An open letter to the Honourable High Court

To,

The Honourable Chief Justice Manjula Chellur and Justice G.S Kulkarni.

 

Respected Sir/Madam,

I am writing in response to the statement issued by the division bench of the High Court that heard the PIL filed by one Afaq Mandaviya and chaired by yourselves.

It was observed that doctors were behaving like factory workers, must show more compassion towards patients, should resign if they demand better security for themselves and shouldn’t feel threatened as senior doctors are working while the junior doctors are on strike.

I’ll start out with a story of a patient who started haemorrhaging (bleeding profusely, in case you don’t understand what haemorrhaging means) in the ICU on Sunday evening, the day the junior resident doctors chose to go on a ‘mass leave’.

The patient was operated for a distal cholangio-carcinoma (a cancer of the common bile duct, the tube that connects the liver to the intestines) 18 days ago. The surgery usually takes around 8-16 hours, depending on the complexity of the case. The junior resident who scrubbed in for the surgery was handed the sole task of retraction, akin to the job of a bailiff in the court. He didn’t see much while the surgery was going on, didn’t learn much, but still stood on his feet for the entire duration of the surgery, while his seniors scrubbed in and out of the case. Just like the bailiff in the court stands guard as judges keep changing through the day.

Precisely 18 days later, on the fateful Sunday evening, I received a call saying the same patient was bleeding profusely and had lost close to 1 litre of blood (the body circulates around 3-5 litres of blood, just for your reference), from the same resident who was scrubbed in for the case initially. He was on duty on a Sunday, and I’m certain would be unable to tell you the last time he took a Sunday off.

By the time I had arrived (45 minutes later due to traffic, most of which was heading towards Phoenix Mills, comprising of those who had worked hard all week and were enjoying their weekend), the patient was on a trolley, intubated (a tube in the wind pipe to ensure she breathes well), with one of my residents holding a blood bag while it was being transfused, the other wheeling the trolley (as the Class IV employee whose job it was to do so, hadn’t reported on time), and a third resident from another unit holding a mop over the bleeding site to control it.

We rushed the trolley to the emergency OR, where I realised that the residents had called for a ‘mass leave’ to protest violence against the doctors. The residents changed into OR clothes and scrubbed into the case with me. Not only the two residents from my unit, but also the third resident from the other unit. They were well within their rights to shun the case. To go on ‘mass leave’ just like their colleagues. But without them, I would be like the judge without the bailiff. I knew how to operate the patient, but I wouldn’t be able to navigate the system with the minimal possible delay.

We operated the patient, stopped the bleeding and shifted her to the ICU. All three waited for the entire duration of the surgery, shifted the patient to the ICU and ensured that she was stable and conscious. Every residents had gone on ‘mass leave’ in the late afternoon, these three only went on leave, later that night after ensuring that we saved the patient from exsanguinating. This done by junior residents, who have been compared to Class IV workers (factory workers) who perform their duties to the minimal level expected and shun overtime work if they aren’t compensated for the same. So much for compassion and dispensing duties.

Senior doctors, you say, don’t feel threatened while continuing work, when the junior doctors have gone on ‘mass leave’. This is based more on your whimsical notions than on facts. Ask any senior doctor the reason for not joining the ‘mass leave’ movement, and your notions will be dispelled. Every doctor, whether senior or junior, working in the emergency department, in private hospitals, nursing homes etc. fears that he will someday be thrashed by relatives of a patient who couldn’t make it. The only reason that senior doctors haven’t joined strike is to ensure emergency services remain unaffected, as also the fear of ESMA being used against them, being permanent employees of the Municipal Corporation, as opposed to the resident doctors who are temporary employees.

You tell us that doctors don’t need security, and that if they do need security they must live 100 metres from the hospital, and let those who aren’t scared, dispense their duties. How do you explain 53 assaults on doctors without a single conviction. If you have the (pardon my language) balls to convict and imprison these individuals who assault doctors, instead of passing ludicrous and biased observations, attacks on doctors might actually decrease in number. Why have a bailiff in the court, why have policemen guarding the premises, if you are confident that you discharge all your duties honourably?

Lastly, we Indians have a pathological problem of neglecting the root cause and escalating the matter on hand. The matter on hand is serious, no doubt, but the root of the problem lies in the lack of infrastructure, and a defined referral pathway among government hospitals, amongst others. Would the doctor in Dhule be assaulted if there was a neurosurgeon available at the facility? Would he have been assaulted had there been a defined referral pathway from Dhule Civil Hospital to a nearby one that had a neurosurgeon available.

