Tag Archives: neurology

Living By The Words ‘Being A Doctor’.


Living By The Words ‘Being A Doctor’.


© Dr. Rajas Deshpande

“He is critical, an emergency heart surgery is planned tomorrow morning. The surgeon says there is very little chance of surviving this. I don’t know what to do. I cannot imagine this is happening to us.” Dr. Ranjeeta Joshi was crying on the cellphove, still making an effort to keep her voice even. Her squeezing agony about the sudden illness of her Orthopedician husband Dr. Sudhir Joshi reflected in each word she uttered.

This was a weird coincidence! I was not working that day, attending a court summons because a patient was being divorced for having epilepsy. On the way back I also had had a terrible argument with a very precious friend, we were both hurt. Both these had emotionally upset me badly, and so on my way back to Pune, I changed my route to visit my favourite Ganesh temple, where I usually rediscover my lost calm when life batters my patience and bludgeons my peace. Just as I entered this temple premises, I had received this call from Dr. Ranjeeta.

I knew the couple well because Dr. Ranjeeta is struggling bravely with two bad diagnoses: Multiple Sclerosis and Rheumatoid Arthritis. The fluctuations of both cripple her often, but she stands back stronger every time. I knew she was already using a walker. Dr. Sudhir is one of the most renowned Orthopaedic surgeons in Mumbai, with his own hospital at Dadar. Dr. Ranjeeta looks after the administration of that hospital.

I was shocked. I didn’t know exactly how I could help. I reassured her. I told her I was praying for both of them, and urged her to have complete faith in a good outcome. One of the best cardiac teams, Dr. Ramakant Panda, Dr. Vijay DeSilva, Dr. Tilak Suvarna and their colleagues were to operate Dr. Sudhir in few hours. I prayed for the couple, informed her so, and returned to Pune.

She kept updating me. The surgery lasted over 11 hours. Dr. Sudhir was shifted to CCU.

Dr. Ranjeeta ran the show at their Dadar hospital. The staff of their hospital refused to accept salaries that month, and told Dr. Ranjeeta: “You have always looked after us and our families. Now it is our turn to stand by”.

Every passing day was like a slow mountain of fear heavy upon the shoulders of everyone involved. While using her walker and occasionally a wheelchair, Dr. Ranjeeta successfully managed to attend all his needs as well as home and hospital. Dr. Sudhir gradually came out of critical status, in a few days started walking again, and within two months started attending his patients.

Barely after 10 weeks of this major calamity, this medical phoenix started performing major surgeries again, back to his “Doctor Normal”.

When they came today, I was quite moved to see him all back to normal. Of course the love that the couple emanated for each other is beyond words, and I will refrain from expressing what is more beautiful unsaid!

Dr. Ranjeeta, with tearful eyes and a smile, said “We are so happy and grateful to God that we won! I feel every doctor must decide to be a survivor, strive to keep fit, because so many lives depend upon him / her.” she said.

“You are such a brave motivation!” I told Dr. Sudhir.

“It is my privilege to be a doctor, not everyone is lucky enough to become one. In death no one has a choice, but in life we do. I wanted to live and practice again, because being a doctor is a special ability! I can do so much for so many. I love this so much, that this itself became my motivation to survive and become fit again.” Dr. Sudhir replied.

As I stood mesmerised by his words, a beautiful guide to every doctor, he extended something.

A Montblanc Special Edition JFK Fountain Pen, something I was window shopping for so long!

What I ever did to deserve it, I will never know. But this beautiful pen will always remind me of the great JFK,, and more importantly, how I must make the best of my own life as a doctor .

One of the most famous quotes of JFK reads: “As we express Gratitude, we must never forget that the highest appreciation is not to just utter words, but to live by them”. There are thousands of prayers involved in becoming a doctor, in surviving, in reaching where we are today, each one of us. If only we live by our words, what we promised ourselves to be, never giving up, we can defeat so many adversities that stand between us and our life-goals.

Thank you, Dr. Sudhir and Dr. Ranjeeta Joshi, for this reminder, and being a great example.

