Tag Archives: law

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

Carefully calculating the dose and mixing it with the intravenous fluid with precision, I told the kind old lady: “I am starting the medicine drip now. If you feel anything unpleasant, please tell me.”

Through her pain, she smiled in reply. Her son, my lecturer Dr. SK, stood beside us and reassured her too. He had to leave for the OPD, there already was a rush today. “Please take care of her and call me if you feel anything is wrong” he said and left.

Dr. SK’s mom was advised chemotherapy of a cancer. It was quite difficult to calculate its doses and prepare the right concentration for the intravenous drip. Just a month ago, my guide Dr. Pradeep (PY) Muley had taught me how to accurately prepare and administer it, so when Dr. SK’s mom was admitted, he requested me to do it for her too.

The drip started. After a few hours, I noticed that her urine bag needed emptying. The ‘mausi’ supposed to do it was already out for some work. Any resident doctor in India naturally replaces whoever is absent. So I wore gloves, requested a bucket from the nurse, and emptied the urobag into it. Just as I carried the bucket with urine towards the ward bathrooms, Dr. SK returned, and offered to carry it himself, but I told him it was okay and went on to keep the bucket near the bathroom where the ‘mausi’ would later clean it. © Dr Rajas Deshpande

Once the drip was over, Dr. SK invited me for a tea at a small stall outside the campus. He appeared disturbed. He said awkwardly: “Listen, please don’t misunderstand, but when I saw you carrying my mother’s urine in the bucket, I was amazed. You are a Brahmin, right? When you were away, my mom even scolded me why I allowed you to do it, she felt it was embarrassing, as we hail from the Bahujan community. I am myself a leader of our association, as you already know”.

I knew it, to be honest. His was a feared name in most circles.He was a kindly but aggressive leader of their community, but always ready to help anyone from any caste or religion, to stand by anyone oppressed, especially from the poor and discriminated backgrounds.

“I didn’t think of it Sir! She is a patient, besides that she’s your mother, and I am your student, it is my duty to do whatever is necessary. Otherwise too, my parents have always insisted that I never entertain any such differences”. I replied. © Dr Rajas Deshpande

“That’s okay, but I admit my prejudice about you has changed,” he said. “If you ever face any trouble, consider me your elder brother and let me know if I can do anything for you”. What an honest, courageous admission! Unless every Indian who thinks he / she is superior or different than any other Indian actually faces the hateful racist in the West who ill-treats them both as “browns or blacks”, they will never understand the pain of discrimination!

As fate would have it, in a few months, I had an argument with a professor about some posting. The professor then called me and said “So long as I am an examiner, don’t expect to pass your MD exams.”

I was quite worried. My parents were waiting for me to finish PG and finally start life near them, I already had a few months old son, and our financial status wasn’t robust. I could not afford to waste six months. © Dr Rajas Deshpande

I went to Dr. SK. He asked all details. Then he came with me to the threatening professor. He first asked me to apologise to the professor for having argued, which I did. Then he told the professor: “Rajas is my younger brother. Please don’t threaten him ever. Pass him if he deserves, fail him if he performs poor. But don’t fail him if he performs well. I will ask other examiners”.

The professor then told me that he had threatened me “in a fit of rage”, and it was all over.

With the grace of God, good teachers and hard work, I did pass my MD in first attempt. When I went to touch his feet, Dr. SK took me to his mom, who showered her loving blessings upon me once again, and gifted me a Hundred rupee note from her secret pouch. © Dr Rajas Deshpande

Like most other students, I’ve had friends from all social folds at all times in school and colleges. I had excellent relations with the leaders of Dr. Babasaheb Ambedkar Association, and twice in my life they have jumped in to help me in my fight against injustice when everyone else had refused. I love the most fierce weapon of all that Dr. Babasaheb Ambedkar himself carried: the fountain pen!

No amount of fights will ever resolve any problems between any two communities, the only way forward is to respectfully walk together and find solutions. Fortunately, no doctor, even in India, thinks about any patient in the terms of their religion or caste. (© Dr Rajas Deshpande). Just like the Judge in the court premises, humanity is the single supreme authority in any medical premises. Blood or heart, brain or breathing are not exclusive to any religion or community. Just like the bigger brain, a bigger heart is also the sign of evolution.

