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A Love Letter For All Haters Of Allopathy

A Love Letter For All Haters Of Allopathy
© Dr. Rajas Deshpande

Allopathy / Modern medicine is like my mother to me. Naturally, when someone tries to spread misinformation about this path of healing, it is my territory to defend, and I will. I am open to the idea that I may not understand other pathies well, I understand mine only because I studied it well. Time and again, I have received many articles criticising Allopathy in many languages. Most of these articles make claims about their own ‘pathy’ being divine or magical, curing everything. They justify this with some twisted quasi-scientific logic, very convincing for those who are a few sandwiches short of the picnic.

We Allopaths save more lives on any given single day than all other pathies combined can save over months. Thousands of doctors from other pathies who have recovered from heart attacks and strokes and other critical medical conditions will testify that Allopathy saved their lives. The facts that there are far more Allopathic hospitals all over the world, that corona patients in ALL countries are being treated primarily by Allopaths leaves no space for any argument whether Allopathy is useful or not. © Dr. Rajas Deshpande.

To understand basics of medicine, it takes five years for the highest rankers of each generation. To criticise it without studying it requires an outstanding idiot.

Think Cricket. We all enjoy seeing the Master Blaster perform, aware that he has gone though extensive practice and patience to be where he is. Yet even those who have never qualified to be in their own family’s cricket team, will advise the Master on TV how to play. They can be ignored as certified nincompoops. The other category- copiers- are most dangerous. They will just pick up the Master’s style / words, copy the technique, use all the same external paraphernalia and then pretend to be superior to the Master Blaster. Truth and scientific logic then takes a hit out of the boundary.

From Mahatma Gandhi to Einstein, from Daniel DeFoe to P.G. Wodehouse, from Bachchan to Tendulkar, greatest of the great have faced undeserved criticism from envious, jealous, noodlebrained nobodies whose only chance to some attention is criticising any success, achievement and affluence. © Dr. Rajas Deshpande

Some of the best brains in each generation get into Allopathic medicine, and are trained in a curriculum made by highly educated achievers in the field of science. The same Nobel prize as was won by the greats like Guru Rabindranath Tagore, Amartya Sen, Abhijit Banerjee, Dr. Hargobind Khurana, has also been won by those who form the basis of Allopathy or Modern medicine.
Our science is based upon the principles and practice of basic biosciences like physiology, biochemistry, pharmacology, genetics, all defined by geniuses across the world. We follow the principles of scientific evidence as defined by science, not by personal whims and hunches. . Our paths are enlightened by brilliant guidelines of people who discovered the causes and treatment of diseases like malaria, tuberculosis, HIV etc. saving millions of lives. Each year, there is a Nobel prize dedicated to medicine.

Thus, thought processes of many generations of geniuses in science have made us Allopaths. We we are in fact relieved to know that everybody cannot understand us. That would have made our minds average.

Millions recover every day from heart attacks and strokes, thanks to Allopaths. Millions who would have otherwise spent their life on bed, walk well again because Allopathic knee and spine surgeons can perform complex surgeries, cheapest in India. Ask any patient of Parkinson’s Disease, Epilepsy or Heart failure, what happens if they miss their Allopathic doses. It is our challenge to anyone who hates Allopathy to take care of one dialysis patient without dialysis, treat one bleeding brain injury or one heart valve defect without surgery or one patient of respiratory paralysis without ventilator. © Dr. Rajas Deshpande

Maharshi Charak and Maharshi Sushrut are respected all over the world because of their own good work. I have met some very respectable Ayurvedic pratitioners. They never use Allopathic terminology to impress thier patients or name their medicines. They know their own limitations.

Using the terminology from Allopathy while criticising it is like calling your wife by the name of your neighbour’s beautiful, out-of-reach wife whom you like. From migraine to arthritis, from brain to corona, why do they use the words of the very science they refute? The height of this idiotic ridiculous is to twist scientific information, using Modern medical terms (protein, genes, virus, corona etc.) to justify the basis of their own treatments! How in the name of science are you going to treat a condition which your branch didn’t even know the name of? These hypocrites will use X rays and MRI, blood tests etc. reported by doctors – radiologists, pathologists in Modern medicine and prescribe their medicines saying that the Allopathic medicines are useless!

