DOCTOR FIRST AND DOCTOR FOREMOST PART 2 , THE GOOD,THE CORRUPT AND NOT SO LIKEABLE ONES

Formerly there were only three or four Medical colleges in Kolkata and Chennai.Now private medical colleges have flourished in Chennai and coming up fast in Kolkata .I have lived in these cities,so I know.It might be true for other cities too.I was a student of Nilratan Sarkar Medical college in Kolkata.

When I was studying,the classes would start at 7.30 A.M and it would be night before I came home. No time to have a proper lunch even.And in the evening with a bit of free time I would take delicious Luchis/kachoris (a dish made with wheat flour,stuffed with mainly pulse and asafoetida and fried in oil) served with potato curry/cholar dal(a curry made with chana dal ) from"Naren's canteen" ,a makeshift canteen with only two tables and four rickety chairs.

Luchi with cholar dal

Or I used to have delicious Aloo chaaps (made with besan flour and boiled potatos mixed with spices,or may be Begunis (made with eggplants/brinjals) or Piyaji's(made fom sliced onions and besan flour and fried in oil.A very old man used to live in a tiny room allotted to him outside the Ladies hostel with his young nephew.We used to call him" Darwan jee" (Darwan meaning security staff) and he used to make these delicacies for us in the evening.

DARWAN JEE

 

ALOO CHAAPS

BEGUNI

PIYAJI/PIYAJU

And even after passing out we used to spend most of the day and sometimes nights too in the hospital during internship and  house surgeon training.All students had got admission on merit basis.So no slacking.Everyone had to be on the toes for any medical emergency.We had hands on training in all facilities of Medicine.

Nowadays the academic competition has become so stiff that students prefer to sit in the hostel/home and study for the respective examinations.Than going to the wards to get hands on training. Here I would like to quote the famous lines by Sir William Osler.

To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all. Sir William Osler (1849-1919).

So the student who learns medical lessons by heart,without actually learning to diagnose and treat patients will never be a good doctor.But this is what is happening nowadays to a certain extent.You simply cannot diagnose a complicated problem with only book knowledge.Or perform a surgery with only book knowledge.In Gynaecology & Obstetrics,especially in delivery of a baby the surgeon has to be very alert and watchful and be able to take split second decisions,to save the lives of both  mother and offspring.

It is only on hands training with experienced teachers,and learning by observing and assisting that you become a good surgeon yourself.Of course book knowledge is also essential,You need to constantly update your knowledge by studying books,medical literature and attending conferences and CME (continuing medical education ) meetings. 

So I had to sacrifice a lot and learn to love my patients from my peers.And that has helped me in having a successful,satisfactory career.And I really pity those with only book knowledge.

Most of the doctors you meet will fall under the good category.Armed with both hands on training and updated book knowledge they are well liked by the patients and all. Some have the added advantage of up to date training in top hospitals outside their own countries.They diagnose and treat patients with care. Here I remember this poem written by an unknown doctor.

This is quite true for us doctors.We have to toil day and nights too.I have been on "on call duty"for 48 hours at a stretch.Formerly I had no proper room,no proper toilet/washroom when I performed these duties.Then happily I started staying in the accommodation provided to me.So I was called at night only for emergency surgical cases.

Performing multiple planned and emergency surgeries,resting afterwards on an easy chair (an upholstered reclining  arm chair for resting). No proper food.And no time to take proper food.And our hospital Casualty used to be crowded at all times.

EASY CHAIRS

And before that I worked in a suburban hospital where the floor was crowded with extra patients.There was hardly any space to walk.And at that time there was a government order that no patient can be refused admission.There was huge shortage of blankets , pillows and medicines.The amount of medicines and other stuff were in acute shortage because the amount supplied by the government was too small compared to the inflow of patients.And the nursing staff faced the actual wrath of the patients and relatives.And in the casualty room we doctors had to tackle critically ill patients and also face the wrath of the relatives due to no fault of ours.
And we had to treat anything from surgical and medical emergencies.Even snake bite.These cases,we used to transfer to the nearest government hospital with the facility to treat such cases.
these cases need Ante venom (Ante snake venom) injection immediately.But we did not have it, so the patients needed immediate transfer.

