Tag Archives: medstudent

The Bullet Indian Doctors Bite

The Bullet Indian Doctors Bite
© Dr. Rajas Deshpande

“Her health is fluctuating. We need to admit her in ICU. Why didn’t you bring her earlier?” I asked the daughter of a 75 year old lady who had developed weakness in both hands and legs about two weeks ago.

“Doc, we thought she had weakness due to age, gave her some herbal boosters and vitamins, as we were scared of modern medicine. We hear a lot of bad things nowadays” there was no trace of any regrets in her voice that she was telling me this.

Wish I could tell her all that we hear about the reality of people criticising modern medicine nowadays. But who has that kind of time?

“Can we please treat her at home? She is scared. Also, we have limited finances, my husband is not in town. My daughter has her exams on”. she requested. We often accommodate many requests, but really, our society never stops asking for more than possible. I explained her in detail that not everything can be managed at home, admitted the old lady in ward and gave all instructions to the staff. She had had very low potassium levels, we corrected them. On the second day, she started feeling slightly better.

Third morning, as I continued my OPD, I got a call from the ward. The nurse had a panicky tone “Doc, this patient has become drowsy suddenly since a few minutes. Her daughter is not here, I noticed when I went to check her. Pulse rate is high, no fever, and oxygen levels nomal. But she is breathing faster”.

“Sis, please check her blood sugar and send her blood sodium- potassium levels, and haemogram, I will be there in a few minutes” I said. I called the lab and requested them to process her samples urgently.

The sugar level was low, we gave her sugar and she became alert. In a few minutes we got the electrolyte levels, her sodium was also low, we started the correction.

“I have informed her daughter, she is on the way” the agile nurse said. As much as doctors, the credit of saving lives goes to the millions of active and alert nurses and junior doctors. I went back to the opd, apologised to the waiting patients and started again.

In some time, I received a call again. The nurse was still panicky. “Doc, the patient’s daughter has just returned. She is creating a ruckus here, shouting and abusing. Please come asap”.

I went there again. Indeed the daughter was furious.
“I will post this on facebook, I will write about the hospital, I will sue them. How can they do any tests without my permission?” she went on.

I said hullo to her, stepping between her and the patient nurse. © Dr. Rajas Deshpande

“Why did you do her blood tests without asking me? We had done blood sugars last month, they were normal. Also we had done the sodium and potassium two days ago. You should have asked me before sending blood tests” she went on.

Two angry humans is too much of a mess. I summoned my inner peace. I had done what was good for the patient, I wasn’t scared of anyone. Especially ruckus makers. Her anger was her problem.

“Madam, may I explain?” I asked in a calm voice. Not that I am not short tempered, but I am a doctor.

I told her how some tests need to be repeated, and how there’s no time always to ask permissions by calling relatives. Patient’s life is always more important than the permission of relatives, especially if they are not on site. Sometimes, we need to do tests just based upon suspicion of certain complications. Every passing second increases the valley between life and death, the doctor and nurse must have the fastest brains and actions upon earth. To explain everything to every relative till they grasp and understand is another stupid, idiotic expectation in emergency. It’s like asking a soldier on the border to explain every citizen in the country why he fired each bullet. A medical soldier has to do the best, be medico-legally safe, document everything, explain to the relatives and obtain permissions, and still face anger, humiliation and social media threats, rating scams and attacks on reputation by anyone anytime. All this while having the best intention- saving the patient! © Dr. Rajas Deshpande

“You take fever by a thermometer many times a day – once is not enough as the condition is still persistent. Likewise some tests, even if costlier, need to be repeated. Unless you have written that we do not want any tests, we have to do what we think is good for the patient, that’s our sacred duty” I told her.

She calmed down.

“See, doc, I am sorry, I exploded, I am going through much stress at home due to issues with my daughter and my husband is not supportive. Now that you have explained I am okay with the tests”. she said.

“What about the shouting, the abuse, the insults to allopathic doctors treating you right now, the humiliation of the nursing staff and waste of my time, that caused discomfort and delays to other patients?” I wanted to ask, like most doctors, but we have no time. She wasn’t going to change anyway. Like most of our society.

When I discharged the patient, now walking on her own, the family was still upset, because the hospital did not comply with their expectation of a “discount”. A genuine “Thank You” is extremely rare in Indian hospitals, even when the critical walk home.

Three months fast forward. I received a call from the daughter again “Doc, my mom has become drowsy again, shall we come to the hospital?” she asked.

“Sorry, I am not available, please see another doctor at any hospital of your choice” I replied.

Many good doctors have exhausted their patience and will to be kind and compassionate due to such incidences happening every day. Now most are concentrating on patients who have better common sense and manners, politeness and willingness to understand the use and limitations of modern medicine. Money is the last thing a doctor can think of, but sadly it is the first and only thing that most relatives think about. While treating the patient, the first thing- patient’s life – has not remained the priority for most hospitals, it is now the safety about medico-legal aspects and reputation. A wise doctor has to learn how to balance in between.

Doctors in India must bite many such bullets every day!
© Dr. Rajas Deshpande

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The Story of a Deadly Brain Aneurysm..“Doc, was the treatment delayed?”

The Story of a Deadly Brain Aneurysm..
“Doc, was the treatment delayed?”

© Dr. Rajas Deshpande

“Doc, was the treatment delayed?”
The angry husband, Mr. Mane asked in a calm voice but the accompanying relatives had a menacing look upon their faces.

The patient, his wife Mrs. Sujata 35 years old, was brought unconscious two days ago, in a comatose state, at about midnight. I was out of city, so my colleague Neurologist rushed to the hospital and started treatment. We were constantly in touch, within an hour Sujata’s scans were completed, and she was shifted to a critical care unit. She had large bleeding in the brain, and was already beyond a possibility of surgical treatment.

About five years ago, she was diagnosed with an aneurysm in the brain. It is a defect in a blood vessel which balloons out as its walls become thinner and may rupture suddenly, causing either instant death or bleeding in the brain, many a times huge. This diagnosis needs immediate treatment, the right words that describe its risk are: “This is like sitting on a time bomb, not knowing when it is set to explode “.

Many patients do not have much symptoms besides headaches or minor neurological issues usually found on examination by a neurological expert. There are many NeuroIntervention specialists in India since last two decades, who can reach the balloon via a catheter/ tube and close the balloon/ aneurysm so the risk is eliminated and patient cured. Sometimes neurosurgeons are required to operate if the aneurysm has a wide base, and close the connection between the balloon and the artery from which it arises, by an open surgery. © Dr. Rajas Deshpande

Five years ago, we had informed all this to Mr. Mane and Mrs. Sujata. Like many educated patients nowadays, they obtained multiple opinions. Almost all doctors had told them what we had told. However one retired allopathic doctor, now quite old, and one non-allopathic practitioner told them “It is not necessary to do the surgery. Doctors these days advise unnecessary costly treatments”. They started some vitamins and health boosters. © Dr. Rajas Deshpande

The couple decided to wait. The came for follow up once after two years, we told them it was better to operate, but they said “We met our neighbour doctor, he is very senior, and he said that there’s no danger in waiting. I think he knows, see, nothing has happened in two years.. we are happy as it is!”

After that they did not follow up. They had even stopped allopathic medicines. They had come now, when she was beyond any possibility of rescue.

When after a day we told the family that she was brain dead, they asked the question above: “Was her treatment delayed?”.

After explaining to them that everything was done faster than even the best centers in America would have done, they calmed down.

Out of curiosity I asked Mr. Mane: “What did your neighbouring Doc say, the one who had advised to not operate her?”

“Oh, he was very kind. He said nature is cruel and anything can happen anytime to anyone. He arranged for an ambulance too for us.”.

Mrs. Mane didn’t make it, we all felt very sad that a young life that could have survived was lost to a wrong advice. Many doctors who do not specialise in certain complicated and advanced branches of medicine often try to please the patient by giving them an advice that attempts to impress the patient by saying what they want to hear.

It is true that sometimes surgeries are wrongly advised and performed, hence the social confusion about trust. There’s only one way out- explaining the patients and giving them credible websites to refer to, referring them to another specialist who is qualified in that branch. Some trust-less patients will still pay with their health and life. © Dr. Rajas Deshpande

If such cases go to the courts of law, challenging the speed and/ or efficiency of treatment, the honourable courts should consider delays and decisions at every step beginning from the day of onset of symptoms, the delays in visiting doctor, specialist, performing advised tests, obtaining another opinion if advised and getting the prescribed treatment in time. Just holding the doctors and hospitals responsible for not being able to rescue the patient at the last stage is not justified.

Leave aside a few wrong ones, but most surgeons only advise a surgery after deeply thinking about all possibilities, risks and outcomes. Sometimes even when the outcome is uncertain, they must operate. At such times their reputation and career is at a stake, because every mistake is nowadays amplified into a media blast. Still they think about what’s the best for the patients, and try to do their best. Surgeries and procedures, even the costliest, are the cheapest in India since last thirty years- surgeon’s fees are still lowest in all branches, and if we consider the medicolegal and media risk and a violent mobs backed by some politicos, actually the doctor is at a high risk during every major surgery. © Dr. Rajas Deshpande

A doctor is not a merchant or politician to sweet talk to the patient and give them a pleasant but wrong advice and jeopardise their future just to “retain the customer“. This is a noble profession where sometimes strongly worded and unpleasant solutions are essential to save the patient. To expect all the patients and relatives to understand complicated medical concepts and treatments (which takes even brilliant doctors years to grasp) is comical.

We sincerely hope that our society recognises the huge stress every doctor goes through, every day, trying to do their best for patients.
We also wish that the law, politicians and media note that it is often the delays before admission that kill the patients than those after.

© Dr. Rajas Deshpande

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Thirty Years of Suffering and One Tablet of Gratitude

Thirty Years of Suffering and One Tablet of Gratitude
© Dr. Rajas Deshpande

At the age of 18, he started noticing difficulty in falling asleep because of a weird pin-prick like sensation in his calves. He ignored it initially, but later in a few months it grew so severe that he could not sleep. Then started a nightmarish phenomenon of sudden squeezing sensation on the legs, sometimes with other abnormal and disturbing symptoms like gnawing pain, pulling and jerky movement of both legs. A little massage initially helped, but within minutes, symptoms returned, and now came up to his thighs. Many a nights, he could not sleep at all.

Lack of sleep worsened his daily performance, and he started getting irritable, confused and often very depressed because of the ongoing symptoms. There were phases of relief without any apparent reason, but the problem almost always returned with more severity. He went from one doctor to another, was told he had nerve problems, muscle fatigue, deficiency, and even psychological issues. Various tests done did not show any abnormality. In the last few years, his symptoms spread over to his hands and became so severe that he could not sleep at all. He tried many medicines from many pathies but had no relief. Then he started having suicidal thoughts.

That’s when Dr. Lakshman Sathe of Dodaich arranged for a video consultation with me for Mr. Rajendra Badgujar, now 50 years old, resident of Sindkheda. As any learned neurologist will have guessed from the description above, I concluded that Mr. Rajendra was a severe case of a rare disease called “Restless Legs Syndrome”. Although rare and more common in women, this extremely troublesome condition is now increasingly recognized in Indian population. This usually is caused by a genetic predisposition, but may also be associated with certain other medical conditions including iron deficiency. The most common complaints are ‘restlessness’ of legs, due to weird squeezing, pricking sensation or jerky movements. Very good treatments usually in form of tablets are available, but most of these tablets have serious side effects if incorrectly used. Also, only if the diagnosis is accurate and not associated with any other related conditions, patients respond well.

Mr. Badgujar, who had suffered for nearly 30 years, had complete relief within a week of starting the new medicine, and is now not only having sustained relief with only one tablet, but has also slept blissfully over last two months. Still, that is not the reason for my article. This poor man travelled to Pune for 9 hours, daring the CoViD pandemic, with his family, only to personally say thank you to me. This single tablet of gratitude calmed my restless mind instantaneously!

Most neurologists can readily diagnose and treat this condition in the first or second visit itself, sometimes a few tests may be required. If the patient reaches the right specialist for various medical conditions, not only is he /she relieved at the earliest, everyone saves a lot of money and we can thus contribute to improve the reputation of our noble profession.

©Dr. Rajas Deshpande
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PS: Every qualified neurologist can diagnose and treat this condition effectively.

Say, doc!

Say, doc!
© Dr. Rajas Deshpande

“Doc, may I eat fruits?”
“Yes”
“Papaya?”
“Yes”
“Apple?”
“You can eat all fruits.”
“Banana also?”
“Yes”
“But I get vomiting after eating banana..”
“Then don’t eat banana”
“But you just said I can eat all fruits “
“I’m sorry, please eat only what you tolerate well. Anything else?”

Next patient.

“Till the time we finalise and treat the cause of your unconsciousness episodes, please don’t drive any vehicle “ I told the twenty year old girl whose family stood surrounding her dipped in worry.

Since after a head injury during riding, the patient had had fits. She continued to ride her moped to her college inspite of strict warnings by doctors not to drive. This time she was admitted because she had fallen from her bike as she had a fit while riding.

“How will she go to the college then?” asked her angry mother.

“You will have to make alternative arrangements” I replied.

“Can she drive a four wheeler?” asked her father.

“No”. I now understood that they didn’t want to understand the risk.

“Three wheeler?” asked a relative who had the most common Indian OCD: talking without thinking, expressing opinion because it’s a constitutionally granted freedom.

“What three wheeler do you want her to drive to college ?” I asked the OCD bro.

“No. I just asked out of curiosity “ he replied more guiltlessly than your favourite politician.

How many irrelevant questions should a doctor reply to patiently?
Running between emergencies, making crucial life and death decisions for others over 30-40 times a day, with zero allowance for mistakes and facing angry, troubled souls who we genuinely want to help, how much extra time and patience for irrelevant questions is a doctor expected to waste? If relevant and crisp, every doctor enjoys the conversation, effective communication. When that enters the realm of “charche pe charcha”, it frustrates the doctor. Imagine that happening about twenty times a day. © Dr. Rajas Deshpande

Can a doctor refuse to answer irrelevant questions? Yes, but that risks a bad online review, rating in spite of correct diagnosis and good outcomes!

The consultation charges that a regular doctor charges are meant for a thorough history taking, examination and deduction of possible diagnosis, advice about tests required, and the best possible options of treatment/ management. It also includes a to-the-point explanation and information to the patient and attendant. It doesn’t include the unending “questioning” and expectations that the patient/ relative should grasp everything immediately- medicine is indeed very complicated. We usually give patients the websites to read from, but it cannot be the doctor’s responsibility to make the patient understand everything- it’s like asking the Judges to explain their decisions and law to both parties involved in each case- every day.

Every medical student should learn how to patiently, courteously tell the patient and relatives to limit the conversation to relevant questions only. It is an art. One can also schedule a separate paid consultation in case the family had extended questions and needs the doctor’s extra time.

Just when I was finishing a late day, a patient who had just left returned, panting because he was running.

“Doc, I forgot to ask you- is it okay to smoke a few cigarettes? – I am quite stressed you know”.

I smiled and replied “No you can’t. Reduce stress rather than killing yourself slowly with both smoking and stress”.

That was a relevant question though, as it reminded me of reducing stress in my own life. © Dr. Rajas Deshpande

© Dr. Rajas Deshpande

Who Won Over The Pandemic In India?

Who Won Over The Pandemic In India?
© Dr. Rajas Deshpande

As the covid situation improves, now begins the race for looting the credit and masking, twisting the reality. There’s a lot yet to happen, we hope there’s no second peak, the situation is best described as unpredictable at present.
It will be conveniently forgotten that hundreds of doctors, policemen, labourers, many covid warriors like nurses, hospital support staff, ambulance drivers, and government officials died to save millions of Indians. It will be downplayed that hospitals and staff therein were pushed to inhuman tasks for over eight months, some without payment. It will be never recorded that many PG students died due to unfair and unsafe postings during this pandemic, thousands worked without payment for months. It will also be conveniently forgotten that private hospitals- usually treated by society and politicians as “money minded looters” – were the only existing mechanism that could save our country from a much larger death toll.
The reality is that millions of patients went home because our private hospitals, doctors, nurses treated them day and night, without caring for their own family.

It will be comfortably masked that many government healthcare facilities were a failure, that enough manpower could not be found to man jumbo centers, that we lacked any other government machinery to provide healthcare in such a situation except arm-twisting and exploiting private practitioners and hospitals. Let us never commit the mistake of presuming that such a pandemic will be a one-time rare event as some evil countries now know what biowarfare can lead to. While electoral speeches will claim “Success” in defeating covid, the truth remains: that COVID has exposed us, our poor preparedness and arbitrary actions often without estimations of how they will affect millions of poverty-ridden illiterates. While sloganeering and declarations of “Thousands of crores” will be announced for people during elections, no one will question why we have not built any more hospitals, why we are not recruiting more qualified doctors in government set-ups, and why doctors find it impossible to work at govt-run hospitals. The sad stories of big netas getting admitted in biggest private hospitals and getting best of healthcare while the poor people on the street kept dying because they could not find ambulance, ICU, hospital or even family members to support will never be forgotten. © Dr. Rajas Deshpande
We will never know who and why was given “Fast-track” certification for the emergency production and sale of huge quantum of PPE kits, masks, gloves, sanitisers, medicines (which were later declared questionable), tests for covid etc. Enormous profits were extracted even from doctors treating covid patients (because we all have paid huge amounts in last ten months for the safety gears, sanitisers etc.). We will never know how many thousand crores were earned by those who sold “immunity boosters” without a FDA validated scientific proof, taking advantage of illiteracy, ignorance and superstition in our country. The profits earned by one and all by the sale of these pandemic-essentials will remain hidden, and the bashing of private hospitals for overcharging will continue.

