Tag Archives: Malpractice

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

©️Dr. Rajas Deshpande

A hungry poor man named Atmaram went to a big hotel, had a nice big meal, and told he had no money to pay. He was beaten up and handed over to the police. He was released after a warning and a slap.

Next day he filled up petrol in his bike, and said he couldn’t pay. He was again beaten up, handed over to the police. Then he went to the medical shop, bought medicines and mineral water, ate the medicine, drank water from the bottle, and again said he couldn’t pay. He was now jailed for a week.

Next week his house was damaged by heavy rains, so he went and requested to be allowed to sleep in the house of the chief minister. He was arrested again, thrashed up.

As angry Atmaram shouted at the police, he was beaten up by them, another crime was added to his offences. In the court, Atmaram insulted the lawyers and judges and accused them of accepting bribes and charging too much. The judge punished him extra for his behaviour. Atmaram was angry and threw his shoe at the judge. His punishment was extended.

“You must respect the authority “ the court said.

“But I am poor, I need free food and petrol and medicines. I need sympathy too” Atmaram argued.

“You should have begged and applied for favours and eaten in places that provide charity meals. Petrol, however essential, has the same price for everyone. You can sleep on the footpath, and above all, you are not allowed rudeness and violence because you are poor and needy” The court said.©️Dr. Rajas Deshpande

When released from the jail, Atmaram drank a lot of desi alcohol, had an accident and fractured many bones. He went to the best private hospital, got operated and refused to pay his bills that crossed one lac rupees. When the hospital insisted, the operating doctors were beaten up by Atmaran’s relatives, the hospital was vandalised, the police arrested the doctor who saved Atmaram’s life, the government closed down the hospital, while the media and the society kept villainising the entire medical profession.

The headlines next day reported the sympathy expressed uniformly by wag addicted tongues: some said the entire profession was tainted, some blamed the greed of the doctors, even some doctors desperate for attention shed crocodile tears about the ethics in this profession. ©️Dr. Rajas Deshpande

In the courtroom, during the trial, Atmaram sat facing the doctor, still heavily bandaged.

The hon’ble judge, kind but surrounded by security, told the doctor accused of negligence and malpractice in the court: “You as a doctor carry more responsibility for ethical behaviour upon your shoulders. You should never turn away the poor”.

The doctor, defending himself, asked “but Milord, doesn’t our constitution insist on equality? Why do you yourself or ministers get security but not the doctor? Why isn’t everyone supposed to stick to ethics in every profession including politics, police and judiciary? Why are others exempt? How do you explain beating up of doctors while also saying that the society treated them like gods?”.

There were no answers. The kind court asked if the doctor had to say anything else in his own defence.

The doctor said

“Yes Milord, but the real answers will hurt:

Jealousy against medical professionals across society and many other professions is a reality. Why else will anyone who couldn’t qualify to become a doctor try and teach the qualified doctors what they should do?”©️Dr. Rajas Deshpande

“A culture of exploitation of non-votebank groups

and a complete failure of government healthcare with no one accepting responsibility is well known to everyone, but even judges have no courage to suo motu question this and correct it, even when they see the poor dying”. ©️Dr. Rajas Deshpande

“In a country with never ending poverty, how much free can a healthcare facility provide? For how long? This is already forcing closure of hospitals and exodus of good doctors out of the country.”©️Dr. Rajas Deshpande

“Milord, can you assure that every doctor will get his/ her fees as per his service to every patient, and if the patient can’t pay, that much charge will be exempted from the income tax of that doctor? How else do you except a doctor to meet his needs and dreams? Just because there are millions of poor patients, is the doctor’s life and hard work taken for granted? If there has to be financial sacrifice, why not have everyone contribute to it by creating a national health tax fund for treatment of poor patients? Why healthcare is subsidised only at the cost of a doctor?”

Just at this point, Atmaram, who sat in front of the judge, collapsed unconscious, almost blue black.

The shocked judge requested the doctor to examine him.

“He is no more” said the doctor.

