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A Year as a Doctor’s Apprentice

Stethoscope

I have completed my Internship, which was just for 1 year but felt as if it is an end of an era. This year although was the best so far in terms of learning medicine, but it was worst ethically and has left a deep impact somewhere deep down in my conscience. I have been shown a glimpse of reality, which I used to feel was only a part of books and newspapers. From abandoning an unknown patient to slapping pregnant females in labor, I have seen the worst possible scenarios, which I would like to share in here. This is what you go through when you work as a doctor’s apprentice.

                   You wake up at dawn, iron your clothes and apron, open up your newly bought stethoscope and are ready, totally pumped up to serve patients on the very first day. But, the whole excitement crashes as soon as you enter the hospital chaos, and the hospital staff leave no room at all to humiliate you in worst possible way. “Aye Intern!”, “Aye Intern!” and you turn back, that’s an instinct, because it takes a while for a mind to adjust to the reality, and you see a Maushi (Ward Servant) shouting at you to get off the recently mopped floor. On the first day itself they make you regret your decision to join this profession. You are startled at the trailer itself, and you don’t feel like watching the movie anymore. 

                   A month passes by and you get acquainted to the routine insults and are compelled to treat the patients in an unhygienic way, yes, you heard it right, unhygienic is the right way. You spend few hours in casualty and you will see the Resident doctors fighting over a patient. Nobody wants him admitted in their own ward. They have also named it “Batting”, you would see them proudly blabbering around “Hey! Aaj meine 6 Bat kiye”, meaning he got rid of 6 patients that day. Where do these patients go? You wonder. They get admitted to the wrong department, where they don’t get a proper treatment, or else they are encouraged to go home, in spite of their vulnerable health. You are just getting yourself accustomed to batting, when your eyes suddenly catch a sight of patient sitting outside casualty (shown in the pic below), inside the hospital campus. You inspect him to find out a “Diabetic foot” totally necrotized till an extent which requires an amputation. You want to help him, so you talk to the person in charge and try to take him inside, when you hear a roar, CMO (Casualty Medical Officer) is shouting at top of his voice, he is shouting so loudly that you tend to focus on the loudness rather than listening to what he is trying to say. Then over a period of time you start understanding his rhythmic squawks, and you are shocked to learn that you are not supposed to help people like this. Bringing patients in will increase the work load.

(A real pic clicked by me outside Sassoon Casualty)

                Now, instead he asks you to shoo him away. It is now unethical for you and you refuse. But, his smell becomes so unbearable that the guard shoos him away with a stick. That’s the moment when you feel helpless for the first time in your career. It makes you think, “Are you really treating a patient in need?” A govt. hospital is not expected to show such a behavior towards the poor, wasn’t it bloody built for the poor?

   You feel like you have seen everything, when you land up in the worst possible departments one by one. You are trying to put an Intravenous Catheter to a patient, when your ears fall on something which pops up a memory of Aamir Khan (from Satyamev Jayate) in your mind. “I have sent the patient with Code blue”, and the resident puts down the receiver. You then find out that he was talking to the Chemist regarding his own ‘CUT’ (The percent income he gets for a referral of a patient to that Chemist shop). If you have read carefully, the first question that baffles you is: What is Code Blue?

Codes are implemented for secret communication:

Code Blue: Make a Bill of Rs.4000

Code Black: Make a Bill of Rs.7500

Code Red: Make a Bill of Rs.10000

The chemist gets this code from the resident and accordingly he formulates a bill, 35% of which goes to the Resident Doctor. Aamir khan was opposed by so many doctors for his proclaiming episode on Doctors. You now realize the essence of it and understand the reason for the opposition.

Giving birth should be your greatest achievement not your greatest fear”, as said by Jane Weideman, a woman needs a lot of support during pregnancy. But, in an Indian Govt. hospital, giving birth to a child is not a unit less than suffering third degree torture in jails.

Pregnant women are beaten like anything, and worst of all the doctors feel it as justified. Before delivery its obligatory for an Obstetrician to do a Per Vaginal examination (PVE), which according to norms is to be done with Rubber gloves on and with use of a Lubricant. You will not once see a Govt. hospital using a Lubricant over Rubber gloves during a PVE. Its discernible that the woman will be in pain without a Lubricant, and would shout out of pain, but the thing you find implausible is when the doctor hits her and asks her to keep her mouth shut. Unreasonable usage of Buscopan and Drotaverin to speeden up the Labor, and unwanted episiotomies with accompanying Fundal pressure maneuvers (which are contraindicated) leaves you baffled. You decide at that very moment that none of your loved ones will deliver in a Govt. hospital hereafter. Its better to be childless than making a woman go through such crucification.

