Tag Archives: Indian doctor

Robodoc

© Dr. Rajas Deshpande

“The doctor wasn’t even replying. He didn’t answer my questions” the patient, an angry lady, told me about one of my colleagues. The patient’s husband sat besides her, expressionless.

I reviewed her case in detail. She had had varying complaints for over four years, mostly severe pain at various points on her body. When a patient has symptoms (complaints) grossly disproportionate to the signs (doctor’s findings), there always is a suspicion of ‘exaggeration’ or ‘lying’. This can happen involuntarily due to stress, depression or anxiety, or voluntarily usually for seeking attention. She had seen many specialists, and had received strong doses of almost all types of pain killers and other pain control medicines, still her response after every course was ‘zero relief’. That was definitely suspicious. I looked at her husband. He appeared tired and aloof, reluctant to participate in any discussion. I had to make him talk.

“Is she stressed? Have you noticed any change in her personality?” I asked them the question that usually opens the dreaded can of worms.

“I am fed up, doctor” said the husband, “She needs continuous attention. Since our marriage four years ago there’s never been a month when we did not visit a hospital. All doctors tell her to go to a psychiatrist, but she refuses. The moment I return from office she starts complaining about her health. I don’t know what to do now, I feel I am better out of my own home” he avoided looking at her.© Dr. Rajas Deshpande.

His wife started crying, and in a shrill voice, shouted at me “Why are you speaking with him, doc? I am your patient, speak to me. No one believes me. I am suffering so much!”

I assured her that I was going to help her sort out the issue. Once she calmed down, I was able to explain to her the way stress affects human mind and body, and that it was possible to get well soon. I told her that being stressed was not a “psychiatric illness” but an overworked, burdened state of mind that needs attention, and that it can often be cured by speaking with the right person. She asked me many questions. As a special case, I made an effort to reply to each one of them, even the irrelevant ones, sometimes repeatedly. She agreed to visit an excellent counsellor colleague of mine. She drastically improved in a month after the counsellor worked upon her. However, she came back with new complaints within two months. She visited me twice more, and each time cried a lot, then when I pacified her, asked the same long list of questions mixed with new ones.

My sympathy and compassion started waning. I have promised myself never to be rude to any patient ever, and I religiously follow that. Yet my patience was wavering now.

The more compassionate, patient, sympathetic a doctor becomes towards the patient and their family, the more it is taken for granted and misused. The doctor is then expected to be an unending source of “psychological support”, mentoring and motivating, and a punching bag or a cry-to teddy bear. While in a healthy doctor-patient relationship this compassionate attitude is natural and welcome, many doctors do not know when it starts growing upon them and stressing them out. It is not easy to listen to a continuous flow of medical symptomatology especially wrapped in negative emotions. While positive outcomes do bring back life into a doctor’s motivation to do better and more, this expectation to be a listener of all sorrows until the storyteller is satisfied is unnatural and impractical. It tells upon the doctor’s health. This is now happening in almost all specialties, and wise doctors are learning to separate patients into “whimpering, chronically-dissatisfied-with-everything storytellers” versus patients with genuine medical, surgical and psychiatric issues. © Dr. Rajas Deshpande.

To concentrate upon what can be corrected, to treat what is possible should be the right priority, and here’s where a doctor’s compassion, sympathy and patience are best employed. To expect a doctor to resolve issues like ‘Swabhav’ (inherent nature) of a human being is wrong. A doctor also cannot solve the root causes of stress like poverty, unemployment, interpersonal incompatibility, overambitious, over-expectant personality or attention seeking. Many patients and families expect the doctor to resolve ‘every minor issue’ related to ageing, refusing to accept that resuming complete normalcy of health is impossible after a certain age, especially with some medical conditions. Doctors can guide patients, but cannot accompany the patient and family to fine tune every minor issue.© Dr. Rajas Deshpande.