Let’s get the facts right: the private healthcare has sacrificed bigtime in this pandemic to save the life of millions. The credit of saving our beloved nation from a far more devastating outcome goes to these private hospitals, doctors at both private and government hospitals, postgraduate students, many brave, daredevil police officers, administrators like collector / commissioners, other grassroot covid warriors. Most declared policies were either ineffective or redundant. The courts in some states and even the Supreme court had to intervene and correct some wrong decisions, which itself saved many and eased the life of many more, we will be grateful to the Judges who took the best possible view of a blurred scenario. I must humbly thank certain political leaders, chief ministers of few states and others in the government for their individual hard work and involvement in this fight.© Dr. Rajas Deshpande

Yet, as our great nation India recovers, there will be proud chest-thumping by some leaders about “I / We defeated Covid Virus”. No. We doctors are a scientific community unblinded by bias. We know that Covid has unmasked the glaring, shameful shortcomings in our system. Covid has shown us our misplaced priorities. Covid has exposed the hollow claims of us being a developed, civil society. The number of maskless literates even during the peak of this pandemic is a proof of how backward we are as a community. India has almost no respectable medical research, we have a shameful federal healthcare infrastructure, we are considering non-doctors as teachers in medical colleges already sinking in quality, we have to rely upon quacks for healthcare delivery to the poorest and the rural, and yet the headlines of us donating nearly two million N95masks, HCQS to other countries gives us a feeling of pride, and we sing songs of a glorified glory.

The entire credit of pulling the country through this pandemic goes to every grassroot warrior, junior doctor, other doctor, nurse, private hospital, administrator, police. officer, and donors of multiple crores who sacrificed their life, family, or lifetime earnings for India.
Let no one befool you to believe otherwise.

© Dr. Rajas Deshpande

Dedicated to the real COVID warriors.

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The Hurt Passion Of A Doctor

The Hurt Passion Of A Doctor
© Dr. Rajas Deshpande

The recent picture of our favourite cricketer Mr. M. S .Dhoni exhausted and fatigued on the field caused a lot of concern, and we wish him best health with many more years on the field. The passion with which he plays is inspiring, we all love and respect him just like we have loved and respected Mr. Sunil Gavaskar, Mr. Sachin Tendulkar, Mr. Anil Kumble, Mr. Virat Kohli and many other greats that the Indian cricket has produced.

By the age of 40 or so, most of the heavyweight sportspeople usually retire from a competitive life and take over other, less tiring jobs. They have spent their entire youth in working extremely hard, with untiring efforts to perfect their craft. The fields of both sports and films are unforgiving, and exceptional talent is required to make it to the top. On the plus side however is the recognition, fame, and money that follows success.

Where does a doctor stand then?

While we cannot compare any two professions given the different client-base and frustrations of each, we can definitely draw some parallels. Competing intellectually starts from school for every doctor, innumerable hours in studying, applying the best mental effort to performance, and overcoming all temptations of a light-heartedly enjoying outside world are just basic compulsions if one has to excel at least in India. The extreme competition for medical admission is worst in our country.

However, that’s just the beginning, and the real struggle starts after one joins medicine: exhausting timetables, extra work and duties, unending patient loads of an hygiene- illiterate society abandoned on health front by its own government are the basic premises. Add expectations of immediate cures and filmy, miraculous recoveries with best recommended World-class internet treatments but with “Indian Compulsions” of charity treatment by doctors from their own pockets, and a never-ending game of moral-ethical looting, compassionless exploitation begins. In the midst of all that mud, a doctor must still keep studying to be abreast of all the modernities of his science, keep a calm mind and be polite and good to even the worst behaved.

Then come home and see pictures of compassion for celebrities. No we do not envy the celebrities. We love them as much as anyone else. We just hate the hypocrisy that our people have created: that if you choose a career in medicine, you are far less likely to be loved, whatever you do, however hard you work, and even if you lose your life. The whole government machinery which rushes to wish celebs and click selfies with them on every tiny occasion cannot have the list of doctors who died treating covid patients! Has anyone seen any selfie of any minister with the doctors who saved their lives from covid?© Dr. Rajas Deshpande
There are thousands of young and old doctors in India, this very moment, working in covid wards, more exhausted and tired than any cricketer in the world. They cannot retire: 99 percent are so financially dependant on their daily income or monthly salaries, that they have silently accepted the tyrannous, cruel policies of various governments to inhumanly exploit them. They are on the verge of death due to exhaustion, and some are already having thoughts of ending it all. Over 500 have died. But the very same society has no compassion for these exhausted doctors, it has abandoned the very heroes who have stood between them and death. Their salaries are pending, they have to buy their own masks and kits, and thousands are estranged form their families for quarantines.