    You meet Malpractices at each and every step. You discover that the true sense of Noble is lost somewhere. For one whole year you have to suffer both physically and mentally. You try to fight your inner conscience. You try to create changes, bring reforms. But, after myriads of attempts when nothing works, you realize that after all ‘Ignorance is bliss’ and learn to live with it and instead post a blog about it.

 

[person name=”Dr Varun Patel” picture=”” title=”Founder” facebook=”http://facebook.com/varunipatel” twitter=”http://twitter.com/varunipatel”  linktarget=””]This Post is an attempt to show you the reality in Indian govt Hospitals. Kindly comment below about your views on this topic.[/person]
23 Comments
  1. Shamefully outrageous and yet sobering.. but something which the medical fraternity will unite to decry and deny..

  2. Makes one wonder if doctors have started taking a hypocritic pledge and replaced the Hippocratic oath.. Nobility and ethics are expendable sacrificial lambs at the altar of callousness where the goddess of wealth trumps the goddess of health as hospitals turns into temples of business..

  3. I admire that you didn’t compromised and wrote such a revealing blog.
    I think Medical council of India should provide a provision for Complain and Inquiry for this type of severe Injustice and crime.

  4. It’s so sad.. It’s a curse if you are poor in our country. You read a article like this and you want to help but there’s no direction from the government. How can you volunteer with your time, there is no clarity. Our country needs a strong leader and It takes a lot to stand up against the system and be the voice. Thanks for sharing.

  5. Dr Varun Patel,

    Though to be very honest i was not surprised to read about the behavior of these doctors. But i was more happy to see there still some people who feel bad about it. In India at large i have found people have just lost the Idea of being human. Let it be domestic servants, child labor, employee in office etc all are treated in bad to worse.

    Iam not sure how well you will be treated after this blog but for sure You have made some people to think if they have humanity left in them or not

  6. Reality is ok! When would the reforms come in? Insecurity causes the doctors to be more corrupt & greedy, which in turn makes them ruthless and inhuman! Hope there are periodic evaluations & random checks on humane nature & co-operation nature. A doctor’s medical knowledge & diagnostic skills may be excellent but if he is not a good human being, is he a good doctor? What can we do and how to improve the nature of the doctors? Would good pay-scales improve their nature? Post-graduate & even regular medical courses, even in private colleges of repute go to highest bidders! Can we expect such doctors to be humane? Like our politicians who spend a lot in the elections try to recover their expenditures, even doctors must be doing the same to recover their expenditure for education & bribing their way to the lucrative jobs!

  7. I admire your courage to speak out,in India doctors are considered next to God…. This is the state of our Govt hospitals ,no Govt will accept it.

  8. Thanks Dr Patel.

    Aleast you had the courage to speak up. Hopefully things will improve.

  9. Medical profession has more or less become a profession to mint money rather than serving humanity. I really appreciate your courage to write this blog, even though you have to serve as a junior doctor for the next couple of years. There was a huge outcry from the medical fraternity when the Satyameva Jayate episode was broadcasted on this.

  10. Dear Youngman,
    I am an Orthopaedic Surgeon practicing in Botswana. I am a graduate from GSVM Medical College, Kanpur, 1969 batch. I passed out in December 1973and finished my Masters in Dec 1977. I got selected in State Health Services three times and also cleared UPSC exam but could never master the courage to join government service. The decay had just started but what you wrote seems like a horror story. We were Saints if compared to the present doctors.
    The reason is very simple. We did not have to pay one or more crore of Rupees to get a seat for medicine and PG and the society was not so violent, arrogant and apathetic. It is changing times. Young men like you should try to bring in the change. Do not loose heart and keep helping people. Always remember money in Medicine should be a by product of service. Try also to understand that God has chosen you to heal people. Do write back to me at probir13@yahoo.com
    Keep the good work going
    Dr. P. K. Basu
    Life Gaborone Private Hospital
    P Bag BR 130, Gaborone, Botswana

  11. Hi,

    Things have always changed for good when people unite.

    For uniting people we all have to believe in the strength of righteousness and unity. Its the first step that is the difficult one. The CMO or Senior docs behave in such manner because they find that they can do so. Not questioning them back gives them the power to do so.

    I agree with some of the people above that as young Doctors ( or any profession in that matter) can be instruments of change. It feels good when students at IIT or IIM refuse top salary placements to do what they feel right. The Doctors by profession are considered as God who can make a difference to ones life. It is a different profession and more humane. Its unfortunate that greed has overtaken the noble profession that it is. They get easily swayed by these Pharma companies and other such things.