Why are bridge courses requested if Allopathy was useless? Why don’t we see those various criticising pathies open up their own original hospitals and practice their own science, why would so many graduates from different pathies be working with allopathic hospitals today? If you are so confident of your pathy being superior, please take an oath that you will never practice other pathies, that you or your family will never take treatment from any another pathy. © Dr. Rajas Deshpande

My Allopathy/ Modern Medicine is not perfect. We have failures. We have limitations. We have multiple, dangerous and sometimes fatal side effects, all recorded and informed to the patients. Nothing is hidden. Our pathy is unfortunately costly, as it has many licences, instruments and processes. But we have the largest number of people all over the world rushing to us every moment, we are here and ready, day and night, serving and saving them, with scientific principles universally accepted and respected.

Every accident goes to an Allopath, bleeding and dying, in a hope to survive. Most diagnosed cancers receive their treatments and some are even cured in Allopathic hospitals. Every coma reaches an Allopathic hospital, with their family’s folded hands begging to bring back a father, a mother, wife, husband, child back from the clutches of death. Most of these go back alive and happy, some we cannot save. Are these failures of Allopathic medicine your strengths? Could you have saved those? Do our minor inabilities, limitations, failures make you feel great? If so, you need a visit to a qualified psychiatrist: if your pathy has one.

It is pathetic to see the excessive quackery allowed in rural India, looting innocents with cheap deceptive tactics, false claims of curing jaundice, rabies, paralysis, epilepsy and what not. It is pathetic to see famous public figures criticising Allopathy and then themselves getting admitted in the best, priciest, Allopathic hospitals in India or abroad. What other proof of shameless hypocrisy do we need? Criticising Allopathy is a serious disease. I think it is a type of anosognosia: inability to understand the reality of one’s own illness/ condition.

After reading such baseless criticisms of Allopathy, my foremost wish is to invent ways to perform a brain transplant on their authors. However, a “rejection” of a good brain by their bodies (you know, a dangerous side effect of Allopathy) is really worrisome. So we will let them be- please treat yourself with your best medicine: Allonil.

© Dr. Rajas Deshpande

Allopathy is now known as “Modern Medicine”. However to reply the critics and to best reach masses I have used the term Allopathy, which they use while criticising it.

Welcome to translate this article in local languages with due credits. This article is only aimed only at those who spread misinformation and hatred for Allopathy. I do not disrespect any other recognised pathies.

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© Dr. Rajas Deshpande
“Sir, we are screwed. The Chief Minister and other ministers have closed all doors, they won’t respond. Our careers are in grave danger. Can you please help us?” I frantically spoke.
From the other end of the phone, the Don, Dr. Nitu Mandke answered: “See me at my home at 12 midnight”.
The Maharashtra state resident doctor’s agitation for dignity, national pay parity and better living conditions was on, and I was given the responsibility of coordinating and being the face. We had successfully established a multilevel network.
When students go on a strike anywhere in any field, it is almost always out of desperation, either for dignity or for rebellion against some sort of suppression by the system. Students never rebel for money or power. This raw student power is almost as mighty as the army, and although it falls prey to political misuse sometimes, it has tremendous capacity towards achieving intellectual evolution of the society. The government always treats any unrest as an offence to its ego, and uses everything at its disposal: CID, Police, Administration, Force, Threats, Caste Politics, Cheating and Legal torture to mow down student agitations. Students have no money, no experience and rare political or social backing, and must unite and stand up for themselves. © Dr. Rajas Deshpande

On the fourth day of the strike, a big politico from the ruling alliance came over to our office at Mumbai KEM. There was no telling between him and a mafia goon. The members of student’s central committee: Dr. Sanjay Singh, Dr. Dinesh Kabra, Dr. Narender Sheshadri, Dr. Pramod Giri, Dr. Nilesh Nikam, Dr. Kuldeep, Dr. Vishal Sawant, Dr. Noor, Dr. Shahid, and few others were with me. The politico did not have any scruples using an arrogant, raw and filthy language to threaten that if we do not stop and withdraw the strike, our careers and even life will be in danger. As he was from the ruling party and threatened us in presence of the police, there was nothing we could say.
There are angels everywhere. A senior police officer who was supposed to “keep a constant watch” upon us ‘student leaders’ was quite fatherly. He told us “Do what you must, but don’t declare. Dumb people cannot interpret silence. Stay away from any violence”. © Dr. Rajas Deshpande
Unknown calls kept threats alive. That is when a resident doctor suggested we meet the Don: Dr. Nitu Mandke, the famous heart surgeon who was known to be a fearless, straightforward celebrity doctor.