Few paranoid, suspicious, accusative, aggressive patients and the types mentioned above have now made it necessary for the doctor to be extremely aware and alert, cautious, and to some extent emotionally aloof from the patient at least in the initial phase. Every word has to be spoken with caution. This “Robotic Doctor” or “Robodoc” is actually becoming a sad reality in the Western world where every medical consultation is considered a potential chance of litigation. A careful doctor avoids getting trapped into emotional exploitation. While this may upset some patients, much of the educated class is still happy with a proper professional consultation, diagnosis and treatment rather than only a compassionate sweet talk. Given the Indian scenario where patients are driven emotionally rather than scientifically especially in the illiterate and financially challenged echelons, a doctor needs to be better equipped for avoiding misuse of his / her compassion and sympathy, as it also converts readily into a permanent source of rewardless stress. This is unhealthy for doctors.

This is one reason ‘Robodocs’ are on a rise. A sad truth about an essential evolution in the medical profession across the world. The only thing that can change this is individualising patient care.

© Dr. Rajas Deshpande

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The Gift From Heaven

He woke up today morning, caught a bus to his earlier workplace and collected some boxes. Then he got a bus again and travelled for two hours to reach me.

“I made these chocolates myself for you, doctor” he told me with immense pride.

He was paralysed on one side, since 17 years, at the young age of 23, due to stroke. He lost his job. About a year ago he came to my free opd for reduction in stiffness and weakness that had made his life difficult. After some weeks he responded well and has now resumed his work as a chef from home. I am as proud as him, and consider this Diwali gift a gift from heaven!

Thank you, Sachin Balasaheb Damle, and Hats Off to your patience, courage and grit!

Happy Diwali🙏🏻

©️Dr. Rajas Deshpande

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The Medical Court Martial and the Punishment

The Medical Court Martial and the Punishment

(c) Dr. Rajas Deshpande

“What is the exact diagnosis?” the patient, Mr. Abhishek asked.

In his early thirties and succesful, Abhishek was anxious too. I told him that his looked like a stress headache, migraine was a possibility, the tests I had told him would help us rule out other possibilities. There is no lab test for confirming the diagnosis of migraine.

“What is each one of these medicines for?” Abhishek asked. That the doctor had an experience equalling his total age had nothing to do with his right to ask questions. He was buying the doctor’s services after all! For a moment I wished I was not a doctor, that I could tell people off by snubbing them, that I could rudely decline to reply to questions that were against common sense. But then I reminded myself: that I did not have this liberty. I must face the court martial of a doctor, a chosen punishment, every time I see a patient.

“Sir, you have told me you had a headache. These medicines are for headache” I replied, smiling.

“Is it necessary?”he asked.

“No”. I said., “As a doctor I have only three options: prescribe you medicine which I did, recommend a surgery which is not applicable in your case, or suggesst you a non-medicine path like lifestyle change” I replied. Practice makes one patient too.

“Are these steroids or antibiotics?” his wife asked.

“No” I replied, and thanked God that they believed me here and did not ask for proofs.

“Are these tests necessary?” Abhishek.

I told him the pros and cons of doing the tests, and reassured that it was not an emergency. Even if they did not trust me, I had to do them good. That’s the duty of a doctor.

“What lifestyle changes do you suggest?” he asked.

“Ensure 8 hours of sleep every day, give up cellphone use after evening, reduce screen exposure to less than three hours at a stretch, maximum eight hours. Eat fresh and healthy home cooked food three times, and eliminate fast food. Resolve relationship and work stress issues. Reduce weight by consulting a qualified dietician. Start exercising.” I told him. This simple formula for a healthy life is mostly possible for the poorest of the poor illiterates, but impossible for the educated affluent! What a paradox!

“Impossible, doc! Tell me something practical. My work needs me to use screen and cellphone over 12 hours a day. I mostly work at night, I have to use fast food or tiffins. My wife also works, she has stress of her own, we haven’t had time to even have children yet! There’s no energy left for any exercise when I return” . Abhishek was genuinely frustrated with his schedule without even knowing it.

“Then Sir, please take the medicines as prescribed, and gradually make changes that eliminate stress. Please do these tests especially if you do not have relief in next two-three days” I thought it will be over now.

I was so incorrect!

“Do these medicines have any side effects?” his wife asked.