“What could have happened ?” asked the kind but sweating judge.

The doctor told the court about three possible reasons. Two of them were scientific and medical: a sudden cardiac event or a large blood clot in the lungs common after fractures and trauma.

The third non-medical, unscientific cause made the Judge seriously ponder.©️Dr. Rajas Deshpande

“Will this court be now closed down, Milord? Will your efficiency be questioned, will you allow the relatives to attack you and understand their sad situation at the cost of your murder?”

“I understand what you mean” said the kind judge.

Needless to say, the doctor was released without a blame.

Can anyone please solve the mystery of the third non medical, unscientific possible cause of Atmaram’s death?

(C) Dr. Rajas Deshpande

Please share unedited

The Addiction of Bitching Allopathy

© Dr. Rajas Deshpande
“Allopathy is like a beautiful, gorgeous, much desired woman out of one’s league, you know. Those who do not get her keep raising questions about her character.” said Dr. Sen.
Dr. Sen is a specialist in heart diseases. Known for his witty and acid remarks with bitter accuracy, he was admired by a few who did not mind such remarks about themselves. Most others were scared of his sarcastic humour, and the weak minded hypocrites with bloated egos maintained a safe distance, lest he expose them.
My Bangla friends have always enriched my life with a class of academic excellence, superb literature, supergenius class films, exotic food and that sweet speech with the cute accent where even quarrels sound like speaking to an infant in a cradle! Of course one does not want to face an angry Babumoshai or his sister, for they can kill only with words. © Dr. Rajas Deshpande
A middle aged patient had come to Dr. Sen with many heart related complaints: breathlessness, fatigue, chest pain, palpitations and swollen feet. He was found to have heart pump failure. If the heart does not pump blood forwards correctly, the impure blood stagnates backwards. If not treated in time, this can turn fatal. This patient already had diabetes blood pressure, but for many months now had chosen to avoid allopathy for the fear of side effects. He had been through almost every other proven and fake pathy.
Dr. Sen gave him standard medicines, and asked him to return after two weeks. The patient came back after a month. He appeared near normal now. © Dr. Rajas Deshpande
“How are you now” asked Dr. Sen.
“I am feeling quite alright, doctor. Just after I visited you, I also went to Dharambaba’s ‘Health magic’ healing center. His medicine helped me immediately, I feel far better now. But I continued your medicine too. I have come to tell you that I want to stop your medicines now. I asked the assistant of Dharambaba, she told me I can continue the allopathic medicines along with their treatment”.
Dr. Sen removed his specs. He took his battle position.
“Do you know the contents or names of those medicines?” he asked the patient.
“No, but it is written that they have no side effects. The only problem is that they are very costly. Baba does not charge anything, he is divine and treats patients for charity. Even the western yoga is free, american yoga experts teach it at his center, I only had to buy their kit for clothes and music”.
The total that the patient spent there was more than five times the fees of the heart specialist, but the well qualified heart specialist was still “inferior” to the unqualified methods because he charged upfront! Not to count the expenses of some grievous side effects that the patient was going to face in the future, never knowing that they were related to some unknown medicines in the past.
And if the patient faces an emergency during such unknown treatment, it is not the Baba that they rush to, but the nearest allopathic casualty. It is not surprising that no medical negligence/ medicolegal cases are heard of about the umpteen existing alternative pathies in India!
The level of superstition and defamation that allopathy faces is only comparable to the torture of prophets and saints all their lifetime. © Dr. Rajas Deshpande
“I cannot tolerate any allopathic medicine” is one of the funniest and stupidest sentences a doctor gets to hear from some superstitious patients. Most doctors choose not to answer that.
Dr Sen flared up each time he heard this sentence: “This is like saying all computers are only used for pornography, and all smartphones for only sexts! Do you know how many medicines are there in allopathy? Do you know how they are studied? Just because you had some side effects to some medicines, don’t blame the entire science”.
Well, the least you can do if you do not believe in allopathy and do not tolerate medicines, is to not go to an allopath at all. Almost all allopaths are too overloaded to have to listen to superstitious analysis and criticism crap from those who aren’t even enough qualified to do so.. But if you do choose to visit and try allopathy, have enough sanity of intellect to not start any other pathy at the same time. Allopathy is so scientific that it has to mention the side effect of each medicine used. We cannot lie, hence we cannot compete with those who lie. Even minimal common sense tells us that many plant products are also poisonous, there are allergies to almost everything. How can someone claim an unknown medicine to have “no side effects?”© Dr. Rajas Deshpande
If your son / daughter is an engineer, try telling him / her about the rockets made a thousand years ago and listen to their response. Will you sit in a five thousand year old airplane flying upon faith and mental power? If yes, do not try allopathy. If you have a scientific mindset, you are the right person to benefit from a scientific medical practitioner.
Once a ruling party MLA came to visit Dr. Sen, with all his flaccid human paraphernalia. Very ill mannered, very obese, but his arrogance was the first worse thing to be noticed. Dr. Sen checked him up and wrote a prescription, explained him the condition, diet and precautions.
“You must visit Dharam baba once” said the MLA to Dr. Sen, “he cures so many patients of heart disease. You know, allopathy medicines have too many side effects. I am going to visit him soon.” © Dr. Rajas Deshpande
“Is it, Sir? Very good. Please stop my medicines when you start any others. These medicines are not to be taken with any other pathy medicines, there may be severe side effects. Please convey my Namaskar to Dharam baba”.
“When should I follow up with you again?” asked the MLA.
“Oh it is not required. Please continue the treatment under Dharam baba. In the rare event that you do not benefit from Dharam baba, try the famous Hakeem of Kanpur or the Vaid-Guruji in remote Maharashtra who cures everything by dropping some yellow liquid in your nose”.
“Doctor, you seem to be making fun of me” said the MLA.
“No, Sir”, replied Dr. Sen “You are making fun of your own health and life. You have no right to bitch what you do not understand”.
© Dr. Rajas Deshpande