We went to his home, and waited, hosted by his extremely courteous family. He returned home past midnight. We briefed him the details. He asked a few questions to assess our determination and strength. He asked us to stay united and avoid any misbehaviour during the agitation. To our surprise, he picked up the cellphone and called the Chief Minister’s PA. The CM was fortunately available, and talked to Dr. Mandke. © Dr. Rajas Deshpande

After the call, Dr. Mandke told us: “CM has advised us to meet the Deputy CM tomorrow. Two of you come to Lilavati Hospital tomorrow at 2 PM. I will take you to the DyCM.”.
At Lilavati hospital, Dr. Mandke’s chamber was intimidatingly clean and posh, yet simple. He checked our applications for the CM and corrected them with his beautiful pen. His briefcase had every essential of writing stationary, the mark of a perfect man.

As we waited, I asked him cautiously: “Sir, shall we start?” He replied that he was waiting for someone to carry the bag on his table. I offered that I will carry it. He laughed his thunderous laugh, and looked at us as if we were small puppies. “ Deshpandyaa, that bag has two and a half crore rupees cash for construction of my hospital. A professional bodyguard will carry it. People kill for that. Do you want to carry it?”. I shut up.

In his big car, for the 45 minutes that his bodyguard drove us to the DyCM, I asked Dr. Nitu Mandke questions about what was going through his mind when he was actually operating the Shiv Sena Supremo Mr. Balasaheb Thackeray. Such an enormous pressure it must have been!
“Oh yes, it was stressful. But he is a gentleman, and he had assured my safety. His word is enough”.© Dr. Rajas Deshpande.

That’s when we told him how some politicos had threatened us recently. He laughed and replied something that has been tattooed upon my cortex permanently:
“Rajas, a doctor is a doctor and king of lives forever. Politicos come and go. Idiots misbehave with others when the have any post or power, in any field. You should not budge. It is pathetic to see doctors licking shoes of those in power, under various pretexts. It is up to you to maintain your dignity and pride. That is the true luxury, everyone cannot afford it. So long as you do the right thing, fear nothing. The few crores in that bag is nothing compared to how I feel about myself”.

We entered the VIP zone and bungalow. His car was not stopped anywhere. The DyCM offered us tea, and gave us a patient listening.
“These junior doctors and students are my boys, our own boys, they will look after the health of our people tomorrow. You must help them” Dr. Mandke insisted. The DyCM assured he will. The spell was broken, talks resumed.
Many twists and turns later, one of the most memorable strikes was called off.

A year later, I saw a white Lexus car in our KEM campus at Mumbai. Fond of cars and having never touched a Lexus, I went to see it from a close distance. Just as I tried to touch it, the driver’s window rolled down, and I heard “Deshpandyaa, open the door and come in. Do you like my new car?”
And I sat besides the King of proud men, one of the most proficient Cardiac Surgeons, Dr. Nitu Mandke, in his Lexus. The feeling is unforgettable, not only for the Lexus, but for his simplicity, love and affection for a ‘nobody’, a junior doctor like myself!

Needless to say, then onwards, I have guarded my dignity and pride as a doctor more than any other possession I have. That took away many opportunities and huge finances, still I am doing quite well by God’s grace, and Dr. Mandke’s blessings.
How I feel about myself is more precious than anything I can earn. The luxury of pride is mine.
© Dr. Rajas Deshpande

Dedicated to all students, resident doctors, proud people in every field, student unions and their apolitical fearless leaders.
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“It seems this hospital is distributing death to the patients”

“Aisa Lag Raha Hai Ki Ye Hospital Marijon Ko Maut Baant Raha Hai”

A leading and brilliant Indian TV anchor has framed this sentence. There are over a million deaths all over the world, covid hospitals are burdened up with dead bodies in almost all countries, and the whole medical fraternity is on the frontline, all Indian hospitals have cooperated with whatever demands were made by the government. Still, the news anchor obviously implies that the hospital is ‘handing out’ death in such cases.

It is NOT the doctor’s duty to shift patients and dead bodies, still they are doing this wherever there’s no staff. But if you expect that the docs leave critical patients to die and please the TV cameras, it will never happen, our ethics are supreme.

He didn’t say that:

:Virus is distributing death
:Those responsible for inadequate healthcare are distributing death
Or
:Irresponsible people who don’t follow rules are distributing death

He just blamed the hospital like a Judge.
Media Judge.

We have few questions:
Why didn’t the journalist/ reporter who was shooting this case and crying that the patient didn’t have enough clothes give this patient his own clothes?
Why didn’t he shift the patient to other hospital which had beds?
Did the reporter take written consent from the patient to shoot him naked?
Did the reporter call helpline to attend this patient? What was the government’s response?

And lastly, is this happening only in certain states?