“Yes, all medicines have side effects, these are the ones with least side effects for your condition” I started getting faster and shorter with my replies now.

“What if he develops any side effects? Can we call you on your personal number?”

How could I tell them that every doctor prescribed over 100 different medicines every day and all of them could have some side effect or other, minor or major, and that if everyone kept calling for each side effect, the doctor won’t be able to practice!

“Usually side effects are not seen with these medicines. If you have any allergic reaction, please stop these and report to the nearest doctor or hospital. I may not be reachable always” I wondered what people did before the cellphone era: how happy the doctors then must have been!

They appeared partially satisfied and left. My court martial in this case was over. “Only twenty more court martials remaining for today!!” I reassured myself.

After about two weeks, I received a call from the casualty. Abhishek was admitted in an unconscious condition. His wife was in a state of shock.

“What happened?” I asked her.

“Doc, sorry, but he did not want to take any medicine with side effects. So we went to someone who gives a herbal medicine without side effects, made at home. We took it for about five days. The headache improved first, then went on worsening. Then Abhishek had a lot of vomiting and did not eat anything for three days. Today he got up and collapsed while taking a bath”.

“Did you ask the person what was the content of his potion?” I asked while examining an unconscious Abhishek.

“No doctor, he says it was his own invention, a secret” she replied.

Abhishek was paralysed on the right side. His MRI showed many blood clots due to dehydration and a small bleeding on the left side of the brain. This is called cerebral venous thrombosis.

Many people who go on prolonged fasting, drink less water, overexert without enough hydration develop clots in the veins of the brain as their blood becomes thick. Some diseases of the blood and some medicines like hormonal preparations, alcohol, contraceptives etc. (even herbal) can exaggerate this tendency. This is a major cause of clotting, bleeding and swelling in the brain, resulting in paralysis or even death. One should never make sudden changes in diet without consulting a qualified expert.

We admitted Abhishek in the ICU. He gradually recovered over few weeks, but his speech remained patially slurred. His company ruthlessly fired him, they did not care how dedicated he was to them. The most fortunate thing was that he retained his intellect, memory and ability to move. The couple has now changed their lifestyle and are far happier although not richer. He is off all medicines now.

Almost every doctor bears the punishment for the few who overprescribe and overinvestigate: a trustless court martial, bitterness and allegations by not only educated but even totally uneducated patients. A doctor must be compassionate and kind, but the limits to how many unnecessary questions he should patiently reply to remains a dilemma.

This daily court martial of doctors must end. The doctor’s consultation time and peace of mind is as much important for the next patient as for himself. Newer generation doctors should also be taught to politely deal with such situations.

A polite reminder to ask only relevant questions, to book another appointment for more time is justified in such cases. The society should understand and accept that a qualified doctor has repeatedly proven his merit, acumen, ability and correctness before being allowed to practice.

Unlike the many we vote for.

(c) Dr. Rajas Deshpande

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Cerebral Palsy and The Californian Driver

AlKhalil Mohammed Qasem was noticed to have one sided weakness shortly after birth. His parents were told that nothing can be done, they have to accept that the child will always be bedridden. They decided to fight fate. They knew that their child was intelligent, that he had only problems with movement. Cerebral Palsy is a most misunderstood, misdiagnosed and mistreated medical condition. It is best handled by paediatric / adult neurologist or a paediatrician. There are some types of cerebral palsy where the child indeed has good intellectual functions yet severe abnormal movements, stiffness or imbalance. Few have fits too.

He came to us five years ago. There was a huge language barrier, I explained to his parents through the interpreter that all the medicines I wanted to try for him had side effects, some serious. They gave me permission in good faith. We started treatment. He improved. They went to USA. AlKhalil started going to school. He topped his class always. The parents made extraordinary efforts to provide best for him. His father works as a supermarket executive.

Now AlKhalil has finished school and joined college. He is also working part time to help his father at the supermarket, and drives his own car.

He came all the way from California today for a follow up.. He showed me his driving license with a pride and smile I have seldom seen! Driving a car is such a fond dream of everyone growing up!

AlKhalil and his parents have defeated cerebral palsy!!

