May 2010, Bankura, India –A head injury patient lay in the emergency room just on intravenous fluids for the second day. He did not even have the pension money to do CT scan at government subsidised rates (INR 800-US$16). I lay down in my hostel bed listening to the legendary Floyd’s “ we dont.. need.. now no education…” in my iPod and wondering whether “I should have reached the purse and given him the 800 rupees required for the CT scan?
June 2010, Bankura, India– In the paediatrics department there was a boy whose parents had not visited him for the second straight day. All this after I had counselled them thathe would require a surgery, for the heart defect he was suffering from, and they must prepare to arrange for transportation to the state capital where the surgery would be done free of cost in a government hospital (the Government does not provide ambulance). “We can’t afford so much money”, they told me and asked me to do whatever was possible with medicines. I roughly calculated my expenses for the coming month to check of I can give them about INR 2000 (US$50) to these parents. I figured out I could make a difference. I even had a master plan as I dozed off for my afternoon nap–going to the ward master in the evening, instruct him to somehow reach these parents from their address (through the local police station) and let them know that money for transportation has been arranged. Well I ended up doing nothing!!!
With every passing day events such as these kept on repeating and slowly I stopped feeling. What could I do? I just could not help them all. A senior Post Graduate Trainee (PGT) explained that such things were normal in the most backward district of West Bengal, India. “If the parents don’t worry about their own begotten child –why should you?”. I was further explained that as doctors our duty was to treat diseases, and it was by treating diseases that we should be earning our livelihood.
“You can’t just go around donating to every guy who comes up with a sob story…”—was the logic.
May 2012, Kolkata, India– Just watched a movie called “The Motorcycle Diaries”. It is the story of Che Guevara (the one whose figure stares out at us from coffee mugs, posters, and t- shirts, his life , idolised and abstracted in theaters, rock songs and political speeches) a medical student who takes an epic journey across Latin America in his motorbike.
The movie underlines the epic 8000 km motorcycle journey which Che undertook with his friend across Latin America in his motorbike. In the journey he had experienced “close contact with poverty, hunger and disease” along with the “inability to treat a child because of lack of money” and “stupefaction provoked by the continual hunger and punishment” that leads a father to “accept the loss of a son as an unimportant accident.” Che was moved so much by these events that from a doctor he turned to a reformer and then ultimately a guerrilla soldier.
This made me look up and ask a question- are we doctors at all?
Or have we reduced ourselves to a status of mere physicians-physicians who cure diseases?
More than 104 million children in the planet are undernourished. Every day that more than 40,000 children–more than one every second–succumb to diseases linked to chronic hunger.
As doctors in a developing nation we need to be enrol ourselves as soldiers in a war much difficult than any previous guerrilla battle ever fought – a battle where ailments can be cured but freedom from hunger, deprivation and health never achieved. So the next time you prescribe a costly medicine or order an unnecessary test, embark on this war. Spare a though on this war the next time you go to take a gift (even a pen) from a pharmaceutical company representative. Spare a thought when you gloat over food in a medical conference, which presumably are just for exchange of knowledge.
Unless, we as doctors join this war, “ a state of complete physical , mental and social well being and not merely an absence of disease or infirmity” will never be achievable.
Author’s Disclaimer: The incidents stated in the blog are highly fictionalised and any resemblance to any person/incident is purely co-incidental.