Please stop making TRP business out of dying patients. Why aren’t administrators stopping the interference with healthcare in hospital?

हॉस्पिटल मरीजो को मौत नहीं बांट रहा, कोरोना मौत बांट रहा है, और आप जैसे रिपोर्टर उस मौत का तमाशा बनाकर पैसे कमा रहे हो. सवाल उनसे किजिये जो इन हालात के लिये जिम्मेदार हैं. डॉक्टर और हॉस्पिटल्स अपना अपना काम कर रहे हैं. आदरणीय प्रधानमंत्री की सूचना का आप भी पालन किजीये, और कोरोना योद्धाओं के खिलाफ़ जहर फैलाना बंद किजीये.

(No hospital is distributing deaths, but corona virus is, and people like you are making money by exploiting their deaths for earning money by dramatising everything. If you dare, ask questions to the right people. Doctors and hospitals are working to full capacity to serve patients and the nation. You must first learn to respect the words of Hon’ble PM, and not spread lies against medical frontline warriors.)

Stop your poisonous blah.

© Dr. Rajas Deshpande

We are suffering, India!


© Dr. Rajas Deshpande

After witnessing hundreds of careless, maskless and even purposeless (sitting by roadside) people today, I don’t know how many more weeks it will take for the pandemic to go. The longer it takes, the longer will all of us who work for patients have to use excessive precautions that include an extremely uncomfortable get up. When you use such masks in closed hospital environments, in few hours your head aches, you start feeling suffocated, giddy, hot and tired. You cannot just remove everything and buzz off in two hours like many officials or politicos do after meetings/ TV bytes (many of whom btw don’t even know how to properly use even simple face masks).
I bet no one other than doctors or nurses can wear a proper covid gear for 8-12 hours for days in a row while being among patients. Even to take phone calls, drink a sip of water or have a desperate morsel of food after hours of work is a dangerous circus because this get up comes with a lot of precautions. When this happens because others are irresponsible, it is time to stand up for oneself.
Every doctor, every nurse is suffering this torture every day, since months, thanks to both sides. On one side are those in administration unable to control careless, arrogant, irresponsible people all over the country, and are therefore exerting all their angry pressures upon doctors and hospitals, trying to impress public by ceaselessly speaking against these frontline warriors. On the other side are irate, fearful, frustrated and poor and middle class patients and relatives who vent all their anger upon healthcare workers, because none of the “TV Star” faces claiming to be on their side on TV is actually reachable in real life for them. Have you seen a rich or powerful patient ‘suffering’ in this pandemic?
The ever irresponsible Indian media is also creating a havoc greater than the pandemic by spreading poison against healthcare set-ups, and an entirely new crop of ‘social workers’ looking for loopholes, blackmail material, tiniest mistakes to make viral news/ videos against doctors and hospitals. This is their moment of awaited glory: exploiting a rotten situation. It is surprising that while many doctors / interns and nurses have been served notices and have faced suspensions for speaking out the truth, no action is taken against false information deliberately being spread by either media or those who are making videos in and around hospitals during lockdowns.
We are suffering, India, and the careless, irresponsible attitude of our people is causing many deaths as well as extreme torture to all healthcare workers. Many doctors and nurses have been infected, many have died, and many are on the verge of a breakdown. Some have started thinking about quitting.
We are proud to serve, to risk our lives, for every patient from every religion, every state, rich or poor, but we can not continue to die for stupid, egoistic crowds who do not care if others die even when that is avoidable. That is indirect murder, and everyone irresponsible during this pandemic- not wearing masks, not following social distancing, not obeying healthcare guidelines should be charged with criminal offences.
In the 25 years of my career in this glorious profession, I have seen worst of the worst, including bird flu, swine flu epidemics, natural disasters and thousands of helpless bleeding patients lying around. I have met violent relatives face to face, restarted dead hearts and worked under gunpoint. I have dealt with highest and lowest social cadres of people in society. I’ve met hundreds of brilliant students and insisted that they practice in India. But for the first time ever, this pandemic has created a doubt in my mind about the mindsets and perceptions about doctors in India.
I am not sure if I should advise anyone to live an unprotected life without respect, forced by everyone’s whims and caged by society’s expectations after sacrificing so much to become a doctor. There are so many other ways to show our love for our country. Best way currently appears to be only speaking, sm-posting and shouting about one’s love for their country. You always see rich businessmen and celebrities with highest ministers and those who run various governments, but never the greatest Indian doctors. So we medicos must not be enough patriots to shine with the biggest administrators of our land. That says a lot. We should prefer other ways to show our love for India. There are anyways many non-medicos everywhere who think they can run Indian healthcare very well. Let them handle, they don’t seem to need good doctors or nurses.
Think, my beloved India.
Your Doctors and Nurses are Suffering.
Jai Hind!
© Dr. Rajas Deshpande

