Tag Archives: Medical

“Is The Diagnosis Wrong, Doctor?”

“Is The Diagnosis Wrong, Doctor?”
© Dr. Rajas Deshpande

“Doctor, there is no improvement at all” said the angry husband, throwing the case-file upon my table.

Well this is not an extraordinary sentence for any doctor, one must be prepared to openly deal with this. I had been quite polite and well mannered with them, there was no reason he had to cross that line. I could understand though. When they pay my fees, they expect some result or satisfaction.

While teaching my students, I have always insisted that if the patient / relative says that there is no improvement or change with the prescribed medicine, one must first consider the possibility of a wrong diagnosis, a missed condition or a misinterpreted finding. Doctors are humans, and do commit mistakes, or misinterpret findings. This is normal, and happens with every doctor. Medicine is far more complicated than most people think they know. A good doctor knows this and learns, while all the time keeping patients safe, but a doctor with ego kills his own practice, and may cause harm to the patient.

I asked them to sit down and reassessed the case in detail. A 28 years old female. Headache, giddiness, imbalance, palpitations, breathlessness. Lack of sleep and bouts of crying. Past and family medical history not contributory. Physical examination completely normal. MRI of brain normal, Vitamin B12 and D levels low. I had started vitamin supplements, anti-anxiety medicines and an SOS for headache.

She told me all her earlier complaints had improved, but now she had a severe backache. I told the patient that I was trying my best to understand her condition, and to resolve her problem, but her findings and complaints didn’t match. She looked at her husband, and asked him “May I speak frankly to the doctor?”.

Openly agitated, the husband sarcastically offered to wait outside if she needed privacy. However he stood glued to the chair as if he knew her answer. © Dr. Rajas Deshpande

The patient thought for a moment, told him it’s ok he can wait inside, then started to talk. She revealed that she was the only child of her affluent parents, had passed engineering, but now had to quit job and stay at home to raise children. They lived in an extended family, with grand in-laws, in laws and an elder brother, his wife and two children. This patient was the ‘last in the line’ to take orders, all others being senior to her. Her husband and in-laws were perfectionists, and she was tired of their continuous expectations. She had dreamed of making a career too, wanted some free time outside home for herself, but year after year, she didn’t get even a minute for herself. She was tired of it all and there seemed no respite. © Dr. Rajas Deshpande

“I am not averse to hard work, but the continuously condescending and fault-finding attitude makes me feel that I am useless”, she said, and added cautiously: “We were in the same institute and my ranks were always better than him. Look at where I am now” she started crying.

I offered them water and coffee, and waited for her to settle down. The husband became restless and defensive, but his tone was far lower. “I understand her problem, doctor, but what can I do? I cannot leave my family. My work pressures are quite high too, the IT industry is going through a bad phase”.

“I can assure you that she has no neurological problem now’ I replied, “she should improve with lifestyle changes, counseling for the family, and adequate free time for herself. I will refer you to a good counselor” I told them.

The husband laughed. “I can understand, but my parents will not. We will see what best we can do for her”. A bitter tone in his voice didn’t escape me.

‘Sir, she told us what bothered her, and must not be held guilty for trying to speak her mind. It will only help identify and treat the problem better. Please see a counselor together and avoid discussing this at home right now” I requested the husband. © Dr. Rajas Deshpande

There are many reasons why a patient does not improve. Untreatable medical conditions, depression, seeing the wrong specialist are the most common reasons, but there also are patients who want medical leave,those who want to avoid work, who want attention, so will keep on complaining of false symptoms. They do not improve with drug treatment.
On the other hand there are many who keep on taking the wrong medicines for years, those who self-medicate, do atrocious / injudicious dieting and exercises, yoga that doesn’t suit them, and do not follow the doctor’s instructions about abstinence, who keep on indulging salt, sweet, oil, alcohol, tobacco and other drugs freely available in India. © Dr. Rajas Deshpande

A doctor remains a lifelong medical student. A doctor who thinks he / she is always correct is most dangerous. It is not uncommon to meet doctors who are angry / upset with the patient / colleagues when their diagnosis, treatment is questioned. The first thought of a doctor when the patient does not respond positively should be to consider a misdiagnosis, reevaluate the case in more detail, reassure the patient, and obtain a second opinion if necessary. All this done, one must look into other possibilities, with an approach to resolve the issue rather than trying to shove down the patient’s throat their own faults.
We all go through bad patches in life, doctors and patients. If the child is wrong, the parents correct them still with love. A doctor’s attitude should be similar, with due care to also protect themselves. If not the doctor, who will understand the patient whose family refuses to understand them? In so many ways, especially in the Indian society, the doctor must don the role of an elder brother/ sister. Although patronising is legally discouraged in medical practice, and should be refrained from in cases where trust is questionable, one can make exceptions for some cases that need reassurance where the family fails to do so.

