Stethoscope- A noose around the neck in these times ?? Dec02

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Stethoscope- A noose around the neck in these times ??

StethoscopeFor more than a century, there have been few objects that have commanded respect and been a symbol of dignity and pride as the STETHOSCOPE. As a child, holding a stethoscope fueled many a dream. Listening to one’s own heart beat was a magical moment. It was not only the doctor on house call in the good old 80s and 90s who used to be treated with reverence, but even the Stethoscope and the briefcase. Why, even Bollywood movies in the 70s and 80s used to have a scene centered in the hospital or a doctor making a house call complete with his suit and stethoscope which would contribute to the climax of the movie (a different matter as to how realistic it used to be).
But now times are –a – changing. It’s been a year now since this incident happened but I recall it with anguish and pain at how demoralising the profession can get at times. This incident happened almost a year back when movies and the political system were constantly engaged in taking potshots at the medical professsion.
A young doctor, fresh from his post graduation, having finished a long 36-hour duty and 50 admissions through a sleepless night decides to head home. The duty, apart from the routine pneumonias, fever, diarrheas also involved shifting 3 patients to the ICU in the nick of time, counselling a family that their only son has been diagnosed with leukemia and explaining in a somber way the treatment options and prognosis to fill them with some hope, and much more. With the duty having been finished, and looking forward to sleep, the doctor decided to hitch a ride back home. The last thing the doctor wanted to do on a post duty day was to drive in the city’s bustling traffic as the 1 km long traffic jam could already be visualized. He stands in front of the hospital gate and tries to get one of the auto-rickshaws. Quite a few pass with already passengers, few stop by but zoom past on hearing the destination with a characteristic smirk as if the destination was Mars. Finally one Auto rickshaw stops by. He looks at the stethoscope the doctor is holding in his hand and offers a ride saying one cannot say No to a doctor.
The driver confirms that his passenger is a doctor indeed and marvels at the stethoscope. He launches into a discourse on how doctors are God, how he is not going to charge this young doctor for the ride, how a doctor saved his wife’s life. The young doctor who was drained after an exhausting duty felt a bit of happiness that respect still exists for the profession. With recent media and political attacks on the profession it was hard to keep the motivation going but the doctor felt that being in the profession and working long hours was all worthwhile just to receive the thanks. But the conversation began to take a strange turn….. The driver suddenly started speaking about giving the doctor 2000 rupees and offering to take him anywhere in the city free of cost. He wanted to give the doctor the ride of his lifetime. Perplexed the young doctor also noticed that something was not quite right. The tone of the conversation was strange. The doctor conversationally says one does his duty, he is after all not the doctor who treated the driver’s wife (after all, she was treated near their village in another state ) and that every work is God’s work. He even advised that if he is grateful to the doctor who has treated his wife, then he must try to help even those poorer to him to access healthcare and probably encourage blood donation too. Suddenly the vehicle is screeches to a halt and the driver now, in an agitated manner, demands 500 rupees. He says the tire must be immediately fixed. With the conversation getting more surreal, the doctor tells he does not have any change of 500 and gives him 100 rupees. With bloodshot eyes the driver turns around, takes the 100 rupees nonchalantly and says: you doctors killed my wife. And even during her death you people took 200 rupees. He hurls a string of abuses and then replies: Now the debt is closed. I wanted to teach you people a lesson ( as much as Bollywood filmy as it sounds, this incident is no exaggeration and is a verbatim translation of the driver’s sentence). Not wanting to risk anything further, the doctor gets out of the auto and decides to trudge back home thanking his stars that this happened at 5 pm just about 500 metres from hospital or else, who knows?
A morale shattering experience! As he wearily trudged back home, he realizes that the whole experience started from the point he was picked up by the driver. The driver who figured out he was a doctor from the stethoscope in his hand. The driver who has now lumped all doctors in the same basket and lost faith in the healthcare system as a whole. Perhaps he has been watching movies one too many which these days pretend to be doing service to the community by portraying doctors in bad light. He wanted to make a point to the doctor.
This is NOT a standalone incident. Being at the receiving end of a barrage of sarcasm, doubts, and even abuses from family members, friends and the community has become part and parcel of a doctor’s life now. Oh you are a doctor, you must be making lots of money, why don’t you see patients for free?? Is a common refrain these days. Or if one has a doctor friend, one assumes he or she is entitled for lifetime of free talk time to discuss health issues of not only self but relatives, cousins, neighbors and yet puts up facebook updates demeaning doctors. How can you not have humanity to come and see me when I am suffering from stomach ache for last one hour shouted a patient at a doctor not realizing that the doctor was delayed as he was involved in resuscitating a patient who was in neutropenic sepsis and had a cardiac arrest.
STOP generalizing us. A majority of us work long double-digit hours per day, often not caring for food or sleep putting patient care at its premium. STOP abusing the doctor at the government health centres as they work with the minimum of facilities and do the best they can. STOP thinking that Google has all the answers and self medicate before you meet a doctor. STOP blaming the hospital that they didn’t do anything during a terminal event when the patient or the family neglected the health for long or did not have regular follow up.
Why is it that the actor of a movie or a talk show who talks in public interest about the supposed ills that affect healthcare in the country charge in crores? Can people from other professions stop being holier than thou?! Usually when any issue of doctors serving in rural areas crop up, social media is abuzz with updates on how ruthless the doctors are. A recent bill to be tabled in a state legislative assembly points out that a certain percentage of people need to be treated absolutely free. Sure. Here is my prescriptive suggestion as a well-meaning citizen- Let 15% of all cases a law firm takes be absolutely defended for free especially for people from rural areas. Let 15% of every project a construction engineer gets be done for free in rural areas. Let 15% of all software programs be written for free to improve technology and education in rural areas. Let all movie stars, and entertainers perform for free in rural areas at least 10 times a year. And more importantly let 15% of all politician’s income be transferred directly to the poor people in his constituency.
Improving healthcare does not start from criticizing doctors or opening more and more medical colleges. It’s about improving access to already available healthcare, improving awareness and education, about having a strong referral system with good communication networks, about ensuring good penetration of insurance. It’s about creating good preventive and promotive programs.
Let us also as medical professionals have a strong regulatory body to keep a check on ourselves. To weed out the greedy ones. To be strict on malpractice and unethical money grubbing institutions. Let’s hold a mirror to ourselves to clean the black marks before it is pointed out to us. To be more open and honest about our mistakes and look at ways to constantly improve ourselves. To Improve our communication skills and take time to counsel every patient and his family about the disease, treatment and prognosis rather than just writing a prescription.
Let there not come another time that we have to defend the integrity of our profession. Let there not come a time when doubts are cast upon us. And finally let there not come a time when young kids stop aspiring to be a doctor because it’s too stressful and stigmatized. Let there not be a time when the stethoscope is shunned away and looked at in disgust because it becomes an albatross around the neck, a noose around the neck.

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