Most cerebral palsy patients can have a significantly better quality of life if they reach the right specialist, usually a paediatric or adult neurologist as per their age group. I found no better example.

Miracles are not only possible, they are human too!

©️Dr. Rajas Deshpande

PS

Cerebral Palsy care is a teamwork between neurologist, paediatrician, orthopaedic surgeon, speech therapist and physiotherapist.

Till I’m Alive

Over 4 years ago, a late night frantic call from the casualty baffled me. Quite a complicated case. After seeing the patient I met her anxious family and explained them my thoughts, that the diagnosis wasn’t clear yet, and that we needed to observe the patient. I had already started treatment based upon a presumption. The Mandke family, in spite of being extremely well connected socially and able to afford treatment anywhere they chose, still decided to invest their trust and faith in a junior Neurologist like me. The onus to prove them correct was now upon me.

In a few days Mrs. Madhuri Sudhir Mandke was completely cured of the transient illness she had developed, and discharged. After a few follow ups, I told her the good news: she no more required to see me.

Yet every Diwali, she comes personally or sends someone from her family with extraordinary sweets and gifts. When she came over today, I told her this was not necessary, I had just done my duty. Then she said something that moved me: “Till I am alive I you will receive these every Diwali”.

This gratitude not only increases my responsibility, it is also a perpetual reminder of how important it is for every doctor to take it upon himself/ herself to justify, to stand up to that trust which involves health and life. Every outcome may not be what one strives for, but every effort can be made genuinely to let the patient and family feel that they have trusted the right doctor. It is NEVER sweet talking, wise talking or jovial attitude alone, never pure medicolegal attitude, but a combination of scientific, ethical and compassionate care that brings home the rewards of appreciation by the patient: the highest achievement in medicine.

There’s nothing more precious to earn upon earth!

©️Dr. Rajas Deshpande

The Doctor Who Took Fees: One Star Review”

© Dr. Rajas Deshpande

False reviews and online beratings against doctors and hospitals have become a reality. However much a doctor goes out of the way to do the best for his/ her patient, following are the reasons why negative reviews are still uploaded, some of them ridiculous:

1. Denial of false certification.

2. Recording truth on paper like addiction (smoking, alcohol, ghutka, sleep medicines etc.).

3. Mentioning preexisting illnesses which the patient / family had hidden from the insurance companies.

4. Denial to falsify diagnosis, treatment and inflating bills to claim medical insurance benefits.

5. Denial to give concessions in standard billing, consultation, visit fees.

6. Advising necessary investigations.

7. Charging for follow up visits (different doctors, specialties and hospitals have different policies, all are usually mentioned in the information prior to consultation. All follow-ups are not same). © Dr. Rajas Deshpande.

8.. Waiting time: This is the saddest in India. The standard waiting times for specialists all over the world range from 30-90 minutes, sometimes longer, but it is only the Indian patients who convert this into a complaint. Sometimes earlier patients may have taken more time, asked more questions, sometimes patients cry when a sad diagnosis is conveyed, one cannot ask them to leave the room, there are incessant calls for emergencies etc. . The same traffic and weather conditions affect a doctor’s schedule too, but some are unforgiving. The fact that Indian doctors are available on usually the same day or mostly a week in spite of a heavy workload means nothing to our people, even those who have visited the Western world and witnessed that it takes months to years to get a specialist’s appointment there.

9. Behaviour of the doctor: Agreed that some doctors are indeed rude, some are in a hurry, and that is wrong. But usually doctors develop a lot of patience as they mature, dealing with all sorts of negativity continuously. Sometimes patients do offend doctors by asking illogical questions repeatedly, by challenging every word that the doctor says, or by making illogical demands. These demands include repeating long explanations about the diagnosis and treatment, requests to speak on phone with a distant relative to re-explain everything because they are too busy to come over, asking questions like “Are these medicines necessary?” etc. © Dr. Rajas Deshpande.

10. Unfair, illogical statements “I cannot tolerate any allopathic medicine” rules this section. What do you expect a physician to do?

