Tag Archives: faith

The Good News: ‘Life Is In Brains’

Last three years we were planning a beautiful, comprehensive and patient friendly, “All under one roof” Neuroscience set-up at Ruby Hall Clinic.

Specialty Clinics for Multiple Sclerosis, Parkinson’s Disease, Epilepsy, Vertigo, Stroke, Brain Tumors, and all neurological investigations will be available here, on this floor. Also Neuropsychology, Speech Therapy and Counsellor for family members dealing with difficult illnesses.

My dynamic CEO Mr. Bomi Bhote has long dreamt of a world-class Neuroscience department at Ruby Hall.
“Give our society something to remember you for” he said often. I have tried my best to design this fully new Superspecality Neuroscience Department. After many meetings and many precious inputs from Dr. Purvez Grant, Dr. Manisha Karmarkar (COO), and Dr. Rebecca John, and the blessings of senior Doctors like Dr. Ravi Gulati, MD Dr. Sanjay Pathare we added one stop troubleshooting and convenience so that patients do not have to roam around.

Mr. Iqbal Chaney, Dr. Abhijit Rokade, Mr. Shailesh Kelkar, Mr. Avro Chatterjee, Mrs. Nilofer Shaikh, Mr. Tushar Patil, Ms. Ansha and so many others contributed to the efficient beauty of this set-up.

One item on the top of my bucket list thus ticked off: giving Pune, Maharashtra and India a Neuroscience Department to bank upon. This is just the beginning.

© Dr. Rajas Deshpande


© 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

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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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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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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Young At 98. Secret?

Young At 98. Secret?

©️Dr. Rajas Deshpande

A few months ago I had received an emergency call for a stroke case. The resident doctor informed me that the patient was a lady of 98 years. Her basic tests were normal.

Worried, because stroke is a dangerous diagnosis at any age but more so at that age, I ran to her room as soon as I reached the hospital. A group of her worry-faced relatives waited outside her room.

I entered the room and introduced myself to the patient. She got up.

“Namaskar! How are you doctor? My name is Champadevi Gupta” she said with a big smile and such gusto that I wondered if she was the right patient.

“I am ok, thanks. What happened today?” I asked her.

“Nothing much. I had some giddiness but my children worry so much about my health that they rushed me here”.

Although her examination revealed only mild signs, her MRI had shown a small block in a blood vessel supplying a crucial area of the brain. I explained it to her. She laughed aloud again “I feel okay now. When you feel ok, let me go home”.

She was discharged next morning.

She came in thrice after that, every time walking in with a big smile, lighting up everything around her, keeping her hand upon my head and sumptuously blessing me, inviting for a meal at her home.

Today she came with her youngest son. She is as fit and fine as any young teenager, only happier and more content.

“She has always been like this: happy and content with whatever life brings, in good and bad times” her son Satish told me, “we are 5 brothers, we all look after her, but she still lives alone near my home. She is like a treasure and source of life for all of us”.

Indeed. A laughing, smiling, truly happy, positive and content person is probably the most precious form of human being, and so rare now, that sometimes I want to tell those running behind one thing after another, killing themselves every day: “Look at this lady’s face! This is the secret of a good life, the best health and happiness”.

It is so sad that we are evolving into a “Want more” type of materialistic, selfish, disconnected world with misplaced icons! I was amazed at the willing, involved enthusiasm with which this lucky lady’s children cared so well for her! Incidentally, I had had a tough argument with my teenager kid that morning and had left home in a slightly bad mood. After meeting Champadeviji, whose eldest son of over 80 years still visits her regularly, I was relieved. Parenting is a long term, never ending activity, and may be my own stresses of being a doctor were also distressing my kids sometimes.

As I told her that she was fine and need not visit me for another year, she held my hands, hugged and blessed me, and with mock-anger said “Now if you don’t come to my home I will come to yours without telling you “.

I am now in a true dilemma.

©️Dr. Rajas Deshpande

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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Survival Of The Quickest

© Dr. Rajas Deshpande

This young and brilliant man, Adil Masalawala, suddenly appeared to have changed. His behaviour became different and unusual. He started mumbling and replying irrelevantly. He also had fever intermittently. His caring and worried wife Mrs. Venus consulted a physician who sent them to a psychiatrist.