The Last Bullet For Indian Private Healthcare


© Dr. Rajas Deshpande

Many doctors, nurses and other staff, police officers are dying due to corona exposure. Recently the quarantine period of doctors was cancelled. To add to this, very ridiculously, doctors’ salaries were reduced, and covid funds were deducted from even frontline warriors’ salary. This is like taking money from a soldier’s paycheck to fund the army!!

When I recently heard some people shouting about excess bills in hospitals, doctors not working etc., I felt like shouting back too, but one cannot argue with a sold TV screen.

For decades India has had
Excess urban crowding,
Very poor hygiene.
Very high poverty and illiteracy.
Lack of town-planning for slums.
Severe lack of state/ national healthcare infrastructure.
Tiniest budget for healthcare.
Perpetually under-functioning government hospitals. Every season hundreds die due to epidemics.

Where were you till before the pandemic? Who is responsible for all of the above? Do you want to discuss these factors which are responsible for the pandemic chaos today? Or now you just blame it all upon Doctors and Private hospitals?© Dr. Rajas Deshpande

Only private doctors with small nursing homes and dispensaries, clinics were shouldering all healthcare needs that government hospitals could not provide. They had low profits and catered to middle and lower class. These were destroyed in last few years because of too many stringent regulations and costly licensing. Many closed down. Legal troubles by relatives, politicos supporting them and vandalising hospitals forced many private doctors to stop admitting patients. Protection to doctors was denied by almost all governments till before this pandemic.

Indian poverty is never ending, and charity cannot run anything perpetually unless there’s a strong fund generating mechanism supporting it. If someone expects that doctors charging 2 rupees fees are the ideal healthcare for all our medical needs, they should happily go to such a doctor. We highly respect them too, but it is their choice and there are obvious limitations to that. To develop advanced healthcare in India, higher profits were necessary for higher investment. Corporates, some businessmen and the likes of Mr. Ambani pitched in. Advanced healthcare with heart and liver transplants, complicated brain surgeries, cancer treatments came to India because of these investors. They accepted all the conditions of governments to accommodate over twenty percent poor, nonpaying patients via various schemes. The payments for running these schemes were delayed by various govts for years, and the hospitals were arm-twisted in still continuing to treat everyone. The only source of profits was private and some insurance patients who were paying a higher fees for facilities: from air-conditioning, food to choice of specialists. Higher quality of staff, especially nursing and technicians who can operate high end machinery and robotics requires very high salaries. Maintenance costs are heavy. A specialist cannot do much without such a very good team. Each of these requires good if not great salaries, as they are continuously invited by developed countries who pay far higher.

But then every patient wants the highest facilities, best staff and specialist team, with no payment or basic payment. There’s no concept of billing beyond actual price of medicines and room charges. Service and maintenance is considered a ‘free right’. © Dr. Rajas Deshpande
Even in this modern era of equality, a higher class Indian officer like a minister gets a higher room, better food and other facilities, even higher medical bill sanctions, whereas the labourer from his department gets minimum basic facilities and bill eligibility only for general ward. Law allows higher healthcare’s standards and payments for higher officials. Why do they even have classes in railways and airplanes? If a “Gareeb bechara” migrant wants to fly home, should we offer him road transport or compassionate air travel? Why don’t we do for all the poor something that you all expect doctors and hospitals to do?

We don’t mind if basic and emergency healthcare is uniformly cheap or free for everyone. But when you force a high-end medical commodity (skill-time-investment-staff) to be sold at a loss or extremely marginal profit, you kill the system.

Doctors do not differentiate when making a diagnosis or treating anyone from any financial/ power background. But the private hospitals must be allowed to cater to different classes, earning their profits. That is their only stimulus to grow forward, engage best personnel and bring advanced healthcare to India. Different governments have failed at maintaining high standards of healthcare in their respective set-ups (with some proud exceptions- but because that’s where our powerful go). Some hospitals indeed take more bills for better class of services, including staff, but none of them forces a patient to come to them. Even these hospitals never deny free emergency treatment to anyone.

“But isn’t healthcare a charity? Haven’t you taken oaths to serve?” our loudmouth hypocrites ask.

