Tag Archives: Empathy

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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Disoriented


© Dr. Rajas Deshpande

“Doc, he appears confused. He has delusions. He was very methodical and logical earlier. He had excellent deduction and was considered a genius among his colleagues. Yet now he himself does not understand that he is making gross mistakes in making simple decisions. He appears completely disoriented…” the lady gave me an update in a deeply concerned voice. The devastating fear of mental, intellectual decline of a beloved is not grasped by all. For want of simplicity, we term it dementia. However, the meaning of this term is far broader and deeper than what most people can grasp, and the mental agony that the spouse goes through is beyond many a people’s emotional basket too. Infections and low sodium levels can often worsen the mental-cognitive personality of the elderly. I advised her a few tests to be done urgently and returned to my quarantine chores.

Her words kept on echoing for some time in my mind. This pandemic has challenged what the humanity perceived as truth till date. Disoriented, demented, illogical, delusional: isn’t that what the whole humanity has become today? Hasn’t this virus uncovered our intellectual, emotional limitations and selfish vulnerabilities? Have we not become exactly what the best human souls taught us never to become: money minded selfish humanoids hiding behind facades of clever and intelligent, politically correct wordplays, fatally attracted to glamour and clamour, emotionally cut off from the world, concentrating upon our families, cults, religions and regions? And of course, intermittently well-crafting the social service façade by donations, our signature face on every penny.

Financial success and numbers have become the new, hidden definition of life. Some wisely hide the word ‘Financial’ in the prior sentence. We won’t be able to name any financially unsuccessful / poor geniuses from the fields of medicine, science, art and even sports. I do not hate capitalism, in fact I believe that wealth creators are the ones who fuel the world. But among these are the compassionate and human who would rather be a million short of their billion rather than destroying a competitor and his/ her business. Squeezing-twisting every arm in the giant machinery that governs laws to finish everyone else and engulf everything with a gluttony that is hailed as business acumen is a real tragedy unfolding right now. We very gladly become the proud cogwheels of such ‘man-eating’ giant machineries that bleed competitors to a certain death.

While never being able to make peace with our neighbours we speak of world peace. We cannot bring ourselves to acknowledge the good in our competitors and enemies, we cannot deal with those with a different religion or country, come what may! While excepting ourselves from laws and rules we blame and blast those others who break laws. While secretly cultivating the filthy “money is all that matters” gene in our next generation, we encourage blindness towards the moral, ethical bypasses required to earn humungous money. The amount of real happiness, truth and honesty that needs to be sacrificed to be extremely rich is the worst inheritance our next generations will have to suffer from. Clever Wordplays is the sociopolitical success mantra of today!

I had never thought that I will witness anything more emotionally traumatic after seeing the hundreds of dead bodies and bleeding, broken-bone victims during the Killari earthquake. Today’s migrant crisis appears to cause deeper wounds than that upon our soul. This is a very tragic question, but what causes more hurt: witnessing dead bodies or extreme suffering of the living? Millions of migrants facing the worst wrath of fate, walking under a scorching sun towards a faraway home with their children, some dying, some delivering on the roads, strong men and women labourers breaking down and wailing – will be a shameful and guilty memory which I will carry for the rest of my life. We have excess caps and shoes; they are walking in rude heat bare headed and barefoot for hundreds of miles. We are discovering new cooking skills, they are discovering new depths of hunger. We are complaining about broken air conditioners, they are gasping for a glimpse of their beloveds in their zuggi-zopdi. We are too comfortable and grateful knowing that we are not them.

That India is overpopulated appears to be our strength on social media. We can show how many million fans, hits and likes there are, but we cannot speak a word about a tragedy which happens right in our backyard. We are scared of the worst: socio-political ostracisation, defamation, destruction of a hard-earned reputation and closure of financial support for survival. An intellectual is more scared of losing freedom of creativity, giving his best to the world and so mostly decides to be a silent spectator around strongmen with their invisible socio-political weaponry. Society as a whole has never protected or rewarded its intellectuals, especially in backward countries.