The Morphine That Killed a Hospital

© Dr. Rajas Deshpande

“He fell down while checking the patient”, said the panicked Dr. Mrs. Sane about her husband, “and became unconscious”.

Dr. Sane tried to maintain his calm. A sick doctor has the curse of knowing the worst of everything, and has a perpetual feeling of sitting upon a ticking time-bomb. It was a sad feeling to see this middle aged brilliant general practitioner fighting tears.

“Sir, the OPD numbers have shot up because of these epidemics, especially dengue. I see over a hundred patients every day. The Inpatient beds are full. There are daily problems: medical, administrative and medico-legal.. those I am used to. But now there are too many politico-social and press-related issues that worry me”.

Dr. Deshmukh, a senior practitioner and a common friend, accompanied Dr. Sane. He cautiously poked him “You must tell the doctor what happened the day before”.
“Oh that’s a part of our profession” Dr. Sane replied.
I insisted that he must tell me.

Reluctantly, he disclosed: “Some goons came in with a municipal councillor and threatened to waive off the bills of a dengue patient. He was in the ICU for five days, quite bad, but went home walking. Till the time he improved, they kept on threatening us to break the hospital and thrash us if something went wrong. Upon discharge, they didn’t pay a single rupee. There’s nowhere to complain, as the hospital requires many municipal permissions”. © Dr. Rajas Deshpande

Dr. Mrs Sane lost her cool. She started sobbing. “No one blames those who dump garbage, keep their surroundings unclean. No one is blamed when epidemics spread and thousands die. No one is held responsible for failures of almost all preventive services and lack of basic facilities at government’s healthcare institutes. But the already overworked general practitioners must bear the brunt of everyone’s anger: the public and press are always free to bash the last face they see: the doctor who is actually helping every patient,.. Dr. Sane has not had a proper lunch, not spent a full day with kids in months.. That hospital has become our curse“ She broke down.

