Tag Archives: Treatment

The Last Bullet For Indian Private Healthcare


© Dr. Rajas Deshpande

Many doctors, nurses and other staff, police officers are dying due to corona exposure. Recently the quarantine period of doctors was cancelled. To add to this, very ridiculously, doctors’ salaries were reduced, and covid funds were deducted from even frontline warriors’ salary. This is like taking money from a soldier’s paycheck to fund the army!!

When I recently heard some people shouting about excess bills in hospitals, doctors not working etc., I felt like shouting back too, but one cannot argue with a sold TV screen.

For decades India has had
Excess urban crowding,
Very poor hygiene.
Very high poverty and illiteracy.
Lack of town-planning for slums.
Severe lack of state/ national healthcare infrastructure.
Tiniest budget for healthcare.
Perpetually under-functioning government hospitals. Every season hundreds die due to epidemics.

Where were you till before the pandemic? Who is responsible for all of the above? Do you want to discuss these factors which are responsible for the pandemic chaos today? Or now you just blame it all upon Doctors and Private hospitals?© Dr. Rajas Deshpande

Only private doctors with small nursing homes and dispensaries, clinics were shouldering all healthcare needs that government hospitals could not provide. They had low profits and catered to middle and lower class. These were destroyed in last few years because of too many stringent regulations and costly licensing. Many closed down. Legal troubles by relatives, politicos supporting them and vandalising hospitals forced many private doctors to stop admitting patients. Protection to doctors was denied by almost all governments till before this pandemic.

Indian poverty is never ending, and charity cannot run anything perpetually unless there’s a strong fund generating mechanism supporting it. If someone expects that doctors charging 2 rupees fees are the ideal healthcare for all our medical needs, they should happily go to such a doctor. We highly respect them too, but it is their choice and there are obvious limitations to that. To develop advanced healthcare in India, higher profits were necessary for higher investment. Corporates, some businessmen and the likes of Mr. Ambani pitched in. Advanced healthcare with heart and liver transplants, complicated brain surgeries, cancer treatments came to India because of these investors. They accepted all the conditions of governments to accommodate over twenty percent poor, nonpaying patients via various schemes. The payments for running these schemes were delayed by various govts for years, and the hospitals were arm-twisted in still continuing to treat everyone. The only source of profits was private and some insurance patients who were paying a higher fees for facilities: from air-conditioning, food to choice of specialists. Higher quality of staff, especially nursing and technicians who can operate high end machinery and robotics requires very high salaries. Maintenance costs are heavy. A specialist cannot do much without such a very good team. Each of these requires good if not great salaries, as they are continuously invited by developed countries who pay far higher.

But then every patient wants the highest facilities, best staff and specialist team, with no payment or basic payment. There’s no concept of billing beyond actual price of medicines and room charges. Service and maintenance is considered a ‘free right’. © Dr. Rajas Deshpande
Even in this modern era of equality, a higher class Indian officer like a minister gets a higher room, better food and other facilities, even higher medical bill sanctions, whereas the labourer from his department gets minimum basic facilities and bill eligibility only for general ward. Law allows higher healthcare’s standards and payments for higher officials. Why do they even have classes in railways and airplanes? If a “Gareeb bechara” migrant wants to fly home, should we offer him road transport or compassionate air travel? Why don’t we do for all the poor something that you all expect doctors and hospitals to do?

We don’t mind if basic and emergency healthcare is uniformly cheap or free for everyone. But when you force a high-end medical commodity (skill-time-investment-staff) to be sold at a loss or extremely marginal profit, you kill the system.

Doctors do not differentiate when making a diagnosis or treating anyone from any financial/ power background. But the private hospitals must be allowed to cater to different classes, earning their profits. That is their only stimulus to grow forward, engage best personnel and bring advanced healthcare to India. Different governments have failed at maintaining high standards of healthcare in their respective set-ups (with some proud exceptions- but because that’s where our powerful go). Some hospitals indeed take more bills for better class of services, including staff, but none of them forces a patient to come to them. Even these hospitals never deny free emergency treatment to anyone.

“But isn’t healthcare a charity? Haven’t you taken oaths to serve?” our loudmouth hypocrites ask.

