Health in the time of Hartal Mar14

Health in the time of Hartal

It is that time of the month in Kerala again……….the good old hartal. A political party calls for one, calculated to disrupt life and activity in the worst way possible. The populace or at least the majority gear up for the holiday with a calm acceptance and in some cases anticipation. The small business, unsuspecting visitors to the state and events scheduled for the day take a beating. Beverages, legal and otherwise, show brisk sales. All in a day’s play for us in Kerala. Healthcare, of course has to run a different course. That is expected to function as if there is no disruption. It can’t shut shop and sit at home. Asthma, appendicitis, ureteric calculi and labour don’t know there is a hartal on. And so, function we must. Now, on to the hospital. The pace is visibly slower, the OPDs are sparse but the ER is bustling. The ambulance drivers are doing overtime, ferrying more doctors than patients. Who wants to drive in their own vehicle and risk a broken windshield or punctured tyres? Not that ambulance offers complete immunity- there have been instances of stone pelting and injuries to doctors and other personnel in ambulances too. In a memorable instance the same miscreants landed up in the hospital ER to be treated by the same doctors they had stoned a brief while before. As if showing up for work is not tough enough, one has to manage other disruptions. The children who otherwise would be in school are now at home with no caretaker. The house help who otherwise would be at your home, is now at her home as there is no transportation- there is as yet no provision to provide ambulance service as transportation for house maids. Ah…just the mundane concerns of the average population. Back in the hospital, there are disruptions of other kinds. Carefully laid out workflow like so many assembled pieces of jigsaw, are in disarray. Like…the planned list in the OR can’t start on time, will have multiple impediments in the form of unavailable staff or relatives and lack of support services. The emergency transfusion of a rare blood type may get stalled with disastrous implications. The planned discharge does not happen leading to inconvenience of the patient and for the one waiting for the bed to be vacant. On the flip side, this is the day everyone in the vicinity of the hospital wants a check-up- after all they are jobless for the day and the hospital is within walking distance. And the list goes on.. At best of times, healthcare is a finely arranged balance of many unpredictable moments and components. Disruption has far reaching consequences, seen and unseen, for the care provider and the patient. And when the disruption is manmade, it’s just a case of cutting off your nose to spite your face. While there is always a mention of ‘Essential services will not be disrupted’, the reality is inevitably otherwise. Essential service for the common man is also provided by common men and women- they too have lives and concerns as the rest. When society and media expects more of healthcare providers, they must be willing to support them to deliver the best. Are you listening, fellow common man?...

INTIMATIONS OF MORTALITY Mar07

INTIMATIONS OF MORTALITY...

What can be as morbid as a discussion on mortality? While artists and writers may find it romantic, doctors for the large part don’t like any serious discourse on death. Right ? Well, not quite. Counterintuitive as it may seem, when advances in health and care have seen longevity at an all time high and going higher yet, we have started seeing more and more concerns about mortality and end of life issues. From bestsellers’ Mitch Albom’s Tuesdays with Morrie and Randy Pausch’s The Last lecture, we’ve learnt to confront the inevitable with grace and dignity. With all this, can our fraternity be far behind. Over the last few years, we have had some deeply insightful writing. Atul Gawande’s recent book- Being Mortal is a wonderful recent example- an important book on a topic becoming increasingly relevant. Here are a few others; letters, poems, videos that examine different facets of mortality. Peter Saul- Let’s talk about dying Australian intensive care specialist uses the TED platform to raise important questions on the decisions surrounding end of life. Vivek Hande- RIP, Dear warrior… Indian gastroenterologist pens this ode to a cherished patient. Oliver Sacks- My own Life Neurologist and writer Oliver Sacks confronts the news of inevitable.. Danielle Ofri- Patients need poetry and…so do doctors This one is a double bonanza- New York physician and writer Danielle Ofri writes on Poetry and doctors while introducing Rafael Campo and his poem. The multiple links in this article are a treat in themselves.. Pauline Chen – Final Exam: A Surgeon’s Reflections on Mortality Liver transplant surgeon and author/ columnist Pauline Chen in conversation….on writing, inspirations, mortality and more… As you see, thoughts on mortality are not all morbid. Every once in a while, it can give us a...