A Doctor's Pride and Shame

It is with mixed feelings that I look back to the summer of 1973 when I had to choose between medicine, engineering or English from the career basket of that time. The last 35 years have been a roller coaster ride of immense pride and intense shame.

It is a matter of pride that the life expectancy of Indians has increased to 65 years from the 34 in pre-independent times. I also feel proud that infections, easily treated with antibiotics, have stopped being the leading cause of death, at least in urban India (63% deaths are now due to life style diseases!). Small pox has finally gone from the world (we used see households die of this infection in the early 70s), and polio is on its way out. Children seldom die of tetanus, measles, whooping cough and diphtheria, these days, thanks to our immunization programme. Also, a variety of interventions for diseases caused by choked arteries, tumours, eroded joints, obstructing stones in the gallbladder or kidneys can now be treated with safety and ease. Medical science has indeed become a saviour.

            I feel ashamed when I read reports of my brethren turning killers: making more than a living by killing helpless innocent female infants even before they are born, and developing biological weapons that can kill innocent people. Many of the best medical minds in Hitler’s regime designed innovative ways to kill Jews, researching on how to kill more in less time. The potential misuse of euthanasia in the hands of some doctors will therefore remain a perpetual threat.

            The medical profession, that I know, embodies the “e”s of ethics and empathy. In moments of confusion the patient turned with complete faith to the benevolent doctor, not always for potions or cures, but for sound ethical advice. If Dr Binayak Sen was charged by the government for aiding terrorists, the world hailed him as a massiah who stood by his marginalized patients and refused to betray them.  He did the profession proud.

            I hang my head in shame when doctors go on flash strikes, oblivious of the faith and expectations of patients who had come knocking to their hospital door in desparate need of help, (that there was a goof-up by the “babu” in the secretariat, does not exonerate us of betraying our patients), when reports accuse us of ordering unnecessary expensive tests for monetary “cuts”,  when my brethren turn a blind eye to exanguinating  patients or accident victims, and  fearing legal hassles, prefer to let them die, or, when  kidneys are bought and sold in well regulated medical markets. Where has empathy evaporated?

            And medicine is not all service and dedication any more. It is a contract between customers (treatment seekers), and the health providers (doctor or hospital), covered under the legal umbrage of COPRA. And hospitals are good business ventures, with 5 star hospitals making good money treating the sick.

            Decades back, doctors had few medicines, few gadgets but plenty of respect. We now have hospitals resembeling shopping malls, a maze of hi-tec equipment, a bulging pharmacy, but scant and dwindling respect.  The medical profession could do well to try and regain its nobility.

As published in Hindustan times , july, 2009.