Yes we have taken an oath to serve everyone rich and poor equally, but no, we have not taken any oath to neglect our own health and well being. Yes we have taken an oath to serve, but we have not taken any oath to live in perpetual poverty and financial stress. Yes we are under an oath to do our best for every patient, but we will not be bending backwards to fulfil their unreasonable demands. Yes we want to save every life, even if it is dangerous , but we will not unnecessarily endanger our own life because someone forces us. We haven’t taken an oath to abandon our families. The Hippocratic oath does not ask any doctor to stay hungry, work without sleep, and do the unscientific because various governments cannot pay for adequate number of doctors. Still we are doing all this already. Let us be clear: we proudly and intellectually serve our country, but we refuse to be considered slaves of either the system or the society. © Dr. Rajas Deshpande

Capping bills in private hospitals will be the last bullet for all advances in healthcare development in India. Be prepared to go back to the chaos of ancient times in that case. Quality will suffer most: right from specialists to nurses to medicines. You can of course force one generation of doctors to work like this, under low cost and excess work. People aren’t fools to send their children to such hells of social slavery. Yes you read that right. There’s a difference between service and slavery. Do not attempt to turn medical service providers into slaves. It will backfire very sourly.

Instead of this, the government can invest in existing private healthcare players to create low cost infrastructure alongside their private hospitals, or privatising its own healthcare institutions with increased capacity. Our governments do have friends in very high places who can invest.

We love India. We are not against any particular government, and this post is not against any leader or party. But we do feel very strongly that healthcare decisions must be made involving everyone concerned, that this people-pleasing for short term will turn out to be a huge disaster in long run, and it will be irreversible. If any government thinks that cancelling hospital permits and doctors’ licences in a country with severe shortage of medical services is the right way forward, God help it.

If private and corporate hospitals start shutting down now, it will be permanent. India will then have to mostly rely upon prayers alone for healthcare. And of course those who think they know medical science more than doctors. India has no dearth of such “fatally self-medicating” ignoramuses.

Jai Hind

© Dr. Rajas Deshpande

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Suspend All Doctors, Cancel Their Registrations…


© Dr. Rajas Deshpande

Have you ever spoken with a doctor, a judge, a police, minister or an an IAS officer in their office? Almost every common man has had almost a similar experience: an arrogant air of authority, hidden hints of superiority and a subtle dose of “I know better than you” whenever one tries to argue. Now we know all of the above can be wrong occasionally, at all levels. Of course, there are exceptions in all professions. In a new world which is now shedding away traditional chains of inequality and racist slavery, we Indians are probably the most reluctant to change. In performing one’s duty, no one is superior to those they serve.

A doctor needs to be patient and compassionate with the ill-behaved and arrogant, unlike police, judge or minister who will punish people for such behaviour. Additionally, far before COVID19, there have been fatal infections like MDR Tuberculosis and other viruses which have endangered and even killed doctors. The stress of this daily fear of death is difficult to explain to the idiots who argue “but you yourself chose this profession, nobody forced you, you knew all the time about these risks”.
My dear infinite stupid, yes, I chose this profession willingly, knowing the risks, but to live on and serve, not to willingly and knowingly expose myself to fatal infections. A soldier joins the military ‘to live on and fight and protect the country, not with a wish to die with enemy’s bullets’.
When a citizen tells them from the comfort of a protected home that “You already knew you could die in the army”, it is ingratitude and insult to their profession. We choose to be in this profession because our compassion and courage is higher than our fear, not because we want to die. To be honest, we do not expect many to even grasp this concept. © Dr. Rajas Deshpande

I have deep respect for some Judges, IAS and police officers who are geniuses, and the first mark of a genius is a humble openness to all logical argument, with parsimony of words and zero presumptions of having a superior knowledge. Even a few minutes with them enhances your life. They are calm and respectful of others. Their language is never “Suspend, Fire, Transfer or Shoot”, because they know what it takes for a genuine person to reach where they are. These geniuses are far above attention seeking, cheap media publicity, arrogant show of authority and blame-mud-slinging to cover their own mistakes, inferiority complexes, and inadequacies.

It takes longest time and a hardest curriculum with hands-on experience of years to make every single doctor. The more specialised a doctor becomes, the rarer it is to replace his experience. Still anyone can commit mistakes.
If a Judge, a police Officer, a Minister, an IAS officer is wrong, does our constitution allow any TDH in media or society to get up and threaten them with suspension? Can you imagine a nagarsewaks / municipal councillor / local politico, goons or even major/ minor officers threatening a judge, IAS officer or a commissioner with cancellation of their rank, licence or degree? Even the courts of law do not suspend anyone or strip them of their hard earned registration without giving them a complete and patient hearing.

Yet almost every TDH in almost every nook and corner in India, from temporarily elected less-schooled representatives to highly educated junior and senior administrative officers often threaten on TV channels that doctors’ registration, licence and degrees will be cancelled. This apparently gives them a sense of pride and accomplishment and also sends a wrong message to a public that these doctors must serve.