It was so logical! The offices responsible cannot even be reached. The court does not see any of these system failures that cause millions of deaths all across India, happily ordering lakhs and crores and imprisonments for doctors, for trivial mistakes.
Whom to blame? Oh yes, the doctor who has studied to treat the sick!

Anyway, in a country fond of muscular heroes and billionaire godmen, who expects a brainy analysis? © Dr. Rajas Deshpande

“I had a dream of making best health facilities available for my area. I have taken a big loan. We treat poor patients free anyway. Many rich are sent by local politicians, leaders, administrators with instructions to attend immediately and free too. Paying patients are mostly suspicious because of all the negative things publicised by press about all doctors., they also expect immediate and positive outcomes. I have not slept for many a nights. “

I examined him.He had obvious features of being fatigued mentally and physically.. A syncopal attack, where the BP drops down suddenly and makes the patient unconscious, was likely. I advised him tests and told him to take rest for there days.

“Not possible, sir! Even now the OPD is waiting” he replied. An angry Dr. Mrs Sane requested me to intervene.

“Your duty to the society does not free you from the duty towards your own health and family” I requested him. But Dr. Sane agreed only when Dr. Deshmukh offered to send over a junior doctor to his hospital to take care of the OPD.

“How have you been, Sir?” I asked Dr. Deshmukh. He is one of the most respected and busiest general practitioners in town, with a big hospital. © Dr. Rajas Deshpande

Dr. Deshmukh smiled.
“I had an angioplasty three months ago. The only risk factor was high BP and stress. There is no use fighting or explaining our situation to the society, government or press. I have closed down my hospital. I only see OPD patients now. Anyway many patients thought that I worked day and night for earning more money. Let them go to the corporate or government hospitals.”

The death of his hospital was not a surprising news, many small private hospitals and nursing homes are either closing down or converting into profit-making franchises. Many doctors are suffering high BP, cardiac and neurological problems and even dying due to excessive stress.

The meaning of this nightmare will soon unfold upon our society.
Till then, this is a heartfelt appeal to all the over-stressed doctors to rethink about their priorities, rearrange life and make sure stress does not kill.

For the morphine of “medical social service” is only good in small doses, it kills when overdone!
© Dr. Rajas Deshpande

Did you plan your murders and suicide at 17?

Did you plan your murders and suicide at 17?
© Dr. Rajas Deshpande

What were you doing when you were 17?
I know not all questions can be answered fully and truly. But some truth applies to all at this age. At 17, we are full of dreams of a good, respectable and if possible luxurious life. And of course of true love.
Well, what options do we have at 17 for such a rich and respectable life?
If you google-search top grossing Indian careers, you will find management, IT, Chartered Accountants, Law, Data management, Sports, Entertainment, Politics and Medicine. Which option would you choose out of these, if you are intelligent and hardworking?
A 9-5 work life with family time and regular food and sleep and holidays, with healthy, alive people around you, or one with no sleep, highest stress, no family life, always being surrounded by illness, crying and death, lifelong exposure to deadly diseases, having to study every day of your life, lifelong competition and struggle, unsure when some patient or mob or press will end your life or career?

No teenager thinks “I will become a corrupt doctor carelessly treating patients to earn all the money I can by prescribing wrong, unnecessary tests and risking my life with deadly diseases just to earn the title of a doctor, and enjoy harming and killing many many patients all my life, long after my classmates have retired..”.
There is far more money and often more respect in many other professions. Illiterate politicians at age 30 roam in Red-beacon cars, Finance, IT and management professionals at age 30 flaunt Beamers and Mercs, while most Superspecialist Doctors aged 45 drive scooters / small cars in India. Why will a talented, hardworking teenager choose at 17 to spoil his / her life by becoming a doctor? This is not for the mildly intelligent to understand.

Where does the “doctor” class come from? Usually academic, poor, middle class families, rarely from rich class. Which parent will teach their children to do bad to ill patients to earn more money? Do you teach your children at age 17 to “loot” sick people?

