Tag Archives: Resident Doctor

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

Carefully calculating the dose and mixing it with the intravenous fluid with precision, I told the kind old lady: “I am starting the medicine drip now. If you feel anything unpleasant, please tell me.”

Through her pain, she smiled in reply. Her son, my lecturer Dr. SK, stood beside us and reassured her too. He had to leave for the OPD, there already was a rush today. “Please take care of her and call me if you feel anything is wrong” he said and left.

Dr. SK’s mom was advised chemotherapy of a cancer. It was quite difficult to calculate its doses and prepare the right concentration for the intravenous drip. Just a month ago, my guide Dr. Pradeep (PY) Muley had taught me how to accurately prepare and administer it, so when Dr. SK’s mom was admitted, he requested me to do it for her too.

The drip started. After a few hours, I noticed that her urine bag needed emptying. The ‘mausi’ supposed to do it was already out for some work. Any resident doctor in India naturally replaces whoever is absent. So I wore gloves, requested a bucket from the nurse, and emptied the urobag into it. Just as I carried the bucket with urine towards the ward bathrooms, Dr. SK returned, and offered to carry it himself, but I told him it was okay and went on to keep the bucket near the bathroom where the ‘mausi’ would later clean it. © Dr Rajas Deshpande

Once the drip was over, Dr. SK invited me for a tea at a small stall outside the campus. He appeared disturbed. He said awkwardly: “Listen, please don’t misunderstand, but when I saw you carrying my mother’s urine in the bucket, I was amazed. You are a Brahmin, right? When you were away, my mom even scolded me why I allowed you to do it, she felt it was embarrassing, as we hail from the Bahujan community. I am myself a leader of our association, as you already know”.

I knew it, to be honest. His was a feared name in most circles.He was a kindly but aggressive leader of their community, but always ready to help anyone from any caste or religion, to stand by anyone oppressed, especially from the poor and discriminated backgrounds.

“I didn’t think of it Sir! She is a patient, besides that she’s your mother, and I am your student, it is my duty to do whatever is necessary. Otherwise too, my parents have always insisted that I never entertain any such differences”. I replied. © Dr Rajas Deshpande

“That’s okay, but I admit my prejudice about you has changed,” he said. “If you ever face any trouble, consider me your elder brother and let me know if I can do anything for you”. What an honest, courageous admission! Unless every Indian who thinks he / she is superior or different than any other Indian actually faces the hateful racist in the West who ill-treats them both as “browns or blacks”, they will never understand the pain of discrimination!

As fate would have it, in a few months, I had an argument with a professor about some posting. The professor then called me and said “So long as I am an examiner, don’t expect to pass your MD exams.”

I was quite worried. My parents were waiting for me to finish PG and finally start life near them, I already had a few months old son, and our financial status wasn’t robust. I could not afford to waste six months. © Dr Rajas Deshpande

I went to Dr. SK. He asked all details. Then he came with me to the threatening professor. He first asked me to apologise to the professor for having argued, which I did. Then he told the professor: “Rajas is my younger brother. Please don’t threaten him ever. Pass him if he deserves, fail him if he performs poor. But don’t fail him if he performs well. I will ask other examiners”.

The professor then told me that he had threatened me “in a fit of rage”, and it was all over.

With the grace of God, good teachers and hard work, I did pass my MD in first attempt. When I went to touch his feet, Dr. SK took me to his mom, who showered her loving blessings upon me once again, and gifted me a Hundred rupee note from her secret pouch. © Dr Rajas Deshpande

Like most other students, I’ve had friends from all social folds at all times in school and colleges. I had excellent relations with the leaders of Dr. Babasaheb Ambedkar Association, and twice in my life they have jumped in to help me in my fight against injustice when everyone else had refused. I love the most fierce weapon of all that Dr. Babasaheb Ambedkar himself carried: the fountain pen!

No amount of fights will ever resolve any problems between any two communities, the only way forward is to respectfully walk together and find solutions. Fortunately, no doctor, even in India, thinks about any patient in the terms of their religion or caste. (© Dr Rajas Deshpande). Just like the Judge in the court premises, humanity is the single supreme authority in any medical premises. Blood or heart, brain or breathing are not exclusive to any religion or community. Just like the bigger brain, a bigger heart is also the sign of evolution.