In a country where the policy makers have miserably failed for generations to create enough doctors for their population, where we still continue to have that discrepancy, suspending a doctor is like snatching away food from someone already dying of hunger. One doctor gone screws up many patients’ lives. There’s no other profession where generations are taken care of, lifelong, by one person. Yet apparently, some officer’s egos are more important than those patient’s families, health and lives.

Every day there are news of political, social reasons of suspending, threatening doctors. Deny concessions, freebies, shoe-licking, decline to compromise upon scientific principles or accept inhuman conditions for doctors, and almost every officer unleashes their administrative adrenaline pumps against the entire medical profession. Refuse to accept incorrect policies and guidelines that are against patient’s interests, and insubordination leads to losing your jobs. The most shameful and pathetic addition to this “Suspend-Crazy” admin category are some senior doctors who fail to guard the principles and juniors of their own glorious, noble profession. © Dr. Rajas Deshpande

Like every Judge, Police or IAS officer, even politician, every doctor has also worked very hard to earn their degree and licensing. Every Medical college and University in India is approved by the government. The Medical Council of India has been given the authority and statute to license a medical practitioner upon presenting his / her degree and following principles it has laid down. No one other than the MCI should be able to cancel the licence of a registered medical practitioner. Every case of suspension of a doctor: whether a postgraduate or a senior doctor should be referred to a separate impartial MCI committee. Even the Hon’ble courts of law usually request expert opinion before concluding about medical issues / cases. Yet, our admins and politicians from different states suspend and threaten doctor’s registration cancellation as if it was granted by them or their party or government as a favour. No. We don’t accept that. Every IMA branch in every city must stand by such victimised doctors, protest such injustice, represent the harassed doctor and protect him/ her.

There of-course are doctors who commit mistakes, like Police Officers, IAS officers, Ministers or even some Judges. All of them should be accountable and be brought to the right penalty with the same dignity as others. No one has the right to pretend that a doctor is a slave to their whims, greed and tantrums. © Dr. Rajas Deshpande

The Hon’ble Supreme Court has very clearly stressed the fact that it is very important that doctors should be able to work and make their decisions without stress, insecurity, duress or fear. The article above intends to highlight that same purpose, especially in the light of some recent happenings. Every doctor out there is risking life only to save others, serve the nation. They do have problems, issues and insecurities that need sorting out. Please address their issues scientifically and logically, rather than inhumanly threatening them by suspension and cancellation of licences because you have no resources, funds or answers. Treat your doctors with the same compassion that you expect from them. Or, if you know better, if you want doctors to blindly follow unscientific instructions of admins and whims of politicos why make doctors? Suspend all doctors at once and do it all yourself.

India will definitely be healthier if you listen to the doctors, and don’t threaten or suspend them for trivial reasons.
Jai Hind!

© Dr. Rajas Deshpande
Written with a sad heart that on one hand where the Hon’ble PM has asked people to respect and appreciate the efforts of doctors, nurses and other corona warriors, many are looking for reasons to corner, threaten and suspend them at the drop of a hat, sometimes just for headlines.

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A Superhero Doctor’s Dresscode
© Dr. Rajas Deshpande

A Doctor cannot enter home every day and start giving injections to her kids. A policewoman cannot wield a danda/ stick every day upon return, at her family members. A Judge probably cannot say “Order-order” when a child cries at home. We are not supposed to carry our professional mindset and attitude in certain places. Likewise, one cannot expect people from other professions to advise others what is beyond their domain. A doctor will never understand how complicated a politician’s or a policeman’s job is, and vice versa.
A clean and clear mind is essential for every doctor. Even a small mistake in thinking and decision making or actions may cause grievous, even fatal mistakes. © Dr. Rajas Deshpande
There are many doctors who have become infected even before the pandemic with diseases like tuberculosis and hepatitis, while trying to save patients.
It is very essential that every doctor, especially junior, learns to ignore what is not a doctor’s domain. The unscientific territories of political thinking and religion or discrimination are not for the doctor, however tempting and patriotic they may be touted to be. Pressures from society and media can ruin the peace of mind so essential to make a good doctor. A doctor who falls in line with sociopolitical expectations to do something unscientific is not only dangerous to the patients, but can never be called a good doctor.
There are those in higher offices, including doctors, who cannot overcome the ‘superior-inferior’ discriminatory mindset and will advise one and all what to do, taking credit for all good and blaming others for all bad in every situation. They take for granted that a military type hierarchy works everywhere. No doubt it is extremely essential in the military, but in medicine we need brainstorming at every step, a student cannot be expected to act on patients if a senior gives a wrong instruction. One must know, challenge, ask, resolve doubt and then act. © Dr. Rajas Deshpande
Like a Judge in the court who cannot rush an unlawful decision even in an emergency, a Doctor should also only choose what is scientific, even in an emergency. Of course there always should be a sense of time and good. A superhero doc may choose to be a couch potato in his/ her shorts etc. at home, but when on duty, he/ she must don the special dress called pure ethical medical science.
Every Judge who gives a legally correct decision all his life, without being affected by any pressures whatsoever is indeed a superhero. A doctor who takes care of all precautions and helps every patient all the way is indeed a superhero. The heroism lies in defeating the disease and saving every patient one can, NOT in being unscientific and risking lives. Wishing you all decades of success, and millions of saved lives. Always proud of our frontline doctors and nurses!
© Dr. Rajas Deshpande

