“Do you want a broken leg, Doctor?”
© Dr. Rajas Deshpande
Three days after he suffered a paralysis, after having tried Voo Doo, Herbal and some other medicines, an old man of 80 was shifted to a big private hospital once he became comatose. The three sons accompanying him didn’t even touch the comatose patient, they didn’t even care about whether he was covered properly or not.
His Blood Pressure was too high, and he turned out to have a bleeding in the brain, untreated till this moment. His brain was swollen badly.
Every private hospital has free mandatory beds for poor patients. This family was asked about their preference and eligibility. © Dr. Rajas Deshpande
“We will pay everything. Don’t worry about the money. He should get the best room and facilities” his son said. They signed the necessary documents about knowing the critical condition of the patient, charging schedules, willingness to pay etc.
Then the sons came to me and said “We don’t care about the money, doctor, but he should get completely cured”.
This was expected, experience teaches a doctor about relatives as much as about patients.
“He is 80 years old and critical. At this stage I cannot guarantee anything. Complete recovery looks impossible, partial recovery may be hoped for if he responds well to standard treatment” I replied.
“But we will pay anything you want” the younger son said.
I involved the PRO, a lady who had far better patience than myself dealing with attitude and arrogance. Explained them once again, and left after the patient was shifted to our Neuro Intensive Care Unit. © Dr. Rajas Deshpande
The patient improved in five days. Started to speak a few relevant words. Out of danger, shifted to Deluxe Room as requested. The only person who ever attended the patient was a 15 year old grandson, mostly the patient was left alone.
The sons had by then submitted some documents claiming a BPL “Below Poverty Line” status, but those were found to be false. A fake letter in the name of charity commissioner was also attempted. The hospital PRO reminded the patient’s sons about the pending bills regularly.
It became clear that none of the three sons who earned well themselves wanted to pay for their father’s treatment. They had continuous fights amongst themselves, the only thing they agreed upon was not wanting their father. The request “He must get completely cured” was not because they wanted his health, but because no one wanted to take home a disabled father to care for years.
The hospital took a stern stand. The bills had exceeded two lacs rupees, nothing was paid. This indeed was burglary with blackmail.
After repeatedly asking to meet the patient’s sons for another three days who did not pick up the hospital calls, I told the attending boy very carefully to please remind his parents to settle the pending bills, also reminding him that nothing in the treatment will wait or change because of bills.
In two hours I received a call. It was a local Municipal Councilor.
“Doctor, do you want a broken leg? Are you a doctor or a businessman? How can you speak about money to a small boy? Just keep on treating. We will do something about the bills through our MLA. If you speak about bills again, remember, there will be news about your hospital on every channel”.
Do I have time, energy to waste, filing a police complaint? Will it be any use at all? © Dr. Rajas Deshpande
In no other industry, not even in govt. offices, will anyone be given anything on credit: even for a paper worth five rupees. Even the poorest of the poor cannot get free food or travel in private industry. But the entire private medical care is expected to go on working in ‘credit’ mode, for everyone who claims to be poor. Emergency is understood, and no hospital or doctor thinks about money in case of emergency. But once emergency is over, those who cannot afford a private hospital should go to a government hospital. A private hospital needs too much investment per bed, and anyone who questions this can please sponsor one bed in any ICU for a poor patient, see for themselves what the actuals cost.
Who will even address this Burglary and Blackmail that happens everyday in every private hospital in India?
There should be an online portal by government / police for doctors and hospitals to report patients dumped by family, families who refuse to pay, those who use threats and intimidation anonymously. Then the ‘other side’ of this story will be clear.
© Dr. Rajas Deshpande
© Dr. Rajas Deshpande
“Code Blue” someone shouted.
There were sounds of rushing, muffled sobs and wails, metal trolleys banging walls and glass syringes being broken open.
He rushed fastest, asked the relatives to wait outside.
“What’s wrong with him?” insisted the patient’s brother on knowing.
“His heart has stopped. Please wait out we don’t have time”.
The nurses had positioned the patient and started the CPR.