This pandemic will go. Few will have changed their perceptions of the world. Few understand that anything requiring a crowd must please a crowd’s intelligence quotient. Because crowds gather for hate easier than for love. Look at what content gets the best response: hate mongering, roasts, nudity, vulgar language and sloganeering. None of these is a proud achievement of humanity, yet these are the top hits. Pleasing a crowd can entertain, can earn one money, fame and votes too, but cannot ever bring this world health, happiness or peace. Entertainment, although critically essential for a stress-free mind, although soul-awakening, will never be among the first essentials of reducing hunger, pain, disease and suffering. There indeed was a time when entertainment was creative, with art, literature, acting, music and sports, fulfilling for the soul, but now only the superficial, jaded antics and the gaudy glitter with numbers remains the identity of most entertainment forms.

We indeed are disoriented. Yes, I too am guilty of some such disorientation. I have consciously decided to change. I do not have all answers right now, but I better appreciate the bigger picture now. My perceptions of what matters most have further changed. My faith in human nature has been deeply wounded, but my hope has always won, and I will help it heal even now. The current crises just told me what human race truly needs. My wish to make everyone understand has decided to take a back seat. My wish to do what I can is in the driving seat now. My contribution will be probably too small, but I have started.

I want to be well oriented for the rest of my life.

© Dr. Rajas Deshpande

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Suspend All Doctors, Cancel Their Registrations…


© Dr. Rajas Deshpande

Have you ever spoken with a doctor, a judge, a police, minister or an an IAS officer in their office? Almost every common man has had almost a similar experience: an arrogant air of authority, hidden hints of superiority and a subtle dose of “I know better than you” whenever one tries to argue. Now we know all of the above can be wrong occasionally, at all levels. Of course, there are exceptions in all professions. In a new world which is now shedding away traditional chains of inequality and racist slavery, we Indians are probably the most reluctant to change. In performing one’s duty, no one is superior to those they serve.

A doctor needs to be patient and compassionate with the ill-behaved and arrogant, unlike police, judge or minister who will punish people for such behaviour. Additionally, far before COVID19, there have been fatal infections like MDR Tuberculosis and other viruses which have endangered and even killed doctors. The stress of this daily fear of death is difficult to explain to the idiots who argue “but you yourself chose this profession, nobody forced you, you knew all the time about these risks”.
My dear infinite stupid, yes, I chose this profession willingly, knowing the risks, but to live on and serve, not to willingly and knowingly expose myself to fatal infections. A soldier joins the military ‘to live on and fight and protect the country, not with a wish to die with enemy’s bullets’.
When a citizen tells them from the comfort of a protected home that “You already knew you could die in the army”, it is ingratitude and insult to their profession. We choose to be in this profession because our compassion and courage is higher than our fear, not because we want to die. To be honest, we do not expect many to even grasp this concept. © Dr. Rajas Deshpande

I have deep respect for some Judges, IAS and police officers who are geniuses, and the first mark of a genius is a humble openness to all logical argument, with parsimony of words and zero presumptions of having a superior knowledge. Even a few minutes with them enhances your life. They are calm and respectful of others. Their language is never “Suspend, Fire, Transfer or Shoot”, because they know what it takes for a genuine person to reach where they are. These geniuses are far above attention seeking, cheap media publicity, arrogant show of authority and blame-mud-slinging to cover their own mistakes, inferiority complexes, and inadequacies.

It takes longest time and a hardest curriculum with hands-on experience of years to make every single doctor. The more specialised a doctor becomes, the rarer it is to replace his experience. Still anyone can commit mistakes.
If a Judge, a police Officer, a Minister, an IAS officer is wrong, does our constitution allow any TDH in media or society to get up and threaten them with suspension? Can you imagine a nagarsewaks / municipal councillor / local politico, goons or even major/ minor officers threatening a judge, IAS officer or a commissioner with cancellation of their rank, licence or degree? Even the courts of law do not suspend anyone or strip them of their hard earned registration without giving them a complete and patient hearing.

Yet almost every TDH in almost every nook and corner in India, from temporarily elected less-schooled representatives to highly educated junior and senior administrative officers often threaten on TV channels that doctors’ registration, licence and degrees will be cancelled. This apparently gives them a sense of pride and accomplishment and also sends a wrong message to a public that these doctors must serve.