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Distance Yourself, Doctors.
© Dr. Rajas Deshpande

Dear Indian Doctor,
Congratulations on your bravery to face a pandemic without much support or protection. However it looks like once again a lack of funds and scientific PPE availability will be conveniently translated by one and all into “Doctor Bashing” by sermons on call of duty and other emotional yet unscientific logics. Even some administrators who have exposure to screened few, sitting six feet away from everyone are wearing PPE and N95, while appealing doctors to start opds saying there’s no risk. Should one examine a patient without touching? Do we have seven feet long hands? If we are expected to go within 2-3 feet of the patient, aren’t atleast N95 and gloves essential? But logicless arguments only waste time. Always labelled ‘Money Minded Medics’, now when doctors are sitting home, not minding money, everyone wants them to be in the forefront, appreciated by groups clapping from the safety of their homes. © Dr. Rajas Deshpande
But you know what? This has always been, this will always be. Do not expect any major change in social mindset. None of them had merit or patience to study hard for 10-15 years to become a doctor. None of them even knows what sacrifices are required in daily life, family life and personal exposure to fatal conditions on a daily basis. Their tiny grasp is limited to the last visible part: the fees for service. With an exception of honourable few, most cannot understand a medico. Least those who must please and seek attention of majority. And Majority was seldom right as per history. © Dr. Rajas Deshpande. Logic-less mobs are a reality.
Only those among us who shoe lick and toe line will be projected heroes. Most of us are beyond that. It is pathetic that no doctors’ organisations or glamorous bigwigs stood up against some of the major issues concerning fatal risks to our next generations. (DO NOT FORGET THAT).
That’s why writing this: it Is now upto each one of us to fend for ourselves. Stay calm. This is also not a time to argue with administration. Keep concentrating on your own safety while doing the best for every patient. Wear double masks if you don’t have N95. Wear cloth head cap that you can wash. Wear plain spects/ goggles. Use gloves always. If at all you touch patient wash hands thoroughly. Limit examination to necessary. Ask every patient and relative to cover nose and mouth before entering your chamber. If sanitiser is not available use spirit. Leave wallets, purses, bags in your car/ locker. Disinfect your stethoscope, torch and other instruments. Use digital blood pressure machines where possible, if you must auscultate, have the patient turn away face. Change bedsheets and pillow covers frequently. When you leave hospital please wash exposed skin thoroughly. Upon reaching home leave your footwear outside, cover your face and walk straight to the washroom. Change and immediately soak your clothes in detergent plus hot water. Take a thorough wash with preferably hot water, especially washing exposed areas like head. Take your vitamins without fail. Those with high bp and sugars please take rest and leave freely, don’t take your own health for granted. Eat well, stay safe, all of us have to save thousands and thousands for many more decades. Please do not forget that medical practice is far above and beyond one pandemic, covid or not. We must be available to serve all other deserving patients, and for them we must now take the responsibility of our own safety. No one ever stood by doctors’ well being, no one ever will.
Haven’t we always been distanced by the envious, jealous and unscientific? It’s our turn to use that distance and stay away from those. For every patient who deserves us.
All the best.
© Dr. Rajas Deshpande

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

At Home? Risks and solutions.

At Home? Risks and solutions.
© Dr. Rajas Deshpande

While it is necessary that everyone stays home during this calamity, there are certain risks involved in that. Here’s a list of solutions:

Inactivity and excess fried food increases chances of blood clotting in heart and brain. Stay active even at home, and eat healthy, fresh food only. Expose yourself to good sunlight wherever possible while keeping away from others. Reduce sweet/ sugar intake especially if you have diabetes.

