Doctor Diaries.

There are certain life experiences which come to us, courtesy our professions. Some of them make good dinner table conversations, some put a smile on our face years after they occur and some make us feel a deep pain inside. As doctors,  we see many incidents which have the power to move us beyond what we thought was possible. And such incidents make us richer, wiser and sometimes more cautious. I have always wanted to share a few of my experiences as a doctor first, a psychiatrist next, about how we see the good, the bad, the ugly and the hilarious as a part of our everyday life in the hospital. Hence ,the doctor diaries.

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Of when my idealism died.

Off late, medical professionals  have been viewed more with suspicion and wariness than respect and love. We often hear stories about how doctor so and so ripped off a poor patient, or performed an unnecessary surgery or followed some unethical practice.

As much as I know of most people in our profession, they seem hard working to such an extent that they have no time to even defend themselves in times of crisis. In a day and age, where most media bytes  go to a person who voices the highest decibel levels, we seem to have missed the bus by a mile. A lot of us are excellent clinicians, but poor communicators. Mostly, not our fault. We were never taught that our practice, would one day, turn out to be a war zone with land mines, which we had to gingerly tread through. Do not get me wrong. It is not everyday that we go to work like scared rabbits. We enjoy what we do, and how we do it. But on occasion, fear does seep into our bones. This was one such time.

It was a sleepy Sunday afternoon broken by an earth shattering cry, that would have woken the dead. All of us in the surrounding vicinity came out on the roads to see what had happened. What we saw was not a pretty sight. There were two people who had accidentally got electrocuted, lying on the road literally fuming at the mouth. There was this huge crowd gathered around. The stench of burnt flesh was overpowering. I live just across from the hospital that I work in. By the time I made my way through the crowd, I saw that two of our hospital staff had already lifted the victims bodily,and put them into an auto rickshaw.They drove on to a tertiary care center five minutes away for ICU care. The whole episode must have taken around five to seven minutes at most. I was impressed by the immediate action taken by our orderlies and was on my way to praise them, when I was in for a rude shock.

One of the people from the crowd asked us why we had not taken care of the patient. They started accusing us of poor first aid. We appeared confused at first. They must have taken it as a sign of weakness or guilt.

The cause for our confusion, was the fact that, apart from having a time machine to do the needful, we had been as fast as we humanly could. Two of our staff had rushed to find autos on a deserted road to ferry the patients, while two others had helped them into the vehicle and gone to the hospital with them. According to us, we had done all we could and more.Apparently not.

According to the leader of the mob, we needed to check the pulse of the patient before we put him into the auto. The other claimed that we should have done first aid inside our hospital premises before shifting him to an ICU.

We tried reasoning out that time was of utmost importance. That there was no need to check the pulse when the patient looked alive and was breathing. And we shifted him to a tertiary care center only because we did not, as a facility catering to mental illness, have an ICU facility and ventilator support.

Seemingly, all our explanations fell on deaf ears. The crowd kept chanting that we should have checked the pulse. On one level, I knew that they were just out to create a scene. Maybe the shock of seeing a person burn was too much to take. Maybe, they had no idea what to do in case of such a situation.

But on another level, we were scared. Upset that our good intentions were being slandered unnecessarily. Scared that they may abuse us physically.Are really really worried as to why understanding such a simple explanation seemed impossible to them.

Anyway, after a while, for lack of any other logical form of argument apart from the “pulse”, the crowd dispersed. But the hurt remained. That we, (especially our hospital staff who courageously helped the victims without a thought that they may have got electrocuted themselves too) were considered villains even after selflessly doing our best.

It did not matter that half the crowd was totally drunk, and had not moved a muscle to help all through the episode.What did matter, was that a scene was created. And that we looked like the bad people.

In the pat two years, in the small city that I live in, I have seen at least  four hospitals getting ransacked and damaged for some alleged negligence on the part of a doctor, which has later on been disproved. I have participated in rallies held to protect the rights of doctors. The district administration has given us a list of laws and provisions to help us protect ourselves. We now have cctv’s in our hospitals.Despite all of these, the sense of disillusionment remains.

Sort of like, when you have actually done your homework, but forgotten the book at home. The teacher does not believe you, but you want to be believed oh so badly. Standing in front of the class looking like the culprit pains you bad. The pain, that neither your teacher or your friends had the good sense to believe you.Submitting the homework book next day does not really ease your pain. The damage has been done!

And so also in this case.Life  moved on. Work resumed the next day. But every time I pass by the place on the road, I feel a physical pain deep inside me. One for the victim, who was a young man with small children. Two, for my idealism, which died a more cruel death that day.

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Let us start a change.

This morning, our hired help got an emergency call from her daughter’s home. Apparently, there was a tiff between her daughter and son in law, no doubt precipitated by her mother in law,that led to a big war of words. The reason for the fight was that the daughter had returned home a day later than was permitted by the monster in law. My maid was ordered by her son in law to take her daughter back home forever, just like that. And worse, my maid obeyed meekly and begged for forgiveness! My maid’s daughter is all of eighteen, married off 6 months before her birthday, despite all our protests and a very timid, quiet girl. Before her marriage, she would handle all the household responsibilities before going to work herself. She used to work without taking without a day’s off, even on her birthday. And finally agreed to marry a man 10 years her senior, without as much as speaking to him, because her mother told her to. And now this!