In a country where the policy makers have miserably failed for generations to create enough doctors for their population, where we still continue to have that discrepancy, suspending a doctor is like snatching away food from someone already dying of hunger. One doctor gone screws up many patients’ lives. There’s no other profession where generations are taken care of, lifelong, by one person. Yet apparently, some officer’s egos are more important than those patient’s families, health and lives.

Every day there are news of political, social reasons of suspending, threatening doctors. Deny concessions, freebies, shoe-licking, decline to compromise upon scientific principles or accept inhuman conditions for doctors, and almost every officer unleashes their administrative adrenaline pumps against the entire medical profession. Refuse to accept incorrect policies and guidelines that are against patient’s interests, and insubordination leads to losing your jobs. The most shameful and pathetic addition to this “Suspend-Crazy” admin category are some senior doctors who fail to guard the principles and juniors of their own glorious, noble profession. © Dr. Rajas Deshpande

Like every Judge, Police or IAS officer, even politician, every doctor has also worked very hard to earn their degree and licensing. Every Medical college and University in India is approved by the government. The Medical Council of India has been given the authority and statute to license a medical practitioner upon presenting his / her degree and following principles it has laid down. No one other than the MCI should be able to cancel the licence of a registered medical practitioner. Every case of suspension of a doctor: whether a postgraduate or a senior doctor should be referred to a separate impartial MCI committee. Even the Hon’ble courts of law usually request expert opinion before concluding about medical issues / cases. Yet, our admins and politicians from different states suspend and threaten doctor’s registration cancellation as if it was granted by them or their party or government as a favour. No. We don’t accept that. Every IMA branch in every city must stand by such victimised doctors, protest such injustice, represent the harassed doctor and protect him/ her.

There of-course are doctors who commit mistakes, like Police Officers, IAS officers, Ministers or even some Judges. All of them should be accountable and be brought to the right penalty with the same dignity as others. No one has the right to pretend that a doctor is a slave to their whims, greed and tantrums. © Dr. Rajas Deshpande

The Hon’ble Supreme Court has very clearly stressed the fact that it is very important that doctors should be able to work and make their decisions without stress, insecurity, duress or fear. The article above intends to highlight that same purpose, especially in the light of some recent happenings. Every doctor out there is risking life only to save others, serve the nation. They do have problems, issues and insecurities that need sorting out. Please address their issues scientifically and logically, rather than inhumanly threatening them by suspension and cancellation of licences because you have no resources, funds or answers. Treat your doctors with the same compassion that you expect from them. Or, if you know better, if you want doctors to blindly follow unscientific instructions of admins and whims of politicos why make doctors? Suspend all doctors at once and do it all yourself.

India will definitely be healthier if you listen to the doctors, and don’t threaten or suspend them for trivial reasons.
Jai Hind!

© Dr. Rajas Deshpande
Written with a sad heart that on one hand where the Hon’ble PM has asked people to respect and appreciate the efforts of doctors, nurses and other corona warriors, many are looking for reasons to corner, threaten and suspend them at the drop of a hat, sometimes just for headlines.

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Mumbai Diary- 3 To The Silent Patriots

Mumbai Diary- 3

To The Silent Patriots

© Dr. Rajas Deshpande

Neurologist

Mumbai / Pune

Usually I stay in Mumbai on Sunday nights to be able to attend the OPD at Lilavati Hospital on Monday. Strolling by the sea is usually a pleasant addition to a Sunday evening. However, this time there were huge crowds as Christmas was only three days away, and people thronged to have a glimpse and seek blessings of their beloved Mount Mary. I decided to use the evening to visit my favourite Udyan Ganesh Temple at the Shivaji park.

I had my car but didn’t want to drive in Mumbai traffic that day, so I requested for a rental car. As the car came up, a perfectly dressed chauffeur in a white hat got down swiftly and held open the door, politely wishing me. He must be in his sixties. “I am Abdul, Sir” he introduced himself. I introduced myself too.

“Can you please drive me to Shivaji park?. and on the way I also want to visit the Mount Mary for a minute.” I requested.

“Sure Sir” he said.