    The young doctors should remember Chanakaya’s theory and recent Edward Snowden’s courageous steps. If you believe in truth and fairness, you may not be in a position to refuse upfront but be cunning enough to play along and bring the truth in blogs or media or something like wikipedia… Its a different matter that in India even that may not do anything but who knows it may give voice and strength to many who are helpless and weak to raise their point..

    Great work Dr.Varun Patel. Don’t be disheartened if you find yourself alone. Its just that you have not connected with others like you. Its only a matter or time.

  12. I bet the picture is the same all over India. It is part of a culture of people in “upper tier” to treat the poor/people in a “lower tier” like garbage. But the idiots do not realize that they live in the same garbage dump!

    Thank you for identifying the filth in the mindset. You are a true ‘hero’, hopefully, a representation of the new generation with balls to say “enough”!!! My best wishes!

  13. You’re absolutely right Varun! Ignorance is in fact bliss.
    Rather than being viewed as a noble profession, medicine nowadays is seen more as a safe and profitable business. And why not? If it’s all about minting money out of people’s miseries by treating them as objects or milch cows.
    Batting, shooing away the sick and destitute, beating a woman in labor to keep her mouth shut….This is India. Anything goes!
    Talking about the ‘unreasonable usage…’ it’s not just the government hospitals Varun, it happens in most private hospitals too.
    I come from a family of doctors and I’ve often seen my folks and their colleagues mock a patient’s suffering behind his/her back. Now, I don’t know if it’s legal or illegal but it certainly IS NOT the right thing for a doctor to do. What if you were in his/her place? How would you feel? Grow up people!
    My only request to the medical fraternity is that if nothing else then at least show some sensitivity. You’re doctors.

  14. I appreciate the author for bringing this out.
    A lot of people with limited or no knowledge end up paying huge sums of money for drugs & salts, just because someone somewhere needs a thick cut.
    The article answers why there are so many incidents of patients & their relatives getting into scuffle with medical staffs in hospitals.

  15. Awesome Comments, it should get more coverage.

  16. A big “Thank you” for making this public knowledge. Amazing that you wrote this inspite of pressure/ fear that you must have felt while writing it.
    I got a feeling after reading about Code Blue that the medical system in India is not any less corrupt than the US.

  17. Thanks for bringing this to the attention of public. The care provided in our hospitals is absolutely ridiculous. Working in Indian hospitals it becomes clear that there is no value for life. There is significant neglect and large number of people die because they do not get right treatment. I think we need to do something about it together. Raising issues is just a first step, no one will act unless something is done now. Otherwise the fear is that your article will become just one other article on the world wide web!

    Can I please ask you to not post pictures of patients in internet. If you were not well and in hospital you wont like your picture to be posted on internet so do not post other peoples photos (especially without their permission) As a doctor you should respect patients privacy and right to confidentiality.

    Good job, keep it up!

  18. I really appreciate Dr. Varun Patel for your efforts to bring down all these to people’s notice.
    People goes there, ignores all humilaiation and insult done by house keeping staff, Ward boys and Doctors and gets a prescription for medicines any how and come back. They just ignore whats happening arround.
    Being a Doctor, it would have been possible for you as well to let the things go on…..let this business runs as it is and make money in the same way as other doctors are doing. But u decided to bring it to notice. Hats off to you Sir. Our country needs more doctors like you!!.

  19. Amazing. I appreciate you for being brave throughout this year. Hope we have s great doctor now in society unlike the ones compromised.

  20. This is awful. And this kind of cruelty towards needy patients can happen in a country of staggering millions where the Government has no control on the hospitals they run. These people are more of butchers rather than doctors!

  21. Innocent doctors, ignorant patients …… Addicted to servival……
    No profession is ignoble, no man is ignoble, all wish to survive,

    Even prisoners have moral code, but no team to safeguard legally.

    But Doctors have as any other professionals.

    You go to Go to State owned educational set ups, your experience be very disappointing …… Many minds are made into rotten,

    Checks and balanced is the only effective remedy.

  22. Its indeed pathetic……I see so much of this too in a small way….!!!!! Its not new to me…..this disgusting behavior is unfortunately taught……!!!!! There is no compassion left in the meaning of Doctor….the idea is to scare the patient, charge exorbitantly, do unnecessary tests, mentally, physically and financially screw him/her up and make a killing each time a patient walks in.!!!!!! Super specialty, I care/we Care all marketing tactics…..!!!! how can people trust their lives with such heartless people….!!!!!!!

  23. Thank you! Thank you Dr Patel for sharing this with the world. This is something like an elephant in the Indian health care room. That to an obnoxiously ugly one. We all know about it…but no one discuss this. Forget about doing something about it…thanks again doc!

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