In
Marathi goes a saying, ‘टाकीचे घाव सोसल्याशिवाय देवपण येत नाही’, meaning
‘Unless a rock bears an insult by chisel, it cannot become an idol of worship’.
Did the judgement want to submit the same? Doctors, are you going to attain Godly
status? But do you really want such a status, or are you contented with your
human(e) status? Certainly, the latter is true. Doctors just wish for human
treatment, faith in their actions and respect for their hard-earned knowledge.
Gratitude will be treated as a bonus.
Being
a diverse setup, India has always been and will remain a challenge for those
who intend to bring it to par with developed nations. The population is large,
dense, scattered and not connected appropriately. Culture, literacy rate &
level, social customs, and languages vary a lot. I have worked in five states since
I started my career. They had diversity on many fronts. This applies to the
remaining states too. Being a doctor, it was great to learn that all human
bodies are anatomically and physiologically similar. Apart from similarities,
we also learned about human behavioural diversity, but got practical lessons
only when we stepped into the huge classroom called society. Dealing with such
a diverse population was quite a task. Things that were easily understood by
illiterates could not be digested by literates, and aspects that were beyond
the capacity of illiterates were questioned by literates. At times, I couldn’t
decide whether to laugh or shout; but I resisted both, as both would invite
trouble. So I began to accept and overlook it. Friends who stayed in one place
with limited resources also experienced a similar situation; although not as
diverse as mine. Few friends staying in metros or metro-like places began their
careers in well-equipped hospitals, but they also faced similar anger, apathy
and hatred from patients and their relatives. We all accepted and adjusted to
all the rage and remained mute as we always believed and still believe that
medicine is a noble profession. But unable to bear the ever-increasing
stress, when one of us showed resistance, we were blessed with
violence. When we retaliated, we were gifted ultimatums. This started happening
repeatedly. What went wrong and where?
The
doctor-population ratio has always been at a pathetic low in India. This was a
great blessing to quacks and black magicians. The legislation failed to implement
in numerous small pockets of India where a large population stays. Scores of
alternative medicine professionals began to practice modern medicine.
Pharmaceutical legislation not being very stringent, led to OTC (over-the-counter) availability of the entire drug store. Highly inappropriate, wrong
& unethical medical practices along with self-medication resulted in life-threatening
situations. When such patients were brought to a qualified modern medical
practitioner, he/she was expected to save and treat the patient. Unhealthy
relations between modern and other practitioners built a considerable rift;
enough to encourage hooliganism. The facts were conveniently forgotten and the
innocent doctor often (or mostly) lost in the dirty game of shifting the blame.
The other side of the coin is painfully noteworthy. To compete with quacks and
parallel practitioners, many modern medicine practitioners followed unethical
ways, and tarnished the noble image more. Female foeticide can also be
mentioned as one of many such malpractices. Cut practice (a prevalent term for
exchanging favours) is also another major reason for society’s raised eyebrows. Not all doctors are indeed involved in malpractice, but the number of
such doctors is disturbing. Society puts all doctors in the same black frame.
The ultimate result of all these facts is a lack of faith in doctors, anger over
trivial mishaps, rage over minor events and violence faced by doctors.
The
medical profession runs 24 x 7. Doctors as well as paramedics are often
burdened. There are various consents that patients or relatives are made to sign.
They are either exhaustive or hard to comprehend and often signed in a hurry
due to emergency medical situations. Sometimes, due to inadequate staff, these
consents are just signed by patients or relatives without knowing the written
content in detail. From a legal perspective, these consents are very essential.
Apart from getting these consents signed, doctors need to devote sufficient
time to discussing with the signatories to explain the meaning of the written
matter. At the end of all consents, it is mentioned that the matter was
explained to them in the language they understood. The sentence would sometimes
come to the rescue. In India, we often hide the ailment from the patient.
Sometimes, knowingly or unknowingly, a sensitive aspect of an actual ailment
may be kept hidden from relatives too. These practices often invite unpleasant
situations when patients become critical or lose some part of their body or, at
times, life. Patients or relatives express displeasure as this situation was
never explained to them. Due to unexplained and unexpected negative outcomes,
their reactions often become violent, resulting in damage to property and
assault on medical professionals. As a result of excess workload, fatigue often
leads to objectionable remarks by medical professionals. There should be a sufficient
number of doctors and paramedics so that the work goes on uninterrupted and
staff get enough time to rejuvenate. Efforts should be made to delegate a few
responsibilities. But explaining consent and revealing the details of the
ailment should necessarily be done by treating doctors only. This creates
healthy doctor-patient bonding, grows faith in doctor and at times boosts the morale of the patient. When all the facts of the ailment are revealed, the chances of malpractice are almost nullified. The outcome of the case may be
negative, but the reactions will certainly not be unpleasant.
Recently,
Maharashtra witnessed a blanket strike by the medical fraternity against the
judgement in one of the cases of assault on doctors on duty. Not the judgement,
but the words were surprising and shocking. No influential or highly active
group/s joined or supported the medical fraternity in their fight as those
groups had no vested interests. These so-called humane groups turn out only
when muscle or money is the aim. The number of quacks and black magicians who
are held and penalised is negligible. Not only this, but other issues also
remain unsolved for want of enough evidence. As usual, an unending debate about
witnesses, evidence, exhibits, duties, ethics, regulations, rules and so on
continues. Finally, the black buck is killed, but the killer is not identified,
giving rise to a modern-day proverb- ‘हिरन भी मरे,
और बंदूक भी न मिले’.
The victim keeps running from pillar to post. The placards like ‘doctors are
healers’ or a poster of a cute baby in a mother’s lap are now replaced by dry
notices with even more dry mention of codes, sections, para, sub-para etc. The
places of healing now wear the appearance of a lawyer’s office. Doctors are now
engaging themselves in knowing and implementing legal details at their
workplace. With the changing pattern of society, this has become mandatory. But
legal provisions should not act as a weapon, but a deterrent. Unfortunately,
almost all areas face resembling if not similar situations. We have started
calculating everything in terms of money, power, profit or loss. Although we
expect similar things in all areas, including the medical profession, we don’t
react, retaliate, shout, raise slogans, or fight in similar ways in all places.
We probably wouldn't react violently at any bar or restaurant because of
serving bad liquor or bad food, as we were deterred by bouncers staring.
Hospitals cannot certainly have bouncers, nor do schools where certain students
fail to perform even after paying sky-high fees. We don’t raise our voice
against the so-called ‘online Baba’ for not getting relief from ailments even
after performing a few ‘आसन/क्रिया’. We don’t even
question the ugly black scars gifted by a black magician. We are deterred by
the nexus of the online Baba and the black magician with some highly
influential groups. Doctors never found it appropriate to have such deterrents.
So we dare to pull even highly qualified humble medical professionals into the
witness box for not being able to completely treat a patient whose ailment was
already worsened by ‘online Baba’ and/or the ‘Black magician’. Our attitude
needs a change and pharmaceutical regulations a makeover. The legislation
requires a revamp. The Constitution demands a great
amendment.
