Tag Archives: #mbbs

Beyond Ridiculous!

Beyond Ridiculous!
© Dr. Rajas Deshpande

A 9 year old child with fits / seizures was taken to a renowned Paediatric Neurologist. He started treatment with one of the most commonly recommended (by almost all textbooks) used medicine in the treatment of seizures: carbamazepine. One of the most effective medicine, used since over 50 years in children, that can cause side effects of rashes in less than 1/1000 cases. Still rarely, the side effects can be very severe, causing extensive damage to the skin.
The doctor explained this to the child’s parents, and then started the recommended doses. Pediatric doctors are the best trained doctors in dose calculation, they are more aware than any other specialty about the side effects in general, because children often cannot even speak and parents may not notice some side effects. © Dr. Rajas Deshpande

Every medicine has side effects. Even vitamins do. Any medicine can potentially cause life threatening reaction, and that’s why the common warning with each medicine: do not use if you are sensitive to this medicine. How will one know whether there will be any allergy / reaction to the medicine without having used it?

Most medicines can cause side effects at high doses, but some can cause dangerous reactions even with the tiniest dose, or test dose. Some medicines (even the one mentioned above) can cause side effects after many months / years of safe use. While the dose dependent (high dose= higher side effect) side effects are somewhat predictable, the ‘idiosyncratic’ (meaning occurring in individual, not all cases, because of the natural tendency of that person) and “allergic” side effects are totally unpredictable, and can be caused by even such common medicines as paracetamol, aspirin, antibiotics or vitamins. Even deaths have been reported after the use of some common medicines, but even in the highly legalized western world, no court holds doctors guilty for the side effects of medicines, if these were discussed and informed to the patient / family. This is against common sense. © Dr. Rajas Deshpande

This child unfortunately developed a rare but well known side effect of this drug, called Stevens Johnson Syndrome (severe skin rashes), had to be admitted and treated, it cost them one lac rupees. While we sympathise with the child and the family, and wish them the best recovery and health, this is hardly the mistake of a doctor.
But the forum, in a regressive decision, held the doctor guilty, fined him 90000 rupees. This is beyond ridiculous. The court observed that “ if the doctor knew that this drug can cause side effects, he should not have prescribed it”. Translated intellectually, that means NO DOCTOR CAN PRESCRIBE ANY MEDICINE! © Dr. Rajas Deshpande

Moreover, what will this court advise for the child now? Every seizure medicine has some rare dangerous side effects. There are no medicines free of side effects. Shall the child be left without treatment now? Which doctor will want to treat such a case? Which court will guarantee that the rarest of the rare side effect cannot happen again in this case, and with such ill-informed forums, the next doctor trying to do good to the child will not be held guilty? © Dr. Rajas Deshpande

Technically, if using a drug that can cause side effects is a crime as per this court, it should hold everyone concerned guilty: the textbooks / medical bodies that recommend this drug, the pharma which produced it, and even the government which allowed it to be sold. Applying the same logic, if some child developed peanut allergy in a hotel or side effects of pollution and dust by travelling on Bangalore roads, will this court hold the hotelier or the city administration guilty and punish them too? Has this forum/ court banned tobacco and alcohol yet, or will it punish the government for the side effects and thousands of deaths caused by these? © Dr. Rajas Deshpande

The IMA, other medical bodies, Neurological society, and intellectuals should stand by this doctor who has suffered the mental agony. This decision must be challenged in higher courts.
We regret that some patients suffer side effects, no one should, but at the same time, the “side effects of medicine” is not the doctor’s fault, especially in this case where he had explained the parents about such possibility.
We need medically educated forums and judges who can refrain from populist tendencies.
© Dr. Rajas Deshpande
PS:
I respect courts. I respect higher courts more. But I refuse to believe that every decision made by every judge is correct, that every decision is impartial, that it is not affected by pressures. This article is solely based upon the attached news clip. I must admit that this reporter Ms. Meghna Singhania has done an excellent and impartial reporting. Doctors must please stand united against this decision.

https://medicaldialogues.in/side-effects-of-prescribed-m…/…/

The Cult of Good Blood: Superhero Medical Students

The Cult of Good Blood:
Superhero Medical Students
© Dr. Rajas Deshpande

He grew up selling vegetables and fruits grown by his mother. He went door to door and in the village market to sell those. He also walked for two miles every day to catch a bus to a school over 20 miles away. He then enrolled in a private class that waived off his fees, because he had a passion: He desperately wanted to become a doctor.