Yes we have taken an oath to serve everyone rich and poor equally, but no, we have not taken any oath to neglect our own health and well being. Yes we have taken an oath to serve, but we have not taken any oath to live in perpetual poverty and financial stress. Yes we are under an oath to do our best for every patient, but we will not be bending backwards to fulfil their unreasonable demands. Yes we want to save every life, even if it is dangerous , but we will not unnecessarily endanger our own life because someone forces us. We haven’t taken an oath to abandon our families. The Hippocratic oath does not ask any doctor to stay hungry, work without sleep, and do the unscientific because various governments cannot pay for adequate number of doctors. Still we are doing all this already. Let us be clear: we proudly and intellectually serve our country, but we refuse to be considered slaves of either the system or the society. © Dr. Rajas Deshpande

Capping bills in private hospitals will be the last bullet for all advances in healthcare development in India. Be prepared to go back to the chaos of ancient times in that case. Quality will suffer most: right from specialists to nurses to medicines. You can of course force one generation of doctors to work like this, under low cost and excess work. People aren’t fools to send their children to such hells of social slavery. Yes you read that right. There’s a difference between service and slavery. Do not attempt to turn medical service providers into slaves. It will backfire very sourly.

Instead of this, the government can invest in existing private healthcare players to create low cost infrastructure alongside their private hospitals, or privatising its own healthcare institutions with increased capacity. Our governments do have friends in very high places who can invest.

We love India. We are not against any particular government, and this post is not against any leader or party. But we do feel very strongly that healthcare decisions must be made involving everyone concerned, that this people-pleasing for short term will turn out to be a huge disaster in long run, and it will be irreversible. If any government thinks that cancelling hospital permits and doctors’ licences in a country with severe shortage of medical services is the right way forward, God help it.

If private and corporate hospitals start shutting down now, it will be permanent. India will then have to mostly rely upon prayers alone for healthcare. And of course those who think they know medical science more than doctors. India has no dearth of such “fatally self-medicating” ignoramuses.

Jai Hind

© Dr. Rajas Deshpande

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A Superhero Doctor’s Dresscode
© Dr. Rajas Deshpande

A Doctor cannot enter home every day and start giving injections to her kids. A policewoman cannot wield a danda/ stick every day upon return, at her family members. A Judge probably cannot say “Order-order” when a child cries at home. We are not supposed to carry our professional mindset and attitude in certain places. Likewise, one cannot expect people from other professions to advise others what is beyond their domain. A doctor will never understand how complicated a politician’s or a policeman’s job is, and vice versa.
A clean and clear mind is essential for every doctor. Even a small mistake in thinking and decision making or actions may cause grievous, even fatal mistakes. © Dr. Rajas Deshpande
There are many doctors who have become infected even before the pandemic with diseases like tuberculosis and hepatitis, while trying to save patients.
It is very essential that every doctor, especially junior, learns to ignore what is not a doctor’s domain. The unscientific territories of political thinking and religion or discrimination are not for the doctor, however tempting and patriotic they may be touted to be. Pressures from society and media can ruin the peace of mind so essential to make a good doctor. A doctor who falls in line with sociopolitical expectations to do something unscientific is not only dangerous to the patients, but can never be called a good doctor.
There are those in higher offices, including doctors, who cannot overcome the ‘superior-inferior’ discriminatory mindset and will advise one and all what to do, taking credit for all good and blaming others for all bad in every situation. They take for granted that a military type hierarchy works everywhere. No doubt it is extremely essential in the military, but in medicine we need brainstorming at every step, a student cannot be expected to act on patients if a senior gives a wrong instruction. One must know, challenge, ask, resolve doubt and then act. © Dr. Rajas Deshpande
Like a Judge in the court who cannot rush an unlawful decision even in an emergency, a Doctor should also only choose what is scientific, even in an emergency. Of course there always should be a sense of time and good. A superhero doc may choose to be a couch potato in his/ her shorts etc. at home, but when on duty, he/ she must don the special dress called pure ethical medical science.
Every Judge who gives a legally correct decision all his life, without being affected by any pressures whatsoever is indeed a superhero. A doctor who takes care of all precautions and helps every patient all the way is indeed a superhero. The heroism lies in defeating the disease and saving every patient one can, NOT in being unscientific and risking lives. Wishing you all decades of success, and millions of saved lives. Always proud of our frontline doctors and nurses!
© Dr. Rajas Deshpande

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At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

An Interview With a Neurology Legend

An Interview With a Neurology Legend

Dr. Satish Khadilkar

MD, DM, DNBE, FIAN, FICP, FAMS, FRCP (London)

Dean and Professor and Head, Department of Neurology,

Bombay Hospital Institute of Medical Sciences, Mumbai.