In a few minutes, as I returned after praying at the Church, we headed towards Shivaji park. © Dr. Rajas Deshpande.

We chatted, he opened up very well, a rarity in a world full of cellphone robots. His father had retired with many honours from Mumbai Police.

“Those were the days, Docsaab! We stayed in a small society, there were three Hindu and a Christian family around us. Yet there was no awareness about religion, any child went and ate in any home. There was also no hesitation in anyone scolding any child for being naughty .. we were like a single big family. Nowadays one has to think a lot before speaking even to one’s own kids!”. I agreed with him.

I met my favourite deity at the Shivaji Park and returned. As we drove back, we crossed a building belonging to an ultra-rich famous businessman. The intention of the owner to show extremely gaudy luxury and glittery affluence in every inch of that construction was truly manifest. Passing by that building, we witnessed the state police guarding its gates.

Mr. Abdul spoke in a tone with hidden bitterness: “Every glass, every brick of this building is cursed, Doctor saab. This man has cheated and looted millions to earn this kind of money. There’s nothing against anyone being rich, I mean who doesn’t like to have a lot of money? But it should not be made by sucking people’s blood”.

In a few minutes his tone normalised. His smile returned. “Docsaab, I have worked for this company belonging to Mr. Ratan Tata Sahab for over 20 years. No one has ever seen any show-off of affluence or power from the Tata family. Once I was posted as a night-duty chauffeur at Mr. Tata’s bungalow. Sitting in my car, I dozed off by midnight At about 3 AM, I heard someone knocking on my car window. I woke up with a shock: it was Mr Ratan Tata, holding his own bag. I came out of the car shaking and apologising. He said to me: “Why do you apologise? Everyone gets sleepy at night. Not a mistake. In fact I am sorry I had to wake you up, but I must reach the airport as soon as possible. Will you be able to drive, or are you feeling sleepy? I don’t mind if you sleep in the back seat, I will drive the car to the airport and wake you up there. You can bring back the car in the morning”.

Pausing to clear his emotional throat, Mr. Abdul said “I felt that it was like meeting God. Since that day I never felt like working for anyone else. People usually show off and become mannerless when they get even little power or money, they insult and mistreat their employees, dependants and staff. But not Mr. Tata, he has the biggest heart I have known”.

That this should happen with me on the very day of Mr. Ratan Tata’s birthday was such a divine coincidence for me! © Dr. Rajas Deshpande. It provoked a different line of thought.

Soldiers, Police, Doctors, and millions of workers, labourers, watchmen work day and nightshifts, silently performing their duty while also serving the nation with their blood and sweat. Somehow people tend to think that these “true patriots” do not have a right to sleep well, eat well, and spend some good time with their families. Many think that sacrificing sleep, hunger and family time comes naturally as a duty when someone chooses such a career. As if it is a crime for a soldier or policeman to feel hungry, or a doctor to need adequate sleep. As if the children of these professionals do not need a father or a mother at home! © Dr. Rajas Deshpande. Our society thinks that, it is okay for them to sacrifise, suffer, even die in the line of duty. That is hardly a sign of an evolved, civilised or humane society!

Most people in our society get to sleep eight hours, have three square meals a day, then watch TV / entertainment, and in the remaining leisure some of them scream about Patriotism, share posts of emotional speeches about loving one’s country. There’s no better patriotism than actually working hard. Those who shout slogans and bellow speeches actually do nothing good for any country.

Through this post I would like to thank the millions of silent nation lovers: men and women from all religions, from all parts of my Great India, who show their love for their nation in their work, in their perfect execution of duty and service. May this New Year bring you immense inner happiness, exuberant health and realisation of the beauty of life.

Of Course, Happy Birthday Mr. Ratan Tata, if at all this post reaches you someday! You are one of the most respected icons in this world.

© Dr. Rajas Deshpande

Neurologist

Pune/ Mumbai

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The Killer ‘C’.. Are You A Victim?

© Dr. Rajas Deshpande.

“I have no life. I depend upon comedy shows to laugh, I don’t remember when I was truly happy anymore. There’s no connection with anyone. Inspite of working a lot and achieving too much, life seems complicated and meaningless at the same time. I have even started forgetting things now”: the 32 year old man was quite distressed when he spoke:

“Can you take a break?” I asked.

