Tag Archives: organ transplant

A Doctor’s Sacred Obligation

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A Doctor’s Sacred Obligation

© Dr. Rajas Deshpande

As I entered the hospital for my evening OPD, I saw our senior-most cardiologist standing by his plush big car in front of the entrance. A tall, calm and brilliant man with a reputation that many only dream of, he never spoke about himself or his work. It was very unusual, because he was either with patients or walking fast, never still like this.

Curiously, as I wished him, I couldn’t resist asking, “Anything up, Sir?”. He asked me to look at the entrance. A young lady in her twenties was coming out of the hospital, supported by her relatives, smiling and crying at the same time. As she climbed into the car that was waiting for her, she saw the cardiologist and tried to get out again. But Sir asked her to wait, went there, wished her just as her relatives touched his feet one by one, and bid her a goodbye. As they shifted her luggage in the trunk, Sir told me: “That is our 10th heart transplant case. She had come with heart failure that could not be treated, there was no hope for her survival except if she received a new heart. That was a month ago. We performed a heart transplant upon her, with consent for a risk of death on the operating table. I can’t tell you how I feel today, seeing her walk out with a new heart. I am not sure how many people have the ability to grasp this event. It is so much more than a new birth!” © Dr. Rajas Deshpande

The patient’s car rolled away slowly, the relatives folded their hands at the sky. Our dear cardiologist looked at the sky once too, sat in his enviable car and drove away with a winner’s smile.

Late that night after OPD, as I waited at the entrance watching the beautiful rain, I felt a certain calm within. Hundreds of specialist and super specialist doctors in India perform super-complicated procedures, surgeries, transplants every day in India. Some bring back most hopeless patients in coma with their sheer medical talent. Thousands of ultra-critical patients walk out of the intensive/ critical care units. Heart, Liver, Kidney transplants are happening every day, almost in all bigger cities. Joint replacements and spinal surgeries have made miraculous changes in the quality of life of millions those who would have otherwise spent last few decades of their life writhing in a bed. Most Neurological conditions can now be effectively treated to improve both lifespan and quality of life. Complicated brain tumors can be removed, aneurysms treated, many cancers cured, and paralysis reversed if treated in time. Physiotherapy makes dramatic changes in mobility of those who couldn’t even stand.

Where is all this happening? Who is doing this? What is their reward?

Most of these expertises, skills were brought to India by the private doctors who went abroad to study on their own. Most of these facilities were made possible in India by the private hospitals because they earned profits. If they didn’t, no one would invest. It is impossible for the government to invest in healthcare to this extent. Even in the rare govt. set-ups where such facilities are available, they came in too late, with many compromises, and only because some doctors there wanted to extend the benefits to the poorest of the poor, and tried hard to convince the health departments for development of such facilities. The government never spends on advanced (out of the country) education of any doctor. © Dr. Rajas Deshpande. Yet, most people imagine that when a doctor goes abroad for any conference, it is to have fun. How cheap and conceited to look down upon the saviors of so many lives!

Our politicians and leaders, media and society have always made ungrateful and derogatory comments about us. Still, the ultimate truth shines bright: that the geniuses in this profession continue to bring highest class of medical care to India, both in private and government hospitals. They do so because of their own drive: to explore, to excel and to bestow health upon millions. © Dr. Rajas Deshpande. Yes, some such doctors earn very well too, most of them earn via clean practice, pay their taxes, and still treat many patients free. However our society has almost made up its mind that a doctor should never become rich. The utopian, hypocritical notion that doctors should only be happy with the satisfaction and blessings of people they treat, without expecting financial remuneration is as laughable as saying that everyone else right from the politicians to artists or the laborers should also be happy with what they do and should not expect any remuneration. Everyone earns for their work, and so should a doctor. © Dr. Rajas Deshpande

No one will achieve anything good by merely criticizing the very profession that strives hard to save lives. The psychotic addiction some people have, of speaking ill about doctors is based upon a single reality: they want free / low cost treatment of highest quality. There indeed are a few corrupt doctors, but how fair is it to blame all others who do so much for the society?

Our society indeed needs a new, repaired and loving heart for the great doctors who bring it health and life! This ‘transplant’ is being delayed by the puny shortsighted politicos and media who belittle their own saviors. It is high time that at least the educated and intelligent among the society recognize this.

Till then, we will still try and keep your old heart beating well, for we are doctors, and even if you criticise us, we must only do good to you. That sacred obligation is the nobility of my profession!

© Dr. Rajas Deshpande

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The Lawful Massacres

The Lawful Massacres
© Dr. Rajas Deshpande

“Doctor, my brother has kidney failure, he is awaiting a kidney transplant. but the waiting list is too long, he has very less time and his health is fluctuating. We cannot afford to treat him out of India. We can pay some money if any donor is ready to donate a kidney. Please save his life, doctor, I will be your slave all my life.. What can we do?” the elder brother was begging and crying at the same time. His 28 years old highly educated younger brother is his only blood relation alive. The elder brother himself has renal compromise at an early stage.