The people do not know the difficulties we doctors face,especially in suburban hospitals.What can a doctor do if a snake bite case comes where there is no medicine available? I remember,there was this young chap ,bitten by a poisonous snake.He walked in with the dead snake in his hands.I measured the vitals,they seemed to be alright.So I immediately transferred him to the nearest State hospital.And he suddenly fell dead on the steps of the hospital.The Nerve toxins in the snake venom act so fast.And without medicine what could I have done?Such are the difficulties faced by the government hospital doctors in our country ,especially in the suburbs. 

Shortage of infrastructure,shortage of essential supplies and shortage of medicine are among the umpteen problems we had to face in these hospitals.And the patients suffer,we get the brunt of the accusations and anger of the relatives.

But in that hospital the patients were very fond of me and since there was no facility for us to see patients in the Outpatients Department,people used to flock to the casualty room when I had my Emergency duty.Auto rickshaws ,vans and bikes used to crowd the hospital outside my emergency room.And since I could not finish off seeing patients,the doctor next on duty would feel irritated. But the patients came from far off places with surgical problems and I felt it was my duty to help them.

So this fondness of patients helped me a great deal in overcoming the disgust I felt for myself and my inability.Like when the young snake bite patient died on the hospital steps.Way back then,the people understood our problems and since I had several well wishers, there was no aftermath.But in the current patient-relative scenario, maybe the incident would have ended otherwise.Nowadays even if a critically ill patient dies, it seems to be the fault of the doctor.Even a natural death invites the wrath of the relatives.

And now the doctors are being penalised for their bad handwriting. A busy doctor has to see hundreds of patients and there is gross shortage of doctors in government hospitals. So he/she cannot write with a calligraphy pen when so many patients have to be examined and treated within a short time.And to write fast prescriptions,the hand writing tends to be a bit bad.Well very bad in some cases. I use a laptop to write prescriptions and carry a printer around for printing my prescriptions,to disguise my bad hand writing.But this also not possible when you see hundreds of patients.

We will discuss about the good doctors who form about 90% of the doctor population in a later article.We will talk about the corrupt doctors who are a minority.They ill treat the patients,cheat them out of a large amount of money by misguiding them.And maybe most of them do not even have a valid medical degree.

Once I did Open Gallbladder surgery on a patient from Bihar, India.The patient initially came to me with a history of gallbladder removal in Bihar. But the pain was persisting.So I asked for an ultrasonogram of the abdomen and found that an intact diseased gallbladder was the culprit.But anyone could be misled since there was a huge scar on the abdomen.So I did an open Cholecystectomy(removal of the gall bladder) on the patient.There were plenty of adhesions and it was very bad,contracted gall bladder.The patient had had spent a lot of money for his so called cholecystectomy in his native place! 

Similarly I have operated on patients with Appendicitis (inflammation of the Appendix)who have already been "operated" in their native places.There are two explanations. One the surgeon was quite incapable of doing such an advanced surgery,so he closed the abdomen and pocketed the money.The second explanation is that he was a quack and simply opened and closed the abdomen and pocketed the money.And a doctor quack can be dangerous.

When I was residing in the accommodation provided to me in the hospital ,I mentioned earlier, a man supposed to be a doctor working for our hospital lived above my quarters (accommodation).It was an open secret that he was not a qualified doctor.But the government had given him employment and accommodation.With the stolen certificates of a real doctor the compounder had got employment in government service!!There was a court case and ultimately he was chucked out.

Nowadays parents are buying medical seats for their children in some private medical colleges.I am sure the children must also be mostly intelligent. But there are cases when money cannot buy a doctor.When I was working for a short while in a private medical college, there was this  boy who wore very costly shoes and dresses and had the most costly cell phone.  He had paid a huge sum for admission.And I overheard him talking to the teacher.He was saying "Leave me alone,sir, all this is not entering my head."And that boy is a future doctor.