In the past few days after “India’s Daughter” was released, I have seen every social media platform, every single TV station, every whatsapp group and every newspaper give enormous publicity to what happened. There have been pro ban messages, anti ban messages, protests held and discussions dissecting every single aspect of the documentary and the attitudes that prevail. I did watch the documentary myself and felt my skin crawl and tears fall freely when the creep ( in the garb of a lawyer) and the accused speak of Jyothi/Nirbhaya almost mechanically. I felt a helpless outrage. And then it remained that way. Because:

  1. I feel that no amount of media coverage may change the harsh ground realities of thousands of millions of faceless, nameless Nirbahyas across our country or the world. The huge mass of humanity which watches these shows and newsreels are those who already seem to have a slightly different, egalitarian and non traditional mental attitude. These are not much the group who needs to change. Change needs to happen in the rural most parts of India, where women’s dignity and independence are still decided by the men of the family. Where women are not individuals, but burdens. Where the society (as Mukesh Kumar’s lawyer aptly put it) has no place for women. No point in just showing them the middle finger. We need to actively change them. But how?? We have “Beti bachao, Beti padhao”in place, but no “Beti ko respect dena bêteko sikhao”anywhere in sight.
  2. The evil mother in law does exist. Those who have different rules for their daughters and different ones for their daughters in law. Those who think and believe that the ‘sun’ rises and sets with their ‘son’, or rather because of him. They shower so much love on their sons that it becomes a sort of emotional debt to repay back that love, by taking sides when there is fight between the mother and the wife! The daughter in law that they themselves sought after the many ‘girl seeing’ sessions, becomes an object of hatred because she tries to tweak the rules of the house a little. A reverse Oedipus complex I would say! It is difficult to be non judgmental about such women and rationalize their bad behavior with many excuses. When we try family counselling in such situations, it feels as though you are smashing your head against a brick wall! And the men of the family at best, look mutely, smile condescending smiles and say “Oh, you know women, what can we do? “, and act as though the whole thing had nothing to do with them!
  3. And the so called myth that ‘Women are women’s worst enemies” seems true to a certain extent. Pick a random case of dowry death, the MIL is almost always the master mind. Pick a case of child marriage, the mother is the one who has ‘counselled’ the daughter that this is what is best for her(as in the case of our maid). Pick any post marital conflict, the mother is the one advising the daughter to go back, so as to avoid the shame society would hoist upon them, lest a daughter comes back to the maternal home in disgrace. Pick any child who has dropped out of school, it is because there was no one to share the mother’s burden of work (it does not occur that the boy can share this burden too!). These are the bitter realities, which we as the middle class have forgotten and brushed under the carpet. We are truly a lucky group of people whose parents changed their attitudes. But for a lot of other women, these painful realities are a part of daily existence, and they come to us as patients of depression, or victims of assault, if they try swimming against the stream.
  4. Finally,us. Most of us did download the controversial video and watched it in horror, a lot of us walked candle light marches, many hosted seminars on the evils occurring to women and many spoke/ wrote about it( including me, by the way), but it did not cause change where it mattered most. When my maid got her daughter married, it was on the tip of my tongue to advice the girl to rebel, and go back to her studies. But I did not. I protested feebly, and then left for her to decide. I feel like telling my abused patients to get the hell out of their abusive marriages and make a life for themselves, but refrain because of my so called professional ethics. When I hear my neighbor beating or scolding his wife in a drunken brawl, I choose to curb my anger, rather than go back there and help bash the living daylights out of him! I am sure most of us are in the same state of helplessness and hence the quantum of people abusing/ disrespecting/ troubling/ and killing women will not subside.

There are too few of us who do and too many of us who keep quiet. Far too many who accept a ‘pedha’ as a sign of happiness when a male baby is born and sweetened puffed rice (almost apologetically) when a girl is born. Too many of us who still believe that with marriage and children only, is a woman’s life complete. Too many of us who do not protest when widows are not given adequate respect at family functions… and so on the list grows.

Changing rules and government policies may work in the long run, but till then we may continue to lose many of our kind. So let us start the change in our everyday lives. Let us not wait for some incident to happen for us to awaken from our stupor. Let us start small, and consistent. Let each one of us make sure that our maids have an education. Let us not watch/allow watching of regressive serials where women are typecast. Let us not hum item songs, because they do objectify women, how much ever they are supposed to be an integral part of the script!

Instead let us show small children inspiring videos of women who have done great work despite their odds, as a part of school curriculum. Let us teach them how to use legislation in case they are harmed. Let them know that they need not swallow abuse just because their marital prospects and family honor may be damaged. Such small things may go a long way in building positive attitudes at a young age. Let us show them that…

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