LANGUAGE – FOR LOVE OR HATRED?

FROM THE HEART OF A HURT 

HEALER….

                                                             

“You scoundrels! You killed my boy! You are framing wrong causes and trying to escape. You don’t know who I am or the political influence I have. You wait and see what I will do! You females are not worth to be even prostitutes!”

A ten-year-old boy had just died in our Pediatric ICU, where I was the resident. He was brought to us two days back with history of multiple episodes of loose stools and diarrhea. On careful examination he had all features of pesticide(organophosphate) poisoning. There was no history of pesticide consumption despite probing repeatedly. We started treatment immediately. Even in the initial investigations, all his organ systems showed signs of damage. Our team of doctors, especially the residents, spent the next two days trying to save the child. The forensic investigation of his stomach confirmed the presence of pesticide. Despite our day and night toil without rest and sleep for two days, his organ systems shut down and he passed away.

The family had seen our struggle. They saw us by his bed day and night. They saw us foregoing food and sleep. They saw us poring through literature to find a loophole to save their son. They saw how we were unwilling to let go till his last breath. They saw everything and they heard everything, but the moment he died, they forgot everything. Or they chose to forget. We were two female residents and a female consultant on duty. The family hurled verbal abuse at us. They told we were not even fit to be prostitutes. They told we killed their son. They told we fixed up the forensic report. The verbal abuse continued for two hours after our night duty finished. We called the hospital police, who stood as mute spectators to the whole show.

It hurt. Maybe there was no physical assault, but the words cut through our hearts. I despised the decision I had made years back to become a doctor. I questioned my decision to endure so many tough entrance exams, voluminous textbooks, sleepless nights, tears and hard work – yes, the typical cliché toil that all doctors whine about. But that was not the only day when I questioned myself. I am sure, every single doctor would have questioned himself or herself at least once in their long professional lives. As a member of the medical fraternity, it hurts to see a brother brutally abused at his young age like a criminal and have his skull fractured with a brick. Oh well, everything happens “ulta-pulta” here, and criminals get VIP treatment and foreign citizenship. For people who ask, “Anyway he didn’t die na?”, I can tell you that the wound left in his heart may never heal. Every time he faces any form of abuse for being a doctor, the wound will still hurt.

If my verbal abuse experience was not worthy to arouse any emotion, let me share an incident my husband faced years back as a fresh casualty medical officer (CMO). One old man who suffered a car accident was admitted to the Trauma ICU. The senior surgical consultant advised a chest tube drainage in view of multiple rib fractures and blood slowly filling up around his lungs. The agitated family thought the doctor was trying to kill the old man with a tube insertion and demanded discharge to take the patient to another hospital in the city. The patient was wheeled into the ambulance, but the attender / ambulance driver did not connect the oxygen supply. Instead of asking someone to connect the oxygen supply (which was not an urgent requirement in the first place, as the patient was stable), the patient’s bystanders went berserk and started throwing wheelchairs and other equipment around and barged into the casualty screaming to see the person in charge.   

My husband, the CMO who had just signed in for his morning shift and was unaware of the whole scenario as it did not involve the Casualty, and a male nurse rushed to the mob to try to assuage them and find out what the problem was. After getting them to calm down slightly in between the insults, death threats and threats of physical violence, he got the basic gist of the problem and went with the nurse to the ambulance and attached the oxygen supply and ascertained that the patient was stable. As the two of them were going to disembark from the ambulance, the mob of around 15 people tried to force them back into the ambulance so as to accompany the patient to the next city, under duress- in simple words, kidnapping in broad daylight.

My husband somehow managed to extricate himself from the mob by force, but was unable to pull out the nurse with him, even while more people joined the mob. He looked around for the security guard posted in casualty, but to his horror saw the man running away in the opposite direction. Within a minute, the male nurse was kidnapped in broad daylight and taken away in the ambulance. The angry mob had dispersed. The security guard had disappeared. Few minutes later the head security officer came running to ask if everything was fine! Thankfully by police notification, the nurse was brought back safely. To those who ask what security issues do medical staff face, does kidnapping by force from a medical college in broad daylight count as one??