I so much wish that the black clouds of disharmony between different communities are forever gone. The only hope is that our students can open any doors and break any walls, so long as they do not grow up into egoistic stiffs. © Dr Rajas Deshpande

I am proud to belong to the medical cult of those who never entertain any discrimination. A patient’s blessing has no coloured flags attached! Even outside my profession, I deeply believe that the very God I pray exists in every single human being I meet. If at all anyone asks me, I am happy to say that:

My religion, my caste and my duty as a doctor are all one: Humanity first!

© Dr Rajas Deshpande

Neurologist

Pune

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Which Is The Best Festival Upon Earth?

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

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

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

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

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

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

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

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

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

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

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

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

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

A Medical Lesson That Still Hurts

A Medical Lesson That Still Hurts
© Dr. Rajas Deshpande

“Can’t you see I am with a patient? We can talk later. Or may be tomorrow” snapped my lecturer at Pallavi.

Pallavi was 26, had epilepsy herself, but used to sit in our OPD to help other epilepsy patients. She came from her home by local train, travelling over two hours, and went back after OPD to attend her father. She was on many medicines to control her fits and depression, still used to have frequent fits. An epilepsy surgery was not possible, my professor and lecturer who were her caretakers had explored almost every avenue for her. Some unfortunate patients do not respond well.

Obviously she could not get a job and sitting at home worsened her depression. She was quite good looking and kind. However, her father was bedridden with a paralysis attack, and had many problems, even bedsores. That stress made Pallavi cranky and always worried. With no source of income, she was dependent upon help from the staff at our municipal hospital. As she was too proud to accept money without working, my professor had eased her ego by requesting her to help other patients: OPD paperwork, forms, getting medicines, patient education and restrictions etc.

She would either consult us resident doctors or our teachers if there was anything wrong with her or her father. Sometimes her anxiety was too much to deal with, she often asked repeated questions. Some epilepsy and psychiatry patients have worst symptoms around menses, and even get combative.
Most government and corporation hospitals have a never ending line of patients. In that rush it became impossible to answer her repeated questions patiently, and someone or other usually had to either snap at her or prescribe her an anxiolytic. Sometimes being too kind or available results in more attention seeking.

“See if Pallavi is OK” my lecturer told me after a few minutes.

Sulking, Pallavi had gone to the pantry near OPD and sat alone. During our tea break myself and my colleague Dr. Sachin went there too. My thesis / dissertation submission was in final stages, where everything about it seems so pointless and meaningless. I had to submit it within two weeks. © Dr. Rajas Deshpande

“Tea, Pallavi?” we asked her as she sat in the corner.
“No, Doctor. I’ve had it. Thank you” she said. We drank our tea in an invaluable silence.

She suddenly said: “Doctor, my father has started continuously calling me names. He uses very bad language. My headache becomes unbearable when he starts shouting.” She became tearful.
While having tea, I wrote her prescriptions for herself and her father too.
“Doctor, I want to talk” she said, “I need to sort out things in my life” she said.
“Pallavi, the OPD is still heavy, we will talk after lunch, ok?” I replied. It was 3 PM already. We finished tea and returned to the OPD.

A few minutes later, I heard her crying in my teacher’s cabin. “You must learn to be patient” my teacher was trying to pacify her while attending other patients who kept angrily rushing in, demanding their own time. © Dr. Rajas Deshpande

Pallavi got a call from home and left the OPD before it was over.
I went straight to the printer after OPD for the final corrections of my dissertation.

That evening we got the news that Pallavi had fallen off a local train, killing herself. No one knew if it was a suicide.

I have never been able to overcome that till now. What if I would have spent few more minutes, talked her in kinder words, pacified her better?

I learnt one of the most important and precious lessons that every doctor learns eventually: There’s no afterwards. Answer the patient in front of you NOW. Never deny time to one in genuine trouble. A minute of a doctor’s patience can save lives.

This became clearer later, this is true about everyone, not only doctors or patients; no one ever knows which one is the last meeting between any two. Now I make sure to only part with a proper goodbye, a smile and no bad feelings: apologise if I am wrong, forgive if the other one is. Some say that feels too formal, some think it is a way to impress others, or being excessively unnecessarily mannerful. But I know what I mean. There are no guarantees in life: about myself at least. Every goodbye is potentially final.

Patients never seem to stop. Everyone is in their own hurry, tired, pissed off . The doctor is the common point of venting problems, frustrations and also anger. Most doctors acquire the saintly art of not losing patience, raising voice in the worst of situations, but it is at the cost of being inhuman to themselves. To spend 12-16 hours every day (18-20 in case of resident doctors) among the angry, suffering and accusative without losing patience is not a joke. This is one reason why patients see irate/ less interactive doctors commonly and misinterpret it as “ego / pride / snobbishness” etc.

