Hippocratic Oath

I asked my doctor daughter, “Why does one doctor never agree to the line of treatment recommended by another of their own fraternity?” She just smiled. The question has intrigued me over the years and around 35 years ago had the courage to test the theory.

Rewind: It was the summer of ’80 and the class 10 boards had got over. The feeling of relief and freedom is difficult to capture. One evening while playing football I had injured my knee. It gave me much discomfort during the night hence decided early morning to go to the CGHS Dispensary close by. For those not familiar with the way the CGHS used to work, let me give you an idea.

Step 1: Enter the dispensary and stand in a Q to get a token.

Step 2: The person in the window would check your CGHS card and allot you a small chit or token on which would be written the room number and your wait list number.

Step 3: Go to the room given and you will know which doctor has been allotted to you (no choice to decide which doctor you wanted to go to).

Step 4: Stand in the Q and when your turn comes, go to the doctor who will examine you and write a prescription.

Step 5: Take the prescription to the first window. The person there will write the medicines prescribed in one register, put a signature and then you go to the medicine counter to collect your medicine.

The system worked quite well and for free and instant treatment that we got there, it wasn’t bad at all. So here I was a sixteen year old brat who first went to one doctor and got medicines prescribed and all entries made in all registers till Step 4. But before collecting the medicines, once again took another token for visiting another doctor in the dispensary. Completed my second doctor’s examination and now had two prescriptions in my hands, both for the same ailment.

Tried reading the two prescriptions and even with my little knowledge of medicine and the bad handwriting of the doctors, could make out both had prescribed different medicines and treatment. But never a person to do things halfheartedly, I wanted to get the two sets of medicines from the dispensary and prove my theory right with unquestionable evidence in hand. So I walked once again to the window to get the second set of medicines registered in the file. The man in the window even before writing a word looked up suspiciously and said, “Were you not here a little while ago?” Confidence is something I never lacked, even though common sense was in great scarcity. “Nahin, bilkul nahin!” said me. The moment the man started entering the prescription details in the register he saw the name of the patient already appearing a few rows above on the same day. He coolly asked me to show my CGHS card to him once again for verification and I smilingly handed it to him.

With my card in his hand, the man on the window stood up and asked me to come inside the enclosure where he was working from. “Chori kar raha hai davaiyan? Stealing medicines! He shouted aloud so that everyone standing there could hear and see. “Come to the Superintendent and then we will file a police complaint against you.” I’ve always had great faith in the ability of my legs to take me to safety in such situations and felt that the opportune was ripe for it but knew with my CGHS card in their hands, the dispensary and police would easily reach me. I was taken to the Superintendent who reprimanded me and said that we will cancel the dispensary card forever.

I returned home and told the whole story to my dad who was at home being a Saturday. Had it been my Ma, I would have got what all Hindi movies say, “doon kya kaan ke neechey (tight slap below the ears)?” My dad has always been my biggest supporter, often blind to all that I did. He just asked me the reason for what I had done and when I honestly told him the reason, he just smiled, changed his attire and went to the dispensary. Fortunately most dispensaries always had many a Bong doctor. My father who was a frequent visitor to the dispensary knew Dr. Dasgupta, the Superintendent very well. He retrieved the CGHS Card and saved the day for me as he had done many times before.

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Fast forward: A year ago when my daughter was an intern at government hospital at Mumbai, she was a witness to a strange case.

As interns, their work never gave them any breathing time and was difficult to say which day was worse than the other. One day, as she was in the surgery ward she was asked to go down to the hospital reception to bring in a patient. She hardly had expected a patient like this….a bearded man with a skull cap on his head, shackles in his hands and accompanied by a lathi wielding policeman. The man had blood splashed over his white dirty kurta. The man himself was bleeding profusely and had to be attended urgently. As she walked with the police and the patient through the passage in the ward with beds lying on both sides, our patient loudly shouted, “Doctor Saab Salaam”.

The intern looked up to see who the patient was addressing to. “No, he is not calling me. He is looking at a senior consultant who was attending to another patient in the ward. Is this fellow mad? The consultant will kill me for this indiscretion on the part of this criminal? I would get into trouble for no fault of mine.”  

“Paagal hai kya? He is a very senior doctor. Why are you shouting at him?”Said the petrified intern.

“I know Doctor Saab very well.” And he stood his ground strong as he shouted aloud again, “Doctor Saab Salaam!”

The consultant looked up and his jaw dropped in awe, “Abey tu, fir aa gaya? (Hey you, you’re back again?) he smilingly said, as he got up from his chair and walked towards our man in red and white.

“What have you done this time?”

“Doctor Saab, there was this guy Jamaal and his friends who would constantly trouble me in the cell. There were days when they would snatch away my food and would not let me sleep in peace. I warned him many times but he would not listen. Today I lost my cool and attacked him with an iron rod. He had a knife and a chain. I beat him up and stabbed him. Saala won’t live for sure.”The policeman standing by nodded his head as if to affirm the facts.

“Doctor Saab, please keep me back again this time. I will do all your work. Keep me for long and I will be of great help to you, just like last time.”

“No Zameer, I can’t. This time I will not be able to keep you back in the hospital. Last time it was a simple scuffle but this time it is a much more serious case . No one will let me keep you here. Now I am also no longer an intern and today have much more responsibility. I just cannot do what I did ten years ago. Sorry Zameer, can’t help. Yes, I will attend to your wounds and make sure you get well soon. After that, it will be back to the place from where you came."

Later in the day, the consultant called the confused and bemused intern over and shared his tale.

"I was a resident ten years ago when Zameer was brought in by the police. There was a fight in his chawl and he was badly hurt. A police case had been registered against him but Zameer was a jovial fellow. Some of us residents became friendly with him. He got well quickly but wanted to stay back in the hospital. We told the police that he needed more time to recover and he should be allowed to stay in the hospital. While at the hospital, Zameer would help us with managing hundreds of people who would come along with the patients some of whom would often threaten us. But with him around we were safe.”

“During the day he was more than a ward boy to us. He would run errands for us in the ward and in the hostel. At night, Zameer would retire to a patient’s bed allotted to him in the ward itself.  He was our partywala khansama cooking some delicious biriyani for us, the starved souls. Everyone in our batch knew his story and sometimes we felt even our senior doctors and consultants knew about him but never questioned us. Zameer stayed with us for nearly six months before the police did a covert operation to do a check on him and found out the truth. They weren’t too angry at us because Zameer in the hospital was less of a worry for them than at the jail. Moreover for us at the hospital, the policemen of the Kalachowki Police Station nearby were literally Mamoos (Friendly Uncles).”

The patient Zameer was the same, his ailment was the same and for once even the doctor was also the same yet the treatment meted out to him was different. Was this incident in some way proving my theory true that no two doctors think alike and cure alike?

On hind sight remembered the Hippocratic Oath taken by doctors by which they are sworn by Apollo, the Healer, by Asclepius, by Hygiea, by Panacea and by all the Gods and Goddesses to carry out to the best of his ability and judgement to treat the sick. They treat the sick based on their clinical findings and judgement of the ailment and they will never act similarly as no two doctors nor two patients are ever alike. Like there is no single perfect path that leads to God, there is no single proven path to any cure. The doctor will try newer and better ways to cure the patient. No wonder it’s the noblest of all professions.

There goes my theory which till recently seemed my only way of winning the coveted prize in medicine at Alfred Nobel’s home town.

SS