I so much wish that the black clouds of disharmony between different communities are forever gone. The only hope is that our students can open any doors and break any walls, so long as they do not grow up into egoistic stiffs. © Dr Rajas Deshpande

I am proud to belong to the medical cult of those who never entertain any discrimination. A patient’s blessing has no coloured flags attached! Even outside my profession, I deeply believe that the very God I pray exists in every single human being I meet. If at all anyone asks me, I am happy to say that:

My religion, my caste and my duty as a doctor are all one: Humanity first!

© Dr Rajas Deshpande

Neurologist

Pune

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Homoglobin

Homoglobin

© Dr. Rajas Deshpande

“How much is your experience, doc? Have you ever seen any cases like this?” she asked. She was accompanying her father who had Parkinson’s Disease, quite common all over the world.

Many hilarious and abrasive retorts came to my mind:

‘Do you ask such questions about the pilot or driver when you board a plane or bus? , Do you ask such questions when someone absolutely inexperienced is made a minister of important portfolios like health, defence, environment etc.?’ If you can have faith in them, why cannot you trust your qualified doctor?© Dr. Rajas Deshpande

However, being on the doctor’s side of the table, I could not allow myself losing patience so easily. I chose the most professional answer, forcing a smile: “I am practicing since 25 years, over 15 as a Neurologist, and I have seen over two lac thirty thousand patients till now. Almost every Neurologist sees an average of 30-40 patients per day”.

When the rural / illiterate populace asks these questions innocently, I am never offended, but if it is the literate suspicious kind who treat manners and etiquette as an ‘optional’ part of communicating with the doctor, I feel just like when someone spills my ice-cream. It is difficult to connect with a paranoid literate, however hard one tries.

Apparently satisfied with my experience, she shot her next google bullet: “Can this happen because of his low Homoglobin? I read it on a blog.”

“The correct term is Hemoglobin”, I told her, “and its low level does not cause Parkinson’s”.

It was over 45 minutes since they entered, I had replied to every point on the question paper that they had prepared from a Googlesearch syllabus. The next patient must be already angry now, I thought.© Dr. Rajas Deshpande

“How can you be so sure that this is Parkinson’s Disease? What’s the proof?” Fired she.

“There are many diseases where there are no proofs of diagnosis, some can be proven, most are based upon the doctor’s clinical judgement. Sometimes quite costly tests are required to prove what is an obvious diagnosis. You are welcome to obtain a second opinion” I replied.

“Can his Parkinson’s be the side effect of the knee surgery done eight years ago?” She.

“No” me.

I now issued a DNR (Do Not Resuscitate) order for my gasping patience.

Most doctors know the simplified versions of how to explain the patient in layman language about the common diseases/ disorders. Every type of case requires a lot of reading and actual handling / treating to gain insights about that condition, something that is impossible to explain exactly to the patient / relative, especially because they do not know the basic concepts, organs, their functions etc. What even the brilliant medical students take repeated readings and many case studies to understand well, cannot be simplified enough to explain to all and sundry.© Dr. Rajas Deshpande

Add to this: every patient even with the same diagnosis is different, needs an individualised approach, and no google guidelines or statistics can replace the doctor’s wisdom in making a treatment decision especially in complicated cases. To make the most accurate decision and to explain it is a doctor’s duty, but the understanding quotient of the patient or relative cannot be the doctor’s responsibility. Medicine is so complicated, that even the most experienced doctor in the world cannot say he knows everything about any single medical condition.

The more you attempt to educate some literates, the deeper in a quicksand you enter. Because they are not satisfied with the fact that the doctor is making the best effort to educate, but look upon this as an opportunity to question the knowledge and wisdom of the very expert whose opinion they are there to seek!

They try and catch words and cross question as if it is a legal argument.

“You said swelling: show me where is the swelling?” most common question.

“Well, it is called Inflammation in medical language, there is no accurate translation for that word even in Hindi, hence we commonly use the word swelling. It may not be a visible swelling”.© Dr. Rajas Deshpande

It is not always the fault of doctor’s ability to communicate, it is often the over-expectation that one can understand everything. It is laughable that even those some whose life is a mess, who are failures in their own chosen paths try and argue about medical diagnosis and decisions with highly qualified doctors.