11. Unfair, unrealistic expectations: Every drug has side effects, including vitamins, and these side effects are NOT the doctor’s fault. The doctor can alert the patient about common side effects, but cannot explain all side effects of every medicine, as it is impractical. Secondly, while some medicines act within seconds, some take effect over weeks to months. Those without patience who expect relief within few hours / one day usually upload angry reviews about both “no effect” and side effect” commonly.

12. Declining demands for admission. Investigations and OPD treatments are not covered by most insurance companies, so some patients demand admission even when not indicated. When refused, even if the patient was cured, the doctor still gets a negative review.

13. Google masters: Some patients bring a lot of irrelevant questions and conceptually wrong use of medical terms to the doctor’s table, and however politely one declines to waste time over such, a negative review is almost guaranteed. © Dr. Rajas Deshpande.

14. Habitual negative reviewers: I once found a negative review of a patient who had actually responded well to treatment and was cured. He had complained about having to pay for a follow up visit after few weeks. A small google search revealed that he had uploaded many reviews from those about railway stations to collector’s office, from autorickshaws to five star hotels, almost all negative. Unhappy man!

12. Professional Competitors- this is a new reality: doctors hiring agencies to boost their positive reviews and add negative reviews to their competition. The simple fact check of how many positive reviews over how much time reveals the truth.

Some negative reviews are indeed genuine, I have had them myself, and called and apologised to the patient, clarified my stand too. However when they were malicious, I have informed the concerned site manager and also posted a reply about reality.

How to know?

A negative review must have a legitimate name of the person writing it, and details of date and time of the visit. That way the doctor can also confirm whether it is genuine and help resolve it. A nameless review is always questionable, good or bad.

In a recent news, a National restaurant association has decided to sue people who upload negative reviews about food: just because they want more or free, just because of their mindset is negative, just because they are insatiable. Even IMA should consider suing people who upload wrong, defamatory, spiteful reviews about doctors. Even the ‘hired good reviews’ by doctors should be discouraged.

Issued in the best interests of patients and doctors.

© Dr. Rajas Deshpande

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The Beautiful Secret

©️Dr. Rajas Deshpande

“I found her outside the public toilets near sassoon hospital” the lady said almost as a whisper after her daughter left the room. “She does not know. Nobody knows. Please don’t tell her ever”.

That 15 year old girl Teju was brought to me over 10 years ago, with uncontrolled fits. Not all fits / seizures are convulsions, there are many different types. Teju would suddenly behave abnormally without knowing it for a few minutes and then start crying. Her studies were affected as she had such episodes many times a day. She had been to some excellent doctors, but as she did not tolerate the medicines she had stopped them and refused to go to a doctor. Her mother Latha had somehow convinced her to meet a neurologist only once, so they were here.

Latha was a single, middle aged lady, who worked at a few homes all through the day mostly as a cook. Her husband had died long ago, and she barely managed to maintain her livelihood while living with Teju in a chawl. She narrated Teju’s history to me, but when I asked about parents having any fits or other neurological illness, Latha winked at me and said “No, I am okay, even her father was okay”. Then she asked Teju to get her a bottle of water from the canteen, and just as Teju closed the door behind herself, stunned me with her words: “I found Teju outside the public lavatory near sassoon hospital . She does not know. Nobody knows. Please don’t tell her ever”.

Then she explained in a hurry: “Doctor, you are like a brother, I will not lie to you. I had run away to marry my husband, but he was an alcoholic. He died in a road accident. I had no one left in life, and wanted to die myself. One night I was returning home from my job, and went to the public toilet on the way. There in a large heap of waste I saw this girl, only a few weeks old, almost dead. I took her to a doctor, told she was my sister’s daughter, and got her treated. Then I could not think of letting her go, I had found my purpose in life. I am a good cook and get by with salary from cooking at over 5 homes now. I want her to study well, but this epilepsy has been our curse now. I wish I was rich so I could treat her well”.

That last sentence hurt me. One, she was rich. Two, she thought good treatment needs one to be rich.

