Is the Patient treating the Doctor well ?

My late brother , who was a Mathematics professor, more by passion , used to say that 'teaching is one of the noblest professions' and I had never disagreed or challenged his conviction. I have heard enough comparisons of teacher with ladder etc., and the respect that a student pays when he sees the teacher even after decades is ample testimony of the encomiums heaped on this great profession consisting of selfless teachers.

Almost on the same lines I am tempted to put the medical professionals, despite the varied reactions that it could attract. Similar to the teachers in whom you entrust your ward's future, one entrusts the whole body itself to the men in white coats, more out of necessity than confidence. It is a matter of great satisfaction that the doctors too have by and large not belied the expectations of the suffering masses!

I could recollect, sometime in early seventies, my father rushing back from his professional work in Bengaluru holding a plastic mug in one hand suffering a urinary blockage and the relief he had when the block was cleared in minutes by our family doctor !

More recently I had occasion to visit the emergency of a nearby hospital supporting a broken hand in the dead of night and it was a relief to see a set of medics receiving me and immediately providing the necessary relief. In the prevailing pandemic situation the doctors and nurses were so professional and casual , trying to put  me at ease that I even managed to crack a joke while the sling was placed over a plaster of Paris pack. As my treatment was being completed there whined another ambulance siren which brought in a cardiac patient all the way from Telengana and the emergency team moved over to the gate with the same zeal !

While I was concerned about the atmosphere where patients with varied sufferings were being brought in, the medical team was just doing their job with a face mask and a pair of gloves, sipping some tea in between attending to suffering patients.

The next day after I underwent a surgery to correct an arm disorder, and as I was wheeled out of the operation theater to the Recovery room, the interaction between two attending nurses triggered this blog post. When one asked about the lunch as it was past noon, the other replied as "not sure... as my husband went for early duty ..... I think today also I have to manage with some curd rice". Later I learnt that her husband also belonged to the same profession. I was speechless by her priorities, dedication. Easily she could have also gone on leave !

As if this was not enough, when I was discharged from the hospital the next day after a satisfactory procedure, a friend inquiring about it exclaimed how the hospital could charge so much for such a small procedure ! That triggered anger, exhaustion and pushed me more to think about it.

When I slipped at the dead of night and was writhing in pain I ran into the waiting arms of a medical team at challenging situation of exposures and infections while most of the common man were safe inside their drawing rooms, complaining of ennui more from claustrophobic confinement ; a specialist had to be disturbed from his sleep to relieve me from pain; dozen medicos from across specialties like anesthesia, surgery and attending nurses had to be summoned the next day in time; a hospital had to keep their doors open 24 by 7 ensuring uninterrupted supply of power for the conduct of surgery; the pantry was working round the clock to keep the patient and their attendants away from hunger;  a dietitian, a physio therapist ..... the list was endless. Who will pay for their services (note I am not calling it sacrifice, atleast not yet) at odd hours and how will they be paid? From where ?  Most of all, even if they have all the necessary materials to conduct a surgery , what about the specialized knowledge acquired by these professionals to relieve YOU from the pain ? My thoughts were more sharpened by the explanation of a young man who while attending to my arm in the theater was narrating as to how he managed to escape by explaining to so many police men stopping his bike.... all just to reach the hospital and to attend to the suffering mass.!! Come on, Is it not the right time to call these as sacrifices instead of their professional duties ?  - the one who had to answer cops on the way, the one who is yet to think about her approaching lunch, the ones who brave infections and keep receiving patients !!

My thoughts were further confirmed when I met the Executive Director of the hospital who went on to explain how unwisely people avoid hospitals fearing the pandemic and said they care more for the safety of the patients who come to them with other pains and then followed by their own safety. He also said how out of the three cases of cardiac problem, acute appendix and high fever cases who avoided the hospital fearing the spread of infection, one turned out to be serious due to the delay !

While I was working in the much envied and considered lucrative IT services, one of my young Managers used to often lament as to how much we are sacrificing for the sake of the organization vis-a-vis the treatment meted out to us. I never failed to politely remind him that we work for the fat returns while the organization earns out of our skills and that there is no sacrifice involved. I have also seen many outbursts on the social media by my banker friends lamenting about their sacrifice, rather justifiably. I do not mean to belittle the contributions of these professionals but was just trying compare these with the dedication of an ortho Dr who was disturbed from his sleep past midnight to drive twenty minutes and relieve the patient of pain, which cannot wait until the opening of next day's business hours. And while everyone has been advised to stay indoors these souls have braved the situation and exposed themselves, all for treating the suffering souls ; If this is not a noble professional service, I wonder what ever it is !!!