I request yourselves and the Honourable High Court to review your observations and be compassionate towards the poor resident doctors, who form the backbone of the public health system. Condemn the ‘mass leave’ if you must, but, ensure that the grievances are heard. Ensure that security is provided, that residents are not over-worked and under-paid. Doctors need this assurance and compassion, failing which, the profession will see a sharp decline in numbers.

 

Your sincerely,

A disgruntled doctor not on strike out of fear and not choice.

 

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An occupational hazard

Lyla hustled her way across the crowded corridors from the male to the female surgical ward to draw blood from the patients, a part of her everyday job as an intern. Interns are unanimously exploited, forming the bottom rung of the ubiquitous hierarchy in the medical profession. Not only are they answerable to professors and associate professors, but also the resident surgeons, who are just one step above them in the hierarchal ladder.

Blood draws, filling in forms, shifting patients from one end of the hospital to the other, scrubbing in, but only to retract tissues to clear the surgeons field, were just some of the measly jobs entrusted to them. However unimportant their work seemed, it was still critical in the broader scheme of things.

Lyla, unlike her compatriots, willingly performed her duties.During a twenty four hour emergency duty on a fateful Monday, Lyla was just going about her business, until a spate of trauma cases trickled in through the narrow door leading to the spacious emergency surgical services. There were patients with broken jaws, bleeding foreheads, fractured legs and the like. All these patients had been part of a four car pile-up on a the expressway connecting two neighbouring cities, aptly referred to as the death bed for motorists.

Three of the resident doctors were scrubbed in to operate on patients inside the operating complex. The two resident doctors who remained outside, were the junior most resident doctors, who seemed overwhelmed with the situation.

Lyla, who was edging towards the end of her three month rotation in the surgical services, picked up the mantle to stabilise the injured patients. Having mastered the art of triaging patients, she waltzed around the emergency surgical services ward with the acumen of a seasoned clinician. Tending to the unconscious patients, placing a cervical collar, checking their parameters, placing a venous catheter to resuscitate them, and calling in the radiology resident to perform a screening ultrasound to rule out any abdominal injuries. After ensuring that none of these patients had a falling blood pressure or a rising pulse, she moved on to the more conscious patients with fractures. Using a cardboard and strings available by default in the ward, she immobilised their fractures and prescribed other investigations.

The radiology resident had arrived by this time and confirmed that one of those patients had fractured ribs and a collapsed lung with air having accumulated in the chest cavity and the other one had some fluid in the abdomen (indicative of a severe injury that had caused one of the abdominal organs to rupture). The others were cleared to get their CT scan’s done.

Lyla immediately organised an intercostal drainage kit for the patient with the fractured ribs and collapsed lung and informed the residents who were scrubbed in. Patient 2 with the abdominal trauma was shifted to the operating room under the care of the senior residents and patient 1 was positioned for the placement of a tube into his chest cavity to drain the accumulated air.

Junior resident 1 placed the chest tube and junior resident 2 rushed to the operating room. Lyla’s colleague, overwhelmed and under slept, took on the measly job of shifting the unconscious patients for the CT scan, having realised Lyla’s presence in the emergency ward in these desperate times was mandatory.

At last, an exhausted Lyla proceeded to the patients with the least serious injuries, the last of which was a wound over the forehead, requiring four to five sutures to stop the bleeding. The first suture was placed uneventfully, then the second and the third. Lyla was accustomed to this, having entered the final week of her three month stint. Her experience and skills allowed her to suture in a preposterously inconvenient position. The patient lay down on a bench and Lyla bent over in a most un-ergonomic manner. She was surrounded by other patients and caretakers of those patients, but was just too exhausted to ask them to leave.

While placing the fourth and what seemed to be the final suture, she received an inadvertent shove in the back from one of the other patients. She lost control over her instruments and the needle that had pierced one end of the laceration (a wound that requires suturing) pierced one finger of her other hand. Her glove tore and blood trickled down the sides of her finger.

Lyla halted, her bookish knowledge suddenly surfaced from a part of her cerebral cortex. “Wash the wound in running water with soap, and rush to the nearest ART centre.”

She did exactly that. Washed her finger with soap and water, sent a blood sample from the patient to rule out any infectious diseases spread via blood (HIV, Hepatitis B and C) and asked her seniors for permission to go to the ART centre in the hospital.