The nobility of our profession also lies in reassuring the patients that they are well cared for by their doctor, through the thick and thin of their life.
© Dr. Rajas Deshpande

Please Share Unedited.

The Proud Indian

 

The Proud Indian
© Dr. Rajas Deshpande

“I was a man of action. It hurts me inside when I look at myself now” said the huge gentleman.
It was indeed sad to see the state he was in. Parkinson’s disease not only slows the body, but also makes one quite stiff, as if the body is made of some heavy stone. The side effects of levodopa, the most common medicine used in Parkinson’s disease patients, was also causing too many abnormal movements.I told him that some changes were required in his doses, and that I needed his cooperation and patience. He agreed, then I wrote him a new prescription.

“By the way, Doctor, if any of your poor patients needs any help with treatment or medicines, please let me know. I will arrange” he said once I finished with the instructions. Always needy for this cause, I took down his details.© Dr. Rajas Deshpande

He came over a month later, happy. This time he donated for an orphanage I often wrote about. I was more than happy, and told him he did not have to pay my fees ever.

“Thank you, Doctor, but you must let me help your poor patients” said Mr. Abdulkadar Mulla.

Over a period of time, I came to know that he donates medicines and free check up kits required for the treatment of young girls from interior adiwasi areas. He spends thousands of rupees every year, since many years, to help run health camps for such children, mostly through the BKL Walawalkar hospital at Dervan in Ratnagiri district.

This time Mr. Abdulkadar Mulla came over, I tried to understand why he is going out of the way to help out children from the interior.

“Because most people are interested in the kind of show-off charity. When you donate to famous organizations in the big cities, your contributions are recognized and published instantly. That is one reason, charity does not often reach where it must: the interior, deprived sections of our country”.
He paused.
“I must say this, doctor, please don’t misunderstand. I feel very bad when someone thinks of me less of a patriot just because I am a Muslim. I have served in Indian police, I have been in the elite VVIP security, I have served India as my own country. It hurts me when some people loose talk that all Muslims should go to Pakistan. India is my country too, I was born and brought up here, studied alongside classmates from many other religions, I have friends in almost every religion. I have served the nation honestly in an extremely responsible position, and am now serving the society by contributing in the most impartial way I can. There are limitations to what I can do as an individual to go on proving my honesty to my country. It hurts when people accuse us without even knowing us. From film stars to cricket players, so many Muslims are making India proud, still some people generalise against us”.

I had no answer. I told him that at least doctors are bred to never entertain that discrimination, that no medical student is fit to become a doctor until he / she can see each patient only as a human life without any other tag. Whether it is policemen or criminals, dirty politicians or reporters who paint our profession in the worst shades, patient from this country or that, from one religion or another: we doctors have only one duty: save life, safeguard health. There is no religion to the happiness of a saved life, nor to the agony of a death. There is no religion to the hand that helps. © Dr. Rajas Deshpande

I remembered the many Muslim classmates I had through my school and medical college. In fact, I was so close to one in my medical college, that his mother loved me like her own child, and cooked me delicious ‘vegetarian’ dishes whenever I went to their home. Some of my Muslim friends now have their own hospitals treating patients from all religions, especially poor. One of my extremely religious Muslim friends, a super-specialist, treats hundreds of poor patients from all religions: without any discrimination in his treatment or approach.

All of us have been through this, everyone who truly worships God knows love for other human beings. It is very important to pass this “Indianness” on to the future generations, and not fall prey to lesser thoughts, however loud. © Dr. Rajas Deshpande

Mr. Mulla told me he had had a spinal surgery, during which a surgeon mentioned the charity work at Dervan hospital. “I decided to donate to this hospital at Dervan. This way my hard-earned money reaches where it is most needed” he said. This institute, presently headed by Dr. Suvarna Patil, conducts multiple health-centered activities for children on a charity basis. Many renowned doctors and other professionals from India and abroad participate in their activities.

“Saare Jahan Se Achcha Hindosta Hamara” by the poet Iqbal brings tears to my eyes every time I hear it! I am proud to meet the likes of Mr. Abdulkadar Mulla, who prove by their silent actions who they truly are. I am also proud to belong to the community of doctors, for whom human life is beyond any discrimination.

Jai Hind! Happy Republic Day!
© Dr. Rajas Deshpande
Please share unedited.

 

Respect: The Depreciating Indian Salary

Respect: The Depreciating Indian Salary
© Dr. Rajas Deshpande

“Over 1.5 Crore Every Year! That becomes more than ten lacs per month! Wow!!” my student showed me the news that some brilliant engineering students passing out from India were hired by some software biggies in Campus Interviews, “They will start their careers at that salary. That’s life!”