He laughed sarcastically.

“Doc, there’s so much competition in my field, that I cannot afford to take a break. They depend upon me for things to be done well. If something goes wrong, it reflects upon my career. If I am not available, I will be replaced”. He replied.

“What are your work hours?” I asked.

“I start from home at about 9 in the morning” he said. I waited for the remaining part of the reply but he didn’t speak. © Dr. Rajas Deshpande

“When do you return?” I knew the answer in his silence. I had heard it one too many times.

“There’s no fixed time” his wife replied, “Mostly after 9 at night, sometimes past midnight. But even after coming home his calls and online work continues.”

“That’s because I have to deal with the Western clients, their timezones differ” he snapped.

“May I speak with the doctor?” the wife asked him, a little insistent.

He nodded, looking down.

“Doc, we had a love marriage. He was not like this at all. He was full of life and vigor. He made everyone smile and had hundreds of friends. Now he has no friends, but even with me and our daughter, he gets hardly five minutes every day. On weekends he is so exhausted mentally to interact that the schedule is almost set: visiting mall, watching a movie, eating out and coming home tired again, immediately to sleep. He gets irritated without any reason. He was so attached to our daughter, she was his life, but now even she avoids playing with him. Even enjoyment has become mechanical” both of them became tearful.

Then, lowering her voice, she continued “Dr. Rajas, this is embarrassing, but who else can I tell this to? You are like family to us, so I will say it. We had a great sex life earlier. Now he seems to have lost all interest in me. We have lost our physical bonding just because of lack of time. And now we are losing the mental connection too, as he has started becoming quite forgetful” she completed. © Dr. Rajas Deshpande

They were the second couple today with similar problems.

Excessive work hours, traveling long distances, continuous multitasking without resting the brain and body and eating junk have become the lifestyle for not only most software engineers, but almost every doctor, sales and marketing person, and most other careers in India.

The concept of “minimal salary” and “maximum work hours”, so vehemently fought for by the human rights organizations around the world, seem quite unrelatable and impractical in India: not only competition, voluntary overwork, unrealistic financial expectations and unemployment, but a social tendency to “shove this phenomenon under the carpet” has led to a country of human robots who cannot connect with other humans.

India is an exploitation hub since decades. Cheap manpower is our famous boast. And the worst part is that they are thrown away instantly the moment their productivity is less than excess, or when someone cheaper can replace them. Years of loyalty, honesty, hard word had zero meaning in corporate world. You are just another table with an assigned process. © Dr. Rajas Deshpande. Be it secretaries, clerks, employees, students, teachers, or labourers, the message by the employer is loud and clear: work as told or go. We have many others to replace you. Eight hours of work with two hours of travel every day is itself very taxing, add two more hours of work and on is misusing body and brain both. Health is not on the cards here.

5-6 hours of sleep has become a norm with most of the above categories. For a normal brain, 7-8 hours of sleep is essential. Whatever one may hear about geniuses sleeping less, chronic lack of sleep does cause damage in the brain, that manifests as irritability, personality changes, forgetfulness and less mental efficiency.

Years ago, gymming at the Athletic Club in London ON Canada, I met an old man in the locker room. After the initial ‘Hi’, he asked me what I did. I replied that I was a postgraduate doctor, now a specialty fellow at the University. He said “Oh I did my career in health too”.

“Were you a doctor too?” I asked.

“No. I did many jobs, whatever gave me happiness and satisfaction, but I made my career in my own health. For decades now, I have eaten only healthy food, cooked for myself, taken good sleep, read a lot, traveled the world, played with kids and of course gymmed: not to show off my muscles, but to keep fit. I am ninety two now, healthy, and most importantly, happy”. © Dr. Rajas Deshpande

I told him I envied that lifestyle.

“It’s a choice, doc, and a sacrifice too. If you want health, you must give up anything that is against it. I had great job offers, but they did not go with my choice of a healthy life. Now I think I was right. I don’t have too much money, but I am happy and healthy. I had many friends with millions in their bank accounts, but they are either dead or can barely walk”.

I told that couple this short story. They appeared to understand.

