My name is Shaunak and this email comes to you from my On call room in a hospital in Washington DC where I am doing my internal medicine residency. I last wrote to you guys following Jayalalithas death to clear some misconceptions regarding the medical facts of her death. A couple of things have changed since then!
- I dug deep into my shallow pockets and am now a proud subscriber!
- I got hooked to yet another podcast from the NL factory – Lets talk about!
As always, on my drive back from work I was listening to Hafta 113. It broke my heart to hear the letter written by Dr. Rahul regarding the apathy of the Indian government, courts and media (NL included) to the doctors’ agitation in India. I completely second him. To him, I would say : Be the change, never do nothing! Our media, courts and government are slanted against the medical field out of ignorance. They are merely a reflection of the society we live in. Education and a higher IQ does not guarantee that they have been exposed to, or are aware of the hardships that we as doctors face. It is up to us to educate them. Engage with them, do not disconnect.
My letter to NL today, is an attempt to do the same. I was born and brought up in Bombay. I did my MBBS from Seth GS Medical College and KEM hospital which is one of the foremost government medical colleges in the country and the best in Maharashtra. My grandfather was the HOD of Anatomy there and my parents trained there. So imagine the thrill when I was accepted there as well!
Why medicine? I did not do medicine to serve humanity. A lot of the conversation around the doctors agitation has been about how doctors are being apathetic to the plight of the suffering common man. What about me, and thousands others who did not do medicine out of the goodness of our hearts? I saw my parents live a comfortable life. I saw the respect society gave them. I saw them animatedly debate medicine at the dinner table. That is why I chose medicine! That humanity is served by the job I do is just an additional perk. Do I value it? Absolutely. Is it gratifying when the relatives of the patient hug me or bless me after I cure their loved one? Most definitely. Does that matter more to me than my own happiness and security?Certainly not. Why put us on a pedestal we dint ask for?
In 2015, my friends and colleagues at KEM Hospital were beaten with iron rods following a child’s death. Death is always hard. In the pediatric population it is even more crushing. But what gives anyone the right to resort to violence in a medical ward where there are others as sick? One of my colleagues developed PTSD following that incident. How was it his fault that being a public hospital, KEM was short of ventilator machines?
When I administer antibiotics to an infected patient in the hospital, here is the list of things I need to think of:
- What is the most likely organism causing this infection?
- Based on patient’s vital signs and overall picture, how likely is it that the infection has spread to the blood?
- Based on recent patterns, is the organism likely to be sensitive or resistant to the drug I want to use?
- What is the patient’s liver and kidney function like? That will help me decide the appropriate dose.
- How expensive is this medication? Is it something my poor patient can easily afford after discharge?
- Does this patient need to be admitted to the hospital or can he be discharged home?
How am I supposed to make these decisions, when I am simultaneously looking back over my shoulder worried that someone is reaching for me with rods? We always make decisions using our best judgement. Judgement that we learn from years of reading and practicing. How do we trust our own judgement when we are distracted by the fear for our life?
As a medical intern in KEM I have worked 36 straight hours in the emergency room. In the month of May, with just a table fan to dry my body soaked in sweat, I have sat in a 8ft X 8ft corner, drawing blood, placing iv lines and triaging patients. I was abused by relatives if I was not quick enough. How could I complain that the last time I ate something was more than 12h hour ago? There was a line of 20 very sick and poor people standing in front of me, hoping that I will solve all their problems. This hope, which turns into frustration and is quickly replaced by anger and then violence as the line grows longer. Anger which should be directed toward the government and the system. Not us, who unfortunately become the face of it.
I hated my life. I hated my job. Which is why I came to the US to do my further training 2 years ago. Do I miss family? Mumbai? KEM? India? Absolutely. Am I happy with my job now? Absolutely. Others are not as fortunate. Some have financial constraints, others have family ties. Many are less cynical and more patient than I was. They chose further education in India. These are the people who go on the become residents in India and then have their eye turned to pulp.
They sleep in the side room of the wards which have beds with holes and rats lurking around. As first year residents, they bathe every alternate day if they get lucky. Many take to alcohol and tobacco to cope with the stress and depression. Some contract TB and are off work for months, throwing their entire career out of whack. Were they protesting about any of the above? No, All they wanted was security to do their job! Was that asking for too much?
Why did the media not find this agitation sexy enough for adequate primetime coverage? How did this become less important than Adityanath’s love for cows?
The Bombay high court judge blasted the doctors saying “how are you any better than factory workers?” But aren’t even factory workers entitled to a secure job environment?
Apologies, for the super long and rambling letter, but there is so much more that needs to be said and done for doctors in India. I feel that Team NL could potentially do a “Lets talk about” on it and even that may not cover everything that needs to be said!
There is so much I hope to do for the doctor community and the people in general. This is just one small step. I write this letter with the hope that at least one person who follows NL sees our point of view. Most of us would never go to a government hospital. We get our treatment in private hospitals. Spare a moment thinking about patients who get treated there and doctors who work there. They are both just victims of successive governments’ apathy toward healthcare. As Dr Rahul said, it never was and never will be: Doctor versus Patient. We are what we are, for them!
To end on a happier note, I am very excited about the NL science desk! If you guys are still looking, would be thrilled to contribute in my own little way. I am no fancy post doc or neuropsychologist, but hopefully I can be of use.
You guys are doing a great job! Manisha is still my favorite! 🙂
Tight hug to the whole team,
Shaunak Kulkarni,
M.D. Internal Medicine
Hi NL Team,
I just finished listening to the latest episode of Hafta. I have some suggestions to offer.
1) I was deeply moved by Dr. Rahul’s letter which was read in the Hafta. Though you have invited him to write an article on the issue, I feel it will be more practical if you could take inputs from. Dr. Rahul (and possibly other doctors) and run a podcast stressing on the issues of healthcare. I feel it will be difficult for a person who is not into journalistic writing to invest their time to come up with an article by himself. The good thing with podcast session is that the consultant (in this case the doctor), need to spend only a fixed quantum of to.e, which i think many will volunteer to. Of course the heavy lifting part goes to you guys, but it’s your call.
2) in Hafta, I find that the current format of yours often lead to detours from the topics that need to discussed. While, the detours often lead to great discussions, sometimes certain topics often won’t get the attention that it demands. But this issue can quite easily be resolved by using simple organising techniques like a checklist. In our panel discussions we allot fixed time slots for each topic. The detours will be logged in the extra time. But, the clocking mechanism nudges you to switch from the detour to next charted topic. With this, if we fixed a 1 hour time slot, we tend to get everything covered in 90 minutes.
3) I find your web site interface (and the app) to be a bit bulky. Additionally, the infinite scroll option seems to be hampering the UX (user experience, just to avoid any misinterpretations ). I find the intrface used by swarajya and newsminute much more appealing. Also a daily/weekly newsletter sent to our email inbox from your site, just like what swarajya does would also be desirable.
Your interview sessions and let’s talk about series is wonderful. The one on Kashmir was really a researched episode. It helped me to think about the issue from different perspectives. Previously, all I have heard about Kashmir was one sided stories. I