However profound a doctor I may think I am, there are so many things I do not understand: politics, finances, many people’s behaviour, mathematics, government, etc., and I am ok without ith not understanding most. However I do not have the audacity to ask an expert in these fields / professor / CA whether he / she has enough experience.

But with a doctor, these liberties are becoming rampant now.

“I think he has convulsions because of his spondylosis” one halfpant+crocs combo tried to punch a new hole in my knowledge recently.

“Let me decide that” was all I replied, rather than explaining how he was beyond wrong.

The shorter you keep it, the sweeter it remains. I would rather save and use my time for those worried, panicked patients who have enough faith in my abilities, who understand mutual respect, and who will have at least this insight: that the doctor knows best how to treat patients.© Dr. Rajas Deshpande

Of course I am aware that there are some doctors too, who initiate rude conversations, do not respect simple etiquettes, and are quite difficult to connect to. Most patients even when offended by rude doctors, kindly choose not to react although they carry home a bitter feeling. Every medical student, every doctor must be taught in the earliest parts of internship about the code of etiquette and mutual respect while dealing with any patient, and only then expect the patient to follow it too.

Coming back to this lady, I wrapped up the session by telling them to follow up after a month.

“Can he continue to take his three large pegs of rum every night? He cannot sleep otherwise” she asked.

“In my 25 years of practice, I haven’t met anyone whose health improved with alcohol. Do please google that.” I gave her the dose she had begged for.

© Dr. Rajas Deshpande

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“I Swear”

I Swear
© Dr. Rajas Deshpande
 
“Have you forgotten your oath, doctor?” asked the Hon’ble minister to Dr. Prasad.
 
The fat elderly reporter accompanying the Hon’ble minister laughed. “We must teach these doctors a lesson” he said.
Being a doctor, good language and behavior is essential. So Dr. Prasad swallowed the immediate reaction that had sprung to the tip of his tongue, one that involved references to some passionate human interaction.
 
He then smiled.
“Sir, did you attend any school?” he asked the Hon’ble minister innocently.
The Hon’ble minister was offended. He had not had a respectable academic record. © Dr. Rajas Deshpande
“What does that mean? Do you know who you are talking to?” the accompanying reporter raised his voice.
“Yes, I know I am talking to a patient. A human being with the same organs as me, but not the same merit or intentions” said Dr. Prasad.
 
Before the cunning reporter and the Hon’ble minister could formulate a reply, Dr. Prasad continued:
“Sir, all over India, for ten years, everyone who has attended any school has recited every morning, the National Pledge. That is our promise to our beloved nation. Let me remind you of some sentences in that prayer:
I shall give my parents, teachers and all elders respect and treat everyone with courtesy.
To my country and my people, I pledge my devotion.
In their well being and prosperity alone lies my happiness.
Tell me Sir, are all politicians, ministers, media persons, businessmen, lawyers, and other professionals following this oath that they have recited every day for ten years? If yes, where does violence come from? Not only in hospitals, but in every other home, against children, against womenfolk, against even the elderly”.© Dr. Rajas Deshpande
 
“But you are a doctor, you have taken an oath to serve” said the defiant Hon’ble, expert in the art of diverting discussions.
 
“No, Sir”, replied Dr. Prasad firmly, “I have not taken any oath to tolerate violence or abuse, or to risk my own life or limb. I have not taken any oath to feed with my blood and sweat the deficient and perpetually corrupt healthcare systems. I have not taken any oath to be nice and kind to attacking, drunk, abusive or irresponsible people who enter the hospital with an almost dead patient at the last moment and then expect the doctor to perform miracles. I have never taken any oath to treat Judges and Ministers and Rich VIPs above the poor, really deserving patients. I have not promised anyone that I will neglect my family or my own health”.
 
“I have only taken an oath to honestly treat the sick with dignity, not thinking about money. That most doctors do, some who fail are common in every field. My oath is to help a patient recover. If I fail, try me in a court of law. Send me to a court that understands law better, and appeals people not to be violent, tells governments to protect everyone against violence, rather than asking doctors to tolerate violence as a part of their duty. It is exactly as backward as like asking a wife to tolerate her husband’s atrocities as a part of her duties”. © Dr. Rajas Deshpande
 
The restless tail barked again: “But the public pays for your education”
 
“I beg to differ, sir. No one is obliging anyone by paying for doctor’s education. The country needs many more thousand doctors. And we pay taxes too, to be protected. People pay taxes for a good and cheap healthcare system, please give them that, rather than them having to depend upon private hospitals. A doctor is just a small component in healthcare. Don’t blame him for expecting the same protection that every citizen expects. The infrastructure and policies are pathetic, and an intelligent taxpayer will one day understand that the doctors are not taking home any money as their alms. Everyone knows who gets richer with taxpayer’s money, Certainly not the doctors”.
 
“As for your allegation, respected reporter sir” said Dr. Prasad calmly to the tail, “You are educated, you have a responsibility to heal social ills, not widen the bleeding wounds and survive on that flowing blood. There are so many good examples of reporters / media persons who bring immense good to our society. The ability to sit in one’s chamber with all controls, and bark at everyone, manipulate speech cunningly, distort facts pretending to be holier than others, while your seat is dipped in hidden honey is not reporting”.© Dr. Rajas Deshpande
 
“Doctor, you have too much ego” said the angry Hon’ble.
 
“No sir, intolerance to stupidity is not ego. Every religious ceremony, every professional oath makes us repeat the good we must do, including a minister’s oath of office. . Very few actually do it, but everyone thinks it is only the doctor who must follow his oath” said Dr. Prasad.
 
He then checked the Hon’ble Minister and wrote him a prescription that included weight reduction and abstinence from alcohol.
 
Without a Thank You or a payment, the powerful duo left.
 
“I swear” said Dr. Prasad, smiling to himself, “I will never give them the joy of taking it lying down”.
 
That is the basic oath of every self respecting human being.
 
Jai Hind
© Dr. Rajas Deshpande
 
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The Lawful Massacres

The Lawful Massacres
© Dr. Rajas Deshpande

“Doctor, my brother has kidney failure, he is awaiting a kidney transplant. but the waiting list is too long, he has very less time and his health is fluctuating. We cannot afford to treat him out of India. We can pay some money if any donor is ready to donate a kidney. Please save his life, doctor, I will be your slave all my life.. What can we do?” the elder brother was begging and crying at the same time. His 28 years old highly educated younger brother is his only blood relation alive. The elder brother himself has renal compromise at an early stage.

“I am sorry. Indian Law does not allow us any other options”. I felt ashamed of what was happening. I wanted to add “Unless you are in power, unless you are stinking rich and have heavy pulls through many corridors, unless our society so eloquent about criticizing doctor’s intentions learns to come forward to donate organs, you are doomed to a long wait for any transplant”.
In fact, you are more likely to be the one among the three that die every day in India while awaiting an organ transplant. That is over a thousand human deaths every year. More like a massacre.

Because the law is always correct, it saves money, it saves against corruption, and it saves against a few wrong practices. This sacrifice of a thousand lives a year is just a small price to pay!

We are so very much against the word ‘corruption’ and the projected legal correctness of any system, that like the blinded goddess of justice, we refuse to see beyond what is the literal meaning of the law. Whether it is correct, whether it is causing more harm than benefit, and whether it discriminates (usually the rich and the powerful from poor) is something we are not allowed to think. Nor the judiciary probably. © Dr. Rajas Deshpande

Whether it is the action against some great kidney transplant surgeons that made them quit the profession and stop all transplant work, whether it is the “Kidney Racket” headlines on TV channels or in newspapers, the medical profession is already presumed guilty, and everyone seems to derive a pervert pleasure from doctor bashing, some even from within the profession. Yes there are unsuccessful, fame seeking doctors who are jealous of doctors who earn more and have a good name in their field, and most bitter losers like to point out only the bad side of the monumental achievements of such successful doctors: that the transplant teams in India have saved millions of lives of the rich and poor alike by developing transplant surgeries and performing them in a resourceless, supportless, poor country ridden with corruption is a deliberately hidden fact.

There of course are corrupt doctors as in every other profession, but one cannot blindly close all hotels because some didn’t serve good food!

Most of our society looks upon any medical money transaction over three hundred rupees (for anything) as corruption. In a country teeming with people who prefer to eat and drink an unhealthy excess and die early (while many die of malnutrition), for a country where there have to be laws for wearing a helmet, many take it upon themselves to criticise other professions without thinking.