Atul Dhakne, son of a school teacher Mr. Nivruttirao Dhakne and farmer Mrs. Mandabai Dhakne, with his hard work and merit, got admission in the prestigious B.J. Medical College in Pune.

But he wasn’t satisfied. “What about those like me who are from the poor rural background, those who have no access to good classes and education, but want to become doctors?” he worried.

Good Blood speaks, whichever soul it flows in. Young medical students of different origins, studying with him, decided to resolve this. Ketan, son of a lawyer Mr. Avinash Deshmukh (who mostly handles cases for the non-affording,) wanted to do charity like his father. Farooque Faras, whose father raised a family in one small room, was burning with the desire to give. Many others joined in (names below), and the Cult of Good Blood multiplied. They all wanted to uplift the deserving.

“Lift For Upliftment” was born, formed by the superheroes among medical students.

They printed posters and went to almost all junior colleges in Pune, appealing students from poor backgrounds to join their free tuitions / classes, to prepare for the CET /NEET. In the first round, over 40 students joined. After the medical college hours, Atul and his friends took turns to teach these poor students, give them notes, set question papers, conduct exams, assess and counsel for improvement. All expenses were borne from their own puny pocket-money.

There was no fixed place for the class. One local bakery owner, Mr. Dinesh Konde, decided to help these students. He planned the logistics and took them to the corporator Mr. Avinash Shinde, who asked for only one thing in return of his help: commitment to continue this good work. The Cult agreed whole-heartedly. With him, they approached Mrs. Meenakshi Raut, Asst. Director in the education department in Pune, who helped them get two classrooms in a Municipal school after the school hours. The classes thus became regular, every day, from 6-9 PM.

The cult lacked stationery, the huge backup of notes and question paper sets for 40 students, so they approached Mr. Sanjeevkumar Sonavne from Latur, who runs many educational institutes, helps poor students, and even pays the fees of some who cannot afford college. Mr. Shelke and Dr. Harish from Sassoon Hospitals also joined hands to help.

The results were impressive: from the first such batch, 6 students qualified for MBBS, 3 for BDS, 11 for BAMS and 2 for BHMS.

No one had earned anything, but Good Blood flowed forward. Many medical students from subsequent batches came forward to teach free, imparting their fresh acquired knowledge and skills to those who could otherwise have no access to it.

There is no discrimination while accepting junior college students for their class. They have two batches now with 60 students in each. They have also started weekend classes for poor students preparing for NEET in the extremely backward area of Maharashtra, named Melghat. These medical students go to Melghat with their own expenses, teach the rural junior college students over the weekend, and return to attend the tough schedules of medical college again!

“I learned helping others from my mother. We don’t earn anything, but we learn something precious every day” tells Atul, who has now passed MBBS. Ketan Deshmukh, Abhiraj Matre and Farooque Faras help him supervise the group. Their endless enthusiasm only reminded me of how much more I can do. I came to know of this group “LFU” during the recent “Quest Medical Academy” event arranged by Dr. Sushant Shinde.

They are naturally, perpetually short of funds.
I am not rich, but I won’t feel right about myself if I didn’t contribute. They graciously accepted.

When these students came to meet me today, I offered them dinner at a good restaurant (knowing that they stay in hostels). Farooque said “Sir, we will rather use that money to print some more question paper sets”. Farooque’s father has stopped all celebrations in the family, and sends all the money he can, from his one small room home, for the torch of humanity that his son carries forward!

When they asked for an advice, I had but one small request for them: that a Doctor should be completely free of all political and religious influence at work, in teaching, and especially while treating a patient. They assured me that “Lift For Upliftment” has decided to never be affiliated to a political or religious organization, keeping humanity as their highest ideal.

There is no better lamp than the one which carries the light from soul to soul. There is no better definition of humanity than holding hands of those who need it most. I feel very happy today, that I could contribute to this beautiful, divine cause.

Long Live the Cult Of Good Blood, and may we all find it in abundance within ourselves!
© Dr. Rajas Deshpande

The group “LFU” also includes: Esha Agarwal, Shivkumar Thorat, Satyender, Tanvi Modi, Mayank Tripathi, Nikhil Nagpal, Sitanshu, Arvind Kumar, Nagesh Pimpre, all from the B. J. Medical College Pune.