While working from home avoid sitting in one place at a stretch, get up and walk for 10 minutes after every two hours.

Ensure 7-8 hours of night sleep, less sleep may reduce immunity.

Staying with even your loved ones 24/7 may not be all pleasant always. We are not politicians to ‘adjust’ or change party. We fight, but the party remains the same. Take care to reduce friction, allow each member their privacy and ‘Me’ time, do not irritate others. This will help reduce friction. This phase is tense for everyone, not all can express their feelings well.

Try to overcome the media effects on your panic by reducing TV/ screen time. Continuous onslaught of fear inducing news worsens stress. If you are home away from others you are safe enough.

© Dr. Rajas Deshpande

If you have elderly members at home please make them walk or move in wheelchair, bed and reassure them that they are safe, hydrate them well and keep their medicines in stock. Prevent their exposure to shouting TV bad news. Discourage fasting as low sodium levels can cause havoc in that age group.

Reading, writing, board games, light exercises, new recipe experiences, home cleaning and reorganisation, planning life after corona, sorting out cobwebs in your mind that you couldn’t earlier because you didn’t have time are the best things to do. Good time to set priorities in life.

Government should probably look at volunteers who can collect donations: medicines, food, masks, soaps etc. for the non affording and underprivileged. Even they have elderly populations at home and desperately need help.

This is a phase in human evolution, we will emerge stronger, fitter and wiser. Till then take care.

© Dr. Rajas Deshpande

Doctors and Religion?

Doctors and Religion?

Abdul Majid, (middle) my classmate, stayed across my room in the boys hostel, all 5 years of MBBS. I have never seen him sleeping or eating. Whenever we saw his room door open, he was either studying or offering prayers. I have often borrowed his luna moped to go for a tea in late nights. He comes from a very humble family, and had always been among the toppers in every batch: MBBS, MD, and then DM. We have attended many cases together before he finally settled in Aurangabad and made a big name for himself. I have not seen a more hardworking doctor than Dr. Majid.
Ateeq-Ur-Rehman (Right) is another such brilliant doctor, coming from my small town called Nanded, who has scaled highest levels of education in India with sheer merit, and has now settled as a successful Neuro-Intervention specialist in Hyderabad.
While I treat hundreds of Muslim patients who come with complete faith and trust without thinking about my religion, Dr. Majid and Dr. Ateeq have also served thousands of patients from all religions including Hindus, who have complete faith and trust in their ability and acumen.
Whichever religion, state or country a doctor may come from, there never is any thought about religion or caste when we treat patients. Humanity, compassion and Scientific logic is the ground upon which medical science is based. There’s no place for any discrimination, racism or even enmity. Thousands of doctors from all religions: Hindu, Muslim, Sikh, Christians, Buddhist, and many others treat millions of
Indian patients every day. We doctors take pride in rising above all differences, thinking of all humans as one and equal, and in the trust that our patients show in us, irrespective of our names and external appearance. Inside, every doctor, whichever religion or country they may belong to, represents only one principle: the desire to do the best for those suffering.

I am proud to belong to this medical culture and tradition of unity.

© Dr. Rajas Deshpande

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An Interview With a Neurology Legend

An Interview With a Neurology Legend

Dr. Satish Khadilkar

MD, DM, DNBE, FIAN, FICP, FAMS, FRCP (London)

Dean and Professor and Head, Department of Neurology,

Bombay Hospital Institute of Medical Sciences, Mumbai.

He is a living legend, one of the best neurologists anywhere, a stunning example of what an ideal doctor should be like.

He needs no introduction to those in the medical world: he has carved his golden name in global neurosciences with his passion for Neurology and especially NeuroMuscular diseases, pioneering this specialty in India. I am grateful to Dr. Satish Khadilkar for agreeing to guide us all.

Q: How does it feel at the top?

A: Grateful to life!

In the health pyramid, ‘top’ really means ‘more useful’! And there are at least three parts to being useful: providing service, teaching and conducting research. Indeed, I am grateful to life for having provided me with the opportunities to be useful to colleagues and disease sufferers in all the three spheres.

Q: What are the most essential qualities that a doctor must possess?

A: As mentioned above; service, teaching and research are the three main pillars of medical careers. Each of these requires different virtues. Service requires patience, availability, affordability and the capacity to empathize with the sufferers. Teaching requires clarity of ideas and the ability to be inspirational to the new entrants and younger colleagues. And research requires an analytical mind to understand questions, be unbiased to design experiments in search of the answer.