The ugliest sound in the world: the desperate rocking of the bed during a cardiac massage, was heard outside the cabin. The high pitch beeps of the defibrillator followed by the thuds of a body due to the electric shock initiated prayers even in the hearts of strangers. The relatives of other patients in the ICU waited outside their cabins, watching the faces of those who were crying. Those who could not bear the sight went inside their cabins. © Dr. Rajas Deshpande
He went on doing the CPR, knowing that the patient was young, and may still respond. The risk of this highly fatal disease to himself and the nursing staff was taken for granted: there is no time to “dress up” for CPR. He was simultaneously ordering the injections to be given. A male nurse took turns and helped him with the cardiac massage.
It is exhausting. Giddy after some time, he looked at the watch. It was about half an hour since the event. Almost nil chances now. He asked the nurse to continue, and came out to inform the relatives.
“He has had a cardiac arrest. We are trying, but it looks difficult” he informed the patient’s brother.
“Why? How come?” the brother shouted as the rest of the family gathered. © Dr. Rajas Deshpande
“We have been informing you many times. He has been critical. His lungs were not functioning well, his brain has many TB tumors, and his kidneys have been shut due to infection for a long time. It is called multiorgan failure”.
“We don’t know all that, doctor. Save him” said the brother.
Young patient. Fever since over three months. Avoided seeing allopaths for over a month. Diagnosed as multidrug resistant tuberculosis, one of the worst and most difficult diseases to treat. By the time they reached the proper specialist through all the “money saving” channels, it was too late. Almost all Government Hospitals have experts and facilities to treat MDR TB, but somehow people think it is below their dignity to avail of services at Govt hospitals.
The ICU doctor came out after a while. “We are sorry, he could not be revived” he sadly told the relatives.
Then there was a shriek, as the patient’s brother held the doctor by his collar, and slapped him. Exactly the style of Akshay Kumar from some movie. A lady doctor tried to stop the brother, but was held by the women in the family and bestowed with blows and abuses. The security, who had allowed the relatives on humanitarian grounds, regretted it, and desperately tried to control the relatives. © Dr. Rajas Deshpande
In an hour, they all left.
He washed himself. There was no time to cry, complain, register a case or go to TV channels or press. There were 22 other critical patients in the ICU, and he was in charge. He had to forgive, forget, digest it all. And then there was a perpetual expectation of the society to “understand” the misbehavior of the bereaved.
In a few minutes, another gasping patient came in on the same bed. A young girl with continuous convulsions. He rushed and intubated her, stabilised her. He talked to and pacified her panicked parents. © Dr. Rajas Deshpande
He had forgotten the slaps, the abuses and the blows he received a few moments ago. Like filmstars who slap qualified doctors on the screen and earn crores for that “entertainment”, he did not deserve a palatial bungalow and luxury cars, but as a life saver who saved hundreds every year, he was doomed to an asylum walled by expectations, criticism, abuse and overwork. Saving lives was “just a duty” not deserving respect or rewards.
The stress that comes from handling daily CPRs, saving lives and declaring deaths for years together cannot be acted by any of the Tom Dick Harrys on screen. Most of them are not even intellectually equipped to perceive the education, hard work and traumatizing effects of daily deaths and allegations that a critical care doctor faces.
While exceptionally literate and mature film personalities like Mr. Amitabh Bachchan and Ms. Lata Mangeshkar have always praised the doctors and spoken highly respectfully about them, most other “Muttonshop” artists have only exemplified their own jealousy about the highly educated doctors, trying to show them down one way or another.
I know of some friends who spend a sad, spoilt day even when they see a funeral passing by. The doctor has to face it every day, still carry on dealing with money savers, skimpy, arrogant, abusive and violent relatives reaching the hospital at the last moment. He has to garner a calm and control possible only with great effort. This tells upon the doctor’s mental and physical health. Being blamed and held responsible for someone’s death (this has become rampant now: to presume that all deaths are someone’s fault) in spite of trying hard to save them is something no film star, judge or minister will ever understand. Very few doctors are able to enjoy a genuinely stress free happiness in their personal life.
Of all the doctors suffering today because of the illiteracy, poverty and defective policy-making in India, the critical care and casualty doctors are the worst sufferers. My heartfelt tear and salute to their unending suffering for humanity. Also a strong appeal to the press, law authorities and the government to ensure that these highly stressed doctors are not assaulted, unnecessarily criticized or abused.
Just imagine a world without casualties or Intensive care services. That is a choice which doctors still retain.
© Dr. Rajas Deshpande