The anti-retroviral therapy given to exposed patients within 72 hours of exposure is meant to prevent these patients from contracting the infection.

The patients blood sample was positive for HIV. Notwithstanding the low incidence of contracting the infection (0.3%) from a needle prick, Lyla was shattered. She knew she had had a deeper prick. She knew that her chances of contracting the infection were higher. She started her course of prophylactic anti-retroviral therapy (drugs effective against HIV) and pinned her hopes on a false positive result.

The confirmatory results on the patients sample came in a week later. The patient indeed harboured the virus and Lyla would have to continue the drugs for 28 days and bear with the intense nausea, bloating, belching and burning sensation the drugs caused in her tummy. She wouldn’t know whether or not she was infected till at least 3-6 months later.

Lyla didn’t lose hope. She continued her internship as planned. 6 months remained and she wouldn’t let a stray incident affect her.

She went through her OB-GYN postings learning how to deliver babies and suture cuts made to the birth canal in the process, learnt new techniques to secure intravenous access in the paediatric age groups, assisted neonatal resuscitations and managed out-patient departments successfully in the rural outposts.

6 months hence, Lyla had moved on. She had put the incident behind her, deciding against approaching the ART centre to repeat her blood test.

A week before her convocation, Lyla was approached by the ART centre. They wanted to test her for the virus. Lyla was skeptical initially, but acceded eventually. Her samples were collected and Lyla was to be informed only after absolute confirmation.

On the day of her convocation ceremony, after receiving her doctorate, Lyla was summoned to the ART centre. The chief called her into the cabin.

“Lyla, the reports just came in today.” Lyla’s gaze was fixed downwards. She had an inkling, but she needed to know.

“You have tested positive.” Lyla maintained her poise.

“This isn’t the end, Lyla. You know that we can start you on ART and keep you on regular follow-up. You can still practice medicine and lead a life that may be as normal as most around you. Just be careful when it comes to………………..”

Lyla had zoned out. The bookish knowledge re-surfaced. She faced a normal life with a regular career pathway. But the books didn’t take into consideration her emotional state. She didn’t smoke, was a teetotaller, had never even tried drugs, was a virgin, never had a medical or surgical illness, and lived a regular healthy life. Yet, here she was, infected with a deadly virus, known to affect those who had been transfused with blood or those that lived their life on a edge.

She sat through the counselling session, exchanged pleasantries, promised to follow up and take care of herself.

Lyla was the unfortunate intern, amongst the thousands of fortunate interns and residents who come in contact with blood and other body fluids in dangerous circumstances every single day.

In spite of being utterly cautious, in every sphere, the odd mistake or mishap does occur. In other occupations, one pays with financial instability, loss of a job or at worse loss of limbs or injuries to body parts. Healthcare workers, however, face the daunting occupational hazard of illnesses, both physical and mental. Safety for oneself must take priority over everything else. Only then can healthcare workers adequately care for and nurture their patients back to health.

Lyla sailed into obscurity, daunted by the long and winding road she faced ahead.

 

Painfully yours (5)

15 years later: 

My dearest Geet,

I write to you to tell you how wonderful our marriage has been. It has been a privilege to be your husband, your support and your problem-solver.

It doesn’t feel like 18 years have passed by, since I underwent the surgery and suffered from pain as a result of the surgery. I remember conversing with you, till the early hours of the morning, and telling you about my travails. At that time, never had I experienced your silence in a conversation. But you stayed silent, listened to everything, and broke down with me.

You’ve been nothing but supportive ever since. I didn’t need anyone to tell me what was wrong or how I could fix it. I needed you to be there and tell me that it was alright to crib and cry about my problems, as long as I would at least attempt to heal them.

You have been the biggest support, both in sickness and in health. You took care of me at my worst and have consequently seen me at my best. Life and health have been kind to me for the biggest part of the last 15 years.

However, and unfortunately, the chronic pain has come back to haunt me. It has been lingering on since the past 5 years. I ignored the symptoms, initially, as it was bearable. It has now progressed to a form that is no longer tolerable. I haven’t told you about it, as I didn’t want you to worry about me. I have been on a cocktail on medications. My pain specialist even asked me to try marijuana again, to help myself get through it.

The pain that I experienced years ago pales in comparison to this pain. Its constant, nagging and feels like a pin is poking me all over my thigh and back, all the time. I have seen all the doctors, the old ones as well as the newer ones. The solution is elusive, if at all possible.