Depending upon which field you choose, relevant qualities will need to be enhanced. In my mind now, as I have gone on, service has emerged as the noblest frontier for the medicine man. So the essential qualities are compassion, knowledge and the desire to help.

Q: What do you suggest we do to improve the clinical sense among newer generations of doctors?

A: Simple answer: bedside clinics by masters of clinical medicine and shadowing them to see how they utilize the limited resources.

Q: How do you deal with the ever widening knowledgebase while effectively practising as one of the busiest practitioners in the country?

A: Knowledge is of two types, one to know it yourself and the other, to know where to find it! In the present times; we have moved on to the second mode. The great thing about this era is that knowledge is freely available. We only need to develop the ability to design the search to get rapid answers to our questions. There are courses available to this effect.

While this is true for problem-based daily issues, in one’s own area of interest, one has to acquire all the manuscripts and threadbare them, assimilate them and understand them, for deeper knowledge.

Q: How do you handle the incessant negativity which doctors face while dealing with so many incurable conditions and gradually deteriorating patients?

A: Negativity in the doctor’s mind stems from the perceived personal inability to help or to provide solutions. Doctors need to appreciate that their role is limited to being knowledgeable helpers. If we keep in mind the inadequacies of medicine as a science and our restricted role, negativity is less likely to take roots.

Q: What is your take on making holidays, vacation compulsory for doctors to overcome stress?

A: Personally, I do not see the need to take holidays, as my daily work itself is a never ending holiday! I do not remember taking a holiday in last three decades. The better you gel with your work, less it stresses you and less is the need to break.

Having said that, as our work relates to human life, we have to make sure that we take adequate rest and are “on the top of our game” for the hours that we work, as our shortcomings can have consequences.

Q: What advice will you give about handling family responsibilities and duties to the new generation doctors?

A: Human relationships take very long to build and only one indiscretion is enough to undo these. So, in relationships and family, equal attention needs to be given, as you would in your profession. In today’s competitive India, we tend to take the family granted and actually end up doing the least for those who matter most!

It is best to think of this early on while planning the professional career.

Q: What best can be done to stop the exodus of doctors from India?

A: Talented Indian doctors need to be appreciated by the society and the health system in India. System needs to be more humane and responsive to the doctors’ needs. Doctors also need to understand the process of medicine, its goals, trials and tribulations. Till this happens, we shall see movement to greener pastures, where this process has evolved better.

Q: Your guiding thoughts for future Indian Doctors?

A: Let us all remember that we are in medicine to help suffering people. That is the core of medicine. We are healers and scientists. If we don’t veer from this ideal and have patience, all material wants and requirements will automatically fall in place. So to understand medicine, one must never forget that this is the noblest of all professions. I have chosen its nobility as a guiding principle for myself. I found my solace in drowning myself deep in the vast oceans of knowledge about neuromuscular disorders and using it in the service of suffering multitudes.

©️Dr. Satish Khadilkar & Dr. Rajas Deshpande

The Dictators in Hospital © Dr. Rajas Deshpande

“Let my father die. It’s ok. I will not take him anywhere. I don’t want anyone else to treat him” said the 60 year old son loudly. His old father who could listen and understand the conversation, but could not speak or move due to a paralysis, just closed eyes. Tears emerged from the corners of those closed eyes.

Like most doctors nowadays I have learned to master personal opinions and emotional responses, especially with ill-behaved patients, but this was beyond me. Not because he had shouted at me, but because he had just stabbed his father’s heart. Loudly, so that the patient could hear, I said “I think your father should feel better soon, let us see what we can do”. Then I gestured the angry son to see me out of the room. Two other men accompanying him came out and towered upon me.

About five days prior, this son had come to me with his father’s reports. The patient was admitted at a rural hospital. He had severely compromised heart function and his heart rhythm was abnormal. This caused formation of many blood clots in the heart, which went to the brain blocking blood vessels. One such large blockage had caused paralysis and inability to speak. © Dr. Rajas Deshpande

I had asked the son not to shift the patient, as the treatment started by the rural physician was accurate, we had to just wait and watch. Still, they had brought the patient in an ambulance, travelling for over 4 hours. Naturally, the patient had worsened , becoming drowsy. His heart rhythm was dangerously worse. He was unable to swallow, there was a big risk of his saliva/ mouth secretions going to his windpipe blocking his breathing.