My father had a massive heart attack and was at that time saved by Dr.Reddy who was in H.M.Hospital,Chennai then.Now Dr.Reddy is chairman of Apollo hospitals and there is no H.M.Hospital.I had arrived from Kolkata and was sitting outside his room helpless to help.I was not a doctor of that hospital.In the night,my father's heart stopped and he was attended by this most inefficient,ignorant fool of a doctor.He gave him all wrong medicines.I called Dr.Reddy over the phone and reported this.He sent his assistant, Dr. Sathyabhama and by luck she saved my father.He lived for some months more.

The next day I was sitting outside my room and doctors were making fun of me saying."she says she is a surgeon,but she is crying like a baby."I got so annoyed.I went to the senior doctor over there and told him about what exactly happened the night before ,and how ignorant and incapable the attending doctor was.This was apparently conveyed to Dr.Reddy and the attending doctor lost his job.And I am glad since he would have learnt his lesson hopefully.Anyway,God save the persons he treats 😳😳😳

So these are the 10 % of the lot.I really do not know why this happens.Like a bridge/flat built by an unqualified engineer breaks down killing thousands of people, a patient treated by such a doctor is liable to die or fall more sick.

And maybe this is one of the main reasons, doctor -patient-relative relations are worsening.For the misdeeds of a few like these,the whole doctors' community suffers.

The third group of doctors are the administrators.Mostly they have an inferiority complex towards the degree holders.Not that all of them are like that.There are excellent administrators who treat doctors and other staff with respect.But the few I have met in my career have been a bad,jealous lot.

There was this Medical superintendent in my first place of posting,who took alcoholic drinks and lunch with my male colleagues and used to make fun of me.I once operated on my first ever Thyroid patient.In operating on Thyroid gland, one has to be very careful about the "Recurrent Laryngeal nerve".Damaging this nerve can even lead to loss of voice.The operation was successful and the patient could talk clearly.But to take revenge on this superintendent, I taught the patient to talk by sign language in front of the superintendent. The man was glinting with pleasure. And finally when he learnt that the whole thing was a fiasco,his face turned beetroot red.And I was happy to see his face thus.Another time he was supposed to help me with a complicated surgery,but was dissuaded by the others,so did not turn up.But without his help the surgery was done successfully and that was my revenge.

Then another medical superintendent who was very unpopular with all doctors,took a particular dislike for me and used to harass me with charge sheets for unknown reasons. He even complained to our Medical director against me.But well wishers in our Head office told the director that I was a sincere and capable surgeon.So he was very sympathetic and dismissed the complaint.While working under this particular superintendent,I developed multiple heart blocks and ultimately had to undergo Angioplasty.That person used to heckle me after my surgery too and he was the reason my heart blocks worsened.He gave me so much mental stress.And after wasting about six months of earned leave and  using some political support ,I was transferred to my former place of work.

This man was so hated by all staff and he used to charge sheet every one.All doctors used to travel in the same compartment of the train when we finished our duties.But this man thought he was superior to the doctors and used to travel in another compartment by himself and chew peanuts all the time.And thus travelling alone he suddenly died all by himself with no one to help,unidentified. Finally he was identified by his ID card and taken to a Kolkata hospital where he was declared dead.Even his wife and daughter were not affected by his death.But he is dead now.So we will not talk ill of him.May his soul rest in peace.

There was another  reason I lost six months of earned leave .I was trying to come back to the hospital,where I worked and where I stayed.But the male surgeons and the then medical superintendent would not allow that.So I had to fight to come back.That superintendent used to harass me because I was successful in coming back.My mother was falling sick repeatedly and I had to take leave to go to my native place.He used to taunt me and once he told me,"why don't you keep your mother here with you?"I patiently explained that my mother should be with my brothers and not with me with two stents in my heart. 

Suddenly my brother died and when I went to tell him the news that foul person told me"that is why I asked you to keep your mother with you".I was very angry and I did not reply then.I was too shocked with my mother's death.The very unlikeable foul person soon got his just  desserts.He was transferred to a medical dispensary in a distal area  as an ordinary medical officer.
So this all about the "GOOD,THE BAD AND CORRUPT AND THE UNLIKEABLE DOCTORS."Since I am a doctor I do not want this state of  affairs to exist.I would like our community to regain our partially lost respect.

Kudos to the good doctors who are saving people the world over.