The Brahmin, the Cow and the Cardiologist

There is an ancient story of the Brahmin and the old cow. The Brahmin had a lovely garden which he had designed, constructed and took care with great love and labor. He used to proudly show his handiwork to the people who used to come from faraway places to view his garden. 

Once an old cow entered the garden and started eating plants. The Brahmin on noticing this got enraged and started beating the cow with a stick. The old sick collapsed from the beating and died. Once the fit of rage had passed the Brahmin realized his mistake and got guilt-ridden. 

There was an uproar when the villagers learned of the cow’s death, considered a holy creature. The Brahmin being a learned person thought of a way put the death of the cow on someone else. 

When the villagers gathered to punish the Brahmin for his crime of killing the holy creature, the Brahmin explained, ‘Lord Indra (Hindu God) is the deity presiding over the hands. The cow died due to Indra’s fault as he was the controller of my hand. So Lord Indra should be blamed for the cow’s death and not me.’ 

The villagers got convinced by the brahmin’s argument and the news spread like wildfire that Lord Indra was responsible for the cow’s death.

When the news reached Lord Indra ear, he was mortified to be blamed for the holy cow’s death. Taking the form of a traveler he reached the brahmin’s village. 

On reaching the brahmin’s garden, he asked him to show him the garden of which he had heard so much praise.  The disguised Indra asked, ‘Who had designed this garden?’ the brahmin proudly replied, ‘I did.” When they reached the lovely flower beds the disguised Indra asked, ‘who had planted these lovely flowers?’ The Brahmin proudly replied, ‘I did.’ When Indira asked, ‘who had planted these tall trees? The Brahmin again proudly replied, ‘I did.’ 

Similarly when Indira asked, who had watered the garden, removed the weeds, constructed the flower beds the Brahmin proudly replied ‘I did!’ to all these questions. 

Reaching the spot where the cow had died, the disguised Indra asked, ‘Who had killed the cow at this spot?’ The Brahmin caught at this sudden twist in the questioning replied, ‘Err, Indira killed the cow.’

Showing his true form, Lord Indira asked the Brahmin, ‘When you take personal credit for the construction and upkeep of this lovely garden, how can you blame me for killing the cow?’ ‘The praise and blame are both yours alone,’ saying this Lord Indira vanished.

Now let’s come back to the present times. I was visiting a friend admitted to a large multi-specialty hospital. I noticed an old lady sitting with tears in her eyes and prayer on her lips in front of the angiography cath lab. It appeared that her husband was undergoing emergency angioplasty procedure to restore the blood supply to the heart after a severe heart attack (MI – Myocardial Infarction). 

Shortly afterward, the door of the cath lab opened. The cardiologist who was performing the angioplasty procedure walked out with a swagger and style which would have been difficult for even Salman Khan or Shahrukh Khan to copy. Putting his hand over the lady’s shoulder like a God bestowing a boon on a supplicant, he said, “Don’t worry Amma (old lady). I had done an excellent operation and saved your husband’s life.” The woman gave a look of gratitude and effusively thanked the cardiologist. 

But mishaps can happen, and if perhaps the woman’s husband had not recovered and died in the hospital, would the same cardiologist have come and said, ‘I had botched the operation and killed your husband?’ 

In the above story, we see how the Brahmin wanted to take all the credit for himself but in the case of accusation, he didn’t want to accept it and he wanted to blame others. This is a perfect representation of our nature.

Doctors today are quick to take credit for a patient’s recovery, perhaps as; compensation for the long hard work they do, pride in their skill and knowledge acquired through years of hard work and study, to satisfy their egos or to justify their hospital charges.

 The patient’s general condition and immunity, the disease stage, facilities available in the hospital and the city, the help and effort of the other staff members and even the patient’s relatives, and if you are so inclined then God’s grace or luck factor should be also routinely given credit for patient’s recovery so that the public become conditioned that the outcome of patient’s treatment is not due to the doctor’s treatment alone. Other factors may play a more important part in the death or recovery of patient.

If a patient’s death cannot be blamed on the doctor alone, likewise his recovery cannot be credited to the doctor alone.

 (Based on an allegedly true incident)

— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

What is Medical Hakikat? Part - 3

Please Note: This article is intended only for Doctors and medical undergraduate and post-graduate students. Non-Medicos please do not read this article.

I may not agree with your views, but yet I will defend your right to say it — Voltaire

Please read the part one & part two of the blog post before reading this: https://agnipathdoctors.blogspot.com/2019/06/what-is-medical-hakikat.html

https://agnipathdoctors.blogspot.com/2019/07/what-is-medical-hakikat-part-2.html 

Media (mis-) management

Why is propaganda so much more successful when it stirs up hatred than when it tries to stir up friendly feeling? —Bertrand Russell.