A society that browbeats doctors and hospitals to convert compassion into acceptance of non-payment of bills (as if doctors do not have basic compassions and humanity that everyone else has!) has money to queue up in restaurants, bars, liquor shops, malls, and bet millions on cricket matches is still completely ignorant about the exhausted doctor. We can build everything else as development agenda, but India can not invest in doctors. It can have the most modern aeroplanes and bullet trains, but it cannot pay its doctors.

The young doctor is now rethinking. Many have chosen to change their preferences and not become a doctor. Most doctors do not want to push their brilliant children into this chasm called ‘medical practice in India’: a dark, exploiting, thankless, violent and vulnerable machinery to suck out the blood of the most brilliant minds of our generation. The most important part of becoming a doctor is to reduce suffering and save lives. No one, however rich, becomes a doctor with a mindset to earn out of the dying and suffering.

That very passion to save lives is being insulted, mocked, and widely abused by our great nation today. I will continue to write to my students, to the next generation doctors to please preserve this passion: that is the most beautiful part of your soul, and please do not let it be scarred by an unevolved, regressive and exploiting society that we live in. Take care of yourself. We have a mission to save lives, without thinking whether they deserve to be saved or not. We will shortly also devise strategies to end this exploitation.

© Dr. Rajas Deshpande

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Standing Ovation, Doctors with Hemlock

Standing Ovation, Doctors with Hemlock
© Dr. Rajas Deshpande

It is not new that the world has chosen to torture and kill the right and good. From Socrates to Mahatma Gandhi, the speakers of truth and advocates of good have been punished by a majority addicted to the illusions of both. Socrates, who was declared guilty and awarded death by drinking poison hemlock, had a chance to escape. He chose not to. ‘A true philosopher is not afraid of death’ he said. He chose to drink the poison.

At this very moment, thousands of young doctors all over India have chosen not to run away from the deadly virus: because they believe in the ultimate sacrifice: for saving the life of millions. They are the true heroes of India. If a soldier dies, the whole nation rises to salute the sacrifice. Nearly 400 doctors die, and our administrators said they did not have information about it in the parliament. © Dr. Rajas Deshpande

Digital India, where there wasn’t a day without messages about Aadhar cards, PAN linking, etc., and so many other messages reached everyone, yet unable to know tell how many doctors died. We can tell exactly how many patients were positive, how many tests were done, how many discharged or recovered, but we cannot tell how many doctors died while treating them. Shame!

Thousands of junior / PG doctors, interns and medical officers are being forced to work not only against their wish, but against all fair constitutional rights. They are being threatened and punished even after overworking. Their salaries have been cut, some have not been paid for months now. Everyday, patients too are frantically searching for good covid care beds.

Hospitals are overflowing, no beds available in some places, many centers are closing down because of lack of resources, but what we really need now is an IPL. We don’t have money to pay the doctors, create more healthcare resources for thousands of dying patients, but we can definitely watch cricket and forget all that. There’s nothing wrong with sports or entertainment, but is this the right time? Will the IPL profits be used for creating more hospitals? All through the economic crisis, I was amazed by the perpetual news of few Indians getting higher on the list of the richest in the world. I do believe that they are good at whatever they do. However, what was most ironical was that yesterday I read the news of people urging one of India’s richest businessman to buy the Man-U team. Mind you, people did not want a hospital for the dying poor, people did not ask the billionaire to pay the unpaid covid warriors, they asked him for buying a football team!

Add to this the new law about Violence against healthcare workers “During pandemic”. How can this be best described? “No murders, crimes, corruption during summer months”? Or “No stupid talking between 10 AM and 10.30 AM”?© Dr. Rajas Deshpande

The point is, dear Covid warrior doctors, please understand that the society does not want you, it only wants your free service without offering either respect or remuneration. The government has not even responded to our petition about human rights for doctors who have been slogging, carrying the pandemic burden on their shoulders as everyone else hogs the credit of recovering patients. Postgrad medical students have been denied education in their own branch for over six months now. They have been denied leave, permission to meet sick parents, or even a quarantine after exposure that is followed world over. They also face extremely hostile relatives and goons every day in hospitals. Many doctors who died just as they started their careers, are not even acknowledged! Just as every responsible institution in the country has taken precautions to safeguard itself from the virus, working online, just as the parliament is mulling over whether to cut short the monsoon session as some members were positive, no one wants to think about those actually dying every day facing covid patients: our doctors.