© Dr. Rajas Deshpande

The Proof Is In The Pudding


© Dr. Rajas Deshpande

Seven years ago, Srinirmala Kanduri and her doting husband Vamsi Krishna came over frustrated by what appeared to be an unending punishment: Srinirmala suffered from a common type of epilepsy called CPS (Complex Partial Seizures), and was already taking three to four different anti epileptic medicines for the same. Her fits were still uncontrolled, and she would become unconscious without warning. She also had severe panic attacks, in which sudden fear grips the person, and a feeling of doom with actual physical symptoms like sweating, breathlessness, palpitations and blackouts keep reappearing. This not only made her own life miserable, but her husband had to rush home many times as she used to be alone. Their whole existence revolved around the fear and uncertainty of her illness, even at this young age, they could not plan any future.

Her physical examination was normal, and in spite of so many issues and side effects of the medicines, Srinirmala always kept a positive attitude. “I want to overcome this. I want to defeat this illness” she said every time. Sometimes, the medicines used for the treatment of epilepsy / seizures may themselves cause / worsen seizures. That’s what was happening with her. We gradually reduced her medicines, and were able to bring her to a single medicine, although she required frequent SOS medicine for her panic attacks.

Her husband Vamsi Krishna, working with Infosys then, relentlessly cared for her like a parent. He adjusted everything in his own life to suit her requirements: job, duty hours and undeclared leaves. He was not only completely supportive and understanding, but never even showed that he was doing anything extra for her. “We married in love” he says even today with his shy smile!

Then came the great trial of a woman with epilepsy. She badly wanted to become a mother. They were quite anxious and apprehensive, like all patients of epilepsy who face this situation. Vamsi was comfortable always with her choices, and said he would even support her if she wanted to avoid having a child. This is a nightmarish situation, given the emotional attachment that the mother and father have with the child they imagine. Now a days some safe medicines are available, although there’s none with a “completely safe” profile. Epilepsy medicines taken during pregnancy, almost all, have some risk for causing adverse effects upon the baby. Adding a simple medicine like folic acid and some supplements reduces this risk significantly.

Srinirmala and Vamsi decided to bite the bullet. These are the decisions that actually make the lives of the successful. We reduced her medicine doses to minimum, folic acid was added, and Srinirmala came with the good news soon. All through her pregnancy, her husband never left her alone except for his duty. Fortunately no fits came during her pregnancy, and she warded off her mild panic attacks with courage.

Then one day, THE call.

Shanmukhapriya was born in Hyderabad, under the care of Dr. Bhagyalakshmi at the Yashoda hospital, and both mother and the baby were smiling fit!

Another battle against epilepsy was won!

“There are ups and downs. There is uncertainty, no one can escape these. Keeping patience in difficult times helped me most, and that’s what I will advise everyone who plans to go ahead with extending the family while battling epilepsy. When I explained my situation rather than hiding it (stigma associated with epilepsy among the ill educated is a curse in India), my colleagues and bosses at Infosys and later Cognizant were very supportive.” says Vamsi Krishna.

Now Srinirmala has completely recovered, and rarely needs to hit the panic button. “I think it is very important to decide once and for all : that I will live normal, I will be fearless, whatever happens. That is what helped me win my battle” she says.

Then, as she asked the cute, sweet, and beautiful Shanmukhapriya (she is my child too, I feel, and the parents kindly allow me that) to blow a flying kiss at me, she commented “The proof is in this pudding”.

© Dr. Rajas Deshpande

PS: Thank you, Mr. Vamsi Krishna and Mrs. Srinirmala for allowing me this write-up for patient education, and Thank you Ms. Shanmukhapriya, for your heart throbbing smiles!

Beyond Fear: The Lady Who Defeated Brain Cancer


Beyond Fear: The Lady Who Defeated Brain Cancer

© Dr. Rajas Deshpande

About a year ago, a young man came with the MRI reports of his 64 year old mother, 
Mrs. Vijayalakshmi, who was then in Bijapur. She had developed paralysis on the right side of her body, could not speak, and was losing her consciousness fast.

The MRI looked bad, a big tumour was compressing much of the left side of her brain. It looked cancerous, and needed immediate surgery as a life saving option. Otherwise the tumor could damage the heart / blood pressure and respiratory control centres in the lower part of her brain, that risked life. The situation could turn into an emergency anytime now.

The family was devastated. They brought her to Pune. She was sinking fast. Required investigations were done, and we explained the facts to the family. The surgery could risk life or also cause permanent disability, including permanent loss of speech.

Her husband, Mr. Venkat Babladi was always by her side, with his hands folded, and had only one thing always to say every time any doctor visited her: “Please save her doctor, do everything possible”.