“I will start working upon this, doc” said the husband.

One aspect of human evolution should be good mental and physical health. However we are going backwards. People have developed funny concepts: that muscles and physical stamina alone is health, that less weight is the best health etc. We meet many who diet excessively but piss of everyone they meet as they are continuously irritable due to hunger. Mental and physical health shows upon a person’s face: peace and happiness are its prime components. These are impossible without bonding with your family, ensuring adequate sleep and rest, and opting for stress-free career choices.

As for now, the ‘Killer C’ called career is turning out to be the biggest life- killer at least in India.

© Dr. Rajas Deshpande

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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 Remedy of Trust

The Remedy of Trust
© Dr. Rajas Deshpande
 
I entered the ICU in a torn and angry frame of mind. An old patient had had fluctuations in heart rate and blood pressure all night, and was on the thin line between life and death. Irregular heart beats had clotted his blood and he had developed a paralysis.
 
I had had a terrible argument with family that morning, and had left home without a breakfast, thinking that I will catch up in the canteen if hungry. The traffic on the way was as usual bad, it further worsened my mood. Messages kept pouring in: pending bills and health enquiries that were an attempt to avoid a proper consultation. One can ignore, but sometimes ignoring is stressful too!© Dr. Rajas Deshpande
 
As I entered the hospital, I was told about some machine not working. The technician had commented that it was beyond repair now. New one would cost over 30 lacs minimum, and this machine was required on a daily basis. My head started pounding. Another loan now, another recovery period!
As I passed the billing counter, an imposing rogue with a group stopped me. “Sir, the bill is too high, do something”. It was an open threat worded technically as a request. The relatives who folded hands to save the patient till yesterday were standing behind that rogue, looking unconcerned, not even happy that the patient was alive and being discharged after a life threatening illness. I sent them to the charity cell.
I entered the ICU, staring into my cellphone where angry messages of argument kept pouring in, a dear friend was upset that I was not available to see his relatives in another hospital immediately. © Dr. Rajas Deshpande
 
The old patient was sleeping. A glance at the monitor revealed that the patient’s BP was now stable. His heart rate was regular too. What a relief!
The patient’s wife got up, she was in her 80s. Fair, all white hair, and the confidence of culture upon her face, she smiled through her wrinkles and troubles. The Kumkum on her forehead was bright and fresh. She wore a torn saree, and had no ornaments except a thin thread with black beads that made her Mangalsutra. She was bending forward due to age.
She then said “He spoke to me this morning. He is feeling better than yesterday. I know he is old, but please give him the best treatment. We have been together since childhood.” Her eyes became wet.© Dr. Rajas Deshpande
 
Then she made an attempt to touch my feet, something that woke me up with a shock. A tingling feeling ran through my body. I held her hand and asked her it was ok, and returned the gesture by touching her feet too. I told her I will try my best, and her husband appeared out of danger at that moment.
She gently prodded the patient: “Look, our doctor is here. He says you are getting better. Do you recognize our doctor? Say Namaskar to him”.
 
Confused for a moment, the old man stared first at his wife, then at me.
 
He then tried to lift both hands, but only one went up, which he raised to his forehead and whispered “Namaskar”.
 
The old couple, the age of my parents, was saying Namaskar to me and touching me feet, many decades younger to them, because I was a Doctor. They never knew me until two days ago, but had trusted everything I said. They did not question my ability or intention. I like to be professional, but that should never compromise my manners.
I switched off my cellphone.© Dr. Rajas Deshpande
 
I suddenly felt ashamed of the mood that I was in. They did not deserve it. Their complete faith was to me the best return and reward of my efforts of so many years to become a good doctor. No amount of money ‘thrown at me’ by those who think of ‘buying me services’ would actually be my interest or aim. This was.
 
I smiled at the old lady, and told her that should she have any concerns, she can ask the staff to call me anytime, I would be glad to come over. Then, to repay her for bringing my smile back, I wrote on the billing sheet: “No charges for me in the case”.© Dr. Rajas Deshpande
 
When I walked out of the ICU, I was feeling proud and smiling. The faith of this patient and his wife had cured me of my bad mood too. I was prepared again to forget my personal woes, to take over the faithless hundreds, still do them good, in an attempt to reach out to the really deserving faithful, who knew their doctor would only do them good. That is the essence of my profession, my education, and my intention.
 