PS: My heartfelt appeal to all medical students and doctors to contribute by starting similar activity in your region, by teaching poor students who want to become doctors, by joining this group and / or by donating for this cause.

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Convocation Speech at KEM Hospital and SGS Medical College Mumbai Dr. Rajas Deshpande.

Guest of Honor at KEM Hospital & SGSMC
Batch 2011 Convocation 28thFebruary 2017

Convocation Speech Dr. Rajas Deshpande

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Respected teachers and

My dear friends,

This prestigious institute, KEM Hospital, has given me two identities: that of a Neurologist and also as a Medical Activist as a MARD President. This is my home away from home. I am glad that my most beloved professor Dr. Pravina Shah is here today, she had dusted and polished many fortunate students like myself.
This is the same campus where I waited with my father over 25 years ago, he was very anxious then whether I will get my MBBS admission or not. I desperately wish my father was here today to witness this event. The point is, my dear colleagues, never forget the sacrifices of those who marched you here. In the race for making a glorious medical career, many sacrifices are required, but parents, spouse and children are an equal duty, never to be neglected.

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Evolution in our field will require you to stand up to extensive digitalisation and explosions of information. Rather than drowning yourself while coping up, please make sure you don’t retain the unnecessary information or statistics that can be easily pulled up. Instead, we must regularly update the most necessary skills and tools of every successful doctor: a perfect clinical examination, surgical skills, communication, correct documentation and medico-legal awareness. It is also wise to check drug interactions and adverse effects of every drug you use, and obtain a second opinion in every doubtful case.

Students often ask me what is the number one essential of a good doctor: the undoubted answer is concentration: upon studying, listening, upon examination, analysing and concluding. One of the greatest threats to our profession today is the disturbance created by cell-phones. Please take care that your practice is not polluted with such digital disturbance.

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Friends, now a days patients are helplessly prejudiced about our profession. We must take this situation in our stride and start each consultation with an aim to change this pseudo-perception. We must understand the extreme anxiety of a patient in waiting room, an anxiety not only about a bad diagnosis but also about the expenses, time, loss of career and family that often pushes the patients and relatives to the brink of a breakdown. Add a callous doctor, and things deteriorate. Even if your prior patient has been insulting, aggressive or trust less, the next patient still deserves the best doctor within you. Patients often complain about doctors not having simple manners, this can be easily corrected. As for the continuous questions about malpractices and cut practices, I know that no one here has entered this profession with a bad aim, we just need a strong willpower to stay away from wrong lanes. Here in front of us are the glorious examples of spotless heights in medical careers.

Each one of you has already proven his / her intellectual mettle. It is indeed divine and rewarding to be a doctor, but you must also have a diversion that brings you immense peace. That avoids piling up of stress and routine which is so inevitable in medical practice. I found my solace in writing which brought me here today, in Fountain pens, in music and in teaching. Please make an effort to find your solace to overcome stress.

My worst pain about our profession today is that we neither have a strong unity nor a strong face. I urge this batch to please start a new tradition: to stay united, connected and to always stand for each other. In a poor and illiterate society jealous of anyone earning well, especially doctors, we must know how to present and explain the functioning of a doctor and hospital, the hardships, sacrifices and the emotional drain involved. I have attempted that in my book, ‘The Doctor Gene’.

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My friends, I congratulate and thank you all for having me over here. I think that during the convocation I should be sitting there in those chairs: and listening to your thoughts, because you have more dreams today than me, you have more opportunities to learn, more years with in this glorious tradition called medicine, better technology, better treatments and cures cures, and above all more success waiting for yourself in future.

I will gladly trade all my earnings and success to dream like you again, to sit once more in those chairs today, and to hold that super-precious degree in my hands with a pride that has no equal.
Take care, stay united and God Bless You All.
© Dr. Rajas Deshpande

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Thank you, Life; Thank You, God!

Thank you, Life, Thank You God!
photo-07-01-17-21-14-15-2
This was my first birthday without either parent, and I woke up feeling sad about it. Who knew, by the end of the day, God will have set things right, as He always does! Add to that an important message that the day left..

Knowing myself, I cannot understand how someone can like or love such an asocial reclusive loner who is obsessive, over-expectant, irritable, slightly egoistic, sarcastic, does not party or gossip, and cannot understand many people around himself.