She was operated. Her husband, son Mr. Anand Babladi, and his wife all stayed in the hospital, taking turns to attend her. The tumor was sent for analysis.

On the third day, the report brought the bad news: it was a type of cancer called primary central nervous system lymphoma. These tumors have a high death risk, with or without treatment, especially after the age of 60.

“Tell us doctor, where can we do the best treatment for her? We want to do everything” her husband and family kept on telling us. She was still in critical care, but had started now to speak a few words.

Our oncologist Dr. Minish Jain and his assistant Dr. Yuvraj Rangam took over, and started high dose chemotherapy. She developed many complications, some related to the medicines, but her family always stood firm. Every day, her husband sat by her, holding her hand, and telling her that she was going to recover, that he will ensure all was well. Her son and daughter in law arranged for all expenses and logistics, not by staying away and sending money, but by attending her every day after their respective jobs. After few days she was discharged with advice to continue chemotherapy.

Unfortunately, Mrs. Vijayalakshmi had a fall while walking at home, and fractured her hip, she had to be operated. Her chemotherapy had to be stopped. It was resumed after she recovered from the fracture. Then in few weeks, radiation therapy was started. As a rare complication, she developed life threatening brain swelling, and had to be shifted to critical care unit. She lost her speech again. Her husband, who was now on the verge of an emotional collapse, met us outside her room and with tearful eyes, asked only one question daily: “She will be ok na, doctor?”

Medical treatment is mostly standard all over the world, but the affection and care of one’s family is not. Hundreds of doctors treat thousands of such patients, many patients get cured of cancers and other dreadful diseases, a simple statistic that is never made public by those who perpetually talk against medical professionals. Equally unrecognised is the fact that a caring family makes a huge difference in the patient’s recovery, this has become very rare now.

After a year, we repeated her scans recently, and told her the ultimate medical good news: she had defeated brain cancer! Her scans did not show any tumor activity at all. She comes smiling to the OPD now, her husband holds her hand on one side, and son on another.

The most beautiful gift she gave me this time is that she learned two new Hindi words specially for me, because everytime I saw her I asked her how she was, and could not understand her answer.
This time, her husband poked her, then she smiled and said “Achcha hai”.

Those two words were the winning roar of a simple, middleclass woman against a dreadful killer disease!

© Dr. Rajas Deshpande

PS: Thank you, Babladi family for the kind permission to share facts.

Please share unedited.

Worse than Death

Worse than Death
(C) Dr. Rajas Deshpande

“Doctor, I have started to die. Can you help me somehow?” he asked, calmly.
In his late twenties, a handsome young man, well dressed, but with a certain painful gloom upon his face that was a mismatch to an overall nice and clean appearance. What could this be? I started thinking, hoping he was wrong.

Then his shoulder twitched, and arm had a slight jerk. A pang of suspicion bit my heart immediately. He confirmed it in few seconds. Those who take life for granted are often so full of anxiety, and here he was, who had initiated a countdown to his own death, talking to me in a low but clear voice.
“Doctor, I have been diagnosed with Huntington’s disease over 7 years ago” he said, “Till now I had only these jerky movements. Now I have started having some mood problems and also memory issues. My parents died in an accident when I was three. My uncle’s family cared for me till I could go to a boarding school. I stay alone in a rental apartment, I work in an IT company”.

Examination and review of reports established that his diagnosis was correct. There is no treatment.
This illness of brain degeneration starts with abnormal movements, then causes loss of memory and other cognitive functions, mood swings, depression, finally causing complete immobility and usually death ensues due to blockage of windpipe because of food while swallowing. A patient usually survives less than 13-18 years after the diagnosis. Some commit suicide.

What do I tell someone aged 28 who knows he will definitely die soon?
Yes there are research options and support groups. Yes I can send him to a professional counsellor. Yes I can use some mood stabilising medicines and antidepressants.
But can I emotionally detach from this event as a doctor? (C) Dr. Rajas Deshpande

Diagnose and treat with empathy, educate and move on. Don’t take home the burden of your patient’s illness. Don’t get emotionally involved in your patient’s lives and problems. Never. But is that possible?

Shall I ask him if he has any bucket list of things he wants to once experience, before he forgets who he is? Is there something there that I can help him with? Has he planned anything about his life when he is mentally or physically disabled?

I told him that some medicines can help him, and wrote a prescription. Also referred him to an expert counsellor.

What would I do in such a situation? What is it that I would like to hear from the doctor, knowing the obvious too? What is so important in life when one knows that there are only a few years remaining?

Those who have the luxury of ignorance can laugh and superficially answer. Those who answer immediately have seldom used thinking. Those who are assured of their health have changing answers.
But those who know it?

I decided to ask him. (C) Dr. Rajas Deshpande

Next time he visited, he told me that he has resigned from his job, as he had problems dealing with the responsibility. He could not ride his two wheeler too, he had sold it off.

“I am going to my ancestral village, doctor. A dharamshala (religious sanctuary) has agreed to allow me stay and food, and help me as much as they can. I am also willing to donate my body for research, so at least others don’t suffer this. But I have to finalise yet”.

In India, just as there is no scope for genuine research, there also is complete lack of any infrastructure for the care of such patients.

I decided to ask him what troubled me.
“Is there something you wanted to do?” I could not bring myself to say “before you go”.

He tried to smile. His eyes welled up as he thought about the question.
“Yes, Doctor. I wanted to feel someone loving me madly at least once. In fact I had a girl in my office whom I liked. I think she liked me too. But then my diagnosis was confirmed and I didn’t want her to suffer, so I never told her. I met her before resigning, and told her the truth”.

“Everyone will only degenerate,” he continued, “I am ready to see myself degenerate early. But the one purpose, the one good memory of life that one can wrap himself with when facing the decline, is love. Everything else only reminds of loss”.Dr. Rajas Deshpande

Then, wiping his tears and sobbing, for once, openly, without the restriction of pride, he held my hand, and said, “Thank you doctor for all your help. I came to know just now, that not having loved is what I regret most. It feels worse than death. Even if I had felt true love once, I won’t have regretted this early death”.

He had only echoed what every particle, every corner and every breath of life always reminds us of, while we keep on searching for everything else.
Dr. Rajas Deshpande

The Living Phoenix

The Living Phoenix
© Dr. Rajas Deshpande
“Stop treating me as if I am only a woman!” she told the bank manager, who probably did not grasp the meaning of that sentence. Little did he know who he was dealing with.
Sharon Harmon Muir is a lady to beat most men. Right from Religion to Depression, she has fought her battles with the determination to win. She indeed won them, including her last battle with suicidal-level depression.
4 years ago I met her with her husband Harry Muir, for some mild memory issues which turned out to be the symptoms of severe stress and depression. As she revealed the details of her life, I realized what an extraordinary life she had been living. When analyzing her own thinking and her art (painting), she said things that made me realize her genius.
I gave her a compliment I had rarely used: “You are one of the most brilliant minds I ever met”.She laughed aloud, looked at her husband, and winked “I told ya!”. Mr Harry was only too happy and proud.
Sharon was born in South USA to parents who were mill workers. She started her theatre performances at the age of 13. She sold her first painting at the age of 15. She was actively involved in civil rights movement. Once while service in the church, a black couple was denied entry in the church. Sharon quit organized religion that day, protesting against racial prejudice.
She went to an all-male institute of design and technology, University of North Carolina and later started teaching men at the same center to use power tools and build theater sets (That was in the 1960s!). She studied various art forms, ballet, composing music, painting and much more, also working as an electrician.

She says: my job profile was easy: whatever anyone could not do, I offered to do it for them. Working at such odd jobs, she met Harry Muir, who was a political protester within the US army. As Harry was jailed, Sharon’s family opposed the marriage. She was even labeled “carni-trash” then. Together Sharon and Harry worked as college professors, musicians, fine artists, magicians, and stood for each other. Sharon got an excellent corporate job, so Harry decided to complement it by choosing to be a house-husband, cooking and serving and looking after their daughter, and when the daughter went to school, he spent his time as a street singer.
At the age of 50, during menopause, the first attack of depression struck Sharon. In her own words, “It wasn’t me who was sad and suicidal, it was like someone else within me. I fought those thoughts, I knew I had to overcome this”. She developed severe panic attacks that prevented her from going out of their home. So she trained a Scottish terrier who would stop the traffic for her, take her to a safe place and then find Harry!They reached India in search of spirituality, finding it at Meherabad, and settled there. She continued to work as a painter and musician. “I was lucky that I could be the head of the family” she comments, although every time she speaks of Harry now, her voice becomes tender.
Once on a flight from Atlanta to Paris, Harry collapsed and was resuscitated. He was shifted to an ICU in Paris from the airport, and was diagnosed with pulmonary fibrosis (shrinking and progressive failure of lungs) of unknown origin. A few weeks later, they returned to India. In January 2016, Harry suddenly collapsed and passed away while in a hospital. Sharon kept on resuscitating her life partner of 50 years, till the hospital staff arrived after 8-10 minutes. She cannot forget that trauma.
With this loss, her depression resurfaced again, stronger than ever.
The worst loss in life is not death, it is the loss of love. Once more, suicidal thoughts and severe depression engulfed Sharon. To be left alone in a foreign country at the age of 67 is not easy.
“My belief system is very strong. I know my intelligence is above average, so there was no reason I couldn’t do everything I wanted, if I just put my mind to it” she tells how she decided to overcome her depression. “I read about it all I could, tried to get help, and got it”. She is thankful for getting good medical help in India, although she adds with a wink “I didn’t want a doctor who pats my back and laughs aloud telling me not to worry. I wanted a doctor who understands me, my illness and my worries as well”.
After Harry’s death, she had to clear a lot of legal hassles and banking formalities. Her daughter helped her there. When one bank manager tried to behave high-handed thinking that she’s just a woman unable to cope up, she told him : “Stop treating me as if I am only a woman!”.
When she visited me recently, she laughed a lot and told me: “This time again, I have chosen to defeat my depression. I will never give up. Back to life now”.
I usually keep busy, but when some patients talk, I want to listen to the beauty they create in my life. They expand my mindscape. When I asked Sharon what was her favorite subject for painting, she answered with a mysterious smile: “I paint the colors of the spirits of places”.
As I drank in the beauty of that sentence, I realized that the soul of this extraordinary woman can only have one title: “Phoenix”. The legendary bird is not imaginary, so long as we meet people like Sharon. This great magician called nature has given us the magical ability to be everything we want to be, to be happy, to win over any challenges we might face, just with a small trick: wanting to do it.
Sharon is an extraordinary example of that magic.
© Dr. Rajas Deshpande
Thank you, Sharon Harmon Muir, for the permission to share the story of your extraordinary life.

Please share unedited for spreading awareness about fighting depression.

Thank you, Life; Thank You, God!

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

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

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

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

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

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

Thank you, everyone who wished me today!

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

The Epic Struggle Against Epilepsy

The Epic Struggle Against Epilepsy

(C) Dr. Rajas Deshpande

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

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

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

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

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

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

(C) Dr. Rajas Deshpande15622112_1172439906184669_2495525607074222032_n.jpg

The Arabic Gratitude

When a patient from Arabic world is happy, he hugs you and kisses you too! However much unused to we are for such a gesture, it wipes away all the dust off one ‘s mind and rejuvenates the spirit of every doctor, to thank God once again for considering one eligible for this responsibility.


The Divine Eye


The Divine Eye
© Dr. Rajas Deshpande

What does a child of 15 years do if his vision is completely and permanently lost?
He goes to the best place in the world to learn about care and rehabilitation of the blind, returns to India, and starts a society to help the blind: “Puna Blind Men’s Association”(PBMA).

But that was 60 years ago.

Now, it has grown. A 250 bedded eye hospital, one of the largest in India, with over 40 doctors, offering the best world-class eye treatment and surgeries. Poor patients are treated / operated completely free, paying patients are charged very low, and there also is a facility of “Premium Services” for those who want to pay. Over 60-70% of the work is free. Patients are picked up and dropped back free by hospital’s vehicles. Many hands of God donate handsomely to this set up, knowing its good work.

Their Technical Training Institute works to train and rehabilitate the blind from working age group. Their old age home houses over 50 blind women, all looked after well.

Their international collaborations attract foreign doctors for training / fellowships. They conduct postgraduate training courses and research , and have many international publications to their credit. They offer services in almost all subspecialties in ophthalmology, like paediatric ophthalmology.

“The PBMA’s H. V. Desai Eye Hospital” in Mohammadwadi, Hadapsar, Pune is a glorious example of what human wish can achieve, how a single man’s dream can extend the dimensions of humanity. Too good to be true, but true indeed, and standing proud!