The psychiatrist checked Adil and advised him admission. He started with some medicines, but suddenly Adil’s behaviour became hyper, his body started becoming stiff. Then he became drowsy, and his body started shaking violently. An MRI of the brain was reported normal. That’s when the psychiatrist advised a reference for neurologist.

When I first saw the patient, he had many features that could also be caused by side effects of some medicines. Sometimes it is impossible to conclude whether it is the disease or the medicine which is causing certain symptoms. I suggested that we stop all antipsychotic medicines. That could also be a dangerous decision. The family was counselled, and they agreed. Adil’s drowsiness improved, but he became very agitated, and his stiffness and shaking worsened.

There are many neurological diseases of the brain which start as abnormal behaviour. Strokes, some infections, tumors and swellings are examples of treatable, but there are many untreatable and dangerous conditions too. The only way was to urgently investigate the patient further. Although the family was baffled and panicked, Mrs. Venus expressed complete trust in our decisions, and allowed us to shift the patient to the ICU. I could not answer many of their questions, I did not clearly understand what exactly was happening, but this uncertainty and challenge is what medicine is all about.

There is fluid in and around the brain, which nourishes the brain and also acts as shock absorber between the skull bone and the brain. Many diseases like cancers and infections can be diagnosed by studying this fluid, which can be taken out by inserting a needle in the lower (lumbar) spine. We checked this fluid, and we got the first clue: that we were possibly dealing with a viral infection of the brain. Many more costly blood tests were required to find out which virus was causing this. The family clearly stated “Do whatever is needed in your opinion”. We sent the tests and found the answer: Adil had one of the most rare and dangerous viral infection of the brain, called Japanese Encephalitis.

About 30-40 percent of patients with this diagnosis do not survive. There is no definite treatment for this virus, but many of the manifestations can be treated and excessive care is required to avoid life threatening complications of the swelling that it can cause in the brain.

On the fourth day, Adil had convulsions. His condition worsened. We kept on treating each complication as fast as possible and tried to balance the effects and side effects of the many strong medicines that were being used to control convulsions, shaking, and the brain swelling. Besides knowledge, wisdom and experience, our major strength was the trust of patient’s family who never questioned any decisions.

Many patients who develop abnormal behaviour are mistreated as having a psychiatric problem. Most qualified psychiatrists are aware of the red flags and refer patients for a Neurologist’s opinion. However, a majority of patients with psychiatric problems in India are first taken to quacks, magic healers, mantrik-tantriks, who delay the whole process of correct evaluation, diagnosis and treatment. This leads to many deaths, and this is worst in case of cancers treatable in earlier stages.

False advertisements, some even approved by highly placed offices, celebrities and authorities attract people from all classes and cause severe delay in initiation of the correct scientific treatment. While our governments rightly pressurise allopaths to write generic medicines, they mostly turn a blind eye towards rampant misleading false advertisements claiming cures of incurable diseases and centers that flourish reaping from the hope of millions of illiterates.

We almost thought we had lost this case to a permanent disability. Adil’s body had become completely stiff, his memory had become unreliable to a great extent, and he had an incapacitating tremor. After a few days we could gradually stabilise his general condition and shift him out of the ICU. In a few weeks he was discharged, improving slowly. His family, especially his wife fought for his normalcy like a true warrior, and once he resumed his senses, Adil too made every possible effort to recover fast. One day after a few months, he was back to normal again, we declared him cured and fit, physically and mentally. He resumed his job.

Today after about ten years, Mr. Adil Masalawala and his wife Mrs. Venus came over for some trivial issue, and we recalled the horror that we went through and his victory over it. In this case, I thought it was the “Survival Of The Fastest” as the family did not waste any time in quacks, arguments, objections or mistrust, and let us doctors do the best for the patient in the fastest possible way. We are grateful to the family for this trust, and Adil’s survival and recovery itself is our reward. God bless the couple with a long and healthy life!

© Dr. Rajas Deshpande

Real Story, Real Names, With Patient’s Express Permission. Grateful to Mr. Adil and Mrs. Venus for the permission to share the story of their victorious battle.

Please share unedited.