He is a living legend, one of the best neurologists anywhere, a stunning example of what an ideal doctor should be like.

He needs no introduction to those in the medical world: he has carved his golden name in global neurosciences with his passion for Neurology and especially NeuroMuscular diseases, pioneering this specialty in India. I am grateful to Dr. Satish Khadilkar for agreeing to guide us all.

Q: How does it feel at the top?

A: Grateful to life!

In the health pyramid, ‘top’ really means ‘more useful’! And there are at least three parts to being useful: providing service, teaching and conducting research. Indeed, I am grateful to life for having provided me with the opportunities to be useful to colleagues and disease sufferers in all the three spheres.

Q: What are the most essential qualities that a doctor must possess?

A: As mentioned above; service, teaching and research are the three main pillars of medical careers. Each of these requires different virtues. Service requires patience, availability, affordability and the capacity to empathize with the sufferers. Teaching requires clarity of ideas and the ability to be inspirational to the new entrants and younger colleagues. And research requires an analytical mind to understand questions, be unbiased to design experiments in search of the answer.

Depending upon which field you choose, relevant qualities will need to be enhanced. In my mind now, as I have gone on, service has emerged as the noblest frontier for the medicine man. So the essential qualities are compassion, knowledge and the desire to help.

Q: What do you suggest we do to improve the clinical sense among newer generations of doctors?

A: Simple answer: bedside clinics by masters of clinical medicine and shadowing them to see how they utilize the limited resources.

Q: How do you deal with the ever widening knowledgebase while effectively practising as one of the busiest practitioners in the country?

A: Knowledge is of two types, one to know it yourself and the other, to know where to find it! In the present times; we have moved on to the second mode. The great thing about this era is that knowledge is freely available. We only need to develop the ability to design the search to get rapid answers to our questions. There are courses available to this effect.

While this is true for problem-based daily issues, in one’s own area of interest, one has to acquire all the manuscripts and threadbare them, assimilate them and understand them, for deeper knowledge.

Q: How do you handle the incessant negativity which doctors face while dealing with so many incurable conditions and gradually deteriorating patients?

A: Negativity in the doctor’s mind stems from the perceived personal inability to help or to provide solutions. Doctors need to appreciate that their role is limited to being knowledgeable helpers. If we keep in mind the inadequacies of medicine as a science and our restricted role, negativity is less likely to take roots.

Q: What is your take on making holidays, vacation compulsory for doctors to overcome stress?

A: Personally, I do not see the need to take holidays, as my daily work itself is a never ending holiday! I do not remember taking a holiday in last three decades. The better you gel with your work, less it stresses you and less is the need to break.

Having said that, as our work relates to human life, we have to make sure that we take adequate rest and are “on the top of our game” for the hours that we work, as our shortcomings can have consequences.

Q: What advice will you give about handling family responsibilities and duties to the new generation doctors?

A: Human relationships take very long to build and only one indiscretion is enough to undo these. So, in relationships and family, equal attention needs to be given, as you would in your profession. In today’s competitive India, we tend to take the family granted and actually end up doing the least for those who matter most!

It is best to think of this early on while planning the professional career.

Q: What best can be done to stop the exodus of doctors from India?

A: Talented Indian doctors need to be appreciated by the society and the health system in India. System needs to be more humane and responsive to the doctors’ needs. Doctors also need to understand the process of medicine, its goals, trials and tribulations. Till this happens, we shall see movement to greener pastures, where this process has evolved better.

Q: Your guiding thoughts for future Indian Doctors?

A: Let us all remember that we are in medicine to help suffering people. That is the core of medicine. We are healers and scientists. If we don’t veer from this ideal and have patience, all material wants and requirements will automatically fall in place. So to understand medicine, one must never forget that this is the noblest of all professions. I have chosen its nobility as a guiding principle for myself. I found my solace in drowning myself deep in the vast oceans of knowledge about neuromuscular disorders and using it in the service of suffering multitudes.

©️Dr. Satish Khadilkar & Dr. Rajas Deshpande

The Dictators in Hospital © Dr. Rajas Deshpande

“Let my father die. It’s ok. I will not take him anywhere. I don’t want anyone else to treat him” said the 60 year old son loudly. His old father who could listen and understand the conversation, but could not speak or move due to a paralysis, just closed eyes. Tears emerged from the corners of those closed eyes.

