Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?
©️Dr. Rajas Deshpande
A hungry poor man named Atmaram went to a big hotel, had a nice big meal, and told he had no money to pay. He was beaten up and handed over to the police. He was released after a warning and a slap.
Next day he filled up petrol in his bike, and said he couldn’t pay. He was again beaten up, handed over to the police. Then he went to the medical shop, bought medicines and mineral water, ate the medicine, drank water from the bottle, and again said he couldn’t pay. He was now jailed for a week.
Next week his house was damaged by heavy rains, so he went and requested to be allowed to sleep in the house of the chief minister. He was arrested again, thrashed up.
As angry Atmaram shouted at the police, he was beaten up by them, another crime was added to his offences. In the court, Atmaram insulted the lawyers and judges and accused them of accepting bribes and charging too much. The judge punished him extra for his behaviour. Atmaram was angry and threw his shoe at the judge. His punishment was extended.
“You must respect the authority “ the court said.
“But I am poor, I need free food and petrol and medicines. I need sympathy too” Atmaram argued.
“You should have begged and applied for favours and eaten in places that provide charity meals. Petrol, however essential, has the same price for everyone. You can sleep on the footpath, and above all, you are not allowed rudeness and violence because you are poor and needy” The court said.©️Dr. Rajas Deshpande
When released from the jail, Atmaram drank a lot of desi alcohol, had an accident and fractured many bones. He went to the best private hospital, got operated and refused to pay his bills that crossed one lac rupees. When the hospital insisted, the operating doctors were beaten up by Atmaran’s relatives, the hospital was vandalised, the police arrested the doctor who saved Atmaram’s life, the government closed down the hospital, while the media and the society kept villainising the entire medical profession.
The headlines next day reported the sympathy expressed uniformly by wag addicted tongues: some said the entire profession was tainted, some blamed the greed of the doctors, even some doctors desperate for attention shed crocodile tears about the ethics in this profession. ©️Dr. Rajas Deshpande
In the courtroom, during the trial, Atmaram sat facing the doctor, still heavily bandaged.
The hon’ble judge, kind but surrounded by security, told the doctor accused of negligence and malpractice in the court: “You as a doctor carry more responsibility for ethical behaviour upon your shoulders. You should never turn away the poor”.
The doctor, defending himself, asked “but Milord, doesn’t our constitution insist on equality? Why do you yourself or ministers get security but not the doctor? Why isn’t everyone supposed to stick to ethics in every profession including politics, police and judiciary? Why are others exempt? How do you explain beating up of doctors while also saying that the society treated them like gods?”.
There were no answers. The kind court asked if the doctor had to say anything else in his own defence.
The doctor said
“Yes Milord, but the real answers will hurt:
Jealousy against medical professionals across society and many other professions is a reality. Why else will anyone who couldn’t qualify to become a doctor try and teach the qualified doctors what they should do?”©️Dr. Rajas Deshpande
“A culture of exploitation of non-votebank groups
and a complete failure of government healthcare with no one accepting responsibility is well known to everyone, but even judges have no courage to suo motu question this and correct it, even when they see the poor dying”. ©️Dr. Rajas Deshpande
“In a country with never ending poverty, how much free can a healthcare facility provide? For how long? This is already forcing closure of hospitals and exodus of good doctors out of the country.”©️Dr. Rajas Deshpande
“Milord, can you assure that every doctor will get his/ her fees as per his service to every patient, and if the patient can’t pay, that much charge will be exempted from the income tax of that doctor? How else do you except a doctor to meet his needs and dreams? Just because there are millions of poor patients, is the doctor’s life and hard work taken for granted? If there has to be financial sacrifice, why not have everyone contribute to it by creating a national health tax fund for treatment of poor patients? Why healthcare is subsidised only at the cost of a doctor?”
Just at this point, Atmaram, who sat in front of the judge, collapsed unconscious, almost blue black.
The shocked judge requested the doctor to examine him.
“He is no more” said the doctor.
“What could have happened ?” asked the kind but sweating judge.
The doctor told the court about three possible reasons. Two of them were scientific and medical: a sudden cardiac event or a large blood clot in the lungs common after fractures and trauma.
The third non-medical, unscientific cause made the Judge seriously ponder.©️Dr. Rajas Deshpande
“Will this court be now closed down, Milord? Will your efficiency be questioned, will you allow the relatives to attack you and understand their sad situation at the cost of your murder?”
“I understand what you mean” said the kind judge.
Needless to say, the doctor was released without a blame.