That said, since that incidence in our OPD, I do not refuse any question from any patient in front of me. I do not end the consultation unless I have answered their last question or the patient starts taking advantage by asking repeat or unnecessary questios.

Pallavi, I feel very sorry.
Patient First, Patience Highest, Always, for Every Doctor.
Thank you for the lesson.

© Dr. Rajas Deshpande

Real Story. Identities masked. Please Feel Free To Share Unedited.

Stop This Anesthesia

Stop This Anesthesia
© Dr. Rajas Deshpande

“Why so Doctor? Why cannot my child be like others?” asked the angry mother.

Just as I started to reply her, the patient: a 23 year old boy, went into a flurry of jerks. His body stiffened up, his eyes rolled up, and his face turned blue. He was already on the examination bed. Me and my student tried to support him there. We activated the code blue, just in case.
But the fit stopped. The boy came to, gradually. The nurse cleaned the bloody froth from his mouth. Heart rate and BP were normal now. Patient remained confused.

The mother, silently sobbing while patting his head, showed me the many large scars upon his face, head, and elsewhere. “He falls down many times every day and often injures himself. Can you imagine, doctor, what a mother’s heart feels to see her child bleeding every day?” © Dr. Rajas Deshpande
It was a case of hypoxic brain damage. The child was born in a village, the labour was prolonged and they could not reach a bigger hospital in time. If they had facilities, the child would have been normal today. Since birth, the child had had mild mental retardation and convulsions resistant to many medicines, They refused a surgery. I tried to counsel them. In many cases, we can control fits with a good combination of different medicines. But that takes time over a few months.

“We are farmers, doctor. We cannot stay home all day, we need to work to earn. The medicines are all so costly. I can sell everything to treat my son. But please tell me this will stop” the father’s voice was quivering.
It is easy to expect a doctor to detach himself emotionally from the patient, but then it is also like denying the patient empathy and understanding so crucial to their wellbeing.
“I will try my best, and I feel we can control the fits with medicines. Also, I can arrange for free medicines for your son whenever you cannot buy them. Never worry about my fees, I will be happy to treat him free. But make sure that his doses are never missed.” My teachers spoke through me.

“What after my death? Who will care for him? Who will bring him medicines? Who will ensure he takes them?” said the hefty man, and broke down. The proud feel it most difficult to declare their agonies. He tried to hide his face. The father and the mother sobbed on either side of the patient, who wasn’t yet alert enough to grasp it. © Dr. Rajas Deshpande
“There are some help communities and groups for epilepsy patients. We will enroll him into one. They will arrange for his medicines. I will also introduce you to some pharma companies who will give him free medicines as required”.
Then, pausing to realize the unasked question, I replied “And after me too, my students, colleagues or most doctors I know will never decline to treat him free. You just have to show them this note” .
I made a small note of such a request. I have never known any of my students or colleagues refuse to see a deserving patient free.

The tension in the room was melting. The parents had stopped sobbing. A possibility of hope and reassurance destroys the worst of darkness. The father folded his hands in gratitude, but couldn’t speak. The patient had a glass of water and they left.
But my mind was on fire again. Who’s guilty here?
Shall we blame fate for the blatant failures of a system? © Dr. Rajas Deshpande

Why didn’t their village have facilities to ensure good delivery? Why wasn’t it possible for them to reach bigger hospital in time? Who is responsible for millions of children who develop lifelong preventable illnesses just because of a cruel lack of healthcare infrastructure? Patients with heart attacks and strokes and cancers die everywhere everyday, unable to afford treatment or to reach hospitals in time.

In a country that needs serious improvement in almost every area of healthcare infrastructure, the whole focus is being directed at the repeated exams for doctor’s requalification.
Do we need it at all in a country that is grappling with critical shortage of doctors, and where we are promoting every other pathy to allopathy with a six month training? We need many care homes, support systems for patients who cannot afford medicines. Many more ambulances. Many more hospitals in remote areas, Many more qualified doctors to work there while being able to afford a dignified life.

But the only decisions being made are about more exams for truly qualified doctors: why? This tranquilizer to divert attention from the main issues that need correction is the worst treatment possible for Indian Healthcare. © Dr. Rajas Deshpande

Doctors are never defined by the examinations that they pass, being a doctor is far more than passing qualifying examinations. But who will educate those who never bothered to pass any dignified exams?

Just before inducing the anesthesia, the patient is told “You will feel sleepy now. Everything is ok. Take a deep breath”. With complete faith, the patient goes unconscious. It is the doctors who ensure he / she returns safe. Some rare unfortunate patients never know that they will never wake up, because there are things a doctor cannot control.

That unfortunate patient is just like the Indian Society today.
How qualified are the healthcare policy decision makers?
© Dr. Rajas Deshpande

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The Wrong Sacrifice

The Wrong Sacrifice
© Dr. Rajas Deshpande

“Come home this weekend.. I feel like seeing you” my father said. He was already feeling sad, missing my sister who had married three months ago.

That was 14th October, a day prior to my sister’s birthday. I had taken a week’s leave for her marriage and preparations.
I felt sorry for Baba and desperately wanted to meet him. I was quite attached to him.

I asked my professor, and was reminded that there was a shortage of resident doctors, we had a ward full of 50 patients, 10 more than the capacity. “You have to sacrifice some things once you become a doctor, Rajas. I am sorry, but you cannot get leave at present” my professor said.

Late that night I called Baba and told him so. I could feel the heaviness in his throat as he replied “Ok. I am proud that you value your duty and responsibility above me. Take care. And yes, don’t forget to wish your sister tomorrow for her birthday, and get her some good gift. She must be missing us too”.

I had had one of those cruel “brother-sister” fights with her, and we weren’t talking. Another carefully protected window to our childhood, we enjoyed those fights which multiplied our love.

“You have always sided with her, Baba. You are partial to her” I replied with pretend-anger.
He laughed “That’s because I have made you tough enough to take care of yourself in any situation. She has a delicate mind” Baba said.

I assured him I will call her. I did, and wished her a Happy Birthday. She was ecstatic. That evening on 15th October, I called up home. My mom picked up. She told me that both of them were feeling very sad about being away from us especially because it was sister’s birthday. “Baba has tears in his eyes all day” she said.
I tried to cheer up Baba. “I have called your laadli daughter and wished her. I have also sent her a nice dress from Mumbai. Now you have to buy me something when I come home okay?”
“When will you come?” he asked again.
“As soon as my professor allows” I replied.

The next afternoon, on 16th October 2000 at 2.30 PM I received a call that Baba had had a sudden cardiac arrest and passed away. I suffer that call till this minute. I will never recover from the trauma of that moment.

Now, whenever someone questions the integrity of a doctor, the honesty and hard work of genuine doctors or accuses them of working only to earn money, or high-handedly suggests that the hardships and sacrifices involved in this field are ‘chosen’ and mandatory, I feel I made a wrong sacrifice for an undeserving society.

There are sayings in every religion about some animals not understanding their holy texts. Medicine is my religion and I will not explain its holiness to the donkeys who refuse to understand it. Be it the corporators, MLAs or MPs from ruling parties who attack doctors, Journalists or reporters who spew poison against every doctor, or the perpetually “cheap and free” demanding class.

There are thousands of doctors who have gone through this situation: sickness, marriage, rituals and even death in their families which they could not attend just because they were working to save someone, attending other patients. I know of umpteen doctors who got one day leave for their marriage, when their child was born, or their parent was sick.

Before you question a doctor’s intent and integrity, before you talk loose about this profession, please do search your soul.
© Dr. Rajas Deshpande

