Why the residents strike is not so bad after all!

16-18 hour working days, 24/7 on call, sub-standard accommodation, sub-standard mess facilities and a stipend that is equivalent to a peon’s salary. This, my dear friends is what you earn after 5 1/2 years of grueling study schedules.

So, then why do it? Why subject yourself to such torture? The answer is very simple. We select our profession at the tender age of 18 post junior college. For people whose parents are in the same field, it’s but a natural progression, for those who aren’t associated with ‘medico’ families, it’s the interest in the human body that makes them take up the field. Most people don’t know how difficult it gets. Most people don’t know about the exhausting hours and the infinite work that has to be put in to be a good doctor.

The demands from this current strike are simple:

  •        increase the money paid to the residents (stipend)
  •        Reduce the crippling working hours
  •        Improve the accommodation
  •        Better security.
  •        Scholarships for reservation candidates

 

 

As a resident at one of the finest public hospital in Maharashtra, I completely agree with these demands. All, but one. The reservation issue, being too complex and warped to discuss in a forum as this one.

These are the basic issues which have been the talking point of every strike that has taken place in the past few years. So, what did the government do? Nothing! False promises, reassuarances & token stipend hikes of a few thousand rupees. That’s not enough.

 

The basic question arises that should doctors be allowed to strike work and put their patients lives at risk!

 A short review of the history of strikes amongst the medicos will reveal the commonest causes of strikes: doctors made a part of the torture regimens of various oppressive governments have gone on strike in various countries (including our not-so-famous neighbours), doctors strike to reform medical education, doctors strike to protest against political interference in their profession & lastly and what seems the pettiest of reasons, doctors strike to demand a pay hike.

A strike is a way to make an apathetic government take note of the demands made by a certain group of people and fast track their implementation.

The MARD (Maharashtra association of resident doctors) was an organization formed by the resident doctors way back in the 80’s to have a representative body for those who are arguably the most ill-treated, overworked & underpaid trainees around.

The strikes have been for various reasons, one of the first, being a strike calling for the government and courts to prevent the mushrooming of private medical colleges & instead make way for more public medical colleges in the early 80’s.

The strike was unsuccessfull with the court ruling in favor of the government and allowing a large number of private medical colleges, most of which had politicians as their patrons. The results of that landmark verdict can now be seen, what with seats being sold for money by these colleges.

The strike at that time seemed unreasonable, unfathomable & a disgraceful act, as the patients were suffering. The patients weren’t suffering then, they are suffering now at the hands of those doctors with a paid degree.

This is exactly why everyone mustn’t view this strike as an impediment to patient care. If the resident doctors are overworked and underpaid, it will lead to decreased efficiency of the residents, misdiagnosis of the patients, poor treatment and increased costs to treat sick doctors. It will very soon lead to a situation where there will be a complete collapse of the public health system. That will affect patient care and harm the sick and needy in the long run.

 

If the public has a far-sighted approach to this strike rather than a myopic view, they will realize how this strike is actually to prevent the public health system from collapsing in future, to provide better healthcare to the public & save the tax-payers money in the long run.

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letting go…..

You came into my life like a fresh breeze,

So full of joy that would have me think,

Without your support my life would sink,

But I had to let go, even though my life would freeze.

Your walk, your talk, your eyes, your smile,

Behind you, made a dozen drooling boys pile,

But it was me you chose, in your life to enclose,

And I made a mess of it somehow, I suppose.

For, after all these years of being besides me,

You want out, you want to be free,

You don’t love me anymore, that’s what you said,

Those words now haunt me everyday in my bed.

But I have to be strong, I have to move on,

I can’t hold on to someone so far gone,

I will not relinquish my faith in love,

This is something that I will rise above,

I’ll accept the truth and get over this,

Praying  that you will, in your life find bliss.

Saving lives

It was 3 am in the morning and i was really tired after a heavy emergency shift in the casualty. All I wanted was for the clock to strike 8 o’clock, which would signal the end of my Emergency shift and a journey back to the ward.

As I was about to move to the refrigerator to open the bottle of Thumbs up (mandatory for every call night for all those who don’t drink tea/coffee), there came a frail, young, 30 something man with 2 other men who were much older.

“Saheb, admit karvaney ko leke ayya hai,” the older man said. (they wanted to get him admitted to KEM). After a brief history and a rapid perusal through his previous files, I deduced that this was not going to be a simple case to manage. It was a case of Jaundice due to a tumor in the hepatic ducts with some doctor in ORRISA (their hometown) having told him he is INOPERABLE and hence placed a permanent metallic stent in his billiary system. The first thing I thought to myself was to send him away. It was 3 am, my wards were overflowing, we had a specialist cancer centre right opposite KEM and this man did not present with any emergency.

But, my heart told me to do otherwise and I admitted this patient. Little did I know at that point in time what would follow.

After initial investigations and following the routine protocols the patient was transferred from the emergency ward to the Male ward.

The evening after, having not caught a wink of sleep and with 50 new patients admitted, i needed all the strength that I could gather. After gulping up a litre of Thumbs UP, i went to the routine wards to round the patients and make the pending decisions.

The patient with the jaundice I had admitted the previous night was there in the ward, lying down in a corner on the floor (as there were no beds available). The patient was running a temperature, he had a high pulse rate and was breathing funnily. “Surprising,” i thought to myself and leaned over to reassess his condition. The same patient had developed all the signs and symptoms of an infection in the hepatic ducts. After frantically mobilising the sisters, the ward boys and the relatives to help me shift the patient to a better bed, my junior colleague and I shifted the patient and started the resuscitative procedures. The patient needed an urgent procedure to drain his billiary system and clear his infection i.e a Percutaneous Transhepatic Billiary Drain. Urgent calls and messages were sent out to the concerned departments while resuscitating him and eventually after 2 hours of chasing and pleading we got our way through and decompressed his system. The patient was placed on strong antibiotics and fluids and fortunately survived the acute episode.

The patient stabilised within a week and was planned for an elective surgery to remove his tumour the following week.

On my evening round in the following week, we noticed something was wrong with the patient. He didn’t seem comfortable and as happy as he had been. His relatives had all disappeared and he cut a very lonely figure.

The next day his relatives came up to me asking for a discharge. On further probing about the reason, I was told that the patients village had been wiped out by the Orrisa floods and that several of his family members had died or were injured. All their money was washed away and now they were left with nothing but a few thousand rupees on hand. They wanted a discharge against medical advice and wanted to go to Orrisa. However, after a long session of brainstorming and coaxing to stay put in the hospital, they finally agreed to it.

The patient was operated, free of cost with all the unit members chipping in for the essential surgical materials, in the following week and indeed did turn out to be an inoperable cancer. No sort of curative surgery was possible and hence the surgery was abandoned at an early stage. The patient had 6 months to maybe a year to live and the best we could do to alleviate his suffering was to not do anything more.

His relatives understood the situation and made a decision to take him to his native place and keep him happy there. They did not want to go through the palliative chemo-radiotherapies and see him suffer and die away from his homeland.

Inspite of our best efforts, his life couldn’t be saved and hence many would question the title ‘Saving Lives’. However, I strongly believe that we saved him from a lot of unnecessary suffering in the form of palliative treatment. We did manage to save his life from any more pain, suffering and misery than he would already go through. Thats, where I believe we saved his life.

Sometimes its harder to hold back and not do something, rather than do something that you know will be futile. A lesson learnt in this case and will be a lesson for life.

No matter who you are or where you are from, you always do deserve a chance to live your life with dignity and pride and not as a dependant and a cripple. By allowing my patient to live his life with the dignity and pride he wanted we eventually did land up “Saving his Life”!