The govt. failed to provide enough medical colleges and doctors, allowed private colleges, and decided who will start these colleges and what fees they will charge, the courts agreed to this. How is today’s doctor guilty of this? If paying high fees for the desire to become a doctor and serve sick people and later earning enough to repay that fees is a crime, why not ban all private medical colleges and send all patients to govt. hospitals compulsorily? There always will be those who take advantage of any system where money is generated, how come all doctors are blamed?
© Dr. Rajas Deshpande

The govt. made service compulsory after graduation, made bonds, doctors complied in most cases. Those who didn’t, paid fine. After that, they do not remain “PUBLIC SERVANTS”. They become private practitioners, whose service comes under a “consumer law”, thereby the court has decided it is a business. You have govt. hospitals in every small town now. Why don’t you go there and get the cheapest treatment, with usually no tests (because they are not even available!)? No one will force you for extra money or tests or wrong treatment there. That system, where there is absolute guarantee of no “CUT PRACTICE” and referral fees, will never deny service to anyone. Most doctors there are excellent too.

No. You want premium service, best available medical facilities. You want sweet words and better guarantees. You want highly qualified superspecialists in ultramodern A/c buildings with state-of-the-art machines and tests and operation theatres and stents and medicines and catheters attended 24/7 by teams of all experts under one roof, with the best trained nursing staff. Above all you want the freedom to blame and sue someone for everything that may go wrong. “Science is so advanced, doctor, can’t you do something?” you often ask, “My cousin in USA got this same problem, they lifted him up with a helicopter and he was discharged in a week”. You forget one part of the picture entirely: the insurance premium your cousin paid, the treatment charges levied, and the doctor’s fees in those cases. Above all, you didn’t enquire how many poor / compassion / politico/ VIP / govt. servant free patients that doctor in USA sees all his life.
© Dr. Rajas Deshpande

You want the “USA class” service at “Indian” rates. You want the cheapest treatments by world-class doctors, with the ability to sue for crores. If medical tests are unnecessary, ask the govt. to ban them, or go to the people who can treat you without those tests. Ask the fulminant (google this word, my friend) anti-doctor media for the best options from the various quacks they advertise daily. If medicines / instruments / stents / catheters are costly, please ask govt. to only sell cheaper brands and use them. Why doesn’t the govt. ban all foreign medicines? Have guts to go to the doctor and say in writing “Use only Indian and cheapest medicines, catheters, instruments and procedures, I will accept the outcomes as long as the doctor is technically correct”.

No doctor will force tests or medicine. Choosing the doctor, tests and medicines are all your rights and privileges. Own the responsibility of what you do. If you think the doctor was wrong, do file a complaint with authorities, and follow the legal procedure. If you were wrong, face defamation. Just don’t pretend to be lone saints in a world full of criminals.

About the loose talk that our own brethren / doctors unleash upon social media about “most doctors being corrupt”, I think the medical councils and associations must seriously deal with such defamation of our profession. If someone has an issue with medical corruption or malpractice as a doctor, they must go to their specialty association or medical council, not general or social media, as this is just misleading the public. API / IMA must start filing defamation suits if any media plays judge in medical cases before the courts of law have convicted the doctor.

How does one choose a doctor for oneself? Cheapest or Best? How did the doctor you chose become famous / best? Never by only a degree. Of all the rich careers, the richness of a doctor is the costliest, having to toil the hardest over many years to attain that success, with no support from the society, govt. or media. Corruption may make some doctors rich, but never famous.

Let the govt. publish a book of standard tests and treatment of every medical condition and have every doctor follow it, irrespective of the outcome. Alternatively, have faith in the doctor’s education and opinion.

All malpractices in all fields must go: Political, Social, Government, Educational, Public works, Religious, Media, Entertainment Industry, Judiciary, Police and ofcourse medical.

For all those who missed the Indian medical train, enjoy your journey without jealousy! Believe me, you are lucky to not be a doctor in India. For us, the meaning of “Happy Diwali” ended for life when we entered medical college. This Diwali, put on your new clothes, pack some sweets and visit any casualty near you to know what being a doctor means. Then dare to blame an entire profession.
© Dr. Rajas Deshpande

Painful Injection

Injection
© Dr. Rajas Deshpande

“Anyone Treat Anything” and the “Add-On complaints”.