The incidents are increasing day by day.   In my early MBBS days, I had heard about a doctor who was slaughtered right in her clinic by a band of goondas, because the pregnant lady she had referred to a higher centre had died of some complications. Back then I thought that it was a very rare event that hardly ever occurred. Come on, who would want to hurt doctors who help to save lives, let alone kill them! I was proved wrong. Through the years I realized that the incidents have been increasing steadily, with zero convictions being made of the criminals responsible. But who wants to talk about that!

Let’s talk about how costly medical care is. Let’s talk about how greedy the doctors are. How they chose this profession to squeeze out money from poor patients. How they have no service mind and do not serve the poor. How they kill patients who were destined to be immortal otherwise. Let’s have television shows by famous movie stars who have enough medical knowledge to expose the negligence and mistakes of doctors. Let`s have talk shows which let a mother tell how doing a pregnancy ultrasound scan made her baby bald!  Let’s have blogs by celebrities on how barbarically their hypnobirthing plans were upset by money making doctors who forced them to do a cesarean section. Let’s have the media hype up that one case where an anti-seizure drug caused a rare unpredictable skin reaction, and rename it as the doctor`s mistake. Let’s have politicians say that doctors should not strike, because police men get killed but never strike. Let’s have judges who say that it’s shameful for doctors to strike like factory men!

At any cost we should not talk that doctors wasted their youth studying. Or about that kid in the neighborhood who never attended weddings or wasted time playing, but spent his time mugging huge entrance textbooks to get a medical seat. Or that by the time a doctor reaches his mid MBBS time, most of his schoolmates would have started working and earning money (for the record, I have batchmates who were academically at par with me in school, and were getting my current salary ten years back). Lets talks about how lavishly we can spend money on Levi’s jeans, iPhone, KFC, plush restaurants and luxurious holidays. Who wants to spend money on a super-specialist who studied for about fifteen years, when doctors are expected to serve without money? Lets rather get a senior stylist from Toni and Guy cut our hair for 1500 Rs. Oh who wants to ask why engineers, architects, lawyers, business professionals and chartered accountants are not asked to serve the community for free. Well maybe service is only a doctor’s duty.  Who wants to ask whether the community will serve doctors back with free houses, free cars, free education for their children and exempt them from taxes? Maybe they don’t need to buy food to eat as duty will satisfy them.

A masala dosa which was 25 Rs ten years back, may be 60 Rs now in a decent restaurant, but that’s hotel food. While a doctor’s fee should be static at 100 Rs over ten years. We can even fool them once a while with empty envelopes. I know a cardiologist who refuses to accept payment in envelopes after he got empty covers more than once. Recently a physician friend of mine had a plumber come over for a small issue, who counselled him about how doctors should have service mentality and should treat patients for free. The guy left after charging my friend 400 Rs for a five minute job. No condescension on the plumber, but a doctor who studied ten years should not even get even 100 Rs??

Now coming back to the heart of the matter, it beats me that people could think that doctors would want to kill their patients. If that is our intention, why go through insane amounts of study and waste of time when goondas who beat up doctors and kill people may not have even completed school! Nobody beats up an actor when a movie flops at box office. Nobody beats up a street food vendor for getting food poisoning. Nobody beats up a carpenter for a broken chair. Nobody beats up the car manufacturer when a car breaks down. Nobody ever questions authorities when driving through the murderous roads in our country. Why would anyone think that a doctor wants to kill someone!! As a doctor, I can vouch that when we are with a critically sick patient, despite the stress, hunger, tiredness, sleeplessness or any of our emotions, our only aim is to use the best of our knowledge and skills to save that patient. No one thinks about money. No one thinks about their time. And I can vouch for 99.99% of doctors that it’s the same focus for everyone. May be there are some angels of death like the Nazi Josef Mengele who used the noble profession for inhuman medical experiments. Believe us when we say that if our intention was to kill and make money, this is the last profession we could chose!!

