Dear doctor, you deserve to take a bow!
Dear doctor, you deserve to take a bow!
At a time when the entire humanity is in grief, lakhs of bereaved families are mourning and crores of Covid-19 positive patients are struggling for life, dear doctor, my heart is bleeding for you. I am writing this to thank you for relentlessly working overtime by risking your personal and family safety amidst an unprecedented uncertainty, stress and turmoil caused by the apocalypse.
We, the citizens, are in the race for survival and individual safety is the topmost priority for each one of us. Let alone others, our own mothers and fathers become 'untouchables' from the minute they test positive. Alas, we are not at the bedside of our loved ones and we are dead-scared to perform the last rites of those who lost the battle, fearing the pugnacious nature of the virus. Notwithstanding the risk involved, you are taking care of our people to bring cheer in our homes. I don't know whether you have taken the two doses of the vaccine or not, but I salute you for the yeoman service you are rendering while braving all odds!
I get shivers down my spine when I think about you in the ICUs wearing the thick polyester PPEs in grueling double shifts amidst a mountain of grief every day. It is a wonder how you go about the task in the absence of appropriate infrastructure like oxygen cylinders, ICU beds and ventilators and life-saving medicines. The breathlessness of your patient could momentarily stop your own breath. There will be a deep psychological impact on the professional in you, if your efforts prove futile. Sometimes, relatives of the deceased point fingers at you and the resultant exasperation may render you helpless. Doctor jee, it takes us up to ten days to digest the news of a death. How can you come to terms of such deaths on an hourly basis? May be our philosophical moorings are coming in handy for you. God bless you.
Traditionally, we equate doctors to Gods. Trust me when I acknowledge that you are more than that for people at this critical phase of human history. The challenges you brave-hearts are facing, and overcoming are mind-blowing. They are: 1) Multiplied work-load, 2) Unprecedented uncertainty, 3) Shortage of essential infrastructure, 4) Non-availability of suitable medicines, 5) Patients' mistrust, 6) Physical strain, 7) Mental trauma, 8) Worry about personal and family safety, 9) Lack of time to upgrade subject knowledge 10) Fear of attacks from the kin of the deceased, 11) Infodemic, and 12) Media bashing.
Challenges faced by doctors in the government sector are, of course, different but then you all endure the same kind of challenges, once you don the white coat and carry stethoscope. I know you are cheesed off with the half-baked knowledge shared on social media and when patients consult three to four doctors simultaneously, a trait which Dr Bikkasani Kalyani has aptly called as 'medical shopping.'
It is unfortunate that from the day, the 33-year-old Dr. Li Wenliang, an ophthalmologist who lost his life on February 7, 2020 after being infected with SARS-CoV-2 in Wuhan, many doctors lost their precious lives, the world over. The Indian Medical Association (IMA) has declared that around 864 modern medicine doctors have lost the battle against Covid-19 and, God forbid, we are told that the worst is yet to come.
It feels sad that you are paying a heavy price for the failures of various governments. Sorry doctor, we are loaded with money to distribute freebies keeping votes in mind but no funds to provide proper medical infrastructure. It is painful to note that independent India has not even met the WHO norm of 1:1000 doctor-population ratio. Our population has been projected to touch 144,75,60,463 by 2024 and the doctor-population is expected to be around 1.03 per 1,000 population by then. In the face of Covid-like situations, a doctor per 1000 population is meaningless and you all would be swamped with patients beyond the logical human capacity.
India's expenditure of 1.5 percent of GDP on health is meagre compared to the spending of European countries (7-8 percent of GDP). India's expenditure is expected to touch three per cent by 2025 but an urgent correction course is needed, particularly in the wake of lessons learnt from the present crisis. I know how embarrassing it would be when ill-informed political bosses speak about the virus and mutations when they should actually be leaving the job to medical experts.
I am even more worried about doctor couples. For instance, Dr Sama Suraj Kumar and Dr Sindhura have to leave their kid at relatives' homes to meet the workload. Dr Suraj's migraine attacks became more frequent and severe, and he suffered from gastritis due to such daily routines during the first wave. Later, his wife Dr Sindhura contracted Covid. Straight from 14-day isolation, she had to attend an uninterrupted 24-hour shift, even though she was experiencing post-illness fatigue.
"We kept our 2-year-old-son away from us and we definitely miss the times we would have otherwise spent with him. Being a parent, I feel extremely bad for all kids whose childhood is being deprived of social experiences and family bonding because of the pandemic," the young doctor couple told me.
I know the story is similar with many families in which both husband and wife are doctors.
All said and done, doctor, I have a couple of suggestions for you. Kindly take note of them and introspect.
1) Stay away from corporate looting: I don't know whether you have sensed it or not but corporate culture has changed the image of a doctor. You are seen as a profit-maker for the well-maintained, star-hotel like, multi-speciality hospitals. The other day, I saw a bill served to a Covid-19 patient's family. It ran into a whopping Rs. 24 lakh for 28 hospital days. On an average, doctors' fee was around Rs.5,000 per visit! To my surprise, they mentioned names of the doctors who visited the patient, in the bill. Dr Ashish Chauhan confirmed me that doctors don't get a cut of that amount. I know it is the corporate hospital's way to avoid government stipulations. Lest you forget, dear doctor, it is at the expense of your name and credibility! Is it true that managements of corporate hospitals force you all to write a number of needless tests only to make money? If that is the case, avoid the sin. I think you should also stop the corporate pharmacy tamasha in which hapless patients are fleeced by charging exorbitant prices for medicines. You should put your foot down to stop such practices to safeguard professional ethics.
2) Do communicate with compassion: I agree, doctor, it is humanly impossible to have a detailed discussion with every patient in this mad rush hour! Let me cite a latest instance to drive this point home. On the telephonic advice of a doctor, the better-half of a senior journalist, who tested positive and had liver issues, rushed him to a private hospital. His condition was not serious. He wanted to get admitted to be on the safe side. In the hospital, the doctor refused to treat as 'this case needs an ICU bed immediately.' As an ICU bed was not available, he was asked to go to another hospital. The condition of the journalist, who had very good oxygen saturation levels till that point of time, deteriorated moments after the doctor's inhuman verbose had sounded the 'death-knell'. A couple of days later he passed away in a government hospital. I strongly feel that had the doctor communicated in a more subtle manner, the patient would have survived. May be due to lack of time or training, many doctors fail to communicate well. Have you realised that online consultation, today's norm, needs special communication skills? We don't expect you to give false hopes but a word of assurance from you means a lot for the aggrieved families. You know placebo effect, right? A soothing word from a doctor carries a similar psychological impact on a patient.
Sir/Madam, I had to mention these key points with due respects to all of you. It hurts me when people talk ill about you and your ilk who are serving the country on par with our brave soldiers. You deserve respect, not criticism. Before signing off, dear doctor, here is a clarification: For my convenience, I have addressed 'doctors' per se in this column but this letter is meant for the entire medical fraternity, from ward staff to nurses to lab technicians to community health workers to all kinds of caregivers. Let me tell you that I don't want to belittle your humungous work by keeping you in the bracket of a single phrase: 'Covid frontline warriors.' You are more than that. And, you all deserve to take a bow. Stay safe, stay blessed.
(The writer, a PhD in Communication and Journalism, is a seniornjournalist, journalism educator and communication consultant)