A patient who trusts a doctor earns for himself the best in that doctor. Always. Although we do not expect it to be understood by everyone.
© Dr. Rajas Deshpande
 
 

A Policeman’s Tears

© Dr. Rajas Deshpande

“She was found unconscious and naked lying on the road. The baby was near her, moving when we found her, now she also looks unconscious” said the police constable. “Actually I had my civil dress in my jeep, I covered both with my clothes and got them here. Most likely an orphan roadside beggar”.

It was early morning, I had gone to the casualty for a call as a medicine resident, and was chatting with the CMO when this police constable had rushed in the mother and the baby, probably less than a year old. He and his colleague completed the formalities and left. The CMO was alone, so I stayed on to assist.

The lady had high grade fever and some bruises all over her body, only one on the thigh deep enough that it bled. She also had a contusion upon the head. Needless to say, unclean and unkempt, visibly quite weak and poorly fed body. There was a traditional tattoo on her forearm that said “Seeta” in distorted devnagari script. The baby was dehydrated and had fever too, with only minor contusions.

“Sending her to female ward, and the baby to paediatric” said the CMO. We completed the police information and Medicolegal form, the nurses had started the IV line for the lady. I accompanied the baby to the pediatric ward, handed her over to the resident doctor friend on duty and went to the female ward to attend the other admissions. Basic medicines for fever and head injury were started for Seeta. There was no CT scan facility in the hospital. Blood tests were sent.

In absence of relatives, it’s the interns, resident doctors and nurses who attend to the necessities of such patients. Administration mocks everyone sympathetic and compassionate to such patients, be it a government, private or corporate set up. My professor advised some more blood tests. Some tests were not available in the govt. hospital, we had to send them outside. As we had just received the stipend, money was not a big problem.

Next evening I went to the pediatric ward to find out what was happening with the baby.
“She has had convulsions”, the resident colleague told me. We have loaded her with anticonvulsants, but she still has fever. Dr. Jain madam (new lecturer in paediatrics) has advised lumbar puncture, but there’s the consent problem”.
I went to talk to the lecturer, she was all insulting. “Don’t teach me what to do. We will send a request to the dean, and if he allows, then the resident will do the lumbar puncture” she said, “By the way, what’s your interest in this baby? Why don’t you mind your own business? I have heard about you.. you are in the student’s union na? Don’t throw your weight around me.” She said.

The dean consented to our request, and a lumbar puncture was done. The baby had probable tuberculous meningoencephalitis (infection of the brain and its coverings). Antituberculous medicines were started.

The comments of the pediatric lecturer made me extremely angry. Most of her resident doctors hated her attitude too. Those remarks soon spread and various sick, exaggerated and vulgar jokes about me caring for that orphan baby made rounds among my colleagues. But one good thing about wanting to do good is the shameless pride and courage that comes ingrained with it.

My colleague Dr. Madhu stood by me. She often reminded me: “There are five percent good people in the world, and 95 percent bad, Einstein has said, but it is the five percent good who take the world forward, they represent human race”. That has always pumped me up against all the mockery that I ever faced for being “too sensitive and compassionate to be sane”.

The best support for the poor and helpless always comes from the poor and helpless. The pompous, actionless “blah blah” of advising others to be more kind and compassionate is usually the trademark of those who themselves rarely help anyone. The mamas and mausis (wardboys and helpers) of the ward came together to attend Seeta during their duty.

The pediatric resident told us on the third day that the baby’s health had gone bad, and she was unlikely to survive. Dr. Madhu stopped smiling. “At least can we shift the baby near her mom?” we discussed. It was of course not possible.

Dr. Oak (real name), one of our ophthalmology genius professors, learnt about this. He came over and told us in his royal tones, to tap him anytime for any help. He also left some money with us.

On the fourth day, the lady started having convulsions too. We ran around, trying to arrange whatever the professor suggested. She was gradually sinking. Tuberculosis neglected and untreated is one of the most cruel diseases. It takes over ten days for the action of Tb medicines to kick in.