I have never felt so frustrated about the future of doctors in India. I have carried a proud torch of being an Indian medico and am blessed to have a great connection with most present generations of brilliant doctors, but I haven’t slept peacefully last few months knowing that my juniors, students are left to die in the pandemic. Every effort being made is quashed or falls on deaf ears.

I can only say to every doctor in the covid ward right now: humanity will always be grateful to you for drinking this poison hemlock just like Socrates did: bravely and in service of truth and good. If Mahatma Gandhi was alive today, he won’t have published his own achievements, instead, he would have made the country realize how indebted it is to your sacrifice. I believe in the power of one. Mobs never achieve anything. Each one of you out there is a hero saving lives, even when your own countrymen seem to have forgotten and abandoned you.

My Standing Ovation to every doctor working right now anywhere in the world, especially in India.

© Dr. Rajas Deshpande

Picture Courtesy: By Walter Crane The story of Greece : told to boys and girls (191-?) by Macgregor, Mary, Public Domain, https://commons.wikimedia.org/w/index.php?curid=32804549

The Good News: ‘Life Is In Brains’

Last three years we were planning a beautiful, comprehensive and patient friendly, “All under one roof” Neuroscience set-up at Ruby Hall Clinic.

Specialty Clinics for Multiple Sclerosis, Parkinson’s Disease, Epilepsy, Vertigo, Stroke, Brain Tumors, and all neurological investigations will be available here, on this floor. Also Neuropsychology, Speech Therapy and Counsellor for family members dealing with difficult illnesses.

My dynamic CEO Mr. Bomi Bhote has long dreamt of a world-class Neuroscience department at Ruby Hall.
“Give our society something to remember you for” he said often. I have tried my best to design this fully new Superspecality Neuroscience Department. After many meetings and many precious inputs from Dr. Purvez Grant, Dr. Manisha Karmarkar (COO), and Dr. Rebecca John, and the blessings of senior Doctors like Dr. Ravi Gulati, MD Dr. Sanjay Pathare we added one stop troubleshooting and convenience so that patients do not have to roam around.

Mr. Iqbal Chaney, Dr. Abhijit Rokade, Mr. Shailesh Kelkar, Mr. Avro Chatterjee, Mrs. Nilofer Shaikh, Mr. Tushar Patil, Ms. Ansha and so many others contributed to the efficient beauty of this set-up.

One item on the top of my bucket list thus ticked off: giving Pune, Maharashtra and India a Neuroscience Department to bank upon. This is just the beginning.

© Dr. Rajas Deshpande

Orphaned Doctor, Change and Future

Orphaned Doctor, Change and Future

© Dr. Rajas Deshpande

For two decades, I have taught medical batches one highest principle in medicine: To go out of your way to earn the patient’s confidence and trust, make the patient comfortable, understand their anger and frustration, and to never lose temper with a patient. Unfortunately, Covid 19 has started to change some of that. Because some patients and relatives do not listen. They do not care if they endanger other people’s life. They have no concept of importance of time and avoidance of “medical gossip”.

We must now treat everyone a potentially infectious source and take adequate care. Longer the exposure to a potential case, higher the chance of infection. That creates a new covid19 complication in our medical practice: dealing with the adamant, the slow, the repeating and the illogical. The days of personally explaining everything logically and patiently seem to be over, at least till the pandemic lasts, as extra time now means that much prolonged exposure. We should now record history with direct questions, examine and diagnose the patient, handover the list of tests if required and a prescription, and arrange for a telemedicine follow up of limited time to explain and discuss. In confirmed diagnoses, we can give the list of authentic websites which patient can read from and get their answers. That will eliminate a lot of unnecessary discussion and “unlimited questions because I paid for this consult”. © Dr. Rajas Deshpande

To risk his / her own life can be a doctor’s choice, but I don’t think any doctor has the right to risk the lives of his / her own children, spouse and parents. I don’t think it is right for the doctor to ignore his responsibilities towards his children, spouse and parents because he has to serve others outside family.

No doctor can endanger other innocent patients and hospital staff by exposing them to adamant, careless patients who refuse to wear masks in waiting rooms. A doctor cannot have time to go out and fight, especially with our politically powered criminals. The only way-out seems to be politely refusing to see the patient who does not follow basic mask etiquette. What is the point of explaining to a patient or a relative who wears a mask on their neck, leaving the nose and mouth open?

Many a times the doctor can diagnose and prescribe for common ailments within minutes, but it is customary to listen to the patient, to pacify their anxiety, to explain in detail and address many a fears born of google searches. The more difficult a medical condition, the more frustrating it is to explain it to patients. In every branch of medicine, there indeed are many extremely complicated medical conditions, situations which the most brilliant doctors also must make efforts to grasp.

It took me 3 years of specialty education after completing DM Neurology to understand Multiple Sclerosis or Parkinson’s Disease well enough to treat it, and even after 25 years of practice, neither me nor any of my teachers- some topmost authorities in the world- who spent their life studying these conditions can claim to have understood them fully. There are far more complicated conditions of the brain we must still keep on studying. How can these be explained to everyone from every background in few minutes?

While the medical treatment is the same for the intellectually challenged and endowed, the former takes the cake here because they stop once they trust their doctor, the later rarely can. © Dr. Rajas Deshpande

The Indian Doctor has been long orphaned by all. The pandemic has revealed the cruelty with which doctors are being exploited all over the country: especially the UG and PG students, interns and junior doctors. It is high time that every doctor takes charge of his / her own career, come out of exploiting contracts and services, even go to the courts if necessary, to be relieved of injustice, and start a good clean practice. That way at least one can serve many more patients, earn peace, satisfaction and funds, while also fulfilling the responsibility to safely look after one’s family. Resident doctors should seriously consider a national level petition to the courts of law about the various unfair practices being enforced at present.

We cannot change the clumsy, clueless, perpetually failing yet adamant mismanagers of the situation who unfortunately hold the reigns.

I’ve worked with orphans. They are most self-sufficient, beautiful souls who learn how to survive independently in a big bad world. I have learnt a lot from them, but the best thing they taught me was to not be affected by the false sympathy, artificial display of love, sweet talkers with black agendas and mean exploiters. They taught me that just holding hands without words at difficult times is far more meaningful than any huge boxes of chocolates, gifts, and to wit: thali, diya etc..

The key to wisdom is in silence. Doctors should silently change now.

© Dr. Rajas Deshpande

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One Way Relationship: I Quit.


© Dr. Rajas Deshpande

Let’s face it. India is not a country where politeness, manners and etiquette is considered essential or important. In fact if you have these qualities, you are looked upon as weak. The more you accept it, the more crap is piled up upon your cell and mind. Politely saying “don’t message, don’t disturb” never works, and routine cases become emergency because no one is available when people have holidays. So a relative’s health may be completely ignored all week when everyone in the family is busy, and the doctors are then screwed on weekends, with expectations of compassion and sympathy, and with two chocolates “Will pay fees”, and “You are so kind”.

If there’s an emergency, visit the nearest doctor, take the patient to the hospital and admit. Don’t look for an excuse and escape to save time and money by exploiting a doctor who has entrusted you with his / her private number in good faith. They are far busier on holidays than on the working days.

Yes, a doctor is busiest on his holiday, having to attend to umpteen chores at home that are left undone during the weekdays. The weekend stress is extremely high. Family members expect some quality time and interaction too. Even simpler Personal tasks like a haircut, Cleaning home, vehicle, shopping for essentials and completing paperwork, banking, financial supervision etc. completely consumes the weekend of every working doctor. All this has now multiplied due to the pandemic, extra tasks have been added with higher risks. Add planning for upcoming meetings, catching up with academics, and incessant calls of those who think that the doctor will be “at leisure” on a holiday to attend to anything that pops up in their mind.

The irritation of not getting a holiday even on a holiday is unbearable. Be it family or friends, very few truly respect the necessity of some peace of mind for their doctors. Just because they get the doctor’s phone number, people feel it is an open access to their private time. I have even met VIP patients who requested my private number and then told me that their secretary will call me as they cannot disclose their personal numbers. Now I regret having given out my personal number to certain friends who incessantly send reports and ask consultation almost every weekend.

I quit this one way relationship. I may lose some friends and some patients, but it is worth the peace of mind I need to serve my deserving patients well.

Sincerely requesting my patients, friends and family members to NOT message/ call / email me on personal numbers or on social media, on Saturday and Sunday🙏🏻.
No exceptions.

Wishing everyone best health and a great life.

© Dr. Rajas Deshpande