“I am sorry. Indian Law does not allow us any other options”. I felt ashamed of what was happening. I wanted to add “Unless you are in power, unless you are stinking rich and have heavy pulls through many corridors, unless our society so eloquent about criticizing doctor’s intentions learns to come forward to donate organs, you are doomed to a long wait for any transplant”.
In fact, you are more likely to be the one among the three that die every day in India while awaiting an organ transplant. That is over a thousand human deaths every year. More like a massacre.

Because the law is always correct, it saves money, it saves against corruption, and it saves against a few wrong practices. This sacrifice of a thousand lives a year is just a small price to pay!

We are so very much against the word ‘corruption’ and the projected legal correctness of any system, that like the blinded goddess of justice, we refuse to see beyond what is the literal meaning of the law. Whether it is correct, whether it is causing more harm than benefit, and whether it discriminates (usually the rich and the powerful from poor) is something we are not allowed to think. Nor the judiciary probably. © Dr. Rajas Deshpande

Whether it is the action against some great kidney transplant surgeons that made them quit the profession and stop all transplant work, whether it is the “Kidney Racket” headlines on TV channels or in newspapers, the medical profession is already presumed guilty, and everyone seems to derive a pervert pleasure from doctor bashing, some even from within the profession. Yes there are unsuccessful, fame seeking doctors who are jealous of doctors who earn more and have a good name in their field, and most bitter losers like to point out only the bad side of the monumental achievements of such successful doctors: that the transplant teams in India have saved millions of lives of the rich and poor alike by developing transplant surgeries and performing them in a resourceless, supportless, poor country ridden with corruption is a deliberately hidden fact.

There of course are corrupt doctors as in every other profession, but one cannot blindly close all hotels because some didn’t serve good food!

Most of our society looks upon any medical money transaction over three hundred rupees (for anything) as corruption. In a country teeming with people who prefer to eat and drink an unhealthy excess and die early (while many die of malnutrition), for a country where there have to be laws for wearing a helmet, many take it upon themselves to criticise other professions without thinking.

We need many lacs of organ donors for the many dying patients awaiting transplants. We see extremely few organ donors. The only interpretation: “I don’t want to donate organs, I don’t want to help save lives, I will only criticise those who are trying to save lives by closely watching where they cross the law line, and then bash, arrest, defame, try and punish them. © Dr. Rajas Deshpande

The government must seriously reconsider the laws about organ transplant. There must be a freedom to at least donate a kidney for someone one knows, and if the recipient wants to compensate for it, it must be allowed. This can all be documented and supervised by a legal team so as to avoid forceful / illegal sale of human organs. One can also consider the possibility of a rich recipient compulsorily paying for a poor recipients’ transplant surgery, if he / she is allowed to legally ‘buy’ a kidney. That way two lives will be saved. If I sound Utopian, so was everyone who thought that the world deserves to be a better place.

The legal correctness of each transplant should be mandatorily okayed by a judge, and if something is legally wrong, it is that judge who should face the consequences. This is because doctors/ other transplant professionals cannot always interpret all laws correctly, and innocent mistakes are then blown up / misinterpreted as deliberate attempts to kill patients. © Dr. Rajas Deshpande

While the rich and powerful get their kidneys and livers fast and safe in and out of India through the similar rackets that have thrown innocent doctors into jails, it is the poor who are left to die awaiting a transplant: because the government set ups have limited facilities and resources, and the private set ups have to do it at a higher cost to safeguard innovation, technology, investment and skilled personnel. But the only highlighted aspect is the money earned by the hospital or the doctor, not the immense effort and saving of hundreds of lives. Ask hundreds of poor patients whom the transplant teams have saved, whether their doctors worked for money.

Those who choose to differ with this opinion are welcome, provided they answer this question: If your brother, son, daughter or you yourself are awaiting an organ transplant under the approaching shadow of death at a young age (God Forbid), will you choose to be legally correct and prefer to die or explore all options including illegal to survive?

As a doctor, it is very difficult to say “As per law, you must wait even if you die”.

© Dr. Rajas Deshpande

PS: These are the sincere feelings of a doctor’s soul tortured by the plight of those awaiting death thanks to the legal tangles and social apathy about organ donation. I do not support any illegal practices, but I do not also presume that all laws are perfectly correct. There is a lot of scope for improvement, and each waiting day costs us three preventable deaths. Jai Hind.

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The Greater Life.