Somehow though, the friend list is full, thousands of wishes pour in from across the world, and personalised messages and calls and prayers for happinees, health and everything good keep resounding the day with God’s grace. I did not know how many souls I am connected to, and my heart is full of joy today that so many people actually think of me!

Many colleagues dropped in to wish (in fact since two days prior!), bringing gifts (Oh I love them!). And at the end of the day came the family: my beloved students, who come with the sole aim of make me laugh, become a child again.

To deserve this love over and over again, for this is my only treasure and achievement, I must now make an effort: to be less sarcastic, irritable, obsessive, and to be always thankful for these beautiful people in my life. I will make an honest effort!

I can never forget what my friends and students love me most for: my effort to imbibe kindness and humanity and to live a life drenched in an honest culture of creative intellect and equality. On this birthday, I have promised myself to try and improve myself every which way possible, to deserve this love and affection.

Thank you, everyone who wished me today!

Thank you God, Thank you Life, for today!
(c) Dr. Rajas Deshpande


The Wrong Sacrifice

The Wrong Sacrifice
© Dr. Rajas Deshpande

“Come home this weekend.. I feel like seeing you” my father said. He was already feeling sad, missing my sister who had married three months ago.

That was 14th October, a day prior to my sister’s birthday. I had taken a week’s leave for her marriage and preparations.
I felt sorry for Baba and desperately wanted to meet him. I was quite attached to him.

I asked my professor, and was reminded that there was a shortage of resident doctors, we had a ward full of 50 patients, 10 more than the capacity. “You have to sacrifice some things once you become a doctor, Rajas. I am sorry, but you cannot get leave at present” my professor said.

Late that night I called Baba and told him so. I could feel the heaviness in his throat as he replied “Ok. I am proud that you value your duty and responsibility above me. Take care. And yes, don’t forget to wish your sister tomorrow for her birthday, and get her some good gift. She must be missing us too”.

I had had one of those cruel “brother-sister” fights with her, and we weren’t talking. Another carefully protected window to our childhood, we enjoyed those fights which multiplied our love.

“You have always sided with her, Baba. You are partial to her” I replied with pretend-anger.
He laughed “That’s because I have made you tough enough to take care of yourself in any situation. She has a delicate mind” Baba said.

I assured him I will call her. I did, and wished her a Happy Birthday. She was ecstatic. That evening on 15th October, I called up home. My mom picked up. She told me that both of them were feeling very sad about being away from us especially because it was sister’s birthday. “Baba has tears in his eyes all day” she said.
I tried to cheer up Baba. “I have called your laadli daughter and wished her. I have also sent her a nice dress from Mumbai. Now you have to buy me something when I come home okay?”
“When will you come?” he asked again.
“As soon as my professor allows” I replied.

The next afternoon, on 16th October 2000 at 2.30 PM I received a call that Baba had had a sudden cardiac arrest and passed away. I suffer that call till this minute. I will never recover from the trauma of that moment.

Now, whenever someone questions the integrity of a doctor, the honesty and hard work of genuine doctors or accuses them of working only to earn money, or high-handedly suggests that the hardships and sacrifices involved in this field are ‘chosen’ and mandatory, I feel I made a wrong sacrifice for an undeserving society.

There are sayings in every religion about some animals not understanding their holy texts. Medicine is my religion and I will not explain its holiness to the donkeys who refuse to understand it. Be it the corporators, MLAs or MPs from ruling parties who attack doctors, Journalists or reporters who spew poison against every doctor, or the perpetually “cheap and free” demanding class.

There are thousands of doctors who have gone through this situation: sickness, marriage, rituals and even death in their families which they could not attend just because they were working to save someone, attending other patients. I know of umpteen doctors who got one day leave for their marriage, when their child was born, or their parent was sick.

Before you question a doctor’s intent and integrity, before you talk loose about this profession, please do search your soul.
© Dr. Rajas Deshpande

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The Braveheart Orthopaedic Surgeon

The Braveheart Orthopaedic Surgeon
© Dr. Rajas Deshpande

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The stunned auditorium was hijacked by shame. Nearly a thousand paralysed audience helplessly watched the ongoing horrific drama.

It was the annual day function, the only colourful evening in the year that the whole staff, the Dean, all teachers, resident doctors and students from all batches come together in the medical college. Extraordinary talents that the doctors otherwise have to sacrifice for lack of time: Singing, Acting, Music etc. resurface this one night. I was still in my first year.