Whenever a patient has problems out of a specialist’s expertise area, it is mandatory that an opinion of the concerned specialty expert be obtained. I asked the best heart specialist I knew to see the patient, and also a small ENT test to see if we could initiate training for swallowing. Our physiotherapists were already working upon his hands and legs gently.

However, the son (a retired govt. officer from a very respectable post) and two others attending the patient created a big scene when my junior doctor visited the patient. They started shouting and cursing that by calling other specialists we were just “increasing the bills”, and that they did not want anyone else except me to see the patient, not even the junior doctors. © Dr. Rajas Deshpande

My assistant physician called me in panic and updated about this, asking me to immediately act to deescalate the situation. Although there were many patients waiting to be attended in OPD, I had gone to this patient’s room. I explained to them that the patient needs to be seen by a heart specialist too, as his heart condition was very delicate. I also offered them to choose any specialist or hospital they wanted, if they were unhappy here, but they could not waste time as the patient was critical. That’s when the son shouted that he would rather let his father die than be seen by any other specialist.

When they came out of the room, their body language and general disposition suggested aggression. I tried to politely reason with the son that any specialist cannot sit with the patient 24/7, that junior doctors and other specialists as required will have to be called in for the best care, but they declined. The efforts of our medical superintendent and best patient coordinator went in vain. © Dr. Rajas Deshpande

“We will not allow anyone except Dr. Deshpande in the room. Our patient must get better” the son said loudly.

“I will see him till he is under my care, but I cannot guarantee any outcomes” I told them. “Let’s see” he said. He did sign the document informing about criticality of the patient.

No doctor should treat patient under pressure, duress or threat in the interest of the patient. I went to our medical director and requested that the patient be transferred under some other specialist. The hospital offered them freedom to choose, but the relatives declined. “We have come here for Dr. Deshpande, he will have to treat the patient alone” the son said. The hospital decided to take a call next day after a meeting.

That evening as I finished the OPD, I wondered how the patient was. However much angry I may have been with the relatives, the patient was more important than my anger, pride or anything else. I went to their room and checked the patient. He opened eyes and smiled. I asked him his name, and he replied in a husky tone. He was speaking now!!

The next day again, the relatives refused to transfer the patient under someone else, and I kept the treatment on. The trustless atmosphere was quite volatile, and if something had gone wrong, things would have taken an ugly turn. In the next three days, the patient spoke well, and even accepted some sips of water. His hand and leg started moving too.

“Can we take him home now?” the relative asked on the fourth day.

Happy for many reasons, but mainly the fact that the patient had improved, I discharged the patient. I had learnt my lessons. © Dr. Rajas Deshpande

Adamant, unreasonable and illogical demands by patient’s relatives jeopardising the patient’s life is a huge medical problem in India. Illiteracy, political interference, goonda culture and media support make such horror stories a routine reality. The law still expects the best patience and non-reacting approach of medical personnel, with the onus of saving lives still upon them under this pressure. Innumerable instances of harassment and humiliation of nursing staff, especially women go unreported. Relatives, especially politically connected, behave like dictators in any hospital, threatening one and all. Unless this culture ends and doctors are at a freedom to do their best for every patient, medical care in India will always remain inaccurate, incomplete and purely financially guided rather than scientific or even legal. Doctors can actually file a complaint or take legal action in such cases, but they are too many, and no doctor has time for such legal courses. In the best interest of our patients’ lives we go on forgiving and tolerating such abuse. Because neither law nor administration wants to correct the causative factors effectively.

© Dr. Rajas Deshpande

Neurologist Mumbai/ Pune

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Take me for granted

©️Dr. Rajas Deshpande

Neurologist

Pune/ Mumbai

“Is your food more important than the patient?” asked a angry voice on the other end of the phone.

It was a Saturday night, about 11 PM, and I had already had a tough day. I had not had time for even lunch, my head was hurting already. I had known the patient for over five years, her husband wanted to “discuss something” urgently. I had requested him to call next day, honestly mentioning to him that I was on my way for dinner. That’s when he asked if food was more important than patient.

“No. Food is not important than the patient”, I said, “Please tell me.”

“Listen doc, today after dinner me and my wife had our usual walk in the society, when we met a neighbour who told us about a new herbal treatment for neurological patients. He said it worked like magic in paralysis cases and the cure was guaranteed. He had some extra bottles, but it is very costly. So we decided to call you and ask”.

“What is so urgent about it?”I asked.

“Not urgent, but we were both very excited and anxious, so we decided to call you and ask” He replied. I told him that that they were free to try anything they wanted, yet cautioned him to check the contents and then alone take any medicine.

I wasn’t angry.