The Greater Life.
© Dr. Rajas Deshpande
“My younger brother was .. is.. was.. is..” he broke down. The auditorium held its breath. A colleague upon the stage pacified him.
“My younger brother was killed in an accident. But he is sitting in this room right now. I do not know upon which chair, but I know he is here. I hope he can hear me.” he said, pausing again to suppress sobs.
The transplanted liver of his brother somewhere in the same auditorium was silent, but more alive than most alive. Because it had survived death, living a greater Life now.
“My husband has the heart of a rabbit, he is very good otherwise. It was I who ran the show since our marriage” said this illiterate lady in an old green saree, torn footwear and one green bangle in her hand, to a laughing auditorium; “I have always been the lion-hearted in my family. I am not scared of any situation, not even poverty. I raised my children and even husband to a very happy family. But the day we were suddenly told that both his kidneys had failed, I lost my heart too, and broke down. But in a short while, I decided that I can solve this problem too. So I gave him my kidney. Now he is fine. I just want to tell you that you should not lose hope, God stands by us if we decide to stand up to the situation” she folded her hands at the sky, and wiped her eyes with a corner of her patched saree.
Next. She must be an artist or a guest to entertain. Twenty-something, fair and fragrant, as delicately beautiful as a dewdrop on a petal, dressed in an enviable grace, she walked up to the stage. She smiled like breezes before the monsoon, and softly said “I am an engineering student. My life had come to a halt when I was told that both my kidneys had failed. I received a kidney belonging to someone who passed away in a road accident. He may have lost his life but he lives within me. I cannot even thank him or his family: but I pray every day that they are always well provided for and looked after by the same almighty who saved my life”. She didn’t cry then, but there was something that kept her instantly above everyone, when she smiled. It was difficult to imagine that this young girl had had a kidney transplant!
He beamed when he reached the mike. Another teenager. “Forgive my rural language, but now I have the urban courage, to talk loudly and boldly. I was preparing for my own death two years ago. My village does not even have water or electricity. What’s more, nobody in my village knew what a kidney was! I was all bloated up, preparing mentally to say goodbye to my world any day soon. Then the people in my village collected money for me. My mother went from door to door, begging. The hospital and the social worker worked hard to get me donations from different trusts. And here I am, all cured, back on track to live life fully. I have a job now. Thank you, all doctors! Thank you, Joshi madam” he said.
As the “Organ Donation Day function” ended, almost everyone coming out was tearful and smiling. No amount of money can buy the satisfaction of the soul that comes from the greatness of human heart.
“Sir, my father has suddenly collapsed while returning from his office. We have taken him to the hospital near my home” said my student, his shaky voice making an effort not to give away the panic. They had just bought a new house, father was in his fifties, and the only source of earning for the family of four. Lower middle class, all the money went for basics and educating him and his sister. I worried about their future: with the long illness now, who will earn or pay for them? He was in his last year of physiotherapy.
In three hours, he called back. “Sir it’s a bleed .. they say he has no brainstem functions. We have consented to donate his organs. Sir, he will still be alive then, na? Five people will survive because of him” as his voice started shaking, “Sir today morning when we had our tea, papa had said that I must give back to the society. I guess this decision is right, isn’t it, Sir?” he paused to regain his voice.
To a society in which “Me, Mine and I” are the worst diseases, where children abandon parents for saving money and all corrupts blame all other corrupts, his father had professed him to give back. If not here, where else is the great?
“Where is your mom and sister? Hope they are aware” I asked him. “Yes Sir, I am with them. I know what you are thinking, Sir. I will take care of my family Sir, I know I can. I know you are with me..” he said.
Understandably, death takes away the life even of the survivors for a few moments. No one can think sane and calm. But we do come across some, who, once they know the inevitable, still think of what best can be done even in that situation. Organ donation by the live and now even the brain dead patients (where it is medically ascertained by 4 experts that the brain has no chance of recovery, and the patient’s heart and other organs may still work for a few hours ) has changed the scenario of a definite death penalty for kidney, liver and heart failure patients. Up to five lives can be changed / saved when the family of a brain-dead patient (or the patient during his life) has consented to organ donation.
There are very strict guidelines for organ transplant programs, and these are scrupulously followed and monitored by various agencies. Of course there are those who take advantage of the existing loopholes (as in any evolving system), but that by no means should devalue the great work being carried out by different transplant teams all over India. If a soldier dies on the border, other soldiers cannot waste time in crying and rituals, however they might suffer. That gallantry of soul required to continue to fight is unmatched. However, translated into medical battles, we need far more true valour. There are many allegations, but there is no recognition of the thousands of saved lives all over India, via organ transplants. As if all the sacrifices of those families, and all the hard work of the transplant teams were a waste! So many centres for organ transplants have such beautiful success stories and results, so many doctors have taken forward this huge task at the expense of their own time, effort and precious life.
For those who want to live beyond death, those who have an extraordinary heart, and even those who cannot stop criticising the whole medical profession for not being human and charitable enough, here is your chance to show what you are: please sign up for organ donation and save lives. Thousands die waiting for kidney / liver / heart transplants, while so many thousand kidneys, livers, hearts and other transplantable organs are just destroyed every day, people unaware that they can save lives.
The poor and non-affording still have difficulty arranging funds, the government must start this program in its higher healthcare set ups / medical colleges, so as to provide all the necessary backups and teams. Funding should come forward from charitable / religious establishments. There can be a central fund with ZTCC where people can donate, and a proportion of income from various religious / social / political / charitable etc. establishments collecting donations may be streamlined.
The Zonal transplant coordination centres (ZTCCs) work extremely hard to ensure that everything is legally correctly done. The police have recently provided with excellent backup for fast-transporting the harvested organ towards the recipient. Those who cannot think beyond money and criticism will never grasp the life of this activity.
A new era of humanity has begun, our challenge is to stand up to save lives.
Donate Organs. Please.
© Dr. Rajas Deshpande
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