I felt proud, as always, these news and similar have always made me feel that the Indian academic talent has always been looked up to and rewarded by the developed world. The tiny speck of jealousy that we earlier felt for our classmates who went for engineering and had their own homes and cars while we were still finishing internships has faded away long ago. The only regret that sometimes peeps out from the past is that of never having fully enjoyed our teens and youth. The fact that most doctors from India also earn huge salaries in the west as well as the middle east speaks a lot about the flaws in our “Indian” thinking.

“Doctors get respect and that is the best that you can get in life. People think of doctors as Gods. You should never think about money” told every sore-throated, pot bellied and self proclaimed socialist who did not become a doctor, and mostly had no doctor in family. This ranged from our own classmates to the highest administrators in the country.

Over the years, I now feel that even the engineering or other stream’s graduates are almost in the same boat. I cannot wish upon the newer generations what we went through.
What is really making us proud here? That India cannot afford to use its own best talent in any field? That the best in all fields are taken away, because what the best Indian companies can offer them is nowhere near what the world outside offers them? That the best salaries in all government jobs are reserved for bootlickers above the age of 55? That in no field can the government find the young talents superior to white haired yes men? © Dr. Rajas Deshpande

Or boast with a shameless pride that the most revered Satya Nadellas and Sundar Pichais made in India cannot find career scope in their own country?

Or, while proclaiming “Vasudhaiv Kutumbakam” (The World Is My Family) on one hand, are we going to perpetually cry the same song of socialism and patriotism, expecting all of them to only follow the examples of the rare (and respectable) ones who chose to shed material life for the country? India needs a million good volunteers in every field who will live and die poor while serving the society. But to force this upon all those who graduate from India is to invite them to leave the country. From politics and administration to Judiciary and lawyers, we need people who will work free or low cost, because the main disease: poverty and illiteracy, is a never ending curse in India. These are the people who choose the governments who throw “low cost everything” crumbs at the society, rather than uplifting the society to respectable self sustaining, paying capacity. © Dr. Rajas Deshpande The lifelong perks of representatives elected for even five years, from any political party are regularly updated, but the salaries and pensions of doctors and other employees who work lifelong are never upgraded without agitations and then only with allegations of greed!

No doctor wants to be a bad doctor, but no doctor wants to spend life in poverty and insecurity.

If at all a doctor decides to do charity and see all patients free/ concessional all his / her life, not only will they be lost to poverty and anonymity, but our government or media will never notice them. All they get is more paperwork to comply with every day, fear of suspension humiliation by the administrators and a salary that’s a shame given their talent and hard work.

There is this curious tendency in India: to force or to beg in the name of charity, social service or patriotism rather than rewarding the talent. There are very few examples of honesty, hard work and talent rewarded without political connections. © Dr. Rajas Deshpande

Are the medical students any less talented than their counterparts in engineering or other streams? Don’t they study equally hard and work 24/7 many more years before they qualify? Even after that, the highest salary that the government offers the starting doctor (even engineer) is laughable, and if they wish to work at a private/ corporate hospital, they cannot decide the rules of payment strategies. If they must start their own set up, they need huge investments, over fifty permissions, many recurring, every one requiring bribe in some form or other. And whichever one they choose from the three career options above, from day one the society and media will have already presumed them guilty of extracting money from patients, the government and even some judges urging them to understand the feelings of relatives beating up doctors. I wonder how many ministers , judges or media bosses would like to understand the feelings of those who beat them up for something their client/ petitioner didn’t like. The most pathetic part is that while all of the above officers are inaccessible to common man, they still have armed security, and the junior most doctor who faces armed relatives is denied security even by law! © Dr. Rajas Deshpande

Most top medical graduates and postgraduates, like almost all other streams from India are leaving voluntarily because of this situation. To deal with this, the best options that some governments came up with were long term bonds to force govt. service (without telling anyone where the govt. spends so much on medical education), and canceling permissions to leave India even after the bond is completed. Bravo! © Dr. Rajas Deshpande

The Hon’ble PM has time and again declared many institutes like AIIMS to be opened across India. This is welcome, but we must also look at the state of conditions and staff in the existing health institutes run by the government. That needs billions for repairs, facilities and hiring better staff. Unless the salary structure for young and talented medical specialists increases , there are no chances of any AIIMS-like institutes running efficiently, they will soon become dirty buildings with low budget staff, where desperate patients are chronically dissatisfied and mobs find chances to vent anger.

Earlier I had immense respect and pride for every doctor who decided to return to India with a positive attitude and a wish to serve the society, their only expectation being living a modestly good life. Now I doubt if they are doing justice to themselves or their family, by choosing a life of financial and personal compromises, where they not only sacrifice, but are still looked upon as “looters”, face a violent society and a prejudiced government.

Ten years ago, I would have told this student of mine “let go of a good life, stay in India, we have a lot to do for our country”. Today, I don’t interfere with their decisions to make a career outside India. Because I love my India as much as any soldier would,and I also love the talented people in it.

Jai Hind!
© Dr. Rajas Deshpande

Please Share Unedited.

The Bleeding Curse of an Extraordinary Doctor

22886306_1454137794681544_4590057867307928830_n

The Bleeding Curse of an Extraordinary Doctor
© Dr. Rajas Deshpande

“I cannot sleep well, I cannot forget what happened” said the doctor who had come to consult. I was shattered myself. My usual poise was blown to pieces listening to what this mountain of sacrifice was telling me.

As Dr. Anil Dadarao Waghmare told me about his past, I was in frightful tears.

Son of a humble education officer, he had joined MBBS on merit basis, and completed it in time. He wanted to honour the government bond for two reasons: he had an inner desire to serve rural areas in India where medical care was not available, but he also had no other source of income and had no money for investment. This is the common story of most doctors graduating in India.

He joined as a medical officer and was soon posted in a very remote tribal area, where he went beyond his duty to help the illiterate poor tribals. He worked ‪24/7‬, attended all their problems like deliveries, poisonings, snake bites etc., but also went to visit homes of those who could not reach him. He offered his designated vehicle as an ambulance whenever someone was to be taken to a higher rural hospital. His wife and children accompanying him sacrificed normal life. Two of their kids went to the local primary school, the quality of education was extremely poor but they had no option. The third child was only 9 months old. This youngest daughter was often looked after by a 12 year old girl who lived next door, and helped Dr. Anil’s wife with her chores.

One day, Dr. Anil’s wife received a phone call. The lady caller who spoke in local dialect told her that this youngest 9 month old daughter was in her possession, and threatened to kill her if a certain amount was not paid immediately. By the time they could arrange anything, the infant was found dead by suffocation. The 12 years old girl who looked after the child was found dead in a local well after three days, a huge stone tied to her body.
The murderers were soon arrested: the lady confessed to the crime, assisted by her parents, for want of money.

All the three: the murderer lady and her family were being treated by Dr. Anil for over a year, as free patients.

Dr. Anil was transferred elsewhere, and decided to still continue serving the rural population. He has now joined a postgraduate course, but he wants to keep working in rural areas.

“No one cares about a doctor’s life, family or especially security. The situation is worst in the rural areas, where illiteracy, superstition, witchcraft, murders and rapes are commonplace. Local politics is at its worst” says Dr. Anil, “I was ready to sacrifice every pleasure in life to serve rural population, I even compelled my family to sacrifice, but I did not deserve this punishment. This pain is beyond description, sometimes I feel whether my decision to go to such unsafe place with family was correct. This bleeding curse kills me every moment”.

Thank you, those who keep saying that our society considers doctors ‘like Gods’!

While air conditioned hypocrites advise doctors to go and serve in the rural areas, no one will look at the big picture: there are no facilities, but worse, there is no security. You are left at the mercy of local criminals, often politicians.

Film stars, directors, politicians and many judges will never notice this kind of a story, just as they won’t ever comment about the sickest lowly traditions in their own individual profession. Communities ripe with rapists and murderers, and onlookers who film rapes or murders rather than trying to stop them, expect the best brains to work for their healthcare at meagre salaries.

There is nothing wrong with a short term bond for service in rural areas, but while signing such a bond or joining such areas, the doctors should also ask the government a written guarantee of security. This should be the part of the bond. If security can be provided to every TDH in politics, filmdom or to even the lowest ranks in the judiciary, even some criminals, it can definitely be extended to the doctors serving in rural areas. A doctor who feels threatened cannot work and in fact should not continue to work unless adequate security is provided to him / her and family.

Dr. Anil Dadarao Waghmare, you deserve the highest medal any doctor can ever get: because you showed this selfish society how big a doctor’s heart can be, by continuing to serve in rural India. From now on when the loudmouth foghorns in politics and administration try to malign our profession, or try to cover the gaping deficits in basic facilities at rural level by pointing fingers at the doctors, we can tell them your story.

As for the loss of your 9 month old daughter murdered by your own patient, I stand up in tearful, shameful regret of the state of affairs of Indian Rural Doctors.
© Dr. Rajas Deshpande

PS
It is high time the doctors unite to take a strong stand against aggressive attitudes of society, against stupid policies and being taken for granted and spoken against by uneducated loudmouths.

This story should reach every blabbering idiot who has no doctor in the family and keeps on expecting all doctors to be servants of this society. To those among doctors who try to impress faceless media or administrators by continually talking negative about our own colleagues, this story should serve as an eye opener.

Thank you, Dr. Anil Waghmare for the courage and permission to share this story.

What Your Doctor Never Tells You

What Your Doctor Never Tells You

© Dr. Rajas Deshpande

This small girl who had had her third convulsion in last three days was now looking frail. Her mother, extremely anxious, asked me what can be done to “immediately stop” her convulsions. This hyper-mother had stopped all the epilepsy medicines of this kid few days ago. Patiently, I asked why.

“Because I read on an article describing ‘what your doctor hides from you’, in which the author had recommended a particular diet of natural ingredients “, she replied, adding “the article said that all allopathic doctors give you medicines that will keep you sick for longer, so that they can earn more. It also said operations like joint replacements or procedures like angioplasty should never be done.”

Needless to say, this lady was buying the “Purest Natural Guilt Free” products from that website, at a price that was way costlier than all of her allopathic medicine combined.

I told her that it was a mistake to stop the kid’s medicines, and issued her a new prescription. © Dr. Rajas Deshpande

“What do you do, mam?” I asked her.

“We run a bakery, I sell exotic cakes, muffins etc.” she replied.

“Do you lie to your customers? Do you sell them products that will harm or kill them?” I asked.

“No, never! How will my business run then? We have to obtain licenses for food quality.” she retorted.

“It is the same about us doctors, mam. All the medicines, stents and joints that your article has slammed, are approved by government, and additionally, they are scientific products, not just claims. The government also earns tax on each medicine, stent or joint sold in India”.

I was offended somewhere, and so continued:

“We come from similar families as yours, mam. Even our parents teach us culture, compassion and good habits just as yours do. We doctors learn in the same schools as you, and common school teachers have taught us the importance of good. We too have parents, spouses and family, kids whom we teach good values by practice. Why will such doctors hide the truth from you and suggest you something that will harm you, who have come to us in good faith? Do you presume that all of the thousands of brilliant patriotic doctors will hide a cure from patients, and continue to let people suffer? Just because some bakery is selling rotten cakes, how would you like someone badmouthing your bakery, your integrity? ”

“Not you doctor, but not all doctors are like you” she said.

“Thank you for your faith mam, but I know that most doctors are like myself, who have struggled hard to achieve their degrees, to be able to save lives and bring an end to the suffering of millions. It is not an easy task, there are many easier ways to earn money with lesser hard work and sacrifice. You will rarely find the children of stars, sportsmen, industrialists and other ultra rich becoming doctors, no one wants so much hard work for such less money.” © Dr. Rajas Deshpande

“We cannot advertise, while most of the alternative medicine companies, gurus and babas keep on blatantly claiming cures for incurable diseases, spreading rumors about allopathy and some other recognised pathies, cleverly selling their own products to desperate patients who hope for relief, and spend far more in the wrong direction. Look at who all is earning crores while claiming that allopathic doctors are cheating people”.

She said she agreed, and won’t interfere with the right treatment of her child now onwards.

This is a complication of a deliberate and sick propaganda which has been orchestrated to tarnish the image of especially allopathic doctors, to be able to sell innocent patients one’s own unscientific products. It is sad that the very people who complain about the consultation charges of qualified doctors go and buy extremely costly “magic remedies” like some unproven, unscientific laser instruments, vibrators, garments, herbals, extracts etc. © Dr. Rajas Deshpande

The fact that vegetables and fruits are costlier than many medicines, that weekly vegetable expenses or family dinners in India are far more pricey than a specialist’s consultation which can be obtained urgently, speak a lot about where we stand. In the developed western world, there are year-long waiting lists to see most specialists. The fact that Indian doctors are the best and hardest working is appreciated all over the world, but so many Indian gurus, babas and fraudulent quacks run campaigns against our own doctors, in our own country! © Dr. Rajas Deshpande

Want to really know what the doctor doesn’t tell you?.

A doctor never tells you to go to herbal babas when you come to the emergency and need immediate attention. A doctor never asks you to take your lot to the websites that slam medical profession, when you need help. A doctor never abandons even a faithless and arrogant ignoramus, does not ask them to go search internet for blogs and natural remedies when someone is dying of a heart attack or a stroke or accident. While many recent fulminant ads claim that all doctors are greedy and deceptive, there are thousands of doctors in the hospitals all over world, who are not eating, sleeping or being with their family right now: not because they want more money, but because many will die if we don’t work hard. It is so sad that this had to be explained in India!

What a doctor really doesn’t tell you is: how difficult it is to treat and to save lives of the very people who have no faith in the one trying to do them good!

© Dr. Rajas Deshpande

PS: Recently the number of posts circulating to slam all medical professionals, especially allopaths, have increased, especially in an attempt to market certain products. This extremely harmful trend is ignored by all concerned authorities. This article is an attempt to defend the glorious scientific profession I belong to.

Please share unedited.

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.

Please share unedited.

Which Is The Best Festival Upon Earth?

Which Is The Best Festival Upon Earth?
Dr. Rajas Deshpande

“Happy Diwali” said Mr. Abdul as he entered with a box of sweets in the OPD.

Over five years ago he was admitted with a complete paralysis, and had fully recovered as he had reached the hospital within two hours of the onset of paralysis. Since then I had received his Diwali hampers without fail.

A happy gentleman who liked to make funny sarcastic comments (maybe Pune effect), he made me smile every time. “Your fees has increased, doctor, but my feelings of gratitude for you will not change” he said now, silently laughing: “Every Diwali I remember that I was admitted on the Laxmipooja day, and our family was worried if the specialist doctors will be available. My wife was praying that there should be some specialist doctor to attend my case all the way from home when I became unconscious” he recalled. Dr. Rajas Deshpande

Indeed, he was admitted on the auspicious festival day, the junior resident doctor had activated the stroke code, our team had rushed in. I was already in the hospital to see a VIP leader whose headache usually worsened on holidays and then many specialists had to be called in to ego-massage his headache. So I could see Mr. Abdul immediately, and explained to his family that his condition was critical, that there were risks of complications in the first few days. Uncertain with the new doctor, they requested that I talked to their family physician Dr. Feroz. I did.
This is but natural, and there was no reason to feel offended with the anxieties of a serious patient’s family. In the age of trustless relationships where couples check each other’s cellphones like detectives and parents and kids question each other’s intentions, it is hardly possible that a serious patient’s family will blindly trust a new doctor. Even some doctors distrust new (not senior / junior, but the one being consulted for the first time) doctors. The only possible solution is an understanding doctor who takes this in stride, refuses to be offended, and acts in the best interest of the patient, taking an extra step to make the worried family comfortable. There are indeed some who never trust anyone whatever one does to satisfy them, but that is their own cross to carry, one should simply ignore the ugly trait. It is well known that those patients who do not trust any doctor suffer worst, as they don’t take anyone’s advice seriously. Dr. Rajas Deshpande

Three days later, as Mr. Abdul recovered, the family breathed in some confidence, and started believing all that I explained, without having to involve their family physician. Since then, although I have advised that he does not require to see me now, and instead he can follow up with Dr. Feroz, Mr. Abdul visits me every six months for a check up. His wife calls me Rajabhai, a name I would not have allowed anyone to call me with, but couldn’t dare tell this to her!

This is a pretty standard picture across India, most of even the poorest recover well from strokes, accidents, burns, infections, fractures, heart attacks and various other emergencies if they reach hospital in time. While people all over the world wish happy festivities to each other, take holidays, revel and eat and enjoy, while leaders give long festive speeches from their farmhouses to please various voters according to mob IQs, it is the professionals like doctors and servicemen like police, military, etc.who slog and run to save lives. They forget family and enjoyment to be available for those who suffer. The perpetual thankless will immediately say “but this is a choice you made”, but not understand that this choice was made to be respected, to earn well and to save lives, not for the society, the skimpsters and politicians to take advantage of. To see the sick and crying, angry people, to witness death and disability on the very days that your family expects you to be happy with them is not something one can easily come to terms to, and this is lifelong, not a five year term with long vacations. Dr. Rajas Deshpande

The fact that millions of critical patients are attended well during the most auspicious festivals: Diwali, Eid, Christmas, and all other religious festivals included, is conveniently forgotten once the festivals are over, and then the mudslinging about medical professionals starts, with the long speeches advising doctors to work harder with lesser expectations. Dr. Rajas Deshpande

“Doctor, this is not about Diwali or our religions” Mr. Abdul said while leaving, “this is to continue the tradition of humanity. There must be so many patients who can be with their families this festival, because some doctor worked hard to save them. This is my token of respect for those doctors”.

As always, I told Mr. Abdul that I was immensely grateful that the superpowers gave me this opportunity to be a doctor. I meant it. Dr. Rajas Deshpande

I often imagine: what if I was born with too much money, son of a rich father, with no worries for earning and no limits on spending, I would so much love to roam around the world in luxury cars and jets, among beautiful people (you understand), enjoying life to the brim, without caring for any suffering around me. In that case, I might have been very happy probably, but I won’t have respected myself as much. Even the most junior, newest recruit of a doctor is far superior to anyone who has chosen to cunningly ignore the suffering around, speaking big words and doing nothing about it.

Therein lies the best festivity in life: being a doctor, with an ability to abolish suffering and avert death.
Dr. Rajas Deshpande

Happy Diwali to all Patients, Medical Students, Junior and Senior Doctors, Resident Doctors, Nurses, Technicians and wardboys, Hospital staff and administrators, and to everyone who cares for others, showing it in their actions.

Advise Doctors What To Do?

 

For the hypocrites who don’t do anything to correct their own profession (almost every profession has immense corruption), but think they have the right to criticise other professions. Criticising the most intellectual profession of doctors irrespective of one’s own credibility, effort, contribution, or even intellect, has become an ugly fashion.
Here’s the answer:
(C) Dr. Rajas Deshpande

22282081_1436304909798166_7961220724905147443_n

The Silent Murders and Medical Suffocation

The Silent Murders and Medical Suffocation
© Dr. Rajas Deshpande

“Your grandfather is admitted and serious. Please come at once” my uncle said on the telephone.
I was in the first MBBS. This maternal grandfather was my closest relative after my father. An expert in many languages and philosophies, he was a constant source of love, wisdom and inspiration from my toddler days.

I submitted a leave application and travelled immediately to attend him. Grandpa was admitted in the general ward at the civil hospital Beed in Maharashtra. As the wards were full, he was kept with two other patients in a sort of a broad corridor, and IV antibiotics with saline were being given. He was delirious, but he managed to smile when he saw me. As civil hospitals do not have many medicines, my uncle arranged them from an outside pharmacy.

There was an elderly retired police inspector, Mr. Gaikwad, on the bed next to my Grandpa’s. He had uncontrolled sugar levels, and was slipping in and out of consciousness. His elderly wife was attending him, she was herself a patient of severe arthritis, and could not even get up or walk without excruciating pain. There were no chairs / stools or even mattresses for relatives attending the patients, so we slept on the floor besides our respective patients, upon our own bedsheets. I naturally attended the elderly couple too, I had enough time to attend humans as that was the pre cellphone era. Mrs. Gaikwad told me how her husband had spent his life without ever being corrupt, and said while she was proud that he was so clean, that also meant hardships like the one she faced. “Those who took bribes can afford to go to the private doctors in big cities and keep attendants. Our virtues translated in more hardships, the vocal rewards of words do not ease physical pain, nor pay any bills” she said with tears. © Dr. Rajas Deshpande

One night at about 3 AM, while I was deep asleep, I heard a scream and got up startled. Mr. Gaikwad was having a convulsion, and his wife shouted in panic. I ran to call the nurse, but there was only one for the entire ward and she was in the washroom. By the time she came out, the convulsion had stopped. She stopped the insulin drip and called the doctor on duty, who was asleep in the casualty. He came and administered some medicines and went away, exhausted. He was on duty for over three days in a row now, tired and irritable, yet had no option but to go on. I dozed off again. © Dr. Rajas Deshpande
In a few minutes, I realized Mrs. Gaikwad was waking me up again, shaking violently, because the IV needle of her husband had come out and he was bleeding. In panic I stood up. There was some water on the floor, and before I realized, I fell face down upon the bare floor. Such was the impact that my upper front tooth broke, and tore through my upper lip. It was bleeding profusely. The nurse had come and inserted another IV line to the patient by then, and the elderly lady felt quite guilty for my injury.

The nurse asked me to go to the casualty. The wardboy there refused at first to wake up the doctor on duty, saying he hadn’t slept for past two nights. However, as the bleeding continued, he took pity and woke up the doctor. Already angry, the casualty doc cleaned and sutured my lip with the available suture material, the correct one was not there. He asked me to get the painkillers and antibiotics from the pharmacy, and to fill up the necessary papers and pay the fees at the window.
With a swollen lip and an aching head, I returned to the ward and slept again. The next day, Grandpa was already feeling better, he could get a bed in a semi-private room, and discharged in two days after that.
Mr. Gaikwad, the elderly retired inspector passed away after two days, obviously a case of far less medical attention and facility. © Dr. Rajas Deshpande

I carry the scars till date.

Not much has changed in the civil / government run hospitals, even today. Far lesser beds and amenities, a constant lack of medicines and instruments, anarchic uncleanliness, underpaid and understaffed faculty, “sarkari” type procedural delays: overall a third-rate or worse experience in healthcare, with bribes and corruption at almost every level.
What is being projected is opposite though. The whole blame is being planted upon the medical professionals, and all the so-called reforms being made are just tightening of working conditions of the allopathic doctors. We do need reforms in medical malpractice and corruptions, and they are of course welcome, but many more thousand patients die due to apathy and lack of medicines and facilities at the government run hospitals than those who die due to medical malpractice. The number of administrators and government employees who do not attend government hospitals is a proof of the massive healthcare deficit we have everywhere in India. © Dr. Rajas Deshpande

Ambulances, thousands of more basic and specialty hospitals, more doctors, nurses, support staff in govt. run hospitals, better facilities and medicines are basic social requirements before any other development, advertisements or beautification is planned. However, the whole system appears to be concentrating upon the earning, eligibility and qualifications of existing allopaths.
MCI and IMA must also look into “Compulsory Basic Healthcare Facility and Patient Rights and Care” at all Civil / Govt. hospitals, specifying what the govt. must mandatorily implement in all its set-ups, what are the responsibilities of the administration. The overall (incorrect) notion that “All the problems in Indian Healthcare are because of the greed of Allopathic Doctors” is on the rise because of the “Govt. pleasing policies, comments and attitudes” by some. This will be extremely harmful in the long run. Progress can only be made in healthcare once the medical “Yes-Men” and “Yes-Women” are gone, once the voices that can boldly speak the truth are heard well.

Till then, the private practitioners must stay united in raising their voice against such “unilateral reforms” and defamation, or prepare to be forever suffocated by the system.

© Dr. Rajas Deshpande
Please share unedited.

The Untold Slaughter

The Untold Slaughter
(c) Dr. Rajas Deshpande

In my first year of Residency, I was waiting near the hospital elevator, with a colleague, already late at 8.30 AM. The Dean, who is the highest authority in medical campus, on his morning rounds, came with his routine flock: Medical Directors and Superintendents, Nursing Chief, and Assistant Medical Officers, and waited for the elevator. I wished him a Good Morning, he reciprocated and looked at his wrist watch. I understood. “Sorry Sir, I had an emergency last night, I left wards at 7 AM” I said. He nodded and smiled.

He was a respectable odd man out in the system at Government Hospitals then. He was clean and non-corrupt, extremely punctual and active. This reflected in cleaner wards and better services, availability of staff, medicines and devices, although the patients who benefited rarely knew who was the guardian angel behind the service. He had become Dean by a rare chance: there was no one qualified and willing to take on that responsibility, so he was given the charge. However, now those in the “good books” of power were ready to take over, and awaited the right moment.

Like most straightforward and non-corrupt officers with a spine, he was generally hated by the system. He had stopped the bribery and corruption that started from some ward assistant / ward-boy level to all the purchases, appointing committees of different heads. He had stopped the purchase of medicines and devices / catheters from dubious companies which had flourished for years around the town. “Local Cheap Pharmacies” run by the “Well Connected” or aliases of those in power were affected badly, as their whole set-up was designed to run via such government hospital purchases.

The doctors, clinicians and residents like us were happy that the patients got good quality drugs, it is otherwise horrible to witness treatment failures which can never be proven to substandard drugs or catheters. The only face to blame is that of the doctor for a politician or a patient.

Naturally, he was on the hotlist of many in power. The best weapon in politics: the caste card was being used against him. The labour organisations and staff associations that belonged to a different caste / religion than that of this Dean were continuously active to create nuisance, hoping to spread the fire and bomb the press at the first correct opportunity.

Almost all elevators at government hospitals are the basic old re-repaired ones: slow, jerky, unreliable, like many offices. As we waited, few others joined the elevator queue. Among these was a middle aged sweeper lady, who came limping.

“What happened?” asked the Dean to her.
“I fell at home, it’s just a small sprain, I am taking medicine Sir” she replied politely.
The elevator came. As patients rushed in, the Dean held open the door for her, and asked her to get in first.
“Pehle aap andar aao” he said (“You come in first”).
The lady politely replied “Nahi Sir, aap chaliye pehle” (‘No, Sir, You get in first”).
He went in, some staff went in with him, then he asked the sweeper lady to come in too, by a hand gesture.

That was enough. The next day, there was a huge agitation. The allegation was that the Dean said “Aati Kya” (“Will you come with me”) to a sweeper, and made an obscene hand gesture. There were morchas, road blocks in the campus. The sweeper lady declined to comment, her husband who was among the association leaders gave the press interviews. Some student organisations based upon caste and religion were involved, their gusto fueled by those in power. Two of the doctors who accompanied the Dean that day on the rounds also testified that the allegations were true. One of them was in fact the next in line to become the Dean. Everyone sane in the campus felt ashamed.

I was too insignificant then, just as I am today. But I went to the Dean with my female colleague, and we offered to testify what had actually happened.

He smiled through the hell he was going through.
“It was my mistake, Rajas, that I accepted the post. This is how the system works, this is the power they have. It is never any party or caste or religion, it is merely a human tendency and unfortunately, that is in abundance today. We have no chance against the majority, and if the majority chooses to be a mob, we
are helpless. Because mobs are bought and blinded, they have no logic or reasoning. The wisest thing in certain situations is to continue to survive, do your best, till you can help engineer a change”.
“But Sir, those allegations are so unfair and vulgar” my colleague said.
He looked at her straight in the eye, and said “Do you believe all that the politicians say?”.

The change happened overnight.
Disgraced and sent on leave, our Dean did not resign.
“I am the small good that must remain in the system. Twisting facts, making allegations that need no proof, exposing personal lives and relationships, misusing culture, philosophy and wisdom as per convenience are new-age essentials for most political leaders. Illiteracy is a dangerous force. The only hope is those who do not succumb to pressure, keep their eyes open and think with their own brains” he told his friends.

Two years later, when I met him to give him sweets for my passing, to touch his feet and seek blessings, I found the same sweeper lady and her husband waiting outside his office. I told him so when I went inside.

Calmly, he replied “Yes, their son has passed twelfth standard, they need some financial help for his college fees”.
I did not ask him what he would do. Doing good is an obligation with such human Gods, irrespective of what they get back in return.

That places them above every other form of human being dry-blabbering about humanity. I touched his feet thrice that day.
© Dr. Rajas Deshpande

Please share unedited.

PS: Some facts changed to mask identity.