“Doc I have come to you for this severe headache since last five months”.
Examined, investigated, prescription given.
5 days later:
“Doc there is no relief. This back pain is killing me”.
“What about the headache you had?”
“Oh that went away the next day, but this backache has been there for years now. I forgot to tell you last time. I also want you to review and advise about my Sugar and BP medicines”.
……………..
Specialty practice in India is considered to be just like family practice. The concept of “problem-based” consultation is yet to arrive. Once seen by a specialist, all the subsequent health issues are thought to be automatically the responsibility of that doctor, and he / she is supposed to solve them at a “Follow-Up” charge for years. The concept of “New health issue, New consult” is yet to dawn.

Unfair to compare, but this is like visiting a hotel once to eat an unlimited Rice Plate, and then keeping on visiting repeatedly later to reap the “unlimited” benefit from the bill paid on the first day.

There are two sides. Some specialists also encourage this “treating everything” once the patient comes to them, and often transgress their field of expertise to keep on treating everything till the time something goes wrong, when alone a cross-reference is made. Once someone starts practice in some specialty, they should ideally only stick to that branch, unless it is an emergency.

Even at the cost of patient “misunderstanding and blaming”, some specialists follow this correct practice of referring to another specialist where indicated.

“You only give the treatment, doc for everything.. we have faith in you” is very rewarding and beautiful to hear, but at the same time a doctor who thinks he/she can should think twice.

The second issue is that of “Going on adding” the complaints even after the doctor has finished examination and has already issued a prescription.

The whole process is logical, and disciplined: recording the complaints and other medical details, then performing a physical examination, reviewing old test reports and advising new, writing a prescription, and explaining the condition and management to the patient. There are limitations in the time spent for one patient, and a single significant complaint added later after the prescription is written can change the diagnostic possibilities (“I just remembered, I had episodes of unconsciousness / tuberculosis / head injury in the past”). It then becomes imperative that the doctor rewrites the case history, and changes tests advised and even treatment sometimes.

There are simple solutions, but these become difficult in India.
1. The doc must spend extra time with every patient to give them sufficient time to remember. This is feasible only when the charges are time based, as some patients are not done talking even after 30 minutes. The experienced docs then learn the skills and tricks to save time and to “steer” the patient.
2. Patient can fill up / record forms while in the waiting room, where almost all important questions are already mentioned, so one cannot miss. This is difficult in two ways: most of our population is illiterate, and even the literates do not fill up these forms properly. Also, most of the working class come “flying” in a hurry to “get over with this quickly and fly to another meeting/ chore”, so they keep busy with their cellphones in the waiting area (sometimes even in the doctor’s chamber). Secondly, such mention of “all earlier health issues” also invites unwanted exaggeration of otherwise minor complaints especially in the depressed / suppressed / anxious and overenthusiastic patients, often diverting from the main health issue.
3. Doctor’s assistants / junior doctors “filtering” the information for each case: this may be the best option, but again the specialist must take responsibility for their mistakes. Also, one must remember that patients often do not take the “assistant doctors” seriously and may omit crucial information while talking to them. Also, a patient who pays for a specialist’s service deserves interview and examination by that specialist, not only a quick overview of an assistant’s opinion.
4. Patient must make and retain a notebook / digital diary common to all his / her medical issues, consults, details of all prior treatment and tests and carry it for every consult, minor or major. While the doctors / hospitals are supposed to keep their own records, they are blind to what happens outside their medical jurisdiction, so it becomes almost useless. A unified national healthcare software is at least 10 years away.

The IMA / MCI must devise large scale patient education programmes that will help curb the misunderstandings, hate, violence which society harbors towards medical professionals. Encouraging correct referrals, specifying doctor’s fees based upon the equation of “Time + Skill + Experience + Complications in a case” at different levels from family practitioners to super specialists may also help. A basic model of “Primary General Practitioner” who attends simple health issues with referral to a specialist based upon patient’s choice / proximity / GP’s honest opinion and suggesting at least two specialist names will help control this “Anyone Treat Anything” practice so rampant today.