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The Pride Principle

The Pride Principle
© Dr. Rajas Deshpande
“Sir, we are screwed. The Chief Minister and other ministers have closed all doors, they won’t respond. Our careers are in grave danger. Can you please help us?” I frantically spoke.
From the other end of the phone, the Don, Dr. Nitu Mandke answered: “See me at my home at 12 midnight”.
The Maharashtra state resident doctor’s agitation for dignity, national pay parity and better living conditions was on, and I was given the responsibility of coordinating and being the face. For once, there was excellent communication amongst all medical colleges, thanks to the cellphones and fax machines. The divide and rule weapons of most governments which had crushed many of the earlier strikes were not working here, as we had established a multilevel network.
When students go on a strike anywhere in any field, it is almost always out of desperation, and either for dignity or rebellion against some sort of suppression and humiliation by the system. This raw power is almost as mighty as the army, and although it falls prey to political misuse sometimes, it has tremendous capacity towards achieving intellectual evolution of the society. Students never rebel for money or power. The government always treats any unrest as an offence to its ego, and uses everything at its disposal: CID, Police, Administration, Force, Threats, Caste Politics, Cheating and Legal torture to mow down student agitations. Students have no money, no experience and rare political or social backing, and must unite and stand up for themselves. © Dr. Rajas Deshpande
On the fourth day of the strike, a big politico from the ruling alliance came over to our office at Mumbai KEM. Except the party batch and stickers on the luxury SUVs, there was no telling between him and a mafia goon. The members of student’s central committee: Dr. Sanjay Singh, Dr. Dinesh Kabra, Dr. Narender Sheshadri, Dr. Pramod Giri, Dr. Nilesh Nikam, Dr. Kuldeep, Dr. Vishal Sawant, Dr. Noor, Dr. Shahid, and few others were with me. The politico did not have any scruples using an arrogant, raw and filthy language to threaten that if we do not stop and withdraw the strike, our careers and even life will be in danger. As he was from the ruling party and threatened us in presence of the police, there was nothing we could say.
There are angels everywhere. A senior police officer who was supposed to “keep a constant watch” upon us ‘student leaders’ was quite fatherly. He told us “Do what you must, but don’t declare. Dumb people cannot interpret silence. Stay away from any violence”. © Dr. Rajas Deshpande
Next day, we got a message from government that almost every silent agitator gets: you have been cut off (you don’t have enough nuisance value). Unknown calls kept threats alive.
That is when a resident doctor suggested we meet the Don: Dr. Nitu Mandke, the famous heart surgeon who was known to be a fearless, straightforward celebrity doctor. He had already watched the TV news of our agitation. One Resident Doc could contact him.
He returned home past 12.30 AM. We waited, hosted by his extremely courteous family. We briefed him the details. He asked a few questions to assess our determination and strength. He asked us to stay united and avoid any misbehaviour during the agitation. To our surprise, he picked up the cellphone and called the Chief Minister’s PA. The CM was fortunately available, and talked to Dr. Mandke. © Dr. Rajas Deshpande
“CM is going out of the state tomorrow. He has advised us to meet the Deputy CM tomorrow. Two of you come to Leelawati Hospital tomorrow at 2 PM. I will take you to the DyCM.”.
At Leelawati hospital, Dr. Mandke’s chamber was intimidatingly clean and posh, yet simple. He checked our applications for the CM and corrected them with his beautiful pen. His briefcase had every essential of writing stationary, the mark of a perfect man.
As we waited, I asked him cautiously: “Sir, shall we start?” He replied that he was waiting for someone to carry the bag on his table. I offered that I will carry it.
He laughed his thunderous laugh, and looked at us as if we were small puppies. “ Deshpandyaa, that bag has two and a half crore rupees cash for my hospital. A professional bodyguard will carry it. People kill for that. Do you want to carry it?”. I shut up.
In his big car, for the 45 minutes that his bodyguard drove us to the DyCM, I asked Dr. Nitu Mandke questions about what was going through his mind when he was actually operating the Shiv Sena Supremo Mr. Balasaheb Thackeray. Such an enormous pressure it must have been!
“Oh yes, it was stressful. But he is a gentleman, and he had assured my safety. His word is enough”.© Dr. Rajas Deshpande
That’s when we told him how some politicos had threatened us recently. He laughed and replied something that has been tattooed upon my cortex permanently:
“Rajas, a doctor is a doctor and king of lives forever. Politicos come and go. Idiots misbehave with others when the have any post or power, in any field. You should not budge. It is pathetic to see doctors licking shoes of those in power, under various pretexts. It is up to you to maintain your dignity and pride. That is the true luxury, everyone cannot afford it. So long as you do the right thing, fear nothing. The few crores in that bag is nothing compared to how I feel about myself”.
We entered the VIP zone and bungalow. His car was not stopped anywhere. The DyCM offered us tea, and gave us a patient listening.
“These junior doctors and students are my boys, our own boys, they will look after the health of our people tomorrow. You must help them” Dr. Mandke insisted. The DyCM assured he will. The spell was broken, talks resumed.
Many twists and turns later, one of the most memorable strikes was called off. There were those who never physically participated but went home during the entire struggle. They came back dissatisfied, alleging. Those who participated knew they had fought well and won.
A year later, I saw a white Lexus car in our KEM campus at Mumbai. Fond of cars and having never touched a Lexus, I went to see it from a close distance. Just as I tried to touch it, the driver’s window rolled down, and I heard “Deshpandyaa, open the door and come in. Do you like my new car?”
And I sat besides he King of proud men, one of the most proficient Cardiac Surgeons, Dr. Nitu Mandke, in his Lexus. The feeling is unforgettable, not only for the Lexus, but for his simplicity, love and affection for a nobody of a junior doctor like myself!
Needless to say, then onwards, I have guarded my pride as a doctor more than any other possession I have. That took away many opportunities and huge finances, still I am doing quite well by God’s grace, and Dr. Mandke’s blessings.
How I feel about myself is more precious than anything I can earn. The luxury of pride is mine.
© Dr. Rajas Deshpande
Dedicated to all students, resident doctors, proud people in every field, student unions and their apolitical fearless leaders.
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A Mother who killed the Wife

