May 22, 2015

This is your moment, Doctors of India. Make it count...

Okay. So that happened.

You write a regular blog post, hoping to hear the opinion of the usual 5-10 odd doctors who visit your site and the next thing you know, you are getting calls from friends while you are having dinner letting you know that you are in the front pages of national newspapers and on BBC.

Or as I like to call it, just another normal Friday at Godyears.

Jokes aside, I did not in my wildest dreams expect this kind of a reaction. I don't think any blogger could have, honestly. I expected the usual 300 - 400 footfalls at the blogpost before I could move on to some lighthearted post. Well, as of right now, the page views stand a little shy of 1.9 lakhs and I have no idea about all the websites who shared or opined about the post.

But thank you all. The vast number of comments that have arrived here as well as on the sites which allow comments and on my email have been supportive.
Thank you all for sharing your experiences, your memories and your opinions.

Just another life lesson from Scrubs

I guess I have to address the key issues of criticism too before I can get to what this post is truly about.

A lot of the criticism dealt with the "pole dancer" line which ended up being used by newspapers and media and ruffled a few feathers. While I did not expect them to lead with that, you know what? I am okay with it. I will gladly take the hit for that. The end point was that you all spoke up. And even in disagreeing with me, you actually ended up unwittingly proving my point.

You see, in the replies and rebuttals from fellow doctors and journalists who felt I was wrong to say such blasphemy, I kept finding variations of the same sentence "Yes, things have gotten worse and we need to change the way it is all going BUT... "

Well, here's my question... If you knew that the system had gotten worse - if you knew that things were decaying - why did none of you open up and speak about it?

Why did I have to be the little boy who pointed out that the emperor had no clothes?

Is that how you treat patients? You take histories and blood samples, look through the microscopes, identify the causative bacteria and... Nothing? You don't treat the illness? You just sit there watching the patient die a slow agonizing death?

When Dr Rohit Gupta was beaten up and the cctv footage went public, what did you do to let the public know that this was not okay? When a female doctor was manhandled, molested and threatened with rape for following triage, why did you not speak up louder?
Because it was okay? It was part of their job?

I stood up because I don't believe that suffering violence can be written off under the category of "part of the noble profession". These are not men and women trained in warfare that they know to defend themselves. For the same reason, I am afraid I will not accept comments where people try to shame me or other doctors telling us that if we can't handle the lack of facilities, man power, equipment and violence, then we not dedicated enough for the profession. That is just hogwash.
You can add a lot of things under the "selfless" package. But violence doesn't get in.

Know this - we are not facing this alone.
As the Week reported last year, 76.7% of Chinese doctors do not want their children to follow their profession for the very same reasons.  76 percent! Doctors from the two biggest populations on the planet are suffering the same level of disillusionment! It is a malaise that is affecting the profession all over the world. Now is not the time to silence voices asking to heal a wound gone septic.

May 15, 2015

Why I will never allow my child to become a doctor in India

A pup was walking down the street when it came across a group of young boys. The leader of the group spotted the dog and pointed it out to his friends. Seeing the boys, the dog too wagged his tail and barked, looking forward to being petted and making new friends. 
However,even as the pup wagged his tail, one of the boys picked up a stone. The boy turned to the others and told them how dogs are bad because another dog had bitten his grandfather years ago. As he nodded, a second boy picked up another stone even as he spoke of the incessant barking of stray dogs in his neighbourhood at night, disturbing the sleep of his family. A third spoke of how dogs are bad because of religious reasons. The others realized the wisdom in their friends' words and each picked up a stone, aware now that breeds like this could not be trusted. The pup stood where he was, confused as he watched the boys come closer to him.

By the time night had descended upon the land, the boys had dispersed and gone to their individual homes. There was a sense of accomplishment, having stopped a menace from entering their streets. Lying bloodied and brutalized, the pup that had wagged his tail in hope of giving and receiving love licked its wounds. It was too young to know that the physical wounds would heal in due time... but it was now old enough to have learned to distrust the species of stone throwers. The most selfless creature since time immemorial now knew to hate... because that was what it received for no fault of its own. For the crimes of others, it had paid with its body and soul. 

That, in a nutshell, is the reason why I will never allow you, my child, to become a doctor in India.
Still confused, I guess? It is okay. Take a chair and sit down... this is going to take awhile.

Increasingly, I find myself watching and talking to doctors across two generations and various specialties these days. And increasingly, that sense of despair and disillusionment is writ large in their words. They find themselves wondering where things went wrong even as they struggle to bring a smile on their faces. With 0.7 doctors per 1000 Indians, the doctor:patient ratio is far below that of other comparable countries like China (1.9), United Kingdom (2.8) and United States (2.5). Spain's 4.9 seems like an absolute luxury in comparison, I must admit. What this means in layman's terms is simply this - that you are always going to be swamped with patients beyond the logical human capacity in India. 

Thou shalt sacrifice your time, parents, spouse and child.
Getting a 63 hour a week schedule (7 days x 9 hours) is a blessing and most of the young guns who join in fresh after post graduation know fully well that a 100 hour a week schedule is par for the course once you begin working. And sadly, this is advocated and in fact encouraged by most hospitals too - who wouldn't want to have workers in a contract which states 8 hours a day and then get them to work 14, stating that 'this is how it is for all doctors and besides, we are in the business of selfless service.' You would never allow a taxi driver to drive you for 24 hours continuously but asking surgeons to do that every third day is fair game in India, apparently. 
Wanting to do the alloted number of hours in your contract and then come home to your family is now frowned upon in our field... it implies weakness. Nay, it implies a a lack of professionalism. 

Thou shalt sacrifice thy life dream.
This came in my Facebook timeline. It is
actually quite accurate, when I think of it
It is a sacrifice that will take away your twenties and eat away at your thirties. You may enter the field bright-eyed at 18 but I must ask you - what happens if the dream to become a heart surgeon does not reach fruition? If for some reason, you find yourself unable to get the coveted seat or devote the fifteen odd years I assume it will take to become the junior most in your department, would you be happy with your life? Would you be able to live with losing the dream or would the disappointment eat you up from within?

Who cares for the doctor
A young surgeon working in one of the premier institutes in India spoke to me the other day. This was a doctor who was so passionate a year ago about becoming even better, working hard to get into a super specialty course. She had joined the hospital because of its awe-inspiring reputation across India, aware that the hard hours she put in would sharpen her skills and broaden her knowledge of the specialty. The woman I spoke to had lost that drive altogether. 
Walking out of her home at 7 AM and returning home at 10 PM just to fall into bed and then wake up again at 5 in the morning to restart the cycle, she wondered what was the point of it all. She was losing touch with her loved ones and had become a zombie, lost between the politics within the hospital and a total lack of social life. 

All this for a handsome salary of 50,000/- a month (in Mumbai) which she knew would not buy her two nights in the ICU of the very hospital she was working in. There would be a pot of gold at the end of the rainbow, I wanted to tell her. She would earn more in her forties than her techie friends earned in their thirties, I could have consoled her. But I did not. Because I know how she feels. 

Another doctor spoke out recently on a public forum, talking of his experience of doing six years of rural service for the government. When he finally left it two years ago, the man in his thirties had less than Rs 15,000/- in his bank balance with no extravagant purchases or trips to boast off. He needed his parents help at that age to still pay for his rent. It all came to a head when the guy at the shop recharging his mobile revealed how his monthly takeaway was more than the doctor's... without any risk whatsoever.
His one plea to all the doctors listening? Do not be a sentimental fool and get blackmailed by the medical system to go work like he did... because nobody cares for your service at the end of the day. And I totally agree with him. If after more than a decade in the medical field, he cannot provide as much for his family as an mobile shop owner, then why did he need to go through so much of an effort at all? If India considers it a crime for doctors to earn money while closing their eyes when judges, lawyers and uneducated politicians magically accumulate crores, is it not the folly of the person aspiring to be a doctor? How dare he dream of providing for his family? 

More statues, less healthcare is the solution
The very fact that our stats are comparable
with Nigeria speaks for itself
The medical field we entered is not the one we are in today. Even the generations before us acknowledge this. And it is only getting worse. 

For a field like ours in a country like ours which is overpopulated and has a major portion of that hovering below or around the poverty line, having the support of the government to ensure the benefits of health care reach everyone is vital to our success. They needed to make medicines more affordable at the very least. Sadly, rather than increase the amount, they decided to cut the budget allotted to health care by nearly 20 percent. Key sectors like HIV/AIDS lost funding rather than having it increased. This at a time when we spend a mere 1% as it is on public health care in India as opposed to 3% in China and 8% in United States. What can I say, my child? I guess India is healthier than those other poor nations, are we not? 

Defensive medicine 
I wish it were JUST about losing your family life, working twice the allotted hours and taking home the pitiably disproportionate salary though. But sadly, it isn't even that anymore. Now, it is about getting home in one piece. From stopping patients from dying, the medical field is now being forced to worry about not being killed by the patients bystanders.

May 3, 2015

The song of a scarred soul

I share my happiness with everyone.
I keep my scars to myself.

I want to trust with all my heart. 
I cannot find it in me to trust my heart. 

I would go to the end of the world to win love over. 
Standing beside love, I would label myself unworthy and walk away. 

I cherish making friends. 
I fear trusting them.

I am building the road to my future.
I do not understand my purpose.

I do not visit institutions of religion. 
I pray for every person I care about.

I survived. 
The younger me died for me to live.

I miss who I once was.
I don't remember him.

The best moments of my past haunt me. 
The worst moments of my past motivate me.

In the chaos of daylight, I find serenity within. 
In the serenity of night, I am in chaos.

I will show you my scars to help you heal yours. 
I will not allow you to help me heal mine.

I am lost. 
I am lost.

Apr 24, 2015

Avengers: Age of Ultron Review #SpoilerFree

You would have to have been living under a rock not to know that the most anticipated sequel in the Marvel movie universe was releasing. So without further adieu, let us dive into the movie, shall we?

When Tony Stark decides to use a newly acquired energy source to try and create his own version of a peacekeeping force of Iron Men robots, all hell breaks loose when the system attains artificial intelligence and determines that the key to the survival of the Earth is the extinction of its biggest parasite: mankind.

What worked for me: 

  • The pace of the movie: We literally kick off in the middle of an action sequence and from that moment, there is no slowing down. Each sequence invariably sets up the next in rapid succession. 
  • Juggling multiple character arcs: Very few are capable of handling an ensemble cast of this size. But then, In Joss (Whedon) we trust. And he had said all along that he was not looking to go bigger than the first Avengers movie, but deeper. He does that well as we get to see more about the past and fears of each of the Avengers.
  • Action: Quite a few excellent set pieces in here. Besides the Iron Man-Hulk showdown, what you will truly appreciate is how well they work as a team here, feeding off of each others moves. Ultron's end game 'plan' is quite unique, when I think of it now.
  • Characters: Part of the reason why there is no time for fleshing out certain moments which deserved it is because you have to introduce quite a few new pieces from the Marvel Universe as well into this intricate maze that the Marvel Cinematic Universe is building. The Maximoff twins (one gifted with super speed and the other with the ability to mess with your minds and use kinetic blasts) have their own reasons to side with Ultron as the movie gets going. Not to mention a certain 'voice we have grown to love' since the first Iron Man movie, finally getting a body and role. Ultron is no Loki but he is still a very menacing and calculating villain because of the insane logic running within his head. 
  • Actors: Ultron is voiced by James Spader which is really quite brilliant casting. That ability to be funny and yet downright evil sits easily with Spader. You can visualize him clearly in the movements of Ultron at times. Lengthier story arcs for Bruce Banner, Black Widow and Hawkeye (the three without individual movies) are also portrayed well by the super talented trio of Ruffalo, Johansson and Renner. Robert Downey Jr and the two Chris' have played these roles for so long that it is almost second nature to them, I assume.
  • Comic book geeks: There is a lot for them (okay, us!). Seeds of the 'Civil War' to come in the next Captain America movie (between Iron Man and Captain America)  are planted here as there is a visible clash of ideologies. The sequence featuring Andy Serkis takes you to another very familiar fictional land in Africa. 

What did not work for me:
  • A little too much world building for me. I love the Marvel Universe as much as any fan but certain character arcs are deliberately left unresolved because of what is (I assume) to come in future movies. I can't help but feel a bit let down by that. For example: Thor realizes that someone is playing them like puppets and those of us who have seen the earlier movies know it too but someone who watches this movie without seeing the previous ones may feel lost. There are ties to literally every movie of the past in here. 

Apr 23, 2015

Superheroes don't just exist in comic books #WillOfSteel

Do you remember the name of DC comics 2013 movie blockbuster (re)launching their most famous creation?
'Superman, Man of Steel' right? You are wrong actually.
You see, Superman's name does not appear in the title. He (and subsequently, the movie title) is just the Man of Steel. In that sense, he is very similar to another legend from the pages of DC comicbook lore, Batman aka the Dark Knight. Because they are more than just the people called Clark Kent or Bruce Wayne. They are ideals that shine in their world, making the impossible seem possible. Giving hope to everyone around them with their feats.

Sadly, we do not have any Krypton derived aliens in real life on our planet ( or at least if he is here, he is hiding himself pretty well!). But let that not end the thought process that began from the colourful pages of these comic books. There may not be a Flash running around at super speed or a Green Lantern using super powers but right here, in India, there are people who inspire us with their ability to be extraordinary. Some possess a level of endurance that would make honestly make even Superman proud. Others have a capacity for love, patience and courage beyond the odds that even Batman would struggle to master.

And yet, we allow them to remain footnotes in the newspaper while allowing the villains of the day to hog the headlines ironically. JSW looks to change all that with the #WillOfSteel endeavour. Cutting across all fields and boundaries of the country, they have looked to showcase these unsung heroes, letting you know more about the people who truly represent the best of India while also felicitating them.

Honestly, it was tough for me to just choose 'a few'. Each and every one is a hero capable of so much more than you and I... heroes who have braved tremendous odds and sometimes faced terrible tragedies to win. You can see the entire list and nominate ALL the people you feel are worthy winners from this link here.

From my part, let me tell you the ones that caught my eye.

Bhakti Sharma:  Coming from the desert state (irony alert!), she is the youngest female swimmer in THE WORLD to swim in 5 oceans and 7 seas.

KrishnaDas: In a world that is silently being eaten away by the poison of paranoia towards one another based on differing ideologies and concepts, one man stands against the tide of hatred... literally. Believing in the message on his placard "Follow your religion, love everybody", KrishnaDas has been standing at Juhu circle every day without fail for years, hoping to make people believe once more in compassion.
Images source: here

Mohammed Salih: You do not need eyes to see. If you do not believe me, imagine this visually impaired young man who sees the chess board better than you and I. He may not know the colour of the rook in his hand but this national level chess player has beaten quite a few more fancied regular (normal vision) players already.

Mamta Rawat: Closer to the legend of the heroics of Superman's father from the comics as he helped others even as he watched his own planet get destroyed, Mamta rescued hundreds of children who were stranded on a mountain during the Uttarakhand floods, even as she watched her own house get destroyed.

Apr 20, 2015

The Canine's Guide to Nurturing Humanity #1000Speak

Dear friend, 
When I see you, I often worry. You are bigger, stronger, more intelligent & capable than me and yet at times, you seem like a man lost in the dark, seeking a candle light to guide you back. And I worry that none of your kind seem to find it in them to light that one candlelight for your sake. 

I don't know as much as you do obviously but there are a few slivers of wisdom that I have attained too along the way. A lot of it is stuff you know but have perhaps just forgotten. But that is the thing, you see. You don't forget to be kind and compassionate. On the other hand, you enforce it. You make it a part of your daily life. 

My role? I can only help you nurture it by my everyday deeds and pray that you will learn from me... I sincerely hope you do. Because you are truly capable of so much love and selflessness.

Beagle Snoopy Godyears
First of all, understand that you cannot do 
everything by yourself. Accept help 
from those who care about you.

Beagle Snoopy Godyears
Do not get disheartened when you see the heights
that others have attained. There will always be someone
bigger than you. Focus on your individual journey.

Beagle Snoopy Godyears
Often, the shackles that hold you back from 
achieving your goals are just within your mind.

Beagle Snoopy Godyears
Do not let go of your inner child. He will guide you back 
to happiness when you find yourself lost in the big bad world.

Beagle Snoopy Godyears
Be grateful.

Beagle Snoopy Godyears
Find time from work to cultivate a hobby
or vocation that appeals to you.

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