Like most doctors nowadays I have learned to master personal opinions and emotional responses, especially with ill-behaved patients, but this was beyond me. Not because he had shouted at me, but because he had just stabbed his father’s heart. Loudly, so that the patient could hear, I said “I think your father should feel better soon, let us see what we can do”. Then I gestured the angry son to see me out of the room. Two other men accompanying him came out and towered upon me.

About five days prior, this son had come to me with his father’s reports. The patient was admitted at a rural hospital. He had severely compromised heart function and his heart rhythm was abnormal. This caused formation of many blood clots in the heart, which went to the brain blocking blood vessels. One such large blockage had caused paralysis and inability to speak. © Dr. Rajas Deshpande

I had asked the son not to shift the patient, as the treatment started by the rural physician was accurate, we had to just wait and watch. Still, they had brought the patient in an ambulance, travelling for over 4 hours. Naturally, the patient had worsened , becoming drowsy. His heart rhythm was dangerously worse. He was unable to swallow, there was a big risk of his saliva/ mouth secretions going to his windpipe blocking his breathing.

Whenever a patient has problems out of a specialist’s expertise area, it is mandatory that an opinion of the concerned specialty expert be obtained. I asked the best heart specialist I knew to see the patient, and also a small ENT test to see if we could initiate training for swallowing. Our physiotherapists were already working upon his hands and legs gently.

However, the son (a retired govt. officer from a very respectable post) and two others attending the patient created a big scene when my junior doctor visited the patient. They started shouting and cursing that by calling other specialists we were just “increasing the bills”, and that they did not want anyone else except me to see the patient, not even the junior doctors. © Dr. Rajas Deshpande

My assistant physician called me in panic and updated about this, asking me to immediately act to deescalate the situation. Although there were many patients waiting to be attended in OPD, I had gone to this patient’s room. I explained to them that the patient needs to be seen by a heart specialist too, as his heart condition was very delicate. I also offered them to choose any specialist or hospital they wanted, if they were unhappy here, but they could not waste time as the patient was critical. That’s when the son shouted that he would rather let his father die than be seen by any other specialist.

When they came out of the room, their body language and general disposition suggested aggression. I tried to politely reason with the son that any specialist cannot sit with the patient 24/7, that junior doctors and other specialists as required will have to be called in for the best care, but they declined. The efforts of our medical superintendent and best patient coordinator went in vain. © Dr. Rajas Deshpande

“We will not allow anyone except Dr. Deshpande in the room. Our patient must get better” the son said loudly.

“I will see him till he is under my care, but I cannot guarantee any outcomes” I told them. “Let’s see” he said. He did sign the document informing about criticality of the patient.

No doctor should treat patient under pressure, duress or threat in the interest of the patient. I went to our medical director and requested that the patient be transferred under some other specialist. The hospital offered them freedom to choose, but the relatives declined. “We have come here for Dr. Deshpande, he will have to treat the patient alone” the son said. The hospital decided to take a call next day after a meeting.

That evening as I finished the OPD, I wondered how the patient was. However much angry I may have been with the relatives, the patient was more important than my anger, pride or anything else. I went to their room and checked the patient. He opened eyes and smiled. I asked him his name, and he replied in a husky tone. He was speaking now!!

The next day again, the relatives refused to transfer the patient under someone else, and I kept the treatment on. The trustless atmosphere was quite volatile, and if something had gone wrong, things would have taken an ugly turn. In the next three days, the patient spoke well, and even accepted some sips of water. His hand and leg started moving too.

“Can we take him home now?” the relative asked on the fourth day.

Happy for many reasons, but mainly the fact that the patient had improved, I discharged the patient. I had learnt my lessons. © Dr. Rajas Deshpande

Adamant, unreasonable and illogical demands by patient’s relatives jeopardising the patient’s life is a huge medical problem in India. Illiteracy, political interference, goonda culture and media support make such horror stories a routine reality. The law still expects the best patience and non-reacting approach of medical personnel, with the onus of saving lives still upon them under this pressure. Innumerable instances of harassment and humiliation of nursing staff, especially women go unreported. Relatives, especially politically connected, behave like dictators in any hospital, threatening one and all. Unless this culture ends and doctors are at a freedom to do their best for every patient, medical care in India will always remain inaccurate, incomplete and purely financially guided rather than scientific or even legal. Doctors can actually file a complaint or take legal action in such cases, but they are too many, and no doctor has time for such legal courses. In the best interest of our patients’ lives we go on forgiving and tolerating such abuse. Because neither law nor administration wants to correct the causative factors effectively.

© Dr. Rajas Deshpande

Neurologist Mumbai/ Pune

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