The Honourable Chief Justice Manjula Chellur and Justice G.S Kulkarni.
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.
A disgruntled doctor not on strike out of fear and not choice.