We need many lacs of organ donors for the many dying patients awaiting transplants. We see extremely few organ donors. The only interpretation: “I don’t want to donate organs, I don’t want to help save lives, I will only criticise those who are trying to save lives by closely watching where they cross the law line, and then bash, arrest, defame, try and punish them. © Dr. Rajas Deshpande

The government must seriously reconsider the laws about organ transplant. There must be a freedom to at least donate a kidney for someone one knows, and if the recipient wants to compensate for it, it must be allowed. This can all be documented and supervised by a legal team so as to avoid forceful / illegal sale of human organs. One can also consider the possibility of a rich recipient compulsorily paying for a poor recipients’ transplant surgery, if he / she is allowed to legally ‘buy’ a kidney. That way two lives will be saved. If I sound Utopian, so was everyone who thought that the world deserves to be a better place.

The legal correctness of each transplant should be mandatorily okayed by a judge, and if something is legally wrong, it is that judge who should face the consequences. This is because doctors/ other transplant professionals cannot always interpret all laws correctly, and innocent mistakes are then blown up / misinterpreted as deliberate attempts to kill patients. © Dr. Rajas Deshpande

While the rich and powerful get their kidneys and livers fast and safe in and out of India through the similar rackets that have thrown innocent doctors into jails, it is the poor who are left to die awaiting a transplant: because the government set ups have limited facilities and resources, and the private set ups have to do it at a higher cost to safeguard innovation, technology, investment and skilled personnel. But the only highlighted aspect is the money earned by the hospital or the doctor, not the immense effort and saving of hundreds of lives. Ask hundreds of poor patients whom the transplant teams have saved, whether their doctors worked for money.

Those who choose to differ with this opinion are welcome, provided they answer this question: If your brother, son, daughter or you yourself are awaiting an organ transplant under the approaching shadow of death at a young age (God Forbid), will you choose to be legally correct and prefer to die or explore all options including illegal to survive?

As a doctor, it is very difficult to say “As per law, you must wait even if you die”.

© Dr. Rajas Deshpande

PS: These are the sincere feelings of a doctor’s soul tortured by the plight of those awaiting death thanks to the legal tangles and social apathy about organ donation. I do not support any illegal practices, but I do not also presume that all laws are perfectly correct. There is a lot of scope for improvement, and each waiting day costs us three preventable deaths. Jai Hind.

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Wrong Doctor, Wrong Punishments

Wrong doctor, Wrong Punishments
© Dr. Rajas Deshpande

“There are many wrong things going on in our profession, and I insist that you must write about them too. Working at a tertiary care center, I see many patients wrongly investigated and treated” my senior professor said on phone last week.
I did not argue. He was correct. He is one of the most brilliant and dedicated superspecialists I know, and I consider myself fortunate that I studied and worked under him. I just explained to him that my page was dedicated to highlight the good side of this profession, as there are umpteen critics but rare sources that speak about the good.
“But we must evolve. It is known that we are humans and there will be mistakes. Many patients die due to medical mistakes too. If we are open about the mistakes, even the law takes a lenient view. Most of the hospitals stand by the doctor if the mistake is honestly reported in time. Many patients understand that too” he said. © Dr. Rajas Deshpande

I disagreed with him then, but as I worship his acumen, I decided to meditate about this.

Yes there undoubtedly are cases we see almost every day, wrongly investigated and treated. Underqualified, wrongly qualified and even unqualified doctors treat patients according to the best of their knowledge, but unfortunately intention alone is not enough to treat a patient correctly. Political support ensures the safety and proliferation of such practices. Although we all know the basic managements, the patient is not then offered the best.

That apart, sometimes, treatable illnesses are missed just because some general practitioners/ paraclinical practitioners/ crossover practitioners who think they know everything never take a second opinion of an expert in the respective field. Many a times though, it is the patients who choose to stay with the least charging practitioner, never knowing their treatable conditions are worsening all the time that they think they are saving money. The practice of obtaining a second opinion is quite healthy and must be encouraged at all levels, although there are some patients dissatisfied with even the twentieth opinion.

