Saturday 25 March 2017

PROJECT DOCTOR: SAVE THE DOCTORS

Two roads diverged in a wood, and I-
I took the one less traveled by,
And that has made all the difference.   –Robert Frost                          
                   
For the past few days the newspapers have carried several stories about attacks on doctors in various parts of Maharashtra and about Resident Doctors, who are also post graduate or super speciality students, going on mass casual leave as a mark of protest. Their demand is Safety at Workplace, which is a matter of concern for all. My question is if every worker has a right to it, why not the doctors? Are they any different?

Certain other questions came to my mind while reading about the incidents in various newspapers:

A doctor in a government hospital in Dhule is so badly beaten up that he is likely to lose his vision. Another, polio afflicted doctor is attacked in a Mumbai civic hospital.  In a third incident, a lady doctor is beaten up by a child patient’s relatives. It left me wondering, if this had happened to any other professional in any other field of work would the activists and the venerable media not have taken up the cudgels for them?  Then what is the reason for this apathy towards the doctors?

A judge pronouncing- “They (doctors) can resign and stay at home, if they are so scared.”
I am left wondering if it is wrong to fear for your life.

On a social media site, a defiant Resident Doctor wrote:

“They said they’ll throw us out of the hostel…but those people don’t know we live in ward side rooms.

 They said they’ll cut our 6 months pay….but again they don’t know we hardly get time to spend that
  money.

 They said they’ll cut water supply but again those innocent people don’t even know we hardly get  time to take bath.”        
    
 No one can miss the sadness in these lines.

Nearly forty years ago when my brother was a junior doctor in a Government Hospital in Calcutta similar stories had flashed across the newspapers. We, at home, would pour over these stories and empathize with them. We waited with bated breath as we heard of suspension letters being issued and termination or eviction letters being typed. The Government’s trump card has always been invoking the ESMA. Ultimately the doctors bow to the Hippocrates’ Oath that they have sworn and return to work.

In the last four decades these stories get repeated after every couple of years or so. Today is no different. I see the pictures of many of my daughter’s friends holding placards saying “Save Doctors, Stop Violence”.  Nothing seems to have changed.


Many of these doctors, who are on “mass casual leave” for the past few days, are known to me. Some of them, who have been pouring out their hearts in anguish, on the social media with the hash tag ‘ab ki baar aar ya paar’ have come to my house on several occasions. They have grown up before my eyes from happy, carefree, fun loving teenagers, with dreams in their eyes and determination to do the impossible, to responsible, hardworking, conscientious doctors. The dreams are still very much there… only the reality checks ring in a harsh note.

As eighteen year olds they had lots of options before them since each of them had graduated from high school with flying colours. Most of them were toppers in their respective schools. Many had secured seats in the best of science and technology institutes in the country. With their perfect scores in high school as well as innumerable competitive examinations, they had to just name any institute of repute in the country and they could have secured admission there.  Many came from affluent backgrounds with good scores and grades in the eligibility tests and had the option to go abroad to pursue higher studies. They were, in fact, spoilt for choices. And they made a choice. Right or wrong is open to debate since nothing is absolute. To this day they stand by their choice, they have no regrets.

They chose to pursue Medicine. Some of them were encouraged by their families to do so, some were not. They chose the more difficult path, the path less chosen. And that has made all the difference.

As students, from the very first year it was made clear to them that they were treading a difficult path and the very first thing that they would have to forget were vacations. The only ‘vacations’ that they knew of in their five-and-a-half-year curriculum were the fortnightly study leave that they would be given. When the rest of the world were enjoying annual vacations they were burning the midnight oil and pouring over innumerable books. As interns they were told to forget about public holidays and Sundays too, to give them a taste of what they would be truly in for from then on. As residents, too, they have to forget about their families- a sick or dying parent is no excuse for taking leave. I know of one boy who could not be with his father while he was undergoing treatment for cancer and I have heard of another Resident Doctor who was allowed to go only for a day to see her father who had suffered a cerebral stroke and come back the next day without even knowing whether she would ever see him again. As for not being well, that is inexcusable. A friend or a cousin’s wedding, better learn to give it a miss. They have to be happy enjoying the photographs and videos on social media. They are probably the only ones who cannot expect even the friends they work with to be present at their weddings. As it is, these unfortunate doctor friends have to cover up for all their emergency and OPD duties -how can they attend the wedding celebrations also?

They themselves never complain. We, as family, feel bad for them.

 Perhaps, many would like to say they knew what they were in for when they chose the profession. That is undeniable. True. My point is, though true, it is not easy. These are young men and women in the prime of their youth. Like all young people their age they, too, fall in love; they, too, like music and dance; they too have to deal with broken hearts and broken families; they too have talents which, most often, remain unnoticed and stifled because they have chosen to deal with death, disease and morbidity. They have their own way of finding vents- may be a very late night party to celebrate a successful operation or catching a late night show in the nearest theatre after having had the most harrowing day in the EMS.

Still, they never complain.

But when the very people they serve beat one of them up  so mercilessly that the doctor is likely to lose his vision and an even more inhuman court proclaims that if doctors are so scared, they can resign and sit at home, they are bound to raise their voices in concern. Perhaps, the Honourable Court has forgotten that everyone has a Right to Safety.

From the many doctors I have encountered, I have got the feeling that nothing gives them a greater high than curing a patient and sending him back home. Not being able to heal is perhaps their biggest fear, their greatest defeat, their ultimate failure. Perhaps, it is this pride in their work, this joy of healing and this confidence in their specialized knowledge that keeps them going. Whenever I speak to these young doctors who have chosen a specialized area to work in, they are happy doing what they are doing despite the odd hours and heavy work load. Many of them are meritorious students who could have gone to the USA or UK to do their residency or pursue their specialization but, once again, they chose not to, unlike some of their friends. They chose to remain back since they felt they were required more here keeping in mind the imbalance in the doctor patient ratio. What they, probably, forgot to see is that this country fails to give merit its due recognition.

I seriously do not believe a doctor would deliberately not try to do good to the patient. Competency can be questioned or even human errors might creep in under the stressful conditions they work in. Sometimes, these Resident Doctors are working continuously for 36 hours. On an average a Resident Doctor works for 14-18 hours every day without break and he has to do so keeping all his faculties alert. Most of the time he is also on the move, on his feet.

Though I am digressing, I wish to share an experience with my readers. Recently, I went to a reputed multi-national bank with my husband to get my name added as a joint holder. Despite there not being anyone in the queue ahead of us, it took the executive, sitting in one of the swankiest offices in one of the posh suburbs of Mumbai, exactly four hours to get the application registered. Even after a month we heard nothing from the bank despite having completed all the formalities and documentation on that day itself. Finally, only after a reminder and complaint was the work done. In four hours, on an average, under the most trying conditions, a junior doctor in a public hospital would surely have attended to at least 20-30 patients, if not more. Otherwise the public would, surely, have lynched him! Strangely, it is always the public sector workers who get blamed for inefficiency though I am sure even a nationalized bank employee cannot afford to move at a speed of one client in half a day!

As for all doctors not being diligent or ethical is perhaps as true as it is in any other profession. Only their dereliction of duty affects human life directly unlike in others. Hence, they cannot be pardoned easily either. But then every profession has its share of evil, corrupt, unethical people. You find them everywhere- in bureaucracy, in legal and even in the corporate world. I am not writing in support of them. They have to reckon for their own misdeeds.

My only appeal is to have a little patience and empathy for these overburdened Soldiers of God who try their best to alleviate our pain, to give us a respite from our suffering. They are human and sometimes errors or mistakes do creep in but should we not also remember that in many of these cases the doctors have little hand in their deaths. Sometimes the patient’s condition is so critical that little is left to be done, at other times they are rushed in at the very last moment or there may be underlying conditions which complicate the cases. Before beating up another human being, who is trying to help us, should we not once stop to think about the conditions under which the doctor has to perform his duties. As a layman, I cannot go into the exact doctor-patient ratio in our country or the infrastructural or other competency issues since I am not qualified to do so. But before beating up a doctor mercilessly should the relatives of the patient not remember for once that this person was only trying to do his best to heal.

Or do these young men and women, who chose to serve humanity, have to remind us like Shylock, the Jew, in The Merchant Of Venice:

If you prick us, do we not bleed?
If you tickle us, do we not laugh?
If you poison us, do we not die?
And if you wrong us, shall we not revenge?

If we are not careful, very soon we may need to protect another endangered species - the Doctors!


DS