We believe more of social networks and information support systems available on Internet and easily question the cost of pain alleviation , little realizing that it just goes past the normal call of duty.

When a woman delivers, when a heart is revived, when a kidney is transplanted, when a bone is fixed, when a simple bleed on your kid is arrested we heave a sigh of relief and thank the doctor. When we are relieved from an excruciating pain, we say that the doctor was a God ! All we need to do is just to extend the thoughts until the bill is paid. That is all the men and women in white coats may expect. Of course, there are black sheep in every profession but then how wise it will be to paint all of them with the same brush, I leave it more to the suffering patients than to their paying attendants  After all, we were treated to normalcy by the doctors, but then are the patients treating the Doctors well for the services rendered? It time to think.

Dedicated to all the Doctors I know of and others too be it in General medicine, Cardiology, Pulmunology, Dentistry, Urology or any other branch . My salutation to these saviors of humanity!!

Doctors under scanner

Ever since the talk show on the Doctors, their investigations, their advices and their motives were put under a public microscope and rubbished, rather uncharitably,  few weeks back in a popular TV channel, the social networking community is abuzz with claims and counter claims. There are those in public who identified with the counter-examples given and the Doctors seething with the general verdict given on their integrity without fully hearing them- the sole aim of the talk show was achieved resoundingly - its TRP (Television Rating Point)  sky rocketed and the talk show has become the talk of the town! As for the channel is concerned , the objective has been reached and its time to look for and move after another 'raw nerve'. After all such shows are openly described as between 'you and me' and it will be a free for all for some time until the identified 'experts' could deliver 'their' verdict.

Enough exchanges were made amongst 'friends' in social networking websites and it is a revelation that our people have so much to say - its only a pity they don't express themselves in a tone that could be heard by all.

Even while attempting to digest these exchanges, I was also shared with two recorded versions of senior practicing doctors, from YouTube.

The first one was from Dr. Praveen Raj of Coimbatore (http://youtu.be/HCCOKKWfGpM ) True to his profession, the doctor without going overboard and in a calculated tone, which was maintained throughout the session , goes on to decimate the claims made in the talk-show. Wondering on the motive of a programme that started off with an accusation rather than a debatable point, he explains that medicine is not maths to follow a set of formulae and how every decision goes not only with the investigations but also based on the experience of the attending Doctor. He further adds that Master Check ups are not prescribed by Doctors and out-rightly rubbishes the statement "Medicines are given to keep the disease alive". Without caring to conceal the hurt and anger he counters it saying that " If medicines are not given the patient will not be alive". He has no hesitation to trash the 'well sounding " report quoted by another participant and easily points out as to how it is irrelevant to use that report which is more applicable to countries like US and European states.

The second one was from a Padma Shree awardee Dr Bhaktha Vatsalam( http://youtu.be/Z7k6RzMD0pc ), again from Coimbatore- well, this town seems to have its antenna up and focused while their fraternity in other cities did not bother to respond ! He goes on to say that no Doctor enters the profession to make money and pleads to the people to appreciate and praise them. While his claims of only the Doctors working on holidays and weekends to save lives and that they are demi-Gods could evoke another talk show, his points on most of the ailments are man made and invited by ourselves are interesting.

There are substance in both the learned  Doctors' appeals - No doubt- when we are in great pain, when our kin has met with an accident, when our heart takes a breather - we look upon these as Manna from heaven to deliver and relieve ourselves from pain. They do play God in instantly relieving us of the pain and suffering and goes on to even define our lifestyle for the rest of our life for a trouble free run. The struggling baby and the hopeless mother with excruciating pain is many a time saved by the deft hands of an obstetrician, through a timely Cesarean section and the whole effort is forgotten by all concerned on seeing the mother and the kid, without even bating an eyelid for the efforts and timely decision of the Gynec.

But, to claim that the Doctors also approach this without monetary consideration, as claimed by one of the doctors  is also hard to accept. Perhaps what the learned medico would have meant was 'no doctor comes to this profession only for money'.

Every profession has some black sheep and these sheep invariably drive the decision making , more because of the wrongs caused by them on the innocent public.

We describe a bank as the best in service based on one employee who always attend to you with a smile, but this impression will change the moment he is replaced by another with a shorter fuse.