Hospitals without the requisite expertise (qualified experts or technology) to treat certain category of patients and conditions often freely admit any patient and treat based upon incompletes skill and resources (under the legal protection of emergency treatment clause). So long as it is cheap, the patient seldom questions treatment. Once they are referred to the higher center, the trust level sinks as bills increase. © Dr. Rajas Deshpande

This often results in a treatable condition worsening to a stage of untreatable emergency. All the anger against this is usually borne by the last doctor / hospital treating the patient and trying to help in their most difficult situation.The non availability of enough staff at many government-run set-ups is never questioned.

Let us consider that a doctor or a hospital has committed a mistake, and the hospital wants to honestly report it to the patient and apologise, then to legally compensate the patient.
It will be wild daydreaming if anyone thinks that our society is presently mature to handle this.

In India, a doctor is presumed guilty of almost every death or failure of improvement in patient’s health. Even a patient who has abused his / her body, not followed any healthcare instructions (smoking, drinking, diet, exercise, reducing work and stress etc., not taking medicines as advised and self treatment) still thinks he is qualified enough to blame the entire medical profession for his / her failing health.
Relatives who have never bothered to know if the patient took his / her meals or medicine in time, procrastinate taking the patient for timely check-ups suddenly become “google qualified lawyers against healthcare system” once something goes wrong. © Dr. Rajas Deshpande

Blatant advertisements of “complete health check up” including hundreds of unnecessary tests are seen everywhere, and the word “concession or free” is probably the sexiest lure in healthcare industry today. Here, the patients or relatives do not mind their blood being drawn, being exposed to unnecessary radiation, or being charged for unnecessary tests just because it is all cheap / concessional. There are umpteen examples where the patient google searches about symptoms, gets the blood tests, MRI and many other unnecessary tests, and then visits a qualified specialist.

Only the qualified doctor advising the necessary tests is labelled an unholy, profitmaking business.

Suppose the doctor declares his / her mistake. Who guarantees that it will be investigated in secrecy, only legally tried by a qualified team of medically updated judges, and if at all the doctor is guilty, then the legal punishment alone will be implemented, guarding the security and the reputation of such a doctor? In a country where the media as well as judiciary is often tainted, how safe is it for a doctor to honestly admit his / her mistake? © Dr. Rajas Deshpande

In a single day, the media will bring down the entire practice of alleged doctors and a reputation hard earned over decades . The mobs with different lawless communities will vandalise their hospitals. The police is unable to always stand by truth, given the influences that gag and tie them. The judiciary will come in later at a time when the doctor’s life will be scarred and damaged beyond repair. Not everyone among the doctors is expected to have a shameless mind structure to go on despite disrepute. Corporate hospitals very easily disown doctors if their reputation is threatened.

Just as there cannot be any compensation of a lost life, there also is no compensation for a doctor’s lost reputation. A doctor’s reputation is his professional life. So long as the society does not offer protection from mobs, media and wrongful allegations in expectation of free / cheap but accurate scientific healthcare, the doctor will never feel safe enough to come out with his / her mistake.

A trial with ensured privacy and security, guarded information to the media in correct format accepted by the court, and very strict guidelines about proceedings in such cases will alone help doctors come out in open about their own mistakes, and also against the malpractices in their own profession.

Till then, we are all at the mercy of the maturity of our politicians, media and society.
© Dr. Rajas Deshpande

Milord, please don’t try this Medicine!

MLH

An old saying “The young man knows the rules, but the old man knows the exceptions” seems to keep our judicial officers forever young. The following article is not for a comparison between doctors and legal professionals (my best friend is a lawyer, and I owe much of my reasoning and tea bills to him).

Not always while learning could we understand or agree with some decisions made by our seniors, as they either contrasted with the “textbook” instructions, or were never mentioned anywhere, it was the sheer genius and practical experience of those seniors that often saved lives. Such risks were almost always well calculated against the risk of death, and discussed with patient’s relatives whenever they had a capacity to understand (rare). We have never seen a doctor working / acting with the intention of “causing harm” to the patient.

There are often (not at all rare) situations when even two of the world’s best authorities do not agree upon some medical issue. This is beyond the “average IQ” people to comprehend, as they can only understand the most simplified. It is not because of a clash of egos, but a tie between two dead ends.