A miracle is my only hope, and we both know that its unlikely to occur. Some doctors say it is a reactivation of that latent infection that my spine and vertebral column suffered in the first place, some say it is a cry of the dying nerves, and still others say it is completely psychological. To the last group, I say ‘to hell with you’ll’

There is nothing even remotely psychological about this pain. I feel it, I endure it, and I try to forget about it. But to no avail. If only, I knew how to overcome this barrier.

I write this letter to re-iterate my feelings for you, and to tell you that I wouldn’t do this if I wasn’t in pain. I have cherished our life together and enjoyed every moment. But I can’t carry on any longer.

Some will say I’m being a coward, some will sympathize with my plight. I do not care about them. I do care about you and I don’t want you to hate me for doing this.

My reasons are simple. I have lived a long and fulfilling life thus far. I have dispensed most of my duties towards my family and have secured their future.

But, what about my duty towards you? 

Would you like to see me living a crippled life, whining and crying in pain all the time! If I carry on, my misery will not be limited to me, but rub onto you as well. We will not be as happy as we have been thus far.

This quandary has been plaguing me for the past few months. But, I have realized, the time has come. I wonder how people suffering from such chronic pain manage to lead their lives in such misery for prolonged periods of time. A big salute to them.

I am not one of them. I am a part of the other group of sufferers, who end their lives before their condition disrupts their family and engenders hatred amongst their loved ones.

I am extremely apologetic for doing this without consulting with you, but, have faith in my judgement. Even after I leave the worldly creations, a part of me will always live on inside of you.


Painfully yours,

Samar.

P.S.- I will always love you.


[This is the concluding part in a series of 5 blog posts that follow Samar’s journey in dealing with his chronically acute pain.
Chronic pain is one of the leading causes of depression and anxiety, eventually causing the sufferers to contemplate or attempt to commit suicide. This series is dedicated to all those suffering from chronic pain.]

Painfully yours (4)

A recovery which just a few months ago seemed impossible was shaping up. Samar had never felt better in the past year and a half after his surgery. The electrical stimulation, exercises and his own doggedness lead to him being relatively pain free.

The nerves had responded to his agonizing cries and his repeated benedictions. The misfiring nerves had suddenly stopped firing altogether. Their impish behavior had transformed into one of sudden calm.

Nerves are under constant tutelage of the brain. If the brain commands, the nerves respond. If the brain stops commanding, the nerves stop responding. The nerves are essentially conduits of the brain, which reach every part of the body. Had Samar’s mental agony and impudence caused his brain to perceive a more severe form of the pain, than he was actually feeling?  Was Samar unwilling to let go of the pain till he realized that the time had come to do so?

The brain is such an amazing conglomeration of uncertainties, that science has still not been able to fully explore. A transcendent part of the human anatomy, which never ceases to amaze.

Samar’s progress did amaze Geet and the doctors, who were beginning to lose hope gradually. The recovery started when Geet was beginning to lose patience with Samar’s attitude and behavior. Maybe Samar had realized that it was time to move on, otherwise he’d have to pay the cost.

The pain relieving medications, the marijuana, the electrical stimulation packs were being phased out from his life. He planned to kick them out within the next year. He yearned for a pain free existence without any dependence and was working towards it.

The weight gain was the next problem to be worked upon. Samar had gained 15 kilograms of weight over the past year, primarily owing to his lack of physical activity and laziness. The exercise regimes became more stringent as he recovered and Samar was eager to comply with all of them.

He wanted to be a fitter, better person. The pain had all but disappeared and left behind a numbness. An area of no sensation over the course of the nerve, a problem that didn’t bother him as much.

Samar had planned to marry Geet in the following year. He planned an elaborate proposal and wedding with her. Would she agree? He had no doubt in his mind. But before he could do any of that, he wanted to show her, his true self. A pain free, physically fit Samar. He wanted to prove himself worthy of her. And he had a year to do so.

Samar went from strength to strength in the following year, working diligently and exercising rigorously. This helped keep his pain at bay and also helped him lose the excess weight that he was carrying.

A year later, Samar proposed to Geet. It was not as elaborate as he’d planned. But it surely was romantic. An open field, the night sky, a carpet on the grass, some champagne and the ring.

Samar’s life had seen all the ebbs and flows over time post his surgery. Having endured chronic pain for that period of time and then helping himself find a cure, was an arduous task, one which seemed even more grueling owing to the lack of social support.