On the fifth day, the baby passed away in the morning, and the lady shortly after. That coincidence was less tragic than their trolleys being rolled into the mortuary together.

“What happens now?” we asked the mortuary in charge.
“They will be cremated as orphan, unclaimed bodies after the post mortem” he told.

In a world of billions, ruled by religious, powerful and rich, a young mother and a baby girl would be cremated as orphans! We told the mortuary assistant to please keep us posted, and came out. Of course we could not sleep.

Next day we took special permission and went to attend their cremation.
On the way, we bought some flowers, a tiny dress for the girl and a saree for her mom, probably the first new clothes ever for either of them. Dr. Madhu had already brought a few bangles, a necklace and two bindis with her.

Dr. Madhu was sobbing as we returned. The rowdy looking policeman with us also wiped his eyes. He dropped us back to the medical college in his jeep.

He said in a heavy voice as we parted:
“Doctor, we see all the worst things in the society. We meet criminals day and night. But when such young girls and babies die, I feel like shooting everyone who didn’t come out to help them. People just talk, nobody helps. God bless you. You have what it takes to be a doctor. Don’t ever change.”

© Dr. Rajas Deshpande

P.S.
Years later, I read about a divine human being from Chennai, one Mr. S Sreedhar, who collects unclaimed dead bodies from various hospitals, and performs decent and respectful last rites for them. Planning to meet and touch his feet one day.
Please share unedited.

Have Doctors become Mechanical?

(c) Dr. Rajas Deshpande

Sir, most of your stories you share are from your internship days. I have worked as an intern for past 10 months but almost never encountered/experienced such heart touching events and I don’t think, i am any less humane or sensitive than you must be(guessing by your posts). then why almost every intern is so mechanical about his schedule and work? Has the nature of work/ job profile of interns changed to mere mamagiri? Or Its just that, you always went the extra mile to be the awesome being you are! Awaiting your reply eagerly.. Dr. AA

Dear Dr AA, yes doctors have become more and more mechanical, also preoccupied with too many non-clinical tasks like USMLE / MRCP / pg entrance studies, digital addictions and excess non-duty work. Talking to the patients and making them open up is an extremely difficult art. Just like we don’t open up to any roadside stranger, patients do no talk much to a disinterested doctor in a hurry.

There is no one without problems, no one who does not need more love and kindness, but people will not respond if they sense “artificial” empathy. Most illiterates and even infants sense true versus artificial love. So every doctor must learn to imagine himself/ herself in the patients’ condition, and genuinely solve their problem the best they can. There also is a growing tendency to think oneself “superior” to patient or other professionals. No one talks comfortably with the “high handed”. Indeed there are many patients/ relatives more intelligent than the treating doctor, the respect for a doctor is only for his/her medical prowess and kindness.

The first hint of “trying to show off more than what you know” switches off the patient. This tendency is also increasing among some doctors, who transgress their specialty and adversely talk about other specialists or professions. Even the illiterate patients understand (may not express) your overall nature in a few minutes. One must be very polite, humble and genuinely interested and helpful to every patient to be able to connect. In many cases half the agony is the fear of the medical situation. Every doctor does not have time, but those who spend more time per patient hit it well with the patient.

Hope that answers your question. Also, I have always kept a diary. I spent my internship in quite rural and backward areas, the faith in a doctor was still young, and I loved to talk to the “patient”, so time was not an issue. Like most young doctors, I was (and am) never fond of sleep. I had another advantage: I have been a loner.

I know you are (in fact everyone is) gifted by God / Nature a golden heart with a divine song. It is up to us how to use it. The practice of Good Medicine is almost as difficult as a spiritual life: many sacrifices are required. But one should not expect the patient to “Pay Up” or bear the brunt of our sacrifices. It is a choice we have made.

Take care and use the one chance of touching every heart you meet wisely, with immense passion, forgiveness and love. The returns will not be material, but I am sure you don’t care for material gains because you asked this question.

There is no “Extra Mile” for a good doctor. Whatever Good can be done, must be done.

God bless!

© Dr. Rajas Deshpande

Reply to a question asked by Dr. Arvind Arora, Intern, India.