We decide on the quality of service in a hotel by the solitary waiter who always attends on you.

We give verdict on a school /college by the teacher you get !

Similarly, people decide based on the type of services they receive. After all, one also cannot brush aside the confession of a participant from the supporting profession in the show, that indeed there are pressures from some medical  practitioners to misdirect the patients into incorrect and unnecessary tests and investigations. But then it will be uncharitable to paint all with the same brush, too.

Unfortunately, since all the eggs are stacked  in the same basket, the rotten eggs have started polluting the good ones. It is for the true professionals to work with the regulators, stakeholders and others 'who cry foul now trying to hold the flag aloft for this noble profession' , to sift the wheat from the chaff , identify the black sheep  and weed them out.

Doctors, by the services rendered are very unique in nature and need to be appreciated, encouraged and nurtured with. I agree the world will become more painful in the absence of this rare and valuable professionals.

But then to equate them with the Almighty, say there are no blemishes and spare them the 'at times' deserving rod could also spoil these practitioners !!

This will be as unreasonable as the talk-show's attempt to paint  all medical practitioners black with the same brush !!

Doc in the Dock

It was shocking to read about the jailing of a 70 year old Doctor for having insisted on trying to protect the interests of patients in an Intensive Care Unit, rather strongly.  

(http://epaper.timesofindia.com/Default/Scripting/ArticleWin.asp?From=Archive&Source=Page&Skin=TOINEW&BaseHref=TOICH/2013/03/30&PageLabel=3&EntityId=Ar00300&ViewMode=HTML)

My initial points of observations after reading this news are: The strong ire of the cop who 'felt' insulted by the doc's behavior;  The septuagenarian's plight in Puzhal prison on a hot night ; his mental trauma & insult of spending a night in jail after such a long and glorified service. A dignified doctor with a good track record and also a Professor teaching many of the practicing Doctors, his honor has been trampled upon and I wonder whether he will be in a frame of mind to return to the hospital again.

I am sure there must have been some untoward altercations that must have led to the recommendations of the security for filing such a strong case against the old man. Notwithstanding the same, one wonders as to what has prevented the security in observing the rules of the hospital? If he had been accompanying a VVIP, one can understand that he should be in an alert state. But, it appears he was on a visit to supervise the security arrangements in anticipation of the VVIP's visit.

However high and mighty, when one enters others' space, one has to follow the rules and there is no exception. I have seen photographs of high dignitaries in other countries, where they are properly attired for the occasion be it a hospital or an Industrial unit or a war zone. It's only in India that exemptions are assumed to be made for people in high places and this illusion has to be thwarted by the VVIP themselves by adhering to the rules of the place. Of course, there were leaders like Mrs Indira Gandhi who insisted on a helmet while visiting the Pokharan site and the accompanying  top officials and scientists were also seen with one.

The Doctors' association has threatened to act if the charges are not withdrawn before April 4th- Why so long?

What is the reaction of the Hospital authorities for whom the doctor was on duty that day? 

Some months back, I was visiting the Critical Care Unit almost daily for 3 weeks as a visitor when my brother was a CCU patient and the concerned hospital had good security system in place. The hospital has to answer as to how the security at the ICU entrance allowed the person to walk into ICU with the shoes. Had it been objected at the doorstep, the doctor need not and would not have interfered and the whole incident could have been averted. I recollect when the then President Zail Singh desired to visit Guruvayoor temple, the Dewaswoom authorities insisted that he must remove the shirt, as per the tradition. When the dignitary was not willing to comply with, he was forced to cancel the visit. I wish the Security at the hospital has also put his foot down.

As TOI has rightly observed it is surprising why the Magistrate has not exercised his discretion but has ordered  imprisonment and subsequently provided for release on bail after some sureties and bonds.  The accused has also been ordered to appear at the court and sign every day until further orders. Did the doc tried to kill someone? Why jail him in the first instance. At 70 do you apprehend that he may flee?

Despite the arguments and their counters, my heart goes out to the old man who I am sure would be more shattered for having been jailed for an act of duty which he has undertaken to observe when he took up this noble profession. Former Pakistan President Musharaff has said that " He felt humiliated standing before a Judge". If a Military General used to killings on the battlefields , and the rigors of laws and courts felt like it, imagine the mental agony of  an ordinary doctor used to saving lives, when locked up for a night.

Why is that all the sections of  law are applied stringently against one for doing his duties? So much respect for Senior citizens!