As the difference in income between the super poor and the super rich in the country is increasing day by day, the same way the popularity of some doctors is rising astronomically and that of doctors, in general, is falling abysmally.

Some doctors are being eulogized in the most sugary, grandiloquent language in newspaper special advertisement section (Vigyapan Parishisht). They are being honored by the media. Doctors in Kota are spending more than a million rupees (> Rs. 10,00,000) every month in activities promoting self and their hospital’s name. They are giving free services in camps being organized by the media or politicians. They are even sponsoring media events and fairs. But how much time and money they are devoting in promoting doctors image in general? Remember we share in collective infamy as in praise.

           

There is a strong feeling that some members of our own community are filling media ear against doctors. If not, then how reporters are able to get confidential details and information?

We need to establish a Media and Public Relation (MPR) cell to tackle the problem. Ask doctors to pay say around 10% on the amount they are spending on promotional activities as ‘medical PR fund tax’. After all,

God is on everyone's side... And, in the last analysis, he is on the side with plenty of money and large armies — Jean Anouilh.

Use this ‘tax’ money and donation to actively promote the doctor community, their problems, their viewpoints, etc. Office bearers of various medical organizations should issue positive statements in media from time to time.

Valedictory functions should be organized regularly for achievers from the medical community, however small.

Doctors have relatives and friends working in the media. Doctors having access to media should devote some time in promoting the medical profession in general. They should use their influence to counteract any false allegations, half-truth, appearing in media.

Strong action should be taken against defamatory comments including going to court. Highlight to the public our problems and educate and convince public leaders. This can be done when the public is cool and not being provoked by spicy media reporting.

Pressure tactics

No one ever would have crossed the ocean if he could have gotten off the ship in the storm — C. F. Kettering.

After an attack, if the doctors go on protest, then pressure is put through various ways to end the agitation. Doctors working in the government sector are most amenable to pressure. Government doctors are threatened or even jailed under the Essential Services Maintenance Act, threatened with service period break and transfers, etc. Junior Residents are asked to vacate the hostels, their teachers (faculty members) are asked to pressurize the Junior Residents working under them to come back to work.

Higher the post greater is the susceptibility to pressure from the government – Dr. Neeraj Dewanda’s Law of Medical Agitation.

In the past doctors working in the private sector had the freedom and were the pioneer in fighting for the doctor’s rights. But now with a multitude of laws, at the last count > 60 different legal requirements have to be satisfied for private practice and running a nursing home, private practitioners have also become the target for pressure tactics. The largest threat is that of pollution check, with no proper facility for medical waste disposal in many cities.

Once after a serious incident of violence against doctors in a city of Rajasthan, all the government doctors went on strike. When the matter was not resolved then after two days the private sectors doctors also went on strike and closed all the private clinics and hospital in the city. When even the Chief Minister’s relative could not get treatment in the city, the entire administration got in ‘Surgical Strike mode’.

Immediately inspections were carried out by the pollution department even in the night and cases were filed against many hospitals. Notices were posted on the various hospitals for their alleged violation of various laws and building code. Within hours bulldozers were outside many large private hospitals to raze them to ground for alleged violation of these buildings norm. Hastily a meeting was called by the private doctors association and the strike was called off.

Patients also as part of pressure tactics file counter case of medical negligence.

Withdrawing our agitation in mid-stream leave us floundering for air and drowns all. Before an agitation is launched there should be clear aims and objectives to be achieved and it should be withdrawn only on the attainment of these targets. Remember,

Let us never negotiate out of fear. But let us never fear to negotiate — John F. Kennedy.

Summary

There is no easy path to walk in this troubled time, after all,

Alternative, and particularly desirable alternatives, grow only on imaginary trees —Saul Bellow.

We have to balance between forming good relations with the public and taking strong action against any injustice;

Don’t be too sweet, you won’t be eaten; don’t be too sour, you won’t be spat out — German proverb.

All of us have to come forward to serve the medical fraternity with ‘Tan, Maan and Dhan’ (Body, Mind and Wealth). We have to develop a collective determined will as;

Strength does not come from physical capacity. It comes from an indomitable will — Mahatma Gandhi.

And, There are only two powers in the world – the spirit and the sword; and in the long run, the sword will always be conquered by the spirit — Napoleon Bonaparte.

Because we don’t think about the future generations, they will never forget us — Henrik Tikkanen.

Doctors are spending lakhs of rupees on giving their children medical education, but how much they are spending to create the right environment for their children to practice in the future. If immediate efforts are not made now then perhaps (God forbid) the high edifice of medical practice they are building by relentless labor for their children to inherit may reduce to rubble by an errant mob and the children they are raising to be future doctors may be attacked by goons. Remember,

One can never consent to creep when one feels an impulse to soar  —Hellen Keller.