Teju had reentered, so we changed topic. I explained Teju her diagnosis in medical, scientific terms, and the reasons why this illness happens, how we can control it with the right medicines, and how her quality of life will be far better if her fits were controlled. “You will be able to look after yourself and even your mom well in the future if you are self sufficient” I used the trump card. She agreed to take treatment.

“Secondly, never worry about fees. You are a free case now onwards. You can even get discounted medicines at some pharmacies”. I told them addresses. Latha hesitated: “Doctor, we will pay, we don’t want to take advantage. We don’t want you to hush up because we don’t pay”. Their concern was genuine, and I assured them that I will do my best for them. No good doctor will turn away a treatable patient for want of money, I know many who treat poor patients free, unfortunately it never comes on record.

That was long ago. We were able to control Teju’s fits in a few weeks, and bring her drugs to a single dose of medicine. She followed up every six months regularly, each time with her mother. She gew up well, and always topped her class.

Only last month, she came alone.

“Doctor, I have a good news. I have been selected by a software giant in the USA. They have offered me a gorgeous salary too. I am leaving in a week’s time. I have come to tell you two things: first, please take care of my mother for a year, I am planning to take her with me to USA after that. Secondly, I can now pay the fees for both myself and my mom. I am rich now! So please tell your receptionist to make a bill for all my consultations till now.”

I laughed and congratulated her. “Well. I have promised your mom something, I will sort out about the fees issue later with her. As for her medical care, don’t worry I am here. I am glad you are taking her with you, many can’t”.

“Oh never! I can’t dream of leaving mom alone here. She has grown me up alone after my dad died. I know how hard she has worked for her daughter” shesaid, with wet eyes.

I had an emotional moment, a sudden urge to tell Teju the truth. But I refrained. This indeed was the truth now. Latha was Teju’s mom, and I had no right to change that. I regained my composure.

When she touched my feet, she asked “Do you want anything from the USA doc?”

“Thank you, I have everything I want with God’s grace” I told her the truth. Indeed, He had given me the ability to change lives positively, to contribute to humanity in innumerable ways, to help people live better lives, nay – the best lives they could. What more could I ask for?

©️Dr. Rajas Deshpande

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True Story, names changed.

The Fairy And The Prince

© Dr. Rajas Deshpande

The beautiful radiant lady wheeled in the patient’s chair and wished me with a pleasant smile. Some smiles, however beautiful, have a tragic shade. I looked at the patient Rohan. A very well built fair young man in his late twenties, must have been very handsome in the past. He sat paralysed below the shoulders, one eye closed, face twisted, and a large surgical scar upon his head, partially covered by a cap. He could not speak. Any movement would cause violent tremors. He was wheelchair bound and had to be assisted even for toilet.

Rohan and Riya had married just two years ago, against the wish of their parents. Both from very affluent, but uneducated families. Both worked at the same office. In a few months after marriage, Rohan had developed high blood pressure, and was advised treatment. Unfortunately, he got carried away with some false claims about some herbal medicines shown on National Television channels and stopped the BP medicines. The obvious happened: one of the blood vessels in his brain ruptured due to high BP, and there was a huge bleeding. A Neurosurgeon had done an excellent job by taking this high-risk case on operation table in emergency, to suck out the blood clots and save his life. However, the damage was already done by then, much of his brain was damaged on one side. Riya had been caring for him since then. She looked after him just as a mother cares for her newborn.

“Doctor, we know his paralysis will not improve now. But he is brilliant, I know his brain thinks fast and accurate. Since this stroke he cannot speak. We have come with some hope for his speech. If he could just tell me what he feels, if something is bothering him, what he wants, etc., I will be very grateful” his wife said.

We started treatment. In a few days, Rohan could speak legibly, so she was very happy. Rohan’s parents were very happy too. © Dr. Rajas Deshpande

One day, Riya’s father came with her. He asked her to wait outside my room for a few minutes, she reluctantly left. With folded hands and tears, he spoke: “Doctor sahab, my daughter married against our wish. I have forgiven her now. But I cannot see her spending her life like this. She was the most brilliant girl in our town, she had even rejected job offers to go to America because Rohan wanted to stay in India. You can see that she is still young and beautiful. Anyone will marry her; she is one in a million. I’m not saying this because she is my daughter, but you can see for yourself from how she cares for her husband. She has become his attendant now. What is her fault? How can a father see his daughter wasting away her youth like this? They have no family life. I cannot even speak to her about this. Her mother tried but Riya refused to speak. She speaks very highly of you, so I have come with this hope. Please help us”.