The next morning, I had to visit a government office. There was a huge queue. By noon, as the queue extended, the officer got up and with a calm face went for his lunch, displaying a a sign “Lunch Hour”. I wasn’t angry.

©️Dr. Rajas Deshpande

I remembered the time when I had to visit a minister, a bigshot political leader for some issues about resident doctors. We had to repeatedly call for appointment, it was cancelled many times, then we were made to wait for hours, securitymen surrounded the elected representative, considered a public servant. Then at six he suddenly got up and left, quoting an urgent meeting. I wasn’t angry.

Because as a doctor I am perpetually alive to the fact that people take me for granted. That they will misuse compassion, avail of my private time for trivial reasons without feeling any guilt or compensating for it. That they will expect me to be sympathetic even with arrogant, abusive and blatant liars who treaten me with assault.

Because big ministers and political leaders who have a checkered past and disrepute of lying can openly make allegations that tarnishes the image of all doctors in the eyes of our “Election Elite Public”. Blanket allegations by many that accuse all doctors of indulging in malpractices and foreign tours or worse, ‘asking for women from pharma’ have become common.

Don’t these people know that thousands of most successful doctors in India are in fact women, and it is such a huge insult to those as well as the glorious careers of many thousand other medical professionals who live a life of an ideal doctor, who have trained millions of medical students successfully in that tradition?

©️Dr. Rajas Deshpande

More than half of those in the parliament must have been successfully delivered by a qualified doctor, and most of them must have had their children brought up/ treated by expert doctors. Most politicos must be under the treatment of some or other specialist, so that they can work well, still they have this habit of “Attention seeking” by trying to disgrace the whole profession of best qualified people of their own country.

What ingratitude!

The other day I also saw a video of some sermon in some village, making fun of doctors and specialists. The religious speaker, who could have easily qualified as a stand up comedian, and had no clue what a doctor does and why, was making cheap fun of doctors. What was more alarming was the way public was laughing and clapping, thousands of them! I wondered how many of them, their family members were treated by some doctor, and how many of them remembered it. I can understand and enjoy jokes and fun. But this was maliciously criticising an entire profession of highly educated people serving India 24/7, inspite of the hate and paranoia that surrounds them, that too by a person without any medical background or qualification! Many comedians have actually gone beyond “graceful” and “quality” comedy to cheapest low levels to criticise doctors. Hope they meet good doctors who avoid head traumas at least when their children are born!

©️Dr. Rajas Deshpande

You cannot and should not make fun of militarymen. That never means there cannot be anyone wrong in themilitary / army. But there’s a system to deal with that, it is not open for politicos, temporary ministers, and self proclaimed godmen / women / artists to criticise the military. The guilty must be punished, whether in any profession or service, and it should be done legally, and others should stop speaking about it. This should apply to the medical profession too. There indeed must be some doctors who are wrong, they must be dealt with, but we do not go out and blame everyone from other profession!

The most common allegation is about doctor’s handwriting. Well, if you have the guts and patience to listen to over 50 crying/ complaining people every day, while writing for them a “Scientific” list of medicines, which can save life or kill, without committing a single mistake, for decade after decade, then you are welcome for a handwriting challenge with doctors. Google the word “Scientific” and see how much of your speech is scientific before you speak abut doctors! For government hospitals, the daily patient number crosses 150 per doctor. Every prescription is a huge liability. If the chemist can read it and others cannot, who is illiterate?

©️Dr. Rajas Deshpande

I have seen the most artistic and best handwriting by doctors at all levels: students to specialists. Indeed, some doctors may have a bad handwriting, but in a country that has many illiterate leaders, some who never completed school or college, a society with one of the highest illiteracy rate in the world, it is such a paradox that they all have such a unity when laughing at doctors who write 40-200 pages every day, each page bringing back someone or other from suffering to relief, from death to life!

No amount of a leaders’ loud and chest thumping speech will ever save a patient from a heart attack or paralysis. No amount of comedy will take off the ventilator of a comatose patient in critical care unit. No poetry in beautiful handwriting will safely deliver a child. No political leader can stay awake in a casualty to treat a dying poor found injured on the road. All Doctors do this.

Still, I am not angry, because I have come to accept the fact that Indian society hates their most meritorious, studious children: the doctors.

Take me for granted, I am all yours.

For now.

An Indian Doctor, happy with his purpose of saving lives, reducing suffering of Patients from across the world, too busy to stand up and waste my anger on cheap attention seekers.

©️Dr. Rajas Deshpande

Neurologist

Pune/ Mumbai

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