Midway through, one resident doctor climbed upon the stage. He was a strong leader, a good student when sober, and had a strong political support, hence usually had his way around everyone. He was excessively drunk. He took charge of the microphone. Few of his friends, some also drunk, were guarding the doors.

“Our Dean is a drunkard. He is also corrupt, he takes bribe from everyone for everything. He is having an affair with this professor of XYZ department. I order the dean to come here on the stage and apologise after I slap him”.

This was beyond anyone’s imagination. One of the teachers requested the drunken offender to please come off stage, but received a flurry of obscene abuses. There was a silence that prayed for relief from this situation.

Dr. Devendrasingh Paliwal got up from the audience.
“Chal, bahot ho gaya drama. Main aa raha hun. Karle kya karega. This is not the place for your allegations. Get down”. Devendra was always known for his physical fitness, and had an intimidating personality. Straightforward and kind, he had almost no enemies.

He went to the stage, grabbed the mic from the offending drunk, handed it over to the MC, and brought down the drunken resident. Within a moment some others joined him to avoid the impending scuffle. The dean and many teachers felt the relief of a lifetime.

Those who anticipated fun at the cost of misery to others were of course disappointed, but at the beginning of my medical career I learnt one of the most valuable lessons of my life: It takes one man to be courageous, not a herd. If you have guts to get up and protest the wrong, there is a fair chance you will succeed. A good man’s fear is the bad man’s strength.

That night at 2 AM, after the programme I went with my friends to the hotel near the railway station for tea. Too much excitement prevailed. Devendra was sitting with his friends at a nearby table. I went to him and introduced myself. He smiled as if nothing special had happened, shook hands and told me “Kisike baap se bhi kabhi nahi darne ka (never ever be scared of anyone).”

We became good friends, we also shared a common mess. Studying at night and going to the railway station (6 kilometres away) for a tea break at 3 AM was also common, and Devendra often asked others to race him to run back those 6 kms after the tea. I can proudly say that I reached second, although a good two minutes after him!

He became an orthopaedic surgeon and started his own hospital, but his ‘Gene’ of fighting injustice and standing up for the good never left him. Stress and anger can be a big hindrance for a doctor, especially a surgeon, so he decided to drown his ‘stress-anger’ into exercise. Always a fitness icon himself, even today he does two hours of cycling and an hour of gymming. “It helps me concentrate better during my practice and surgery, and also keeps me totally fit” he says.

Few years ago, a doctor was arrested in a typical example of a hyperreactive populist system. This was illegal, but many a times the system gets away with the illegal more fluently than the citizen. Dr. Devendrasingh Paliwal was the president of the local IMA (Indian Medical Association) chapter. He took the system, police and politicos “Head On” as was his nature always. The city’s hospitals shut down. This enraged the politicos but encouraged the medical fraternity to unite like never before, and the doctor, wrongfully in police custody for 8 days, was released!

Dr. Devendra then worked to straighten out the relations with the system, and formulated a “Modus Operandi” involving the police and local politicians to protect the interests of both patients and doctors so that goons and petty politicos do not blackmail either. If only all the IMA chapters follow this lead (and I must also mention the excellent IMA unity and extraordinary leadership in Goa: Dr. Sam Arawattigi, and Kalyan: Dr. Prashant Patil), half the irregularities and injustice against doctors and patients will disappear.

“I have always kept friendship, professional courtesies and Humanity above my medical practice” Devendra says, “I take it for granted that it is my duty to treat free those who cannot pay”.

It is pathetic today to see many brilliant doctors working in perpetual fear under those who exploit them, by choice or in desperation, accepting humiliating and patient-unfriendly working conditions.. People like Dr. Devendrasingh Paliwal are a hope our profession can look upto.

All other things may change, but the value of fitness, courage in one’s heart and a kind nature that compels one to help others are some things which will never change their place as the best three human virtues.

Medical careers are drenched with excess hard work, stress and anxiety. The one training that the doctors in making must inculcate from the beginning is that of physical and mental fitness. Doctors leading a stressful life and always having to present a ‘pleasant face’ to the patients and colleagues, either suffer their negativity alone or pour it out upon their family. Daily physical exercise is an excellent remedy of many frustrations that accompany medical practice. Dr. Devendrasingh Paliwal not only sets an example by doing this, he goes way beyond his duties to bail out others from difficult situations: medical, surgical and social.