This was very difficult, but a duty too. If not me, who could even attempt to resolve this?

“Let us ask her about her thoughts” I told her father and requested him not to react when she spoke. We called her in. I told her in short how her father felt. She sat straight. Her face became distorted and she wept silently. Her father kept on patting her while weeping himself.

“Papa, when Rohan could recently speak after so many months, the first thing he told me was to leave him and marry someone else. He refused to eat his medicines, saying that I should leave him. Then I promised him that I will leave him after two years. That was a lie. I know he will die if I leave. I could feel his love even when he could not speak, that’s something more precious to me than whatever you think I will get if I marry someone else. Till the day he had this bleeding in the brain, he made sure I was best taken care of. He never had his food before me. How can I spend even one happy moment with anyone else knowing that Rohan is suffering in this same world? Would you be proud of me if I did that? Did you teach me to be so selfish?” She broke down. © Dr. Rajas Deshpande. Her father did not say anything. They left.

In a few weeks, Rohan followed up again with Riya. He is now gradually learning to operate a computer. He plans to start his own online business. Riya is helping him do that, while continuing to work. They are now planning for a child soon.

This fairy I met was more beautiful than any other in the dreamy stories I had heard all through my childhood. I am glad that I am a witness to this divine fairytale.

I know even of another couple, where the girl had developed a paralysis in her college days. I had counselled her and her boyfriend about future uncertainties and a possibility of a compromised married life, given her illness. “That’s not the most important thing for us” he had said. They married. Today, about 8 years since then, they have a healthy, happy kid, and he still cares for her as much, now when she is in a wheelchair. This knight lives in a rented house, runs a small grocery store, rides a bicycle, wears the simplest of clothes, yet has a heart that would put to shame many a real princes!

My world as a doctor is full of beautiful fairies and knights, named caretakers. It is because of them that thousands of patients are surviving with dignity today. Medical care is so incomplete without them! I remember my favourite author Richard Bach’s words from “The Bridge Across Forever”: “Princesses, Knights, Enchantments and Dragons, Mystery and Adventure… not only are they here and now, they’re all that EVER lived on earth!” How true!! © Dr. Rajas Deshpande.

Among the stories of sadness and suffering, most doctors also come across best of the human hearts and minds, highest forms of love and care. Such patients and relatives reinforce our own trust and faith in the ability of human efforts to heal. Thanks to what I learn from my patients, my gratitude for being a doctor is endless!

© Dr. Rajas Deshpande

Dedicated to all caretakers, young and old, who silently sacrifice much of their life caring for their loved ones.

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Quit Quit

© Dr. Rajas Deshpande

In the first year of medical school / MBBS, I had a heart break. It made me feel like quitting medicine as I did not feel like going to the same class again. I started bunking classes, spending a lot of time in a small book house which allowed you to read books without having to buy them. Costly coffee shops were not a fashion then. The phase lasted for about three months, till a professor (God bless him!) who knew me informed my parents when I bunked his class. A lot of firing, two tight slaps by mummy dearest, and I was back on track. I had hated that professor for some time and did not talk to my parents for the firing for a few days.

Towards the end of second year I got so engrossed with philosophy, poetry and study of different religious texts from various religions, that I was convinced I wanted to give up medicine and be a philosopher, author. I attended college but my mind was too occupied to concentrate. It was then that I came across a professor who was very brilliant and approachable. He told me to just ‘sail through’ and let the storms in my mind settle. “Teenagers like you must learn to tame the fires within” he said it wisely. I carried on.

Motivation to me is a myth. Some have it within themselves, some don’t. One who needs motivation keeps needing it all the time. I will do something else better maybe, but then I will have quit medicine. Over a period of time I learnt that no one succeeds by being half hearted. I don’t want to leave an unfinished task behind me. I didn’t want to be a quitter.

Then onwards I did fairly well and secured my MD seat. But a crueller test was written for my future.

I joined DM Neurology course in Mumbai. In a few days I had a terrible non-academic argument with one of the professors and was told to get out. Hurt, I left Mumbai and came to Pune. My sister had a rented flat, I stayed with her and mostly roamed alone, usually sitting and musing in a local garden Sambhaji Park. Grew a beard and a belly. I was ashamed to go back to my parents because I did not want to face them with an “I Can’t”.

A few days later, my father called. “Start the next thing today. Quit or don’t quit, but don’t waste time. Any decision in life should not take more than a few seconds to make. You only have to listen to your heart. Take a step, if wrong, correct it. Don’t hover”. © Dr. Rajas Deshpande.

I had desperately wanted to be a Neurology DM. That’s what my heart resounded. I joined back the next day. Since then, I have always made this rule for myself: never to prolong any decision making about my own life. It does not take more than a few peaceful seconds to listen to your heart and act upon it. The moment you allow others to choose for you, you create a mess. There are sometimes great sacrifices involved, one must give up a lot to pursue the path of the heart. But it is the most rewarding path to pursue. There’s nothing money can buy for an unhappy heart, so the choice of money over what your heart truly craves is always a mistake. © Dr. Rajas Deshpande.

There were times when I was angry and upset with parents, teachers, others who meant well and told me I was wrong. Looking back at what life has given me, I regret that. They too did not know the future like me, but they had deep faith in what I could achieve. Their anger, advice and reprimands came with the purest intentions of making my life the best it can be. Today when I have achieved more than what I set out to, I crave for one opportunity to meet each one of them and express my heartfelt gratitude towards them.

Medicine is gruelling. It is not for the weak hearted. Study for decades amongst a culture of corruption, socio-politically motivated decisions, unfair competitions, pathetic living conditions, and then face the tears, sickness, frustrations, accusations, deaths and ungrateful wrath of multitudes for all your life. But it is also the only profession which allows one human to literally take away pain, suffering and death from another. It is the only vocation that brings one closest to the highest form of human achievement: saving lives, easing pain, curing diseases. © Dr. Rajas Deshpande.

Many medical students as well as doctors at different stages in their career feel like quitting. I just want to remind them: one saved life, one smiling patient defeats all other negatives about this profession. You are the ONLY ONE who can make this possible. Others may or may not recognise this, it is for yourself. This is the best gift you can give yourself: the ability to save life.

It is the tendency to hover upon indecision, confusion and delay that one must quit. Quit the choice to quit. Life’s too beautiful to waste time when your heart always knows where to go.

In the memory of my father Dr. Kalidas Deshpande, on his birth anniversary (Ganesh Chaturthi).

© Dr. Rajas Deshpande

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A big salute to this extraordinary benchmark of values in medical profession.

On 4th August due to rain havoc and release of dam waters there was unprecedented flooding in some areas of Pune. Unfortunately this flooded the new Jupiter hospital in Baner, jeopardising the lives of a hundred patients including critical, and even a tribal baby who had had a heart transplant. Within minutes the hospital authorities reacted with an efficiency comparable only to a military task force. The staff, doctors and nurses worked in coordination to shift every patient to other hospitals in Pune, other hospitals too graciously accommodated them on an emergency basis.

It is extraordinary that Jupiter Hospital not only arranged for a safe transfer of every patient, they sent doctors and nurses with each patient to help them settle in another hospital.

Every bill for every shifted patient till their discharge from other hospitals was paid by Jupiter hospital, not a single rupee had to be paid by the patient. The entire staff and doctors stood by this effort, some offered their salaries of next six months to help this task. The administration very politely declined to accept this, and continued to care for each of their doctors and staff even when the hospital had to be shut down for nearly a week.

As the hospital reopens completely recovered from the damage caused by the calamity, I salute this extraordinary phenomenon which should be hailed by every person with their heart in the right place.

Congratulations Dr. Ajay and Dr. Ankit Thakkar for setting this fabulous example of humanity.