A Mother who killed the Wife
© Dr. Rajas Deshpande

“He is angry with us, doctor. He refuses to recognize us, even his parents and children sometimes. It was all my fault, I fought with him so many times over small things. I have said sorry so many times now.. But he is not ready to talk again like he did.. Some doctors said he is in shock, some advised psychiatric treatment. We did all we were told, but he is worse by the day. Please bring him back, doctor!” said the extremely depressed and tearful middle-aged lady. In her lap was a five year old daughter, seated behind her were her in-laws (patient’s parents) and her elder child, a 9 year old boy. My professor was listening carefully, and we Neurology residents were juggling possibilities in our minds.

I was assigned the work-up of this case. After a week-long evaluation and opinions of some senior neurologists in Mumbai, it was concluded that he was an exceptional case of early-onset Alzheimer’s disease. The patient Mr. Bhooshan, an electrical engineer, was about 39 years old then.

Every morning that I entered the ward, I found his wife begging him to forgive her and talk normally again, he looked at her blankly, often irritated and with a questioning face. She would bring the kids to him every evening, and prod them to talk to him, crack jokes, and in general “get him to talk”. He would occasionally call them near himself, pat them, then suddenly vanish mentally from the scene. He sometimes asked his wife about them by names, but didn’t always recall the names accurately. Somehow, children sense moods excellently. They tend to know when a parent is disinterested / hurt / tired or ‘just not there’. These kids did whatever their mother suggested, but they were ok with just sitting by his side, in his lap, holding his hand.

I never saw his aging parents without teary eyes that begged for relief from this hell.

We have different memory areas in brain for sights, smells, words etc., as well as disciplined cascades of time-based memories in our mind. A large part of this is what we call the “Past”. Hidden therein is also our knowledge of ourselves: Name, Birth, Family, Culture, Religion, Education, Friends, Nature, everything that makes someone’s personality unique.

Imagine losing parts of this memory. Imagine not knowing who you are. Imagine being lost “Inside” your own mind. Then also imagine ‘not even knowing that you are lost’. It is only initially that the patient knows and cares about such loss of memory. Unlike dramatic depictions of “violent anger because of forgetting things” in some unstudied movies, patients usually also lose their concern / insight about what is happening to them.

There is a point of no return in the mental / cognitive decline in patients with dementia / memory loss, comparable only to the death of one’s mind as one knows it. Scary.

Relevant medicines were started. There was negligible response.
Mr. Bhooshan gradually became almost blank, and spent most of his day in the bed, often wandering aimlessly and watching windows in the ward. His wife couldn’t come to terms with this. She mostly just sat in a corner, often crying whenever kids visited. Right from Prayers to Herbals, everything that anyone suggested, was being done by the family.

Our counselors talked to her, even prescribed her with mild antidepressants, but she had just collapsed inside.

One evening, I didn’t see her by the patient. Curious, I enquired about her to the patient’s mom who was instead attending him. “Their daughter, the 5 year old, is admitted in the pediatric ward below with high grade fever. She is with her.” replied the old lady.
I went to the pediatric ward after finishing my duty.

I found the kid in bed, weak but comfortable, and smiling. Her mother, the patient’s wife, was telling her funny stories, laughing aloud and imitating comical characters, as she fed the child. Mrs. Bhooshan was a totally different lady then. She talked to me very nicely, without any hint of ‘hiding sorrow’, naturally. The innocent, happy kid invited me to sit by her and share her food.

In two days, the kid was discharged. Her mom had completely changed. She started taking good care of Mr. Bhooshan again, but now with a mysterious peace upon her face, often smiling and mothering her husband too, like her other kids.

Satisfied with the sacrifice that this ’mother’ had made by killing the ‘wife’ within herself, life had smiled upon them again, in the face of an obvious tragedy. They returned home, and she was still nursing him and looking after the kids one year later when I passed my exams and left Mumbai.

Their life had changed, but moved on.
So had mine. I started writing a diary.
Dr. Rajas Deshpande