This is why medical definitions and management guidelines change very frequently. This is why every practicing doctor becomes a criminal, having ‘bypassed’ some guideline somewhere in his / her career for doing good to the patient who did not fit in the medical definition or was not mentioned in the textbooks.

It takes @ 6 years to become basic allopathic doctor, and @ 15 years to become a medical specialist. Only half of this training is in the books, remaining half is the actual experience of dealing with the thousands of complicated medical problems and learning to untangle the situation by an extremely difficult decision making. But we see some specialists do very well as compared to others, and to presume it is only because they “cut-practice” is intellectual poverty! Most doctors who do well do so because of their exceptional abilities in their field, especially in this society with such a bias against doctors as a class!

Legal training does not include medical knowledge and reasoning, it usually deals with crimes like rapes, sexual aberrances, poisonings and murders. Beyond that, a lawyer would have to make a special effort to learn from prior judgments about the precedents set mostly in the western world. To apply these to Indian medical practice is humorous. We have a legal system which has many differences from the western: be it relationships, marriages, sex, rapes, political crimes or homosexuality. In most of these the judges quote “Indian Culture and difference in society”. Separate laws and courts have evolved where industries and money was concerned. Military conducts its own trials / court martial.

But the most intellectually complicated field dealing with human life is left out to be handled by people who may be very good in law, but have little or no knowledge of the intricacies involved in handling a complicated medical case. Most of the judges and lawyers, with due respect, would lack the basic knowledge about the “unpredictability” of various medical treatments, procedures and clinical outcomes, despite best medical brains involved in their use.

Summarily, doctors are as law-dumb as those not doctors are medical-dumb. To allow anyone except medical professionals to either make laws or to try doctors in courts that have had no medical training or acumen (which, incidentally takes years of day & night training in hospitals) is like asking an MBBS doctor to analyse and decide about the decisions of a Supreme court judge. We are so mentally enslaved to the ancient British system, that we have to rise and salute the authority of every judge because they are so “highly placed” socially, legally and ethically (then what are all the criminals doing out in the society and different governments?) that a doctor who deals with human life, saves hundreds for all his life has to beg them with folded hands. Beg to understand that he / she was trying to save a human life, and they will decide the merit based upon their puny medical knowledge, which is unchallengeable!

Laws practiced today were mostly made over 100 years ago. Medical science changes daily. Only the sane and solid minds will sense the paradox here. We need separate Medical courts. Thousands dying due to incorrect political decisions and accidents do not receive even pebbles as compensation despite knocking the doors of all courts, but a single inadvertent medical mistake is punished with 12 crores compensation, a lifetime income beyond 95% doctors in our country!

Yes. Doctors should not have to stand in regular courts begging mercy for trying to do good. We must have medical courts, with special judges who have adequate (atleast MBBS level) knowledge about human body, and are also trained as well in law. Only a multidisciplinary panel of young and old doctors and legal experts can properly analyse the merits or otherwise of a medical case. Or the MCI should conduct qualifying examinations for Judges who conduct medicolegal cases, or train them with experts from various superspecialties about basic principles of a Doctor’s approach to complicated medical issues. Also about the non-medical issues that kill a patient (delay in admission, addictions, health neglect, non compliance with advised tests / treatment, neglect by family etc.) which never appear in legal discussions of negligence cases.

Come on. I have immense respect about the Judiciary and its abilities, I have immense faith in its intentions. However, being a doctor, I cannot harbor superstitions or blind faith. I DO NOT believe that the regular Judges or doctors will understand all that happens in a spaceship travelling to the Mars, only the astronauts can understand those intricacies.  I do not believe that anyone who has not composed the same music as Mozart or Tchaikovsy or AR Rehman or Ilayaraja should criticize them.

The present tradition of any court trying medical cases can only be equated to the legal system punishing an acclaimed singer for singing a wrong note! Unfortunately, as this profession concerns life, the “Wrong Note” or “Bigda Sur” can result in health complications. But then to completely avoid it, one must stop singing.

This is why most new generation Indian Doctors are leaving India. Not that there are better Judges outside, but better payments for the frustration involved!

If not anything else, my dear and most respectable Milord, Sir, please understand the dire necessity of a  “DURESS FREE DOCTOR” the society deserves.

© Dr. Rajas Deshpande
Picture courtesy medicolegal literature help http://www.invohealth.com with thanks.