Its shameful that the Indian doctors do not receive the recognition they deserve despite being well accepted by hospitals abroad for their superior clinical skills and knowledge. Today, Indians can directly consult even a super specialist without any delay, whereas in developed countries like the UK, patients have to wait about a week to consult a general practitioner (GP), and maybe months to see a specialist, provided the GP decides to refer. A large number of our doctors work here in extremely resource limited settings and in highly skewed doctor-patient ratios! Doctors are blamed for lack of hospital resources and basic facilities. The security system in most hospitals are almost dysfunctional and practically non-existent should an alert arise.

Our citizens and netizens are self-made Google doctors whose thirty-minute-long Wikipedia read can apparently surpass 10 to 12 years of focused medical education. Social media plays a huge role in tarnishing the image of doctors. A thousand saved lives are not news enough for their front page, but one teeny-weeny mistake and ‘BOOM’, the irresponsible doctor is the villain in every media outlet! And now shameless journalists are barging into busy ICUs without any aseptic protocols, and disrupting and belittling the busy and stressed out doctors and nurses who are toiling with whatever little they have to serve the masses.

 Let me bridle my high velocity ranting and put down some points.

1.Doctors are not gods and should never be considered as gods!! Life and death are not in a doctor`s hands; though a doctor will always give his best shot at your longevity. Excuse my cliché dialogue, but don’t consider a patient as immortal until treated by a doctor.

2.Money making is not our priority. However, like any other citizen of this country, we also have our monetary needs, and deserve remuneration from our job. Nobody offers free service back to doctors.

3.Despite all the public anger against doctors, the rat race to make one`s child a doctor or engineer has not slowed down in India. Maybe its time to pause and think whether you want your child to have a meaningful youth, or waste his youth mugging and losing sleep, get skull fractures of various configurations while working, and even risk his life.

4.A doctor cannot be compared to a policeman or other armed professionals. To start with, the armed services are harmed by their enemies, not by those whom they try to save. Doctors have not been trained in combat or self-protection. In fact, a doctor may be weaker than his patients due to irregular eating and sleeping habits. However, since the comparison has been raised, may be MCI should consider including martial arts and arms training as a part of medical curriculum. A free arms license may be granted from internship.

5. If the above proposition is not acceptable, then the security system of hospitals across the country should be elevated. We don’t need cowards who run away when a breach of security occurs, or stand as mute spectators who tell us to accept our fate of getting beaten up by the mob. Most of the time, when we call “securityyyyy” out of frustration and fear, there is no response.

6. We need strong laws against those attacking doctors and vandalizing hospitals, not just on paper, but we want to see it being practically applied. If at least one conviction happens, the “lets kill the doctor-attitude” will definitely come down.

7. If Google knowledge, or genuine knowledge makes one feel that a doctor did not treat them well, he or she can try legal action against them via the courts. Violence against the doctor is not the remedy.

8. In the light of current events, there should be strict rules governing media entry into hospitals. No journalist can have more genuine interest in a patient than the treating doctor, and belittling a doctor who was caught unaware in the camera does not improve the healthcare system of the country.

9. Queries regarding inadequate resources or infrastructure of a hospital are not to be directed at the treating doctor, whose job is to treat and not buy beds for the hospital. You have a genuine question? Go ask the government or hospital administration.

10. And finally, if anyone thinks that they can crush a doctor’s spirit by all the public anger, malice and hatred spewed by certain venomous sections of the society, they are grossly wrong. If we could crack those tough multiple choice questions in the entrance exams, if we could withstand the stress of our university exams, if we could conquer the lack of sleep and timely food for duty, if we could ignore our pain for another`s,  if we could put aside our families when our profession demanded, then we are not backing out. We have been the lot who gave our best into everything right from our school days, and we are capable of it ALWAYS!!