I consider myself fortunate that I met this fearless braveheart fitness icon who infused the right “mantras” of courage and fitness into me at the beginning of my medical career!
Much obliged, Dr. Devendrasingh Paliwal!
© Dr. Rajas Deshpande

The Epic Struggle Against Epilepsy

The Epic Struggle Against Epilepsy

(C) Dr. Rajas Deshpande

In a war-torn city, she kept on having fits almost every other day: convulsions and seizures of different types. 21 years old and home-bound, she had suffered with epilepsy since childhood. Dreams of a beautiful life that must adorn the life of a young woman were shattered due to a devastating and humiliating illness.

Her elder brother could not bear to see her suffer. He decided to take risks and enquired. Someone told him to take his sister to India for treatment. The airports in his country were destroyed or closed. All doors to India appeared locked.

Without any clues about future, he took her by sea to a nearby country Djibouti, a small African country. From there they traveled to Ethiopia. Then to Kenya. Finally they reached Mumbai and searched for the lone contact they hoped to meet: Mr. Abdul Aleem Alakeli, who works free to help patients. That was two months ago.

She reacted badly to two of the best medicines used for treating epilepsy, but their faith and determination were extraordinary. The brother and the sister had made a final decision: come whatever may, they wanted to defeat epilepsy.

Today as they left with complete control of seizures, I told the sister what she already knew: that she had an extraordinary brother. I congratulated her for her strong will power too.
Her brother was smiling after a long time, and her pride was obvious.

We wish her and her brother the most beautiful and healthiest life ahead. May God bless them and ensure their safety on the way and back home.

(C) Dr. Rajas Deshpande15622112_1172439906184669_2495525607074222032_n.jpg

The Pride Principle

The Pride Principle
© Dr. Rajas Deshpande
“Sir, we are screwed. The Chief Minister and other ministers have closed all doors, they won’t respond. Our careers are in grave danger. Can you please help us?” I frantically spoke.
From the other end of the phone, the Don, Dr. Nitu Mandke answered: “See me at my home at 12 midnight”.
The Maharashtra state resident doctor’s agitation for dignity, national pay parity and better living conditions was on, and I was given the responsibility of coordinating and being the face. For once, there was excellent communication amongst all medical colleges, thanks to the cellphones and fax machines. The divide and rule weapons of most governments which had crushed many of the earlier strikes were not working here, as we had established a multilevel network.
When students go on a strike anywhere in any field, it is almost always out of desperation, and either for dignity or rebellion against some sort of suppression and humiliation by the system. This raw power is almost as mighty as the army, and although it falls prey to political misuse sometimes, it has tremendous capacity towards achieving intellectual evolution of the society. Students never rebel for money or power. The government always treats any unrest as an offence to its ego, and uses everything at its disposal: CID, Police, Administration, Force, Threats, Caste Politics, Cheating and Legal torture to mow down student agitations. Students have no money, no experience and rare political or social backing, and must unite and stand up for themselves. © Dr. Rajas Deshpande
On the fourth day of the strike, a big politico from the ruling alliance came over to our office at Mumbai KEM. Except the party batch and stickers on the luxury SUVs, there was no telling between him and a mafia goon. The members of student’s central committee: Dr. Sanjay Singh, Dr. Dinesh Kabra, Dr. Narender Sheshadri, Dr. Pramod Giri, Dr. Nilesh Nikam, Dr. Kuldeep, Dr. Vishal Sawant, Dr. Noor, Dr. Shahid, and few others were with me. The politico did not have any scruples using an arrogant, raw and filthy language to threaten that if we do not stop and withdraw the strike, our careers and even life will be in danger. As he was from the ruling party and threatened us in presence of the police, there was nothing we could say.
There are angels everywhere. A senior police officer who was supposed to “keep a constant watch” upon us ‘student leaders’ was quite fatherly. He told us “Do what you must, but don’t declare. Dumb people cannot interpret silence. Stay away from any violence”. © Dr. Rajas Deshpande
Next day, we got a message from government that almost every silent agitator gets: you have been cut off (you don’t have enough nuisance value). Unknown calls kept threats alive.
That is when a resident doctor suggested we meet the Don: Dr. Nitu Mandke, the famous heart surgeon who was known to be a fearless, straightforward celebrity doctor. He had already watched the TV news of our agitation. One Resident Doc could contact him.
He returned home past 12.30 AM. We waited, hosted by his extremely courteous family. We briefed him the details. He asked a few questions to assess our determination and strength. He asked us to stay united and avoid any misbehaviour during the agitation. To our surprise, he picked up the cellphone and called the Chief Minister’s PA. The CM was fortunately available, and talked to Dr. Mandke. © Dr. Rajas Deshpande
“CM is going out of the state tomorrow. He has advised us to meet the Deputy CM tomorrow. Two of you come to Leelawati Hospital tomorrow at 2 PM. I will take you to the DyCM.”.
At Leelawati hospital, Dr. Mandke’s chamber was intimidatingly clean and posh, yet simple. He checked our applications for the CM and corrected them with his beautiful pen. His briefcase had every essential of writing stationary, the mark of a perfect man.
As we waited, I asked him cautiously: “Sir, shall we start?” He replied that he was waiting for someone to carry the bag on his table. I offered that I will carry it.
He laughed his thunderous laugh, and looked at us as if we were small puppies. “ Deshpandyaa, that bag has two and a half crore rupees cash for my hospital. A professional bodyguard will carry it. People kill for that. Do you want to carry it?”. I shut up.
In his big car, for the 45 minutes that his bodyguard drove us to the DyCM, I asked Dr. Nitu Mandke questions about what was going through his mind when he was actually operating the Shiv Sena Supremo Mr. Balasaheb Thackeray. Such an enormous pressure it must have been!
“Oh yes, it was stressful. But he is a gentleman, and he had assured my safety. His word is enough”.© Dr. Rajas Deshpande
That’s when we told him how some politicos had threatened us recently. He laughed and replied something that has been tattooed upon my cortex permanently:
“Rajas, a doctor is a doctor and king of lives forever. Politicos come and go. Idiots misbehave with others when the have any post or power, in any field. You should not budge. It is pathetic to see doctors licking shoes of those in power, under various pretexts. It is up to you to maintain your dignity and pride. That is the true luxury, everyone cannot afford it. So long as you do the right thing, fear nothing. The few crores in that bag is nothing compared to how I feel about myself”.
We entered the VIP zone and bungalow. His car was not stopped anywhere. The DyCM offered us tea, and gave us a patient listening.
“These junior doctors and students are my boys, our own boys, they will look after the health of our people tomorrow. You must help them” Dr. Mandke insisted. The DyCM assured he will. The spell was broken, talks resumed.
Many twists and turns later, one of the most memorable strikes was called off. There were those who never physically participated but went home during the entire struggle. They came back dissatisfied, alleging. Those who participated knew they had fought well and won.
A year later, I saw a white Lexus car in our KEM campus at Mumbai. Fond of cars and having never touched a Lexus, I went to see it from a close distance. Just as I tried to touch it, the driver’s window rolled down, and I heard “Deshpandyaa, open the door and come in. Do you like my new car?”
And I sat besides he King of proud men, one of the most proficient Cardiac Surgeons, Dr. Nitu Mandke, in his Lexus. The feeling is unforgettable, not only for the Lexus, but for his simplicity, love and affection for a nobody of a junior doctor like myself!
Needless to say, then onwards, I have guarded my pride as a doctor more than any other possession I have. That took away many opportunities and huge finances, still I am doing quite well by God’s grace, and Dr. Mandke’s blessings.
How I feel about myself is more precious than anything I can earn. The luxury of pride is mine.
© Dr. Rajas Deshpande
Dedicated to all students, resident doctors, proud people in every field, student unions and their apolitical fearless leaders.
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“Eureka”

photo-09-09-16-12-12-22© Dr. Rajas Deshpande

Half day OPD today. Diwali morning. Busy busy rush.

Push ups. Weights. 30 minutes on treadmill at 7 Kmph. Feel the rushing blood. Check out a muscle or two in the bedroom mirror. Count the packs in certain position. Feel the pride of this sweat too.

For some curious reason, take your smartphone to the shower. Not only because you are a doctor, but plain simple addiction. The idiotic fear that the world will stop functioning without your supervision. It doesn’t. Or does it?

Enter the steamy hot shower feeling like a superman. Start philosophical excursions in your mind finding simplest solutions to everything. Under shower meditation is the supreme spiritual ritual of the day. Not because ‘the world cannot see your tears’, but because the world is altogether absent here in the shower.

This new shampoo is great, just takes some more time. Wait.

The phone rings. I will not pick up. I will just see who it is.

Oh my God!

It’s that Professor of mine, known for never calling anyone, never socialising, and in general being a “limited edition”, generally sarcastic. If I do not pick up his call, he won’t call again, and probably will never pick up my call again. Doctors have bombastic egos, the senior the more. He is over 80 now, and still studies a lot. © Dr. Rajas Deshpande

Pick up the phone. (Thank you Apple for making it waterproof). Come out in the bedroom dripping.

“Good Morning Sir!”

“It’s nearly afternoon, Rajas. Good afternoon! Do you have internet access right now?” Prof.

I am always proudly connected.

“Yes Sir”.

“Okay. You had referred a patient to me. It’s about him” he told me the name.

Yes. I had referred him a case I had doubts about. Things were quite odd, I had never seen a neurological condition like that. I just hope it is not something I missed, otherwise Prof. will skin me alive on phone!

“I examined him. I presented him to our Neurological society, and we concluded that this is pretty rare. There are only two such cases diagnosed with such findings till now. One is in 2004, and the other in 2012. Open your net browser, I will tell you the references”.

Wipe hands dry. Open the net. Check the references. “Yes, Sir!”

“He is going to need some more tests to confirm this condition. He cannot afford. I have written a letter for him to show to his employer, they may sponsor. Or we should look into charity. He will come to you, send me all the reports. Then maybe we will report this”. © Dr. Rajas Deshpande

“Yes, Sir”.

“Okay. Bye”.

Thank God there was no skinning! I must complete reading the reference right now! Done.

Standing there, dripping all over, I realised how much I enjoyed the “Fun” in learning, What a feeling! Eureka!

That whole day, my spiky hair may have offended many who met me, and I had no explanation. Most patients graciously forgive their doctors’ weird appearances, sentences and even some spurts of absent minded stupidity, the senior the more.

Once this very Professor was to be the internal examiner for my senior batch, and I was supposed to present him cases to be selected for the final DM Neurology exams. Terror reigned. Our best case was a Huntington’s Disease patient, and I had studied day and night the whole prior week about that and other cases. © Dr. Rajas Deshpande

He sat in the ward side room.

Trembling, I called in the patient. The patient walked in about four steps till the examination bed, and sat upon it. It was less than ten seconds that the patient was in the room.

Just before I opened my mouth, Professor said plainly “Huntington’s is too short a case for DM. Keep him in reserve. Get the next case”. I felt like being shot before even entering the battlefield!

This professor was my examiner too, for my DM final exams. His genius was scary, his comments deadly. Just as I came out after the final viva, I received a money order sent by mom. As I stood counting the money outside the exam ward, this Professor came out. Looking at me counting the money, he smiled big. © Dr. Rajas Deshpande

“Already planning a party haan?” he kept his hand upon my shoulder.

Frightened, I explained that it was just a regular money order from home.

“You will need extra money this time” he said and walked away.

My heart turned into a boombox.

My palpitations stopped only when someone told me after two hours that I had topped the exams. The whole world paused in my mind to salute three years of extreme hard work, the run of umpteen sacrifices: that of youth, food, sleep, life, enjoyment, relationships, and everything that is “normal human need”.

Of all the qualities that make a genuine doctor, the Nerdiness is probably the most undervalued one. What a doctor appears to speak or write or decide on the spur of the moment is actually the product of years of study, research and hard work, with umpteen experiences that add to the thinking process. © Dr. Rajas Deshpande

It is this same Nerdiness that saves many a doctors from the depression and other mental stresses that their life offers on a daily basis. I love reading my subject at least two hours every night, and I know many doctors who are “lost” in the quest of knowing more and more. All the humanity, compassion, social service, charity, respect and earnings on one side, it is sometimes only this “thirst of knowledge” that makes us forget the umpteen festivals, celebrations and other happy things of life we keep on missing.

Like the soldiers on the border, thousands of doctors spend their Diwalis and Christmases and Eids and Baisakhis in hospitals, tending to the care of the sick and suffering, drinking the poisons of allegations and anger. One sure-shot medicine for this is studying.

For their Festival of Lights is in the service of the suffering, and their celebration is saving life. The fire comes from their quest for knowledge. They burn colourfully to make others smile again!

Happy Diwali to all the Patients, Doctors, Medical Students, Nurses, Paramedical staff, Pharmacists, Medical Representatives, Technicians, Wardboys, Reception and other staff, Mamas, Mausis, Security staff and all those who are connected to the healthcare industry!

© 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