Mayhem In Medical Mohalla

“Wherever the art of medicine is loved, there is also a love of humanity”

—–Hippocrates

I am feeling beleaguered at the moment. Not just beleaguered but put upon, picked on, brow-beaten, but most of all, haunted. All by virtue of my profession. Rather ironic because I chose the noble profession of healing. If I had had any inkling that I, myself, would sicken in my pursuit of health for others, I perhaps would not have chosen to be what I am. But paradoxically, I would not be myself! Never has being a doctor been so much of a teetering precariously on a knife edge as it is today. And never before has our profession been so sullied and reviled.

What was once one of the most respected vocations (I won’t even call it a profession) in society has some- how degenerated into a moral morass, rife with suspicion and mistrust. And where exactly did the rot begin? Perhaps with the inclusion of health-care in the ‘services’ falling under the ambit of the Consumer Protection Act, where the patient morphed into a ‘consumer’ and the health care provider into just another ‘service provider’, perhaps placed slightly higher than wholesale and retail businesses or mechanics, plumbers or electricians. Don’t get me wrong, it is in no way my intention to deride these service providers, they play a sterling role in improving the quality of life. I just want to say that qualified doctors are very different because they save that very life, more often than not.

Since times immemorial, the cornerstone of the doctor- patient relation has been trust. Because taking the responsibility of another human-being’s health is much more than just a service. It is not something which ends with the termination of the contract, which in this case is the patient either being restored to health, leaving in search of greener pastures (read better doctors) or unfortunately succumbing to the condition. It would not be unfair to say that any doctor who treats (and believe me almost all of us do so with the utmost care), puts a part of himself in the form of his expertise, experience and time into the patient. In fact, many ancient cultures would say that this forms a bond for life. I am pretty sure that most of us have had the happy experience of being suddenly accosted out of the blue by a patient whom we have helped pull through, and about whom we have forgotten, who then proceeds to sing peans about us to anyone who cares to listen. I doubt whether such treatment is reserved for the other ‘service providers’ whom the patient has needed from time to time.

Until all of us become realized souls who identify ourselves with nothing other than our animating energy, the body remains our sole identity, while providing an identity for our souls (pun totally intended). And it is no mean task to take charge of putting right whatever has gone wrong in such a precious object. There of course, is also the small matter of the fact that the final blueprint of what you are trying to (for want of a better word) repair is not available at the click of a button.

There is no ‘single gold standard’ in this vast realm. The permutations and combinations which on occurring, can cause diseases or complications are so numerous, that they are enough to give keep several mathematicians simultaneously busy for several lifetimes. I really have no idea who put us on this pedestal of divinity and demanded that we have a solution to all the problems which human health can face, and not just any old solution, but one which can restore and rejuvenate the patient to his prime, no matter even if he or she is in the final throes of a terminal disease.

The proverbial ‘Bhagwan ka Roop’ (while saving lives) gives way to ‘Doctor ya Kasai’, in the blink of an eye, should anything go wrong. This scenario is becoming commoner these days, much to the detriment of all parties concerned. While it is to be agreed that the illness or unfortunate demise of a loved one is a cause of deep anxiety, sorrow and stress, it is by no means an excuse to make the treating doctor a punching-bag to relieve it. All that it leads to is a stressed- out, defensive doctor who can no longer look ahead to provide the best possible care since he is too busy looking over his shoulder for any brick-bat coming his way, ducking and weaving to avoid the same. While there is the instantaneous pleasure of having ‘scored one over the know-it-all doctor’, the long- term effect will only be detrimental to the patient, because the doctor will no longer be as deeply invested in health care, preferring instead to pay more attention to finding out how he can best work out his defense, should anything untoward happen.

A marked difference in the attitude of the public at large to the people offering intellectual services in general and doctors in particular has been noted in the recent past. Several factors contribute to this. With a mere two percent of the GDP being spent on public health, the ‘strapped for everything’ government machinery can hardly be expected to provide costly services for peanuts, leading to an increasing burden on private services. Here again, what patients and their kith and kin fail to realize that many hospitals, especially those that offer tertiary care are corporatized and it is NOT the doctor who is responsible for the humungous bill which they may have to foot. In a personal aside, I think that we as a society, still suffer from a socialistic hangover in which certain professions which exist merely to serve the people while eking out a penurious existence, subsisting on the tremendous ‘good karma’ that they generate, medicine being a prime example have no right to seek a good living. In addition, I also believe that many Indians live in such perpetual dread of ill health, that they would rather believe in the ‘Great Indian Jugaad’ or temporary quick fixes got from all kinds of charlatans who run a thriving parallel health care industry so as to form a minor branch of the economy all by themselves. They only think of when things get out of hand, turning up at the qualified professional’s doorstep after exhausting all their resources, and then expect miracles like a complete cure. It is difficult to convince them that the doctor is not a magician and cannot pull the rabbit of complete recovery from his bag of tricks!

Add to this several unscrupulous denizens out to make a fast buck, like the friendly local strong men (most often with political leanings and protection), ready to swing into muscle- might mode at the drop of a hat or shall we say, imagined malpractice by a doctor. About the great Indian fourth estate, I shall only say that hyenas in the wild have been known to be more merciful than these fearless individuals who conduct media trials so vituperative and vicious so that several generations of the concerned doctor’s family are scarred for life. To add some more spice to this already zingy mix, there exist many movers and shakers of society, ranging from social media influencers to popular actors who are only too keen to jump onto the bandwagon keen on indulging in their favorite sport of good old ‘doctor bashing’, which they are then quick to justify, saying that doctors indulge in large scale malpractice and fool the gullible public and thus asked for their just desserts!

At the end of the day, we doctors are human. We try to tend to superhuman feats, if the sheer efforts that we put in from early teenage, just to make it into medical school are to be believed. We forgo a lot, from the simple pleasures of life like indulgent evenings off with friends and family, to working through our own ill-health without a break. We may not be incarnations of the divine, but neither are we the devil incarnate. We are fallible and fragile human beings, seeking to do our jobs the best we can, many a times carrying responsibility above and beyond our job descriptions. We do not wish to be put on unnecessary pedestals, feted, cosseted and have every whim indulged. But, at the same time, we do not wish to be singled out for unfair blame, victimized, threatened or harmed either.

It is time society gave a serious thought to what fruit the seeds of mistrust which are being sowed will bear, for constantly faced with threat to life, limb and property, forget the best and the brightest, but even the below average will think not just thrice, but a trillion times before choosing to study medicine, and then again, only by circumstance, and not choice. The consequences of giving oneself into the care of such reluctant healers will be the ultimate price paid for turning a blind eye and deaf ear to the pleas of a profession, which works for the benefit of humanity.

In the wake of a highly qualified, competent doctor, driven to suicide for no fault of hers, after being slapped with attempt to murder charges at the behest of an unholy nexus, it is time for us doctors to decide whether we choose to stand united, or fall divided. It is time to form a clique rather than compete, and make sure our demands for an immediate ceasing of unnecessary witch-hunts and strict enforcement of the many laws which have been passed ostentatiously for our benefit, are met promptly by indifferent authorities and lay populace alike. For, it is only when we have healthy and safe work environments that we will be able to ensure the optimum outcome in our efforts of ensuring a healthy nation.

To my fellow medical brethren, I would like to say that though it is our duty to care for our patients, it is time that we cared for ourselves as a fraternity too, deciding and dictating that there will be no more mayhem in Medical Mohalla….