The entrance of an old friend who’d eventually became his wife proved to be the catalyst for a change. His impervious nature had softened over the course of time, to eventually give rise to a never-say-die attitude that he held onto for a long time.

[This is the fourth in a series of 5 blog posts (may be extended depending on feedback and responses) that follow Samar’s journey in dealing with his chronically acute pain.

Chronic pain is one of the leading causes of depression and anxiety, eventually causing the sufferers to contemplate or attempt to commit suicide. This series is dedicated to all those suffering from chronic pain.]

Painfully yours (3)

There were rehabilitation exercises and then there were electrotherapy sessions. Samar was determined to bid adieu to the pain that had plagued him for that long. Thrice a week, Samar would visit the physiotherapists office, unfailingly, to undergo the rigorous exercise regimes that were prescribed to him.

Samar’s pain had become persistent now. The regenerating nerves were punishing him for having been severed in the first place. However, the intensity of the pain had reduced. It was a constant pain of a lower intensity, a fact that bothered him more than the kind of pain that would oscillate between periods of no pain and those of impassionate pain.

Exercising and using electrical impulses to fool his misfiring nerves was his last resort. While Geet would help Samar forget the pain and focus on other things, there were still times when there was a recrudescence of the that severe pain and he’d spiral downwards.

Samar had thought about committing suicide more than once. However, Geet’s chirpiness and positive outlook made him want to give life a second chance.

His physiotherapist always told him, “Samar, your pain is never going to vanish, but with the right mix of therapy, we can certainly manage it better.”

Her words of encouragement and Geet’s constant support helped Samar get past an important psychological barrier, one where no matter what happened, he just didn’t want to get better.

And then one day, it happened. The day that Samar’s physiotherapist, Geet and Samar himself had never imagined would arrive.

On a bright sunny Wednesday afternoon, when Samar was being driven to his therapist by Geet, Samar spoke out.

“I think I need to get a job now. My pain is manageable, my health has improved leaps and bounds, I feel good about myself. What do you say?”

Geet welled up. For the past three months, she had been juggling between her work, her parents and Samar. She’d tell him to go and work even if it was only for himself and not for the  money. Samar always refused. Staying at home and being alone all day was not doing him any good.

Samar was not confident, then, that he could pull off working even for smaller durations. He had a handsome inheritance from his family. He would survive on that for the foreseeable future, at least.

He had come to realize though, that money was not the reason why he needed to work. There was something more to it. He needed a job to feel important again, to make new friends and instill some confidence in himself.

Using the connections, he had established in his heyday, Samar got himself a part time job as an attorney at a non-profit organization.

Samar was doing two things he had always coveted, practice law and volunteer. This coupled with the re-emergence of Geet in his life was the perfect tonic for all his problems.

Samar regained all his lost confidence and was dealing with his disease in a mature manner. Geet, who had been doubling up as a nurse for Samar was thrilled to see this transformation.

His days started with work, with his physiotherapy sessions interspersed in the midst of his working day, which was followed by an early evening trip to the clubhouse and ended with him talking to Geet about how each of their days were spent.

Samar had never been happier. The pain which had been an annoyance to him for so long, was not as bothersome any more. He had just started leading the perfect life and was atingle with enthusiasm for the road ahead. Who would’ve known! Samar had just defeated his own demons, both physical and mental.

He was now focussing on the present with an eye towards the future. Marriage, raising kids, all the things that had seemed impossible a few months ago, seemed realistic now.

Looking at Geet, he knew he’d found the perfect girl. One who stayed by his side not only in health but in sickness as well. He saw his future in her eyes, and it seemed perfect. Or was it?

[This is the third in a series of 5 blog posts (may be extended depending on feedback and responses) that follow Samar’s journey in dealing with his chronically acute pain.

Chronic pain is one of the leading causes of depression and anxiety, eventually causing the sufferers to contemplate or attempt to commit suicide. This series is dedicated to all those suffering from chronic pain.]

The Assault’s (almost!)

Being a doctor in India, or specifically in the institute I was working in, not only required skill, but also strength. Skill to manage the heavy burden of patients unleashed upon you, whilst you’re still the unsuspecting, naive, freshly graduated intern. And strength, to manage the rowdy, almost obstreperous relatives of the poor patients, who couldn’t afford to go anywhere else.  One of the former Deans of the institute famously stated, “When you signed up for your residency program, you have signed up for everything that comes along with it, including being beaten up by angry mobs.”