There always will be allegations of “cut practice” whenever there is referral, as average human nature finds pleasure in blaming others especially successful and presuming everyone else a sinner while imagining oneself a moral-ethical icon.

To imagine that everyone in the medical profession is a sinner and guilty, and everyone in the society is innocent is a sign of immaturity of intellect. This is our working diagnosis right now.
© Dr. Rajas Deshpande

The Human Humbug Virus (HHV)

The Human Humbug Virus (HHV)
© Dr. Rajas Deshpande

It’s a boon that the animals did not learn human languages and are not allowed to have facebook accounts. Otherwise Tigers would have complained about how cruel Lions are, and Rabbits would have intensely criticised Elephants for eating too much.

There is a huge number of “Advisors to the Doctors, Hospitals and Medical Professionals” from various non-medical streams, whose basic qualification in this field is the ability to carry on meaningless humbug that suits the social unrest against Doctors as a class.

Let me clarify few things at the outset: I love and respect my patients and colleagues, but not blindly, and most of the doctors I know also always keep their patient’s good above everything else. Most of my patients also reciprocate positively and many patients like / love / treat their doctor like a family member.

It is some “Good-for-nothing-else” social crusaders that create the rift between patients and doctors, and also prejudice the ‘lesser thinkers’ into believing that the very person treating them is their enemy out to dupe them. These are the victims of “Human Humbug Virus”. This epidemic is spreading fast, and also seems to have affected some doctors who advise their colleagues from other specialties how to practice, without having any experience of practicing that specialty.

A friend recently asked: “What should the average (saamanya) and needy (garaju/ zarooratmand) patient do on holidays if the doctors switch of their mobiles?”. I am surprised.

Are doctors not among the average and needy, given that most Indian docs belong to the middle class? Which other government offices remain open for the average and needy on holidays? If a doctor who has finished his work at 2 AM needs a ride home, who will be ready to provide it? If a doctor is beaten up by drunk relatives, who among the society has spoken against it?

There is this myth being spread: that the doctors beaten up were rude, did not communicate well, did not explain, did not reach in time etc. To tell my own experience in last 20 years, most doctors do their best to explain things to the relatives, especially in a critical case. If the relatives are uneducated, drunk, panicked etc., the doctor cannot wait until they learn and understand. There are lady doctors beaten up in emergencies too: how does our society and the Humbugs explain it?
Then again, anyone right from the prime minister to the supreme court judge can get angry on duty if they don’t like someone or something, so why can’t a doctor get angry at the mannerless, shouting, drunk and violent? How much time and energy is a doctor on emergency duty supposed to waste upon such relatives? Where every second matters, why should other patient’s lives be risked because of relatives who refuse to understand simple logic? Do all these people understand the complicated problems and risks in medicine?

Why presume that it is the doctor’s responsibility to attend all health problems of the poor and the needy on all days? Why don’t these humbugs ask the government about the scanty / absent facilities at all its hospitals meant to serve the poor and needy? So the answer to the question “What should the average and needy patients do on a holiday?” is that “Please go to the government / charity hospital nearest to you, and if you are unhappy about its service, ask the government about it. The doctors who have finished their compulsory govt. services and left govt. jobs are no longer liable to be available 24 /7 for everyone. The only understandable exception is emergencies, in which case too, a doctor at home cannot do much, so one should seek an ambulance and go to the nearest hospital. Most hospitals provide emergency services as duty, and will be happy to help the “emergency” part of it. But is that all? No. On holidays, the emergency facilities are misused as mentioned in the earlier article.