Can anyone please solve the mystery of the third non medical, unscientific possible cause of Atmaram’s death?
(C) Dr. Rajas Deshpande
Please share unedited
Respect: The Depreciating Indian Salary
© Dr. Rajas Deshpande
“Over 1.5 Crore Every Year! That becomes more than ten lacs per month! Wow!!” my student showed me the news that some brilliant engineering students passing out from India were hired by some software biggies in Campus Interviews, “They will start their careers at that salary. That’s life!”
I felt proud, as always, these news and similar have always made me feel that the Indian academic talent has always been looked up to and rewarded by the developed world. The tiny speck of jealousy that we earlier felt for our classmates who went for engineering and had their own homes and cars while we were still finishing internships has faded away long ago. The only regret that sometimes peeps out from the past is that of never having fully enjoyed our teens and youth. The fact that most doctors from India also earn huge salaries in the west as well as the middle east speaks a lot about the flaws in our “Indian” thinking.
“Doctors get respect and that is the best that you can get in life. People think of doctors as Gods. You should never think about money” told every sore-throated, pot bellied and self proclaimed socialist who did not become a doctor, and mostly had no doctor in family. This ranged from our own classmates to the highest administrators in the country.
Over the years, I now feel that even the engineering or other stream’s graduates are almost in the same boat. I cannot wish upon the newer generations what we went through.
What is really making us proud here? That India cannot afford to use its own best talent in any field? That the best in all fields are taken away, because what the best Indian companies can offer them is nowhere near what the world outside offers them? That the best salaries in all government jobs are reserved for bootlickers above the age of 55? That in no field can the government find the young talents superior to white haired yes men? © Dr. Rajas Deshpande
Or boast with a shameless pride that the most revered Satya Nadellas and Sundar Pichais made in India cannot find career scope in their own country?
Or, while proclaiming “Vasudhaiv Kutumbakam” (The World Is My Family) on one hand, are we going to perpetually cry the same song of socialism and patriotism, expecting all of them to only follow the examples of the rare (and respectable) ones who chose to shed material life for the country? India needs a million good volunteers in every field who will live and die poor while serving the society. But to force this upon all those who graduate from India is to invite them to leave the country. From politics and administration to Judiciary and lawyers, we need people who will work free or low cost, because the main disease: poverty and illiteracy, is a never ending curse in India. These are the people who choose the governments who throw “low cost everything” crumbs at the society, rather than uplifting the society to respectable self sustaining, paying capacity. © Dr. Rajas Deshpande The lifelong perks of representatives elected for even five years, from any political party are regularly updated, but the salaries and pensions of doctors and other employees who work lifelong are never upgraded without agitations and then only with allegations of greed!
No doctor wants to be a bad doctor, but no doctor wants to spend life in poverty and insecurity.
If at all a doctor decides to do charity and see all patients free/ concessional all his / her life, not only will they be lost to poverty and anonymity, but our government or media will never notice them. All they get is more paperwork to comply with every day, fear of suspension humiliation by the administrators and a salary that’s a shame given their talent and hard work.
There is this curious tendency in India: to force or to beg in the name of charity, social service or patriotism rather than rewarding the talent. There are very few examples of honesty, hard work and talent rewarded without political connections. © Dr. Rajas Deshpande
Are the medical students any less talented than their counterparts in engineering or other streams? Don’t they study equally hard and work 24/7 many more years before they qualify? Even after that, the highest salary that the government offers the starting doctor (even engineer) is laughable, and if they wish to work at a private/ corporate hospital, they cannot decide the rules of payment strategies. If they must start their own set up, they need huge investments, over fifty permissions, many recurring, every one requiring bribe in some form or other. And whichever one they choose from the three career options above, from day one the society and media will have already presumed them guilty of extracting money from patients, the government and even some judges urging them to understand the feelings of relatives beating up doctors. I wonder how many ministers , judges or media bosses would like to understand the feelings of those who beat them up for something their client/ petitioner didn’t like. The most pathetic part is that while all of the above officers are inaccessible to common man, they still have armed security, and the junior most doctor who faces armed relatives is denied security even by law! © Dr. Rajas Deshpande
Most top medical graduates and postgraduates, like almost all other streams from India are leaving voluntarily because of this situation. To deal with this, the best options that some governments came up with were long term bonds to force govt. service (without telling anyone where the govt. spends so much on medical education), and canceling permissions to leave India even after the bond is completed. Bravo! © Dr. Rajas Deshpande
The Hon’ble PM has time and again declared many institutes like AIIMS to be opened across India. This is welcome, but we must also look at the state of conditions and staff in the existing health institutes run by the government. That needs billions for repairs, facilities and hiring better staff. Unless the salary structure for young and talented medical specialists increases , there are no chances of any AIIMS-like institutes running efficiently, they will soon become dirty buildings with low budget staff, where desperate patients are chronically dissatisfied and mobs find chances to vent anger.