Padmashree Mr. Niranjan Pandya is the vision behind this institute. Col. Dr. Madan Deshpande is the Chief Medical Officer / Leader. Mr. Nitin Desai is the Chairman. The Medical Directors, Dr. Rahul Deshpande and Dr. Dole were justifiably proud when they told me the story of this great hospital.

Today, I was very fortunate to interact with the doctors there, who had me over to speak about “Multiple Sclerosis and Optic Neuritis”. Thank you, Mr. Vinayak Bhandarkar and Mr. Venkatesh Madake for introducing me to this hospital.

I feel proud to have spoken in this institute that harbours the very essence of true humanity!

May this spread and may millions continue to benefit forever!

© Dr. Rajas Deshpande

The Doctor India Needs Most

The Doctor India Needs Most.Photo 13-11-15, 23 58 36a

(c) Dr. Rajas Deshpande

“It’s high time you dropped a big stone upon her head” said the doctor.

Shocked to the core, I looked up to find all three of them heartily laughing: the doctor, the patient and the relative.

This was a 92 year old lady, who had seen Doctor P. D. Purandare for most of her adult life as her primary care physician. She was still healthy otherwise, but often complained of “feeling not perfect, occasional headaches, lack of sleep, reduced appetite etc.”, mostly age related and chronic complaints resistant to most commonly used medicines. The daughter in law, obedient and polite, but fed up with her “whining” mother in law, had asked doctor PDP if he couldn’t “permanently cure” her symptoms. The ever smiling, 70 year old family physician who was known to make even patients on their deathbeds laugh, had replied “It’s high time you dropped a stone upon her head”.

The old lady was unaffected. Education and “legal awareness” had not yet spoiled the friendly doctor-patient relationship by then. She touched the doctor’s face with gratitude. “I am sure I will not die as long as you are around, Doctor. Don’t teach such things to my Sunbai (Bahu / Daughter in law)” replied the old lady, laughing out of her edentulous mouth, a cute laughter that offends nobody, a privilege only of the very old.

I was on a vacation after my final year MBBS exams, and having no daytime friends (explainations later), went to one of the most favourite people in my life: Dr. P. D. Purandare, a general practitioner and family physician who practiced in the small and (then) backward / orthodox town of Nanded. His clinic was an open-for- all walk-in all 7 days, 11 AM till 11 PM. The only rule was the waiting number system. Next patient was the only VIP, whoever you happened to be.

At around every midnight, Dr. PDP dropped me home after the last patient left. There was never any haste at all, the last patient got the same fresh and relaxed doctor that the first one did. Dr. PDP lived his life in his medical practice. Once I asked him why he chose to practice in Nanded while his hometown was the big and developed famous city of Pune. His answer had no flavoured ego, pride or hypocrisy: “Because there was only one family physician here, there was a need for more, given the population” he replied.

He had studied his Medicine in Lucknow. He practiced a few years in East Africa, then returned to India. A scholar in many disciplines especially music and philosophy, extremely well read, fluent in most Indian major languages, he was the only person I have seen
who entered anyone’s hPhoto 13-11-15, 23 56 34aeart freely and spread joy there.

My parents took me to him right from my infancy for any health issues. Vaccination onwards, he had grown me up to a robust health. Whenever I had holidays while in Medical College, I went to attend his OPD. There was so much to learn about humanity and medicine from him. In spite of being a very scientific doctor and a royal human being, he treated everyone as his equal. I have never seen him disturbed or angry. Like James Bond, his humour sprung forth like a fountain in the most unlikely and disturbing situations, and it was only later that people realised that it was that humour which broke the ill spell on that moment. Never cheap but never also mild, his stinging comments usually made people blush. He donned the magic of good sarcasm that left no bruised egos.

He never asked for money from any patient. Most patients went themselves and paid to his compounder HariSingh. Regularly following up patients were supposed to make entries in their own diaries about how much they owed to the doctor and pay as and when possible. People usually paid once or twice in a year, he never saw their books. HariSingh collected the money and hande
d it over to Dr. PDP. Of course many people duped him. Even in that pre-cellphone era, people called him up on all days and nights, and visited his home for emergency and ease both, but his calm was seldom offended.

