with) of hospitals which force doctors to accept malpractices, or do not respect terms of agreement and sack doctors without any mistake. These should also be reported to the medical councils. Any hospital sacking any doctor should have to send an explanation to the Govt., medical council and IMA for the reason of dismissal, and the doctor should also be able to explain his / her side of the story. Hospitals which “use and throw” doctors as per wish, without reason or logical explanation must be brought to the book. © Dr. Rajas Deshpande
Most corporates have excellent backup and protection from the government, and all they will do is to shift the blame on the doctors’ fees, hiding from the patient, media and society the umpteen other profiting headings that the patient thinks are benefit to the doctors. This is a tough war.
Another joke is that while the educational qualification and training of any doctor is strictly scrutinised by medical councils and media, the qualifications of those who own hospitals, run them are completely neglected. No wonder illiterate politicians, “Business Class” corporate houses and CEOs bully doctors into practicing policies which are often against the best practice principles of healthcare.
Very few non-medical CEOs actually have a good knowledge of medical ethics and principles, agree to logical arguments.© Dr. Rajas Deshpande
The media and society who advise umpteen things and expect a lot from the doctors never stand up for a good doctor. Everyone who has met one bad doctor cries all his / her life about all doctors. As if there were no bad apples in their field! The ‘hyper idealistic’ population expects that the entire healthcare comes under the heading of ‘charity practices’., unwilling to spend upon their own health. If malpractices and backdoor incomes are to go, the public should realise that the actual fees will increase.
Governments will always make populist, ultra-short term policies in healthcare, without involving the brainy specialists in practice. If the Medical Council or IMA do not take a firm stand, any doctor who takes a stand against existing corporates / medical malpractices will be orphaned by his / her own community, often boycott, and categorically defamed: until their career is destroyed or they leave the country.
Many Dr. Sumeets are actually suffering this right now in India, with no respite.
Doctors must also realise that this war will never be won fighting alone. If the subsequent generations are to get better quality healthcare, we should start by identifying the problems first.
An easier, nay, wiser option for every super-specialist is to leave India.

© Dr. Rajas Deshpande
PS: The “Chamcha Doctors” who line up with the corporates to compromise in healthcare principles must do some soul searching. Earning profits is not a crime, compromising medical principles is. A real “Doctor” will never do so.
Dedicated to the thousands of young medical specialists who are right now suffering this hell.

RD

Negligence cases deserving severe punishment.

Negligence cases deserving severe punishment.
© Dr. Rajas Deshpande

A police sub inspector in civil dress, his wife and three kids aged 8, 5 and 1 were brought to casualty. All profusely bleeding. My job as an intern was to secure IV line and stop bleeding. As the CMO questioned the PSI, we all realised as suspected from the stink that the police officer was drunk. He had run into a braking truck from behind. One kid and the wife died the same night. He created a ruckus in his drunk state, threatening to kill everyone in the casualty. “If my wife dies, I will see to it that your life is ruined” he threatened to the CMO. The CMO kept on doing his duty, stressed and hurt. We were all real scared next few days. Everyone sympathises with such a loss. No one will aid or enjoy anyone’s death in a hospital.
Then why this curse of blames?

“This happened due to that doctor’s wrong treatment” : common words now heard in many clinics daily. Who causes maximum deaths due to negligence? Can only a doctor cause medical negligence? No.

These medical negligence cases must be punished too, with bad press, crores of rupees in fines, and public humiliation. You be the judge who is guilty:

Teenager son of an MLA. Played with wild snakes as a hobby, proudly encouraged by this MLA. Bitten by a cobra, landed in icu critical. A patient on ventilator was ‘shifted out early’ to accomodate the MLAs son.

Doctor advised a blood thinning medicine to prevent clots after diagnosing clotting disorder,. Patient went with her husband to a quack, took unknown herbal medicine and stopped blood thinner. Developed strokes, now in a vegetative state.

Patient advised to quit alcohol,,as it caused fits. Counselled with family and friends. In a week had alcohol with same friends, had fits, died in casualty.

Diabetic, told to control diet, continued to binge-eat sweets, lovingly cooked by wifey. Landed in coma due to very high blood sugars.

Pet dog, unimmunised, bit many on the same day, the dog died in three days. One diabetic patient bit by this dog died of sepsis / infection (not rabies). Immense horror among the ten-odd families of bitten members till date after a year.

Kid aged 14, parents allowed him to ride two wheeler on road without licence, killed on spot colliding with a truck. Toddler unwatched on the road died, run over by a truck.

60 year old Mother has giddiness for three days, son and daughter in law not free till fourth day to take her to hospital. Dies in casualty due to stroke.

Patient advised not to fast as it may increase chances of having fits. Fasted and landed in ICU with status epilepticus (a series of continuous fits).

Traffic police at a crowded junction busy with his “routine” away from his spot. Head on collision, two dead.

Unfortunately, in almost all above cases, the treating doctors were beaten up, casualty staff and hospitals vandalised, doctors sued, bad press judged an entire profession almost like a criminal, for not saving the victim.
© Dr. Rajas Deshpande

Often the relatives refuse to take patients to higher centers, expecting “big, advanced treatments and impractical outcomes” from low-cost, small nursing homes not equipped with specialty facilities, then end up vandalising or blaming such set-ups upon inevitable disappointment. Missed medicine, overdose, unobserved children, helpless neglected elderly parents, smoking, alcohol, traffic accidents all cause millions of deaths. So do delayed admissions, some herbals and “unknown” medicines, hunger, poverty, stress at home and workplace.

But it is the “death in hospital” that alone matters, and by default the blame is pinned upon the doctor!

Some actors can kill, rape, go naked, smoke, drink, race, gamble, pee in public, set records for drunken misdemeanours on and off screen, knowing that most illiterate and immature populations imitate them blindly. But they will tell the nation how the medical profession (for which they themselves did not opt in spite of excellent merit in school or in some cases even college) should behave and treat patients!

The few honourable judges who have now realised the “blackmail potential” of medical negligence cases, have fortunately started referring these cases to panels of medical experts before concluding and fixing charges. The only maturity issue that remains is about local goons and politicos with flitting loyalties looking for publicity at the cost of the harmless and intellectual population of doctors. These goons turn the helpless frustration, panic reaction towards tragedy and poverty of our society into anger against doctors and hospitals. As long as there are sane people in the responsible media, there is good hope.

Doctors must start recording without bitterness, any hostile tendencies, lies, deviation from duties towards the patient, advised and declined tests and treatment, neglect and avoidance patterns to provide adequate care for the patient by the relatives. Also the exact circumstances of onset of the problems (patient was drunk / drugged / under medication effect / fasting / missed medicine) etc. and relevant past that may have contributed to the event. This will minimise the allegations and misrepresentation of facts.
© Dr. Rajas Deshpande

Ofcourse the doctors must also discharge their duty with the highest standards of practice possible in their set-up. They must communicate well and explain the condition atleast once to the concerned relatives. They must behave courteously, sympathetically and try to understand and forgive the panic states of relatives within the sphere of civilised behaviour. We all love our patients. But like in every other relationship, we fail to say it aloud and make it clear with our behaviour, thanks to heavily stressful and inadequate lives we lead. Let us make an effort on our side to take one more step in the direction of kindness and understanding, in a hope of saving this profession from defamation at the hands of middlemen.

Let us make a greater effort to tell the society that it is only a doctor who will never intend harm. The only reliable rescue from the clutches of death, even a doctor fails sometimes. The effort has to be recognised if not always rewarded, but never suspected.

Negligence, you see, is easy to pin only upon the doctor.
All others are forgiven any number of deaths in all other types of negligence.
© Dr. Rajas Deshpande

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Doctors and Religion

Doctors and Religion.
© Dr. Rajas Deshpande

“You are in our prayers everyday”.. one of the greatest achievements in becoming a doctor is hearing this sentence.

But hey! You all are also there in our prayers every day!

Whatever the religion, whichever faith one may come from, whether rich or poor, whether our concepts, philosophies or traditions match or clash, we doctors treat each patient with the same devotion: making his / her health better. A doctor will only ask about your religion to know your genetic risks and tendencies, lifestyle and diet. Beyond that, no doctor thinks differently about patients from different religions. Who knows better than the doctor, the oneness of human body, inside out?

We don’t have to kill, sing, dance, wear T shirts or shout to prove our unique tradition of “Humanity”: we carry it upon our head from the day we are born as a doctor, till the day we die. Every day in every casualty anywhere in the world, elixir of humanity flows from the doctors and nurses to the patient, and in their prayers lie the true wish of every doctor: “Let all suffering end”.

Most of those visiting religious places ask for health and life. Doctors too work to safeguard these two, all over the world, irrespective of their beliefs. Science gives us the knowledge, Experience hones our wisdom, but the prayers of millions in different religions give us the ability and responsibility to make the right choices.

Our patients, whichever religion they belong to, bring us religious gifts from their highest places of devotion. From Varanasi and Mecca, From Jerusalem and Amritsar, Ma Vaishno Devi, Our Lady of Good Health in Velankanni, Lord Ayyappa temple, Khwaja Ajmer Shareef, Shri Tirupati, Bodh Gaya and many other holiest places, I have received Lord’s blessings via my patients, just like most of my colleagues I know. Abe Zamzam and Gangajal have both felicitated the work of many of us, via God’s messengers to the Doctor: the patients.

Any patient from any country and any religion holds some basic respect for the doctor they go to, for their education, and also for their presumed ability to help.. This “trust of a stranger” is probably the greatest endangered human connection upon earth today.There is no better opportunity to serve humanity than to become a doctor. If there is any social place where everyone is really equal, it is the heart of a good doctor. There are offenders of faith, and misusers of the system everywhere in the world: few doctors and few patients, but not all.

There is so much for the doctor to learn from different religions. The art of medical practice is incomplete without basic knowledge and understanding of human behavior, faith and mindsets. While “scientific” is the highest and umcompromisable criteria for a doctor’s action, this will only bring the patient health, which is incomplete without happiness. Happiness will only come from a doctor who understands human nature well. There, in the wish for happiness in each mind, resides the Lord. Some call it science, some God. Some do not believe in God, both doctors and patients. If themselves genuine, they still connect well via bonds of honesty, kindness, truthfulness and mutual respect: similar foundations as that of most religions.

Many patients will not believe this, but most doctors pray for all their patients everyday before starting their work.
In the good of their patient, they know, lies their own good.
© Dr. Rajas Deshpande

My Religion, My Love.

My Religion, My Love.
(c) Dr. Rajas Deshpande

Once when I was studying in Medical College (MBBS), my Grandpa told me not to waste too much time in praying God, as treating patients was a superior worship. I had promised him that if there ever was a conflict between attending a patient and praying God, I will first attend the patient. I grew up to learn that most doctors all over the world do that.

It is not uncommon to receive criticism over my blogs here. Why not neglect film stars and TV shows? Why defend doctors, knowing that some are genuinely corrupt? Who except doctors will read these articles? etc.

Medicine is my religion and also my love. I have come here, like most of my colleagues, to do good by choice. I can not take it easy when the uneducated and cheap, corrupt TDH make allegations about the super-educated Indian doctors. If one has real guts, they should try merit based entry in some Indian Medical College, or just one year of residency, they will know where they stand. This does not mean that only doctors are intellectually superior, just that only those who have achieved something intellectually worthwhile must analyse/criticize this highly complicated field.

If anyone talks ill about one’s Mother, Father, Wife etc., or God or Religion, people are out with swords and guns, and will defend with blood their honor and that of their beloved and respected. It never means that everything about the criticized person or religion is right, just that it is one’s duty to guard one’s own sacred faith, and only the learned and intimate are allowed to interfere.
Not the wayfarers whose real God is public attention.

This is a scientific field which has evolved through lifetime works of Geniuses, Nobel winners and brilliant brains who changed the course of humanity over many centuries. It is made up even today of most who sacrifice their peace, safety and lifetime in serving others. It has its own control and alternative system: no one forces you to go to a specific doctor or hospital, and every hospital offers more than one doctors you can avail services of. Excess population and unhealthy country (and so the hurry) is NOT the doctor’s fault.

Doctors are the only religion-neutral intellectual profession directly in contact with general public, and there have never been any examples that Doctors compromised Medical practice for religious difference. Because this is our religion too. Whichever God patient may have, most Doctors treat that patient’s health as their God. Some speak, express, sweet talk. Others do it silently. Some others may not be well mannered. But all worship the same God in any hospital: patient’s health. Some ask money in return, some enjoy the worship itself. But most do meet their God in their patient’s health.

This amidst filth of almost completely faithless, trustless, paranoid, corrupt, illiterate, inflation-screwed and violent population (mainly in India) which expects miracle recoveries of complicated medical conditions in minimum expenses, an outdated legal system which protects the faces of rapists and murderers but does not protect the alleged doctor’s identity before trial, where laws are mainly used for exploitation, and where a successful doctor is presumed corrupt. Where research is killed at National level by policymakers.

Some choose to advise all doctors to keep calm and take it all in their stride, to project a “Social Doctor” who must accept all the ills and go on selflessly working for the good of all, “not thinking about money”. This is usually to pseudo-glorify themselves in media and public at the cost of the sufferers of injustice and violence among their own. These “Good-public-image-mongers” often speak a different language in private.

I may be wrong in writing these posts to defend my religion: Medicine, and its worshipers. But I am at least not guilty of being dishonest to either myself or my religion.

This I can vouch: I have met hundreds of Good and Bad behaved doctors, but never one who wanted to harm or neglect the patient. Even the best of the ‘moneymakers’ in Medicine keep patient safety their top priority. Some may have been wrong in their practice, and they must be tried, but everyone generally does their best to do good to the patient.

There is no other career superior in its Humanity Quotient than health services. Just because someone must throw stones at others to get attention, we will not sit back and be the target.

(c) Dr. Rajas Deshpande