Earlier I had immense respect and pride for every doctor who decided to return to India with a positive attitude and a wish to serve the society, their only expectation being living a modestly good life. Now I doubt if they are doing justice to themselves or their family, by choosing a life of financial and personal compromises, where they not only sacrifice, but are still looked upon as “looters”, face a violent society and a prejudiced government.
Ten years ago, I would have told this student of mine “let go of a good life, stay in India, we have a lot to do for our country”. Today, I don’t interfere with their decisions to make a career outside India. Because I love my India as much as any soldier would,and I also love the talented people in it.
© Dr. Rajas Deshpande
Please Share Unedited.
The Doctor India Needs Most.
(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 heart 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
Hide, Don’t Seek
© Dr. Rajas Deshpande
We are all experts in this.
Mr. SP suffered a stroke, lost his job. Still has to run a family that has kids in engineering college. Since last six months he is looking for work, and is freelancing as an interior designer. To go to work he needs special vehicle. To buy it he needs loan. Bank does not give loan because he does not have a job. RTO will not issue license unless the vehicle is in his own name. He is ineligible for a handicapped- job opportunity because he cannot get a certificate, because there is a huge line for the same in only one center in a large city like Pune, where the handicapped people are expected to queue up starting 4 AM in the morning, without a place to sit or a shade. He has been in this queue for umpteen times, but could not reach the clerk as only limited number of people are taken in. He keeps on spending on the autorickshaw fares, his own medicines, physiotherapy, and limps his way through life cursing his fate. He has already decided that his children will not settle in India.
All that India has learnt in it’s recent evolution is to address him as “Man with special needs” or “Physically challenged” instead of handicapped.
Now he awaits Mr. Mark Zuckerberg or Mr. Tim Cook or Mr. Obama to digitally reach out and solve his problem.
In our evolution as the strongest and the most invested nation, we have shoved below the carpet the facts that we have highest number of unhealthy people who cannot reach or afford basic medical care, hunger deaths, a government-run healthcare system that is worse than dysfunctional at best, a valley of inadequate resources created by senseless laws / rules / red-tapism that mock the possibility of a comfortable living of an honest citizen, where bribe is the basis of any function at almost all levels. Traffic kills not only those on the road, but also those in an ambulance.
This even as we pay one of the highest income tax, and probably the highest duties on almost everything.
Neither women nor children are safe, the political backing encourages hooligans to do away with all the eve-teasing they want. Richest of the rich revel in their 100 and 500 crore successes, multimillion ventures and billionaire statuses in Forbes, while there is no answer to innumerable suicides of poverty ridden populace.
Now we will digitally connect them.
We have learnt the western language in an attempt to impress the western press. With our huge population, there always are enough positive numbers to impress the world, while we hide the negative numbers from the world’s eyes. We have learnt perfectly the eternal art of beautifully colouring a home from outside, while there still are decaying crimes, mountains of unsolved legal / procedural basic issues that eat up the lives of those who live within. The rich-poor gap is at its worst, and the onus is upon the citizen to find legal / illegal solutions to their problems. Audacious corruption stinks in almost every govt. office, but we will sing songs of our own greatness and history. We will die to establish an arrogant historic fact rather than help a dying needy in the present.
We need human connections first. We need internal reforms first.
What will an old sick parent “thrown up by children” do with internet? What will a heart attack patient stuck in traffic do with digitalisation, when there are no sufficient paramedics, and they can’t reach him? How will internet, another “profit-based” venture, provide for food and medicines to those who don’t have money?
Will all this internet access / digitalization solve the issues like rehabilitation of thousands of orphans in the country, rehabilitation of women who have suffered rape, whistle blowers being beaten up and killed in open daylight, a perpetually deficient healthcare scenario with increasing gap between doctor and patient, further widened by draconian laws against the tiny number of remaining doctors?
Just Hide, Don’t Seek answers.
Let us all dress up our best for our new girlfriend: the affluent, civilized western world.
© Dr. Rajas Deshpande
PS: I am strongly pro-digitalization, but it is the wrong God to bank upon for a positive change in our country.