One very poor man came with his daughter of about 21, told the doctor about her constant headaches, also adding details about his financial status, that her marriage was held up thanks to his poverty. Dr. PDP wrote the prescription after examining the young girl, now visibly embarrassed by her father’s disclosure. The father pulled out his reluctant wallet from the depths of his clothes. “How much?” he asked. Dr. PDP, with no high-handed expression upon his face, said “Don’t worry.. You don’t pay.” As the hefty farmer father started sobbing out of gratitude, Dr. Purandare asked him if he can please borrow some betel nuts (supari) from him, which had accompanied the wallet from his pocket. Laughing and crying at the same time, the father gave the “supari” to Dr. PDP and touched his feet, asked his daughter to do the same, and told her “This is where they say God is”.

One of the best habits I learned from Dr. PDP was to never count the money someone handed over in good faith. Trust was his second na
ture, and patients swore by his integrity. “It will all stay here, not with you or me” he winked when anyone requested him to count the money.

A visibly shaking Sikh man, walked in, bending forwards and walking very slowly, his actions frozen intermittently, and voice almost inaudibly low. Dr PDP explained to me the classical symptoms of Parkinsonism. A decade later, learning advanced Neurology in Canada, I often wondered how exact and ahead of time was this general practitioner in a small town in India, and what a sad destiny that there was no one around him then to applaud all the talent he had! This, I know even now, is the case of so many excellent clinicians, general practitioners and family physicians in India, whose medical talent goes unnoticed and unacknowledged just because the society is yet to wake up to it.
“Your son is unlikely to survive”
I heard the physician (Dr. AA) tell my parents. I heard my mother wail and my father sob, and in a few minutes my mom was frantically calling one of our neighbours: “Please get a rickshaw and go to Dr. Purandare, ask him I have begged him to run here at once”. Mr. Raghvendra Katti, my father’s favourite student, went in heavy rains upon his Luna moped to fetch Dr. PDP.

It was just after my second year MBBS exam. I had developed typhoid fever, and late during recovery the fever had suddenly shot up one day, and I had become delirious. My consciousness was fluctuating, and highest antibiotics were on. There was a suspicion that something was wrong, but nobody could identify what. Three specialists had already asked my parents to shift me to civil hospital ICU, fearing bad outcome. Fever went upto 105 dF.

Dr. PDP came, all wet and tense. After going through all details and examining me, he asked the treating doctor to give me a shot of steroid. “But he may worsen with steroid” said the treating doc who had a higher degree, and refused to give me the injection. As my mom insisted, he wrote a note on paper that Dr. PDP will be responsible for any consequences. Everyone signed it. Then they gave me a shot. Within an hour, the fever started subsiding. By three hours, I was feeling better. He sat besides me, whistling.

“Chai pilao (Get me some tea)” he smiled as he told my crying parents “Ye saala wapas aagaya (This idiot has returned)”. The physician apologised to him for the “legal” note. “It’s ok, doc, he has reacted to something. Recurring typhoid fever does not shoot up this sudden”. Dr. PDP said. It was later found that the IV fluid was impure. Just changing that made a difference (The company was later banned).

He gave me his old “Savill’s” textbook of clinical medicine as a birthday gift. It is one of the most beautiful clinical textbooks I ever read!

“Har Bandar ka Madaari (A magician who handles all types of monkeys)” was his favourite expression to describe himself as a general practitioner. “You must know basic treatments of everything” he taught me. India needs many many thousand Dr. Prabhakar Purandares today, and also the same patient-doctor relationship where the patient had equal responsibility of faith and trust as the doctor, and both carried it graciously.

He initiated me during my undergraduate days into philosophy, with Jiddu Krisnamurthy, Ashtavakra Geeta, Osho Rajneesh and then Stephen Hawking. When I told him I actually met Dr Stephen Hawking, he was as happy and proud as my father would be. He still prays, meditates and laughs everyday, and makes everyone around him laugh too. He has retired, and lives happily in Nanded.

Everytime we meet, he turns into the Master once again:
“When you realize that all the diseases and diagnoses are not in the books, you become a mature doctor. The disease in mind is far more difficult to treat than that in the body. The young man knows the rules, but the old man knows the exceptions”. His teachings are etched upon my brain.

Once in a very bad, low phase of life, deserted and hurt by the way I was treated by my own, I went to him and broke down. This feeling of being isolated and tortured for being different in my thinking is unbearable. He just sat besides me, didn’t say a word till I stopped crying.

Then he said:
“Pick up the immortals among those who you want your certificates from”.

© Dr. Rajas Deshpande