Doctor, What Ails Thee.....?

The rising incidences of violence against doctors and their increasingly serious nature has stunned doctors like me, who try to practice honestly, rationally & ethically; if not always, well, most of the times! Even the reporting of these incidences is so vicious and one-sided! Where a learned & experienced doctor may struggle to diagnose a condition, within minutes of a patient’s death, the newscasters on various channels start shouting, breathlessly and confidently, the breaking news, “patient dies due to doctor’s negligence”; & to hell with fairness!

The impression that is being created is that, ‘in this matter patients are implacably pitted against doctors’. This has made me nostalgically remember the days I was just starting my practice. It isn’t ancient history!

The year was 1983, a small village in Konkan; a Taluka place with population just over 5000; and here I was, a green, callow youth of 24, fresh out of Medical school, with hardly any idea about the real world!  How was I going to survive and save lives? But the local people accepted and adopted me as their own in no time!

Whether it was the fresh vegetables from their backyard, ‘poha’ from the first crop of rice, or some family function, I was always remembered. And this love and affection was not just because I let some patients pay my bills as they could, or gave free samples to the poor. I certainly wasn’t doing any charity! In fact, I was openly running a business to make money! And, in receiving this affection, I wasn’t an exception! Almost all the local practitioners were treated, more or less in the same manner.

One particular experience has stuck in my mind. There was a family, my devoted patients for almost two years. Their young daughter in law, married just 6 months ago, went back to her parents’ house declaring ‘the marriage is over’! The whole family on both sides had a lot of meetings and came up with a compromise, ‘let “drSaheb” mediate! Nobody bothered to ask me, whether I would accept the job! It seems the girl, among all her in-laws’ family, had faith only in me. What is striking is, nobody found this odd, & nobody, not even her husband, had even the remotest suspicions about the two of us! The in-laws along with her parents came to me, told me the background. I had a long talk with the girl in private, and told her what I could, with the wisdom of a green 25 year old’s ripe experience! Somehow it worked & the girl returned. They have been living happily for last 30 years. I am mentioning this, not so much as a personal boast, but because, in today’s vitiated atmosphere this sounds almost like a fairy-tale!

Today, it is the same me, almost all of the same practitioners, and the same patients…… then where has that love & affection & faith gone? What has happened to make the patients consider the doctor almost as their sworn enemy, only after their money;  and the doctors afraid of their patients? Even I pray to god everyday while leaving for work, “O God, don’t let me be beaten up today by my patients (or their relatives); that is all I ask”!

After thinking long and hard, I realized there are two new factors in this equation.

First is the media, both print as well as electronic. Now, I am not one of those who blame the media for every ill in the society. But they have such wide & deep reach! The news of a doctor raping his patient in a village in UP, or another caught from a Mumbai slum for “kidney-racket” reaches every household in every village in the country within 24 hours. And when, one second of ‘airtime’ is literally worth hundreds of thousands, it is not practical to enquire and report such mundane details like, whether the concerned doctor was a hakim, an untrained  ‘vaidya’ practicing as family tradition, a quack or a doctor with a valid education and degree. As a result, the reader/viewer is left with the impression that all doctors are rapists & kidney-traffickers!

I am not claiming that the media is deliberately conspiring against the medical profession. But let us face it, after all, it is a business, and it is an undeniable fact of this business that only sensational news is marketable! So, the same logic goes for cut-practice or holding a patient (or his dead body) to ransom for fees. For every doctor who thus ransoms a patient’s cadaver for his fees, there are thousands who extend credit to their patients till the next paycheck; if there are doctors who charge exorbitantly, there are also doctors who regularly give money from their own pocket for poor patients to buy medicines. But unfortunately these can never become topics of breathless “breaking news”!

I want you to consider this for a moment. Make a list of all the wrong tendencies in the medical profession; list every “bad” characteristic, you definitely don’t want to see in your doctor. Now, ask yourself, whether all your ideas of these bad things are based on hearsay or, you yourself have had personal experience of these while dealing with some doctor. How many of these unsavory traits are present in the doctors whom you know, are they present in your own family doctor? I am not claiming here that the answers will be an emphatic ‘NO!’, 100% of the time, but at the same time, you will realize (if u r honest with urself!) that, the belief being spread that, ‘all doctors are cheats, liars, & thieves and the sole purpose of their practice is to rob the patients and they don’t care a whit about your (patient’s) welfare & life’ is certainly not true!

Most people personally have a ‘fair to good’ experience with the medical profession as a whole. Yet, in the society at large, there is extremely prejudiced and negative sentiment about doctors & medical profession. I believe the second factor in the equation mentioned above is responsible for this. A good number of sincere activists have come forward in the last 20-25years. They care genuinely for the patients and are fighting to protect the rights of consumer-patients. I haven’t the slightest doubt about their honesty and sincerity. But in their earnest attempts to wake the consumers from what they consider to be a deep slumber, and shrill espousal of their point of view, I think they have lost sight of their own original purpose!

Majority of the doctors are reasonably honest and are vehemently opposed to those rotten apples amongst them. Simply because, these give everybody a bad name and the first to suffer are the honest ones! Had this silent majority been co-opted in the fight against all that is undesirable in the medical profession, it would have been advantageous all round. But instead, these activists have been screaming from the rooftops that “all doctors are thieves”! (I sometimes wonder, what these people do, when they themselves or their near ones need medical aid!). I think this is responsible in a large measure in vitiating the atmosphere.

And this is hurting the poor, ordinary patient more than the doctors!

Currently there is a spate of rules & regulations concerning the medical profession. Also an intense & focused publicity in the media, which is so negative, that one wonders if it is part of a targeted campaign! Even if we keep aside the issue of merit/demerit regarding both, one thing is clear. The ones to benefit immediately & directly from this, are the big corporate hospitals! Actually these, the activist-gentlemen, should realize that they are fighting a proxy war for the Corporate Sector.

Under this continued siege, the small nursing homes & ‘family practice’ clinics have already started shutting down. It is high time, society & the government start thinking about what measures to take, if this trend continues. This is a real possibility, not a melodramatic attempt to ‘cry wolf’!

One thing is as clear as daylight. Medical Service is not a simple trade like ‘baniye ki dukan’ or selling TV or Refrigerator. It deals with human life and thus is closely linked to man’s innermost emotions & fears, and thus his very existence! Therefore mutual trust is its essential foundation. This trust cannot be created by law! In fact the more laws we try to enact, and the more stringent they are made, the more likely is this delicate relationship to sink in the quicksand of hostility and distrust. If somebody suggests enacting laws about motherhood or friendship we will find the very idea laughable. Then, don’t you think, that a relationship which is equally delicate and at times more important, needs to be handled with the same sensitivity and finesse?

Let society, media, activists and the government do as they please! I have a request for you, which is of benefit to both you and me.

Select your doctor with extreme care. The tradition of “family doctor” is almost extinct now. But if u have one, reevaluate him. But once you decide on somebody, never forget that he too is human. Let him know that he enjoys your full confidence, whatever happens! Sometimes (say, once in a year on Doctors’ Day, or Diwali/Dussera or his birthday…) wish him, and then watch the difference this makes to both his as well as your peace of mind! Don’t forget that he is a highly educated & civilized gentleman! Don’t you think he will respond to your politeness and decency in kind? And once that happens, you will gain a trusted friend to be called upon in any emergency, anytime; and he will be able to give you the full benefit of his skills and knowledge without being under any pressure or fear!

After all, as patients, what more do we want?

PS : This is a 'free' translation of the Marathi blog-post of the same name!