There have been a number of near misses during my residency years, not only with me, but also my colleagues. However, a couple of these incidents stood out as a memorable ones.

The First Incident:

Rakhi (name changed to protect identity), was a 45 year old sweeper, who came to the hospital with severe abdominal pain and a continuous fever for a couple of days. Suspecting dengue, the medicine resident on call followed the routine pathway and sent her to the medicine ward for an admission. Her drunk husband, Manoj accompanied her that evening.

Two days after she had been admitted, we received a written call for a surgical reference, stating that her abdominal radiographs indicated gas under the diaphragm. Gas under the diaphragm is a commonly used term amongst surgical specialties to indicate a perforated bowel. However, considering her history it seemed implausible.

Clinical examinations and further tests confirmed their suspicion. She needed immediate surgery. Transfer protocols were initiated and the patient was shifted to the Operating Room (OR). It turned out that she was suffering from Typhoid, which caused her small bowel (ileum) to perforate and let loose the feculent matter into her abdominal cavity. It took us three hours and countless lavages to clear out her abdomen and suture the perforated bowel.

Manoj stayed around for most of these proceedings, volunteering to help in any possible manner. However, his countenance changed when he saw us shifting her to the intensive care unit on ventilatory support. Having seen his mother going through surgery and later being treated in the intensive care unit in the same hospital, a few years ago, his hopes of seeing Rakhi recover diminished.

He confronted us after we shifted her to the ICU, letting loose a tirade of profanities, “You ba*****s, what have you done to my wife? She would’ve recovered well without the need of the machine had she not been operated upon. All you doctors are scumbags.”

We were taken aback with this rant and tried to calm him down, explaining that this was just a temporary phase and that she would be off the ventilator in a day or two. He was assured of a reasonably good recovery.

He would have none of it. His ranting and expletives continued, until finally he broke down, sobbing uncontrollably.

Seconds later, he darted towards the exit. He was going to abandon his wife, leaving her at the mercy of the staff in the hospital.

Every resident is responsible for his patients, whether they have relatives or not. And if her husband would run away, the responsibility of her care would be thrust upon us. It wasn’t a particularly pleasing situation to be in. We were already running on a tight schedule. On a good day, we would get close to four hours of sleep, and we’d had a dearth of such good days. We weren’t willing to shoulder the additional burden of a critically ill patient without relatives.

In a split second, my colleague and I decided to give chase. At that point in time, we thought it’d be worth it. In hindsight, maybe not.

With stethoscopes hung around our shoulders and a white coat to differentiate us from the laymen around, we gave chase, running down the crowded corridors of the hospital and across the bridge, connecting the main structure to its sister concern, across the gates and onto the streets. We somehow managed to keep a visual track of Manoj’s route. Seeing two doctors giving chase, the security guards at the gate of the hospital also volunteered. The chasing party soon expanded from a mere two people (my colleague and I) to a formidable size. Amongst the new members were security guards from the hospital, relatives of patients, who were admitted under our care and were loitering around on the streets and some random bystanders who joined in for the fun of it. Neither of them knowing the reason of their indulgence.

For a relatively older man, Manoj seemed extremely fit. It took us a while to catch up with him. Seeing the chase party following him, Manoj tried to speed up. But we were close enough and I grabbed hold of his shirt by then. He freed himself from my grasp and decided to take matters into his own hands.

Turning around with a menacing look, he quickly shifted to his left. A colossal stone was lying on the street and Manoj lifted it over his head with the seasoned expertise, as if he’d hurl it over us and crush us with it.

In hindsight, I wish I’d never chased Manoj down. I wish I’d stayed on, in that wretched intensive care unit and let him escape. But then, hindsight always gives you a very obvious biased view of your quandaries.

A comical scene ensued. The chaser had now reversed roles and was chasing our company with a giant stone lifted over his head. The ten brave men who gave chase so valiantly, dispersed into the mob of surrounding people to escape Manoj’s wrath. That was the last we saw of Manoj, who dropped the stone, as we scattered around and fled with unimaginable pace.

Rekha was now our responsibility and we took care of her reasonably well. She recovered well, barring few minor complications and was discharged into a social welfare setup soon after. Manoj had disappeared and was nowhere to be found.

The Second Incident:

Just a few weeks after the ‘Great Chase’ and being the butt of every joke cracked in the hospital, came another incident. One which was more serious and had dire consequences.

The mornings in the emergency ward were usually very hectic. Partly, because most of the unit doctors would be managing the out patient services and partly because the patients, who came in late for the out patient services, would end up in the emergency ward, seeking a quick fix to their problems. These requests were rampant on almost all days. A strict diktat had been issued to service every patient that turned up for treatment in the emergency wards, causing formation of unmanageable crowds and a lack of dedicated time to the actual emergencies.

The only protection that a doctor had from being assaulted in such circumstances was a security guard (or two, if the doctor on duty was lucky). What would a lone security guard do against a crowd of a hundred people queued up outside the emergency wards?

A company of four men and a woman came to the emergency ward, on one such morning, while I was on duty. Being from the area and speaking the local language, they were surprised to find an on duty doctor who fumbled with the local language. The nurses volunteered that I belonged to a different community. The discord started there.

I had no control whatsoever on the local language, but spoke reasonably well in the national language. After examining the patient and prescribing some injectable medications, I went back to the desk to fill out the requisition forms for the investigations. I simply suspected a urinary tract infection along with a renal stone and advised an ultrasound and a urinalysis (a test to check for bacteria in the urine sample). I doled out all the instruction in the national language, only to be told to repeat them in the regional language (they understood both languages reasonably well).

Not knowing the language was irksome enough for the group. When I told them to get the urinalysis done from a private laboratory (the laboratory in the hospital was for some reason not performing the test at that time), it got them really wound up.

Communalism stems form age old practices and a legacy that has passed down through generations. Being a part of that city and state, I had never experienced a communal attack (verbal or otherwise) thus far. It changed that day.

Some expletives and raised voices asking me to go back to my parent state, were followed by the group throwing the glass bottle (that I had handed over to collect the urine sample), at me. Reflexly, I ducked and the security guard (the single man) shielded me from any further assault. The group was forced to leave the emergency ward, but that wasn’t the last of it.

The local community and the politicians got wind of the incident and lodged several complaints against me, alleging negligent treatment. How could a doctor working at this prestigious government hospital not know how to speak in the local language? How could an ‘outsider’ get admitted to such a reputed medical school, meant only for the locals? How could he order an investigation from a private laboratory outside the premises of the institution?

Questions poured out from almost every direction. Thankfully, I was shielded from most of these questions by the senior surgeons working in the same unit. Every question was answered tactfully and every answer written down and re-scrutinised.

We are all Indians. We are all expected to know the national language, Hindi. The constitution recognizes 18 regional languages, but the actual number far exceeds that. How can one possibly learn every regional language to cater to every community in different parts of the country!

Our constitution also proposes to provide every citizen with basic rights. Isn’t right to education without a bias towards caste, community and religion a part of these fundamental rights.

As for the investigations being ordered from a private laboratory. I wasn’t a part of the administration or the pathology department. If a particular investigation wasn’t being performed and was vital to patient diagnoses, should I have avoided it? Would that be negligent practice?

Eventually, when the answers were presented to the authorities, their case lapsed and normal service resumed.

The final diagnosis of the patient was: Urinary tract infection with a solitary ureteral stone, size 4 mm. I stood vindicated.

World Cup 2011 Finals- An experience to cherish!

The journey began at 11:45 am.. A long wait for the fellowship, which comprised 2 kids and 4 adults, to arrive and then we were off! Walking all the way from Napean Sea road to Grant road station. The walk in the scorching sun had a weirdly calming influence on my grey matter which had not rested even a minute since morning. Was India really going to win the cup? Was it worth going to the stadium? Am i being a fool for not selling my ticket for a LAC plus INR?

 

All the questions somehow were answered by the amazing confidence that every by passer exuded. And with every step i took towards the station, i somehow stopped thinking as much and started enjoying the sheer craziness that cricket brings out in us Indians!

The roads were choc-a-bloc with cars honking, cutting lanes, trying every possible manouvre to get to the Wankhede stadium as quickly as possible.

Every passer by seemed to take notice of our company, what with each of us (besides me) dressed in the Indian jersey. A few known faces too emerged from amongst the unknown to wish us ‘good luck’ as we were going to a place that 1.2 billion Indians would kill to be in.

 

After a 15 minute walk we reached the station, where a few shady customers tried to bully the kids for tickets to the game. A train to Churchgate almost immediately roared into the station and we managed to get into it. 10 more minutes to churgate station and we were almost there! The unofficial MECCA of cricket- the WANKHEDE stadium. The Churchgate station resembled a fortress with heavy security, blocked exits et al. We managed to find an exit eventually and proceeded towards the entrance gate for the Pavillion stand, encountering a lot of ‘ INDIAAAA, INDIAAAA’ chants. Its amazing how cricket manages to galvanise the very people who are divided by petty politicians with vested interests!

A few known faces and a little bit of luck got us into the stadium in no time and even then waiting in the line wasn’t futile cause all of us got a glimpse of the DEMI-GODS entering the stadium in their spacious Volvo’s.

Into the stadium and the crowd had started screaming an hour before the match even started. The mood was set, people were confident, so it seemed nothing could go wrong!!

The drama started with the toss! Neither the home team captain nor the match refree heard the opposing team captain call for the toss! There was a huge mutter around the ground that the toss was fixed. But before those rumors gathered momentum, the coin was re-tossed and SriLanka won the toss! India had to chase to win a Final on home soil! To top it all the team composition for the match seemed suspect, picking Sreesanth, a pacer ahead of R. Ashwin, a spinner on a Bombay wicket which is usually a turner.. It couldn’t get any worse! The crowd was groaning and rightly so.

India have never been good chasers and SriLanka had a strong lineup both batting and bowling.

 

Eventually the match got underway in an amazing manner. The indian bowling, barring the erratic Sreesanth bowled very well, picking up wickets at regular intervals and limting the run rate. It was a feast for the crowds, who cheered loudly after each maiden over and went ballistic every time a wicket fell.

But, somehow there was the feeling that something will go wrong.. And it did!

A silent crowd witnessed the brutal hitting force of the SriLankan batsmen in the batting powerplay. It was time for the Lankan fans to go all out. And that’s exactly what they did, as silent Indian fans looked on. The match seemed to have tilted in Lanka’s favor.

The Indian run chase got off to the worst possible start, losing the 2 openers in the first 7 overs! The SACHIN TENDULKAR wicket silenced the very crowd that had revved up the decibels just moments ago. What was heartening to see, though, was the standing ovation The Man got for playing what could’ve possibly been his last match on His home ground.

Time went by, a few wickets fell, but this Indian team was different from the others. No target was unchaseable, no team was unbeatable. With that same conviction, Dhoni, the captain, Gautam and Yuvraj kept the scoreboard ticking. Every dot ball was dreaded, every single was cheered as if it was a boundary and when the boundaries were hit the 30,000 plus crowd in the stadium, be it the Ambanis, the Mallayas or the common man in the east stand, roared in appreciation and delight.

Victory seemed nearer when all of a sudden Dhoni went ballistic smashing a couple of boundaries. Confidence grew and everyone awaited the winning moment.

 

One of the greatest bowlers in World cricket today was up against one of the smartest batsmen. 3 runs were required in 1 and a half overs. Lasith Malinga stormed into bowl at Dhoni at 150 kmph.

Dhoni, not having a care for reputations heaved him for a SIX over long-off. THAT WAS THE MOMENT. 30,000 anxious Indians in the crowd jumped up in celebration of the one cup that had eluded India for the past 28 years. Dhoni stood at the centre of it all, absorbing the atmosphere created by his heroics. Sachin & Yuvraj were in tears, Harbhajan and Virat were jumping and Raina and Sehwag were just absorbing the fact that they were the WORLD CHAMPIONS.

 

“For the past 21 years Mr. Sachin Tendulkar has shouldered the burden of Indian cricket, it’s about time we carried him on our shoulders.” Virat Kohli, barely a few years old when Sachin started playing cricket put his words into action and carried Sachin all around the stadium! Gary Kirsten, who played one of the most understated role in the success was also carried around. The humble captain stood away from the limelight.

The World cup was ours!! A walk through Marine drive signified how Sport unites the un-united. There was dancing, singing, people sitting on the roofs of cars, firecrackers and a lot more. And rightly so.

Not only was it a feather in the illustrious cap of Sachin Tendulkar, it was also the defining moment for a certain man named MAHENDRA SINGH DHONI.

A small town boy from Ranchi, Jharkhand has won all the titles that there are to win, the IPL, the CHAMPIONS LEAGUE, the WORLD CUP T20, the limited overs WORLD CUP, the BEST TEST TEAM & with this win the best limited overs team!

What a night, what atmosphere, what a stage to deliver.