To those who advise the medical professionals on behalf of the “needy and poor”, let it be known that there are hundreds of needy and poor patients in all govt. hospitals RIGHT NOW who need help other than medical care. They need food, medicines not provided by govt., emotional support, transport to and from the hospital, home care and attendance by someone etc., including their toilet. How many of the humbugs who preach sermons to the doctors actually go and help these “poor and needy” patients at home or hospital for their non-medical issues?
© Dr. Rajas Deshpande

Recently an 82 years old orphan was admitted under my care in a critical condition, for 8 days. He needed some medicines from outside the hospital. I requested the young male relatives of some other stable patients in that ward if they can please get the medicines from a shop just outside the hospital (clarifying that I would of course pay for them): they flatly refused! Our security guards at the hospital actually attended to the needs of this patient till his discharge. This is the awareness, readiness and participation of our society in patient care: it just dumps ALL medical & non medical issues of everyone to be attended by the doctors 24/7, nobody cares now about other patients.

If you are really interested in helping poor and needy patients, please go to the nearest hospital and you will find at least few patients who need your help. Stop firing your pompous rifles of hypocrisy from upon the doctor’s shoulders. There are orphanages refusing kids, having no foodstuff / education facilities for those residing in them, there are old-age homes where patients cannot walk because there is no one to support them, there are beggars at each traffic signal openly abusing infants and children by giving them sedatives, keeping their wounds open to create sympathy, carrying them without covering their heads in open burning heat of the summers, there are poor disabled as well as manic, violent beggars on all streets… what has any film star, any politician, any government done for them? Go help those needy and poor, my dear HHV victims, before pointing fingers at the doctors.

Unconscious trauma victims and unknown dead bodies are commonly brought into most casualties. Most doctors go far beyond their duty to make the alive survive and dead reach their relatives. Who among the “Humbug advisors” has helped there ever? Only the doctors know how many sons and daughters write forms “Not to continue medical care / ventilation” for their parents who still have some chance of survival, and how many take home an unconscious / critical patient home from hospital, under different excuses.

I have many patients and mature non-medical friends I adore, and we share a very good bond. They will understand the plight of this situation readily. For the remaining, I clarify: It is every doctor’s duty to help a patient in emergency, but the society must stop abusing and advising the very profession which is striving to serve its interests. A few corrupt doctors is not the whole truth.

It is easy to presume and talk ideals. After 30 years of practice some doctors do get their desired home and peace in life, and then they expect that the newer generations should never expect to do better than they themselves did. ‘In our times”, “All our life” etc. are spoken as if the newer generation is begging / dreaming to be you. They are not. Let the new doctors please do better than to earn a big home or a small hospital in retirement. Let them take India to new heights in medical research, in discoveries, finding cures, winning Nobel prizes, and making world-class medical set-ups in India, for all its citizens rich and poor, and let the government pay for those set ups and the treatments too!
Simultaneously let the new gen docs also live a good life. Let them make better families. Let their wives and children not be punished for their choice of a noble profession.

Our prime minister said to the IAS class conference just yesterday: “Why tense? Quality time with family is a must!”. Why doesn’t this apply to the doctors too?

Coming back to the humbug virus affecting even some doctors, it’s high time we realise that every specialty has its own requirements, problems, methods which have evolved over decades. So a cardiologist cannot advise a gynaecologist how to practice, nor can a pediatrician advise an orthopedic surgeon what to do in a trauma case. (And yes, all of these should also not tell neurologists / psychiatrists to see patients faster and charge lower!!). We must have separate boards of practice control / discipline for different specialties. These boards must decide the practice standards for their specialty and fees too. Blanket rules may apply for the common purpose, but diversity is necessary to evolve our system into a better one than what we have today.

The first measure is to identify and treat the victims of this Human Humbug Virus. Next time someone advises the doctors about their duties and helping the poor and needy, especially on weekends and holidays, please request them for their contacts to upload on public platforms so doctors can start sending the poor and needy patient’s non-medical issues to them. Let the channels crying foul about the medical issues donate all the revenue generated during such news and the ads therein for the care of poor patients in govt. hospitals.

Otherwise the HHV will destroy whatever good has survived in this noble profession.

© Dr. Rajas Deshpande

Issued in good faith.
Pl share without edits,