Remember anything which is born must die, but die not a thousand deaths before your destiny calls you — Atharvaveda

(Based on allegedly true incidents)

— ND
© Author. All rights reserved. 
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

What is Medical Hakikat? Part - 2

Please Note: This article is intended only for Doctors and medical undergraduate and post-graduate students. Non-Medicos please do not read this article.

I may not agree with your views, but yet I will defend your right to say it — Voltaire

Please read the part one of the blog post before reading this: https://agnipathdoctors.blogspot.com/2019/06/what-is-medical-hakikat.html

Loss of confidence of doctors itself on doctors

When the assault occurs in government setup, some private doctors comment; ‘we take ten minutes to do what they (government) do in ten hours, therefore such assaults occur’. When it occurs in private setup, some government doctors comment; ‘we do in Rs 100 what they (private) do in Rs 10,000, that’s why such attacks occur on them’. Even in MBS hospital I was shocked to hear doctors commenting, if there is no negligence then why will be there be attacks? When in fact, in most attacks on doctors in MBS Hospital, true negligence was not even remotely associated.

As soon as such allegation happens, a core committee of doctors should immediately verify the facts from multiple avenues, including patient’s case-sheet, other staff, and patient’s statements. If the facts are in our favor then immediate strong action should be launched without any hesitation.

Lack of solidarity & unnecessary leg pulling

There is a destiny which makes us brothers. None goes his way alone — Edwin Markham

On a trip to Singapore, a group of doctors visited a crab farm. They saw baskets filled with crabs from different countries. All the baskets were covered except one. They asked the farm-manager, ‘why this basket is without lid and others are covered?’ The manager replied, ‘Doc, these baskets have covers to prevent the crabs from climbing out and escaping. That basket is filled from doctor crabs from India, hence a cover is unnecessary’.

Why? enquired the doctors. ‘Because’, explained the manager, ‘As soon as any crab reaches the top and start to escape, the other crab pulls its leg back to the bottom’.

Doctors are at present a divided lot with Surgeons vs Physicians, GPs vs Specialist vs Super-Specialist, Government vs Private sector, Senior vs Juniors, Residents vs Consultants, even MBS vs other government hospitals and so on.

Even though we deny this, but some examples will make it clear. Some GPs complain that when they refer a case to specialists sometimes they (specialists) make comments in front of the patient that his initial treatment was not up to the mark. Same is the complaint by some specialist for super-specialist. Some time back, a patient with eye dermoid was referred to Jaipur from ophthalmologists of MBS Hospital but was successfully operated by ophthalmologists in another government hospital. This was given as prominent news in media by the treating doctors that what MBS Hospital Doctors cannot do, they can do. That too with the involvement of senior IMA members who have held high posts in IMA executive. The rest of the doctor community served as a mute witness to this public game of one-upmanship.

Another type of news article appearing commonly is that so and so patient was asked to consult specialists in Jaipur or Delhi but was successfully managed in Kota by local specialists. This sometimes implies (maybe entirely unintended) that the referring doctor was either fool or ignorant of local skills for unnecessarily referring the patient outside Kota.

We forget even though an intern or first-year surgery resident can do it, why do doctors take their relatives to a top-level consultant for something as simple as appendectomy? The reason may be the same, i.e. although the skills are available locally they want their patients or relatives to have the benefit of the highest possible care.

There are also allegations that doctors criticize each other in front of patients. Sometimes there may be really faults and negligence in the previous diagnosis or treatment, but it has been written many times in JIMA in the address of IMA National President, as there are many variations in disease and treatment, we should avoid making any adverse comments in front of the patient.

If you have some special skill or experience, do inform other doctors. But do not expect that your colleagues will necessarily refer the patients to you even though you have the required expertise. IMA and other doctor’s organizations should create forums where doctors can discuss and inform each other about their shortcomings and raise valid requests and objections. Most importantly we should avoid displaying our frustration in front of patient or media. 

(If you have any genuine objection, please feel free to use ‘Agnipath’ to convey your thoughts to others – Editor).

  

(To Be Continued in 3rd Part)

 (Based on allegedly true incidents)

— ND
© Author. All rights reserved. 
Please share this post on WhatsApp, Facebook, Twitter, Pinterest, etc.
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Please give your valuable feedback via comments below. Please note that comments will appear later only after moderation. Please Log in with Google Id before writing comments.

You can receive notification on latest post by subscribing via clicking on the bottom of the page on the Subscribe to: Posts (Atom)

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm.