Tag Archives: Infection

A Medico’s Last Certificate

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© Dr. Rajas Deshpande

A continuous beeping filled up the air in the ICU. Over twenty hearts kept making rhythmic sounds, the nurses kept on silencing the false alarms that rung every now and then, and informing us about the ones that needed attention.

We had kept the cake in the doctor’s room, we were waiting for the right moment. It was well past midnight, we had all wished Dr. Steve a happy birthday, but the ICU was full and busy, we waited for an opportunity to cut the cake.

A very old Parsi man, just recovering from a massive heart attack, was not maintaining his blood pressure. As his alarm sounded again, we rushed to attend him: Dr. Steve, myself and our nurse Ms. Divya. As we adjusted his intravenous drips, he asked us our names. He was funny, and always made us smile in spite of the deadly shadows that surrounded us. When we told our names, he smiled. “See, there’s a Hindu, a Christian and a Parsi happy in this small 10 by 10 room, but they cannot all stay peacefully outside in this big country!” .. Dr. Steve, always interested in one-upmanship, smiled and said, “If you want, we also have a Muslim and a Sikh doctor outside. Shall I call them in?”

With the typical instant Parsi wits, the old man replied “Arrey no no bawa, all our ********** (I did not completely understand that word) political leaders will die if people from all religions come together”.

It was difficult to say whether we were treating his heart attack or he was treating out tired minds. © Dr. Rajas Deshpande

The CMO called, there was a new patient coming up, a young lady in respiratory failure due to pneumonia. As the nurses prepared the new bed, Dr. Steve took down notes from the CMO. Ms. Divya was one of our most efficient and agile staff nurse. Very beautiful and brilliant, she took responsibility upon herself with a passion that would put to shame even some doctors. We all knew that there was something going on between her and Dr. Steve, but both of them kept mum. I knew for sure though, because Dr. Steve had once confided to me about this crush he had upon her. However, overwork always suffocates personal life in a hospital.

The stretcher rolled in, noisy with calls of panic. The patient was gasping. Urgently shifting her on the ICU bed, Dr. Steve intubated her. She coughed a lot, and both Dr. Steve and Ms. Divya were showered with blood stained secretions. Dr. Steve had his mask on, but Ms. Divya had not had the time to put hers on. He angrily shouted at her, while adjusting the patient’s tube, to wear her mask. I finished securing the IV line, and started pushing in the emergency medicines. © Dr. Rajas Deshpande

The patient was a young lady, who had suddenly developed fever, cough and cold. On the second day she had become restless, was admitted in some nearby hospital, but as she continued to worsen in spite of treatment, she was referred to us. It was a viral pneumonia, an extremely invasive and dangerous viral infection had started filling up her lungs with fluid and blood. Just as her oxygen levels improved, she developed an irregular heart rhythm: viral infections often cause severe damage to the heart, a condition called myocarditis. In two hours after admission, the lady died. Horrible moments followed, telling her broken husband and stunned kids that she was gone forever. Completing the formalities and paperwork, we returned to the grind: we were medicos: there’s no choice for us to sit down, panic, repent, mourn or run away.

No one was now in a mood to cut the cake. No one even spoke about it. Next night, Ms. Divya bought another cake, and we all silently wished Dr. Steve a belated Happy Birthday.

Jutst ten days later Ms. Divya developed fever, cough and cold. The same deadly virus, most likely. We all panicked. Dr. Steve took leave and attended her, as her family was far away in Kerala. She had come to Mumbai to earn enough for her family. In spite of all efforts, Ms. Divya passed away in just three days. The faces of her elderly parents and younger brother became one of the worst memory-scars in our lives. Shortly after, Dr. Steve developed the symptoms too, but survived.

I took him out sometimes, to bring him back from the pit of depression and shock that he had sunken in. One evening, when we sat silently on Marine Drive, he said, “I will never have a Happy Birthday again. You know, Divya’s family has no support at all. I have decided to help them out for some time, till we find an alternative”. © Dr. Rajas Deshpande

Staring at the ocean, I kept wondering: In this country, where crores of rupees are thrown almost every other day for even miniscule achievements in cricket and cinema, where millions are spent from public funds upon the useless travel, security, meetings and social dinners etc. luxuries of the super-rich MLAs and MPs, where billions are spent by every political party in elections, there are no funds for the nurses, doctors and other staff who risk or lose their lives serving their patients. If a bridge collapses and many die, if there’s a major accident due to lapses in administration, there is immediate compensation, in an attempt to seal complaining lips. But if a medico is injured or killed, the best thing our society has to say is: “This is because all doctors work for money, it must be the fault of communication on the doctors part!”

We walked that whole night, along the ocean, silently crying. Sometimes the only solace for a medico is the thought that someday someone will desperately need a good doctor or a good nurse, and not find them around. Many medicos who do extraordinary good to their patients do not get any certificates for what they do. Most don’t care. Because we carry our death certificates in our pockets every day. One last certificate that we work very hard for.

© Dr. Rajas Deshpande

Dedicated to the nurses and doctors, medical staff who suffered / died because they served patients, saving lives.

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MEDICARDIA: A Doctor’s Diagnosis.

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© Dr. Rajas Deshpande

Rimless spects, ipad, T-Shirt and denims. Brilliant face, thinning hair. Attitude. A face carefully wiped off of any expression. The typical new age intellectual waited outside the ICU. Body language: severe anxiety.

“Doctor, do whatever you must, his convulsions must stop” said Mr. Prasad. His father was having continuous fits for over three hours, he was just admitted directly in the ICU after all the home remedies had failed. His oxygen levels had dropped to dangerous levels. Patient had ready aspirated during his convulsions. His food had regurgitated and entered his windpipe.

The last treatment for continued fits is completely paralysing the patient with general anesthesia, intubating and starting artificial respiration with a ventilator. There is risk, but lesser than if the patient continues to have fits. Every doctor, for every patient, must make a decision based upon the risk-benefit ratio. Every treatment, medicine or surgery, also has potential risks. The decision that can potentially cause someone’s death is not easy to make. Every doctor lives on the edge of this risk.
Add distrust and suspicion, and we are dealing with law more than with medicine. Welcome to the medico nightmares! © Dr. Rajas Deshpande

The critical care team had already explained the risk to the Mr. Prasad. He had signed the consent, including understanding of the critical condition. We intubated the patient and ventilator was started. The fits stopped. A chest physician was also involved in the treatment. Monitoring of the brain waves still showed abnormal currents in his brain, so he was kept paralysed next two days.

On the third day, the patient developed fever, most likely he had developed a chest infection, so common after aspiration. His condition worsened, his blood pressure dropped. We informed the family.

“Why didn’t you prevent this?” asked Mr. Prasad.
“Sir, have you ever had any cough, cold, fever?” I asked.
“Yes, many times. What has that to do with my father’s infection?“ he replied.
“Why couldn’t you prevent it?” I asked, “Anyone can develop an infection or a heart attack anywhere outside the hospital and it is ok, but if it happens inside a hospital, why does it suddenly become a doctor’s fault? Hospital acquired infections are possible in spite of all precautions, in the best of the hospitals across the globe. The elderly population is especially more prone for infections.”
This being a routine question, there was no reason for me to lose my patience. © Dr. Rajas Deshpande

Our team worked hard to maintain the unconscious patient alive. His heart rate fluctuated, blood pressure dipped to non-recordable sometimes, blood sugars went high, liver and kidney functions were deranged, but we kept on playing the “Medical Chess”, where one doesn’t know what move nature will make next, the only possible next step is to accurately, promptly and wisely counter that complication.

His lungs started failing, the chest physician advised steroids. At this stage steroids could either be life saving, or could cause havoc by worsening the infection. Mr. Prasad was explained the situation.

“What are the chances of survival and complete recovery?” he asked.
“Unpredictable, Sir” I replied.
“Then why use steroids?” he asked.
“If we don’t, the chances are less than if we do”. I replied.

Steroids were added. The patient stabilised and then started improving gradually. Over next five days there was a dramatic recovery. Steroids were stopped.. Mr. Prasad remained expressionless, questioning every move. Three days later, once he started breathing by himself, the ICU team informed me that the patient could be extubated- the tube for ventilation could be taken out. I was in the OPD, I okayed the decision.

In a few minutes, Mr. Prasad rushed into my OPD.
“Doc, my father cannot speak. He has lost voice”. He was quite angry and anxious.

“Let me check” I said and went to the ICU.
The patient was otherwise fine. The throat tube inserted for ventilation sometimes causes swelling in the throat, involving the vocal cords, and such “hoarseness” or loss of voice is common after this procedure. Using steroids facilitates recovery, but in this case, it was now risky to use steroids. We explained the situation to Mr. Prasad. © Dr. Rajas Deshpande

“When will he recover from this?” he asked.
“Usually two weeks, but still one cannot say exactly” I replied.

“Why didn’t you tell this to us earlier? This is atrocious. I will file a complaint. We will go to the court. My friend is a reporter. I will also write on social media about this, that because of the treatment here my father lost his voice” he started shouting.

He did file a complaint with the hospital. Everything was on paper, everything was medically and legally correct. Still the administration must ask me questions and I must reply. Many long emails and documentations followed. One reporter called and enquired about the case, I explained her the situation.

I didn’t sleep well those five nights. Medicolegally we were safe, but who was to deal with the media allegations, the resultant defamation, irresponsible hurtful comments by every TDH on the social media?.

The patient was still under my care. I saw him daily, he was making good recovery. His voice became normal in next three days. He was shifted to the wards and then discharged. He was advised to continue anticonvulsant medicines. Mr. Prasad did not say a goodbye, didn’t write a feedback, he didn’t withdraw his complaint. They just disappeared, and did not follow up. I kept on dealing with the paperwork for a few days even after discharge. I still had a thin bleeding layer of patience left. © Dr. Rajas Deshpande

About a month later, at late night, I got a call from the casualty. The same patient was convulsing. Mr. Prasad had requested to call me.

He revealed that after the discharge he had searched for ‘the best’ neurologists in India, took his father to two of them, and was advised to continue exactly what we had advised. Then he researched internet, found an “ancient remedy” for epilepsy rediscovered recently by a famous baba, that guaranteed complete cure. They had stopped the anticonvulsants advised by me three days ago, as the Baba’s site blasted all modern medicine and the dangerous effects of allopathic drugs.

My remaining patience was destroyed, However, the patient was my first responsibility. I advised the treatment, we intubated the patient and started ventilation again.

“What are the chances, Sir?” asked the rimless eyes with expressionless face.

“We have started with the emergency treatment, the patient will be shifted to the ICU. I cannot accept this case, please admit your father under another specialist” I said. © Dr. Rajas Deshpande

“Look doc, I am sorry if you felt bad about last time. We paid full bills and we will pay again, we have mediclaim. I want you to treat him” he said.

“I don’t work for the mediclaim companies. You cannot pay me for the damage you caused to my peace of mind, the waste of time you caused by writing falsified complaints. You cannot pay me for the sleepless nights because of your threats” I told him.

His face changed. Panic appeared on that expressionless face. He folded hands. There were tears in his eyes. “Doc, I am sorry. I got carried away by what people say about modern doctors. I will do whatever you want. Please save him. I promise I will immediately write an apology to the hospital ”.

Needless to say, a doctor’s heart has many hard scars, but it is the easiest to melt. It did, once again!

© Dr. Rajas Deshpande

Real experience, some facts changed to mask identity.
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Pune Mirror : Pak Patient Improves, Shows Cognitive signs

PAK PATIENT IMPROVES, SHOWS COGNITIVE SIGNS

Pak patient improves, shows cognitive signs
Sajal with her parents and her doctor, Rajas Deshpande, from Ruby Hall Clinic (PIC:MAHENDRA KOLHE)

DOCS SEE SUCCESS IN CEREBRAL PALSY TREATMENT

Rare case of 7-yr-old had several complications and drug resistance that had to be overcome

A seven-year-old Pakistani girl born with cerebral palsy has been successfully treated by city doctors — despite severe infection and an umpteen number of complications —in nothing short of a medical miracle. Not only was she cured, she also started showing signs of cognitive abilities.

A group of doctors from Ruby Hall Clinic treated the girl, named Sajal, last week. She had been brought to the hospital with glossitis, laryngitis, pharyngitis, pulmonary aspiration, bacterial infection, urinary infection, skin rashes and severe sepsis. Timely medical intervention helped treat all these problems even though the child was resistant to several antibiotics. “This made it even more challenging for us to control her infections and treat her thoroughly,” said Dr Rajas Deshpande, head of neurology, Ruby Hall Clinic, adding, “The child came to us with seven to eight types of issues. It was very difficult for us to treat her. But, with the right antibiotics, we managed to ease the severity of her condition. Now, she is all set to fly back home.” He was helped by Dr Ventaramani and Dr Bamkin Amin in the case.

Sajal’s mother, Shahzia, offered, “Sajal suffered from many complications and was not even able to pass urine or stool for three to four days in a row. We were not able to feed her or admit her to any hospital in Pakistan as many doctors turned us away, looking at her complications, saying there were no chances of improvement. That is why we came running to Pune and got her admitted at once. Sajal’s mouth had a lot of rashes, her lips were torn. No cream or gel given to us in Pakistan would heal her tearing lips. The infection was severe and kept spreading. Within three days of coming here, my child showed signs of improvement. Now, after six days, we are flying back to Pakistan.”

This is not her first visit to India; she has made several visits to treat her daughter’s cerebral palsy. “In the last few years, we took her to many countries, from Germany to Europe and Holland. But, no doctor was willing to take up her case. They said our child could never recover. Sajal had several fits and epileptic attacks in a day and a number of allergies and resistance to drugs. She was in a totally vegetative state. After coming to Pune, she began recognising voices, especially mine and my husband’s, reacting to light and also to her siblings. Now, there is more than 20 per cent improvement in her condition,” Shahzia added. She was told that no drugs for epilepsy or cerebral palsy were available in Pakistan.

“If the epileptic attacks of such patients are controlled well, learning or recognising people or voices can get easier. In Sajal’s case, we controlled her fits and her brain showed improvement. Strong antibiotics and antiepileptic drugs were given to her. And now, Sajal has improved by more than 20 per cent,” Deshpande stressed.

Other prominent doctors hailed the judicious treatment, with Dr Hemant Sant, president of the Neurological Society of Pune, saying, “A single infection is commonly spotted, but many infections coupled with complications is uncommon. Such cases are very challenging and a moment’s delay can prove life threatening.” Dr Sushil Patkar, a neurosurgeon from Poona Hospital and Research Centre, added, “Children born with this condition are very difficult to deal with. So, one has to be careful when they get infections. They need constant attention and care. Controlling seizures and convulsions should be the main aim to better the child’s condition.”

Dr Nirmal Surya, regional vice president of the World Federation of Neurorehabilitation and treasurer of the Indian Academy of Neurology, also brought out some ground realities. “Many a times, due to lack of hygiene or low immunity, children do get infections, but severe complication in one of them is usually not reported. With stronger antibiotics, such infections can be controlled and managed well, if the patient is brought in early. More important are rehabilitation, regular physiotherapy and proper diet, which can help boost the immunity for such special children,” he explained.

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This story was published in Pune Mirror today.

Thank you Dr. Bankim Amin, Dr. VenkatRamani, Pediatric resident doctors (Dr. Upendra, Dr. Tanvi Priya, Dr. Abhijit Kudale, Dr. Supriya Takle, Dr. Radhika Gupta,Dr. Suyog Choudhary, Dr Smita Sangade), Nursing and ward staff, Overseas care staff and so many others who made this possible.

Doctors always make one world, without any borders.
We all treat everyone alike, God / Nature decides about the outcome.
We were blessed with some smiles recently.

The miraculous recovery from infections and cognitive improvement in this girl is also due to the unending effort and sacrifice of her parents, who did not “Dump” the extremely challenged girl child as advised by relatives and society, but gave her the life of a princess, breaking umpteen impossible barriers that stood between her and the medical aid anywhere in the world.

Every parent has boundless love for their child, but these two parents have made her health their career.

May every child be blessed with such parents!

Thank you Ms Nozia Sayyed (Pune Mirror) for your dedicated awareness initiative, and Mr. Mahendra Kolhe (Pune Mirror) for the picture!

The Lawless Side of Medicine

The Lawless Side of Medicine
© Dr. Rajas Deshpande

A well educated businessman driving in his car with his family had an accident. He had some bleeding wounds, but was fully conscious and alert after the accident. A few young college-going students stopped to help, picked him up, hailed an autorickshaw and took him to the hospital. The patient’s wife and child followed in another.The junior surgical and orthopedic residents examined the patient, stitched his bleeding wounds and started medicines. The wardboys and other staff carried the patient to the CT scanner, and shifted him to the casualty after the scan. Patient’s wife accompanied him throughout. When the senior surgeon came over and asked the details of his prior health status, the patient requested privacy and revealed that he had recently been diagnosed with HIV infection, and was taking some traditional medicine for that. Atleast 4 College students, the autorickshaw driver, and 2 wardboys had been exposed to direct contact with his blood by then. The treating doctors had their gloves on, but not the complete gear expected to be worn while treating such patients. He himself or his wife had not cared to tell helping hands to protect themselves.
There are many blood-borne diseases, some fatal and some dangerous. While the courts merrily write orders about help to the victim (which is must), no one cares about the risk to the helper’s life while executing such help. No court has ever ordered the government to make Universal precaution gear mandatory in hospitals, especially govt hospitals where thousands of budding doctors, nurses, wardboys, techs are exposed to blood contact daily, without knowing the infective status of the patient. No court has ever ordered the govt to implement precautionary measures to avoid accidents, drunk driving, or emergency roadside assistance. People can drink, drive reckless, cause accidents, govt can do away with wrong licencing, zero roadside assistance, but everyone including the press will pounce upon the treating doctor for a bad outcome! No court ever questioned the authority which issued licence to a driver involved in traffic accidents!

Another. A lady of 60 brought to the casualty unconscious, with drunk “mob” led by her son. The son tells that she never had any health problem till that evening, when she had convulsions. They demand immediate admission in ICU and treatment, and declare that they have no money. The hospital obliges and admits her as a free patient as an emergency as per court rules. Next morning the recovered lady revealed: that she had had convulsions till few years ago, was advised regular medicine, but stopped it many months ago. She was also an alcohol addict and had taken alcohol on the prior night. On the day of convulsion, her husband had had a big showdown with her. Upon questioning the same son next day, he replied to the junior doc: “I never said she didn’t have any health problem, and you never asked if she was addicted to alcohol”. They also didn’t have the BPL card they claimed they had.

Fortunately she went home all well, but one shivers at the idea of what would have ensued had she not improved. Probably another cruelly beaten up doctor and voluptuous bad press against the medical fraternity in general.

It is the responsibility of the doctor to be good, perfect and true in everything he / she does. But if the whole action / decision making of this doctor is based upon what the patient tells, any lying / hiding of information by the patient is then likely to impair the outcome. To presume that all patients always tell the truth is a joke. Many hide addictions. Many hide stigma-illnesses like Tuberculosis, Epilepsy etc. Many hide that they were beaten up by a family member. Many do not tell their drunk status during accident (some traffic accident deaths for which the casualty doctors are so often beaten up by relatives may likely be related to the patient being drunk).

The most dangerous patients are those who have themselves or because of family pressure neglected the disease until the time it has reached a critical level, often beyond cure. When something happens to such patients in the hospital, our society is quite impressed with only an innocent sentence: “The patient was completely alright till admission”.

Some patients do not tell that they missed medicines. Some do not follow precautions. Some take additional herbal / traditional / quackery-born medicines along with the standard treatment, without revealing it. The entire responsibility of outcome in every case in any hospital is pinned down upon the treating doctor.

While compassion and the art of “extracting” the correct details are essential for every doctor, it is not mandatory for the patient to tell the complete truth. In this medicolegal age in a mostly illiterate, superstitious society, it is essential to educate people about telling the truth and taking precautions while helping others.

If you have an open wound / cut / injury over your own skin, please refrain from touching a bleeding patient. Avoid blood contact of any person unless you are in a position to save life by taking that risk. It is wise to keep a box of gloves in your car / four wheeler, or carry a pair in your purse / office bag for such an emergency.

While it is expected that every doctor, irrespective of how busy he / she is, writes detailed notes and prescriptions in capital letters for every patient, there is no responsibility assigned to the patient. If the patient is a consumer and the doctor liable for even tiny mistakes or unfavourable outcome, then the clinical-legal responsibility of patients must also be defined. It must be mandatory for every patient to write the details of their health, prior conditions, all medicines, etc. in legible handwriting and sign it with witness to submit to the doctor / hospital, before treatment is begun.

Many patients, educated or not, know this responsibility and carefully, truly detail the doc about everything asked for. They also mostly respect the outcomes. They usually do not blame others / doctor for either their illness or addiction-complications.

However, there is a surge now a days in “blame it all upon the medic or the hospital”. It is high time some wise judges recognize these issues before deliberating a judgement.

Till then, the Indian Medical Profession is at the mercy of press-interpretation.

© Dr. Rajas Deshpande
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Ban Bloody Everything. Why only Doctor’s Apron?

Apron

Recently there was a study saying that Doctor’s Aprons may (not definitely) spread infections. This inference is quite established and proven many years ago, and solutions for this have been discussed at length. One must congratulate that this is proven again in India. However, the news headlines “Ban the Doctors from wearing aprons” appeared today. This is being projected as a “Long Neglected Mistake” of Indian Medical Profession. There are enough doctor’s bodies and other organisations to take a call about this, every hospital also has an infection control policy.

Let us see what all the doctors use all through the day:
Their own clothes. Usually clean and ironed. Apron. Shoes and socks. Stethoscope, Hammer, Torch, Ophthalmoscope or other scopes required for bedside examination. (This is why even the pockets are specifically designed in a doctor’s apron). Disinfected clothes in the OT / procedure room.

The purpose of an apron is not only pride as wrongly projected. Most doctors see over 25 patients, some above a hundred every day. These patients have clothes which are wet / stained with blood, pus, snot, urine, faeces, and the doctor cannot examine patients from far away, without coming in contact with each patient. Many are brought in in an emergency, there is no time to clean the patient before examination. Then, sometimes a doctor has to rush from his OPD chamber to clean and dress a wound, to apply plasters, to start IV lines, all of these are known to cause stains very frequently, especially iodine. Imagine the OPD patient’s response to a doctor with his / her clothes all stained! In India, a consultant doctor also has to usually run through many hospitals every day.

So then, ideally a doctor should change his / her clothes after seeing every patient and wear a new pair of shoes. They should also shave their head as hair is a good storage for germs. After coming out of each ICU /CCU /NTU / PICU / SICU etc. units, every doctor should take a wash to prevent germs from being carried upon his / her person. A doctor visiting seven wards in a day should take a bath at least nine times, carry a wardrobe with those many pairs of clothes and shoes, and few extra sets for an emergency: because, seeing one patient and then seeing another with the same clothes on may spread germs!

Or they can wear plastic disposable aprons/ masks / gloves for each patient. In private sector, these accessories will be profit-billed to the patients (one set= @ 100 INR), as many times as they are used. So if four doctors will attend a patient in ICU, the patient will pay for four sets of plastic gowns. In a country like India where even basic medicines, equipment, wards, beds, lifesaving drugs are all short in almost all govt. hospitals, this will open up a whole new department of corruption, contracts for such disposable aprons, and waste upon pilferage .

Or, like most of us already do, doctors can wear aprons which are washed / sterilised every day, alternating pairs, changing / discarding whenever infectious exposure is strongly suspected.

While most private hospitals maintain extensive cleanliness and disinfection protocols, these are usually neglected in most charity / govt. set-ups, where extremely old, dilapidated buildings, and old broken beds, furniture, storage systems, computers, fans, plumbing, electric wiring etc. carry all sorts of infections and do spread it. The current “Ban everything that spreads infection” policy must then close down everything that can spread infection, including all hospitals in old buildings to prevent spread of infection.

Then ideally doctor must also wash the stethoscope etc. instruments after every patient. Or why use them at all? Just do all the tests where there is no physical contact with the patients, so no germs will be spread! Also, after every patient, all equipment like MRI machines etc. must be thoroughly cleaned at the patient’s expense. Doctors must also be banned from using any phones, as all phones carry more germs than the aprons. Let the emergency messages be sent via so many pigeons adoring the windows of almost all govt. hospitals!

Then again, the relatives thronging to meet every patient, holding hands with them, wiping their tears, nose etc., and bringing in billions of germs into the hospital. Please ban them all.

Spitting, public urination, tobacco and alcohol, toxic colours and sweets, roadside food, drugs, street violence, poverty, hunger, Malaria, Dengue openly kill thousands in India every day. But some newspapers printed this news as if the doctor’s aprons were the main killers in this country.

Tomorrow same study will be applied to all nurses’ and wardboy’s and porter’s dresses too. These staff members have far more physical contact with the patient than the doctor. We are a country severely deficient in healthcare, every hospital is flooded with patients, there are not enough nurses and doctors to attend only a single patient all day long. Do they all change disposable gowns for every time that they touch different patients? Will there be enough time? Will the patient pay? Will the govt. provide for it?

Medical students wear aprons for all these purposes and also for the discipline. Patient must be able to identify the doctor, and the doctor must be able to reach the patient in time in case of an emergency. Or there are innumerable instances of people posing as doctors and taking advantage of the patient. In an illiterate country, name tags / nameplates are not always read. Even during the worst epidemics of swine flu and bird flu, the govt. was unable to provide masks to medical students or many doctors. Will they provide disposable gowns to medical students?

In India, shameless staring at a woman’s body is like a ritual among most classes, and female doctors face too much of this embarrassment everyday while being busy with patients. Sometimes the apron helps them deal better with such groping eyes.

Please don’t give the people one more reason to hate the doctor, to think that the medical profession does not have a brain of its own, that people have to demand banning doctor’s aprons. I won’t be surprised if there are new regulations and arrests of doctors for wearing aprons, and litigations for spreading infections by wearing aprons. Just because some countries and systems are paranoid and populist, everyone else does not have to blindly imitate.

I know what exaggeration is. It is also the only way to combat the ridiculous. Fashion doesn’t suit a good doctor, any which way.
© Dr. Rajas Deshpande

PS: The study was necessary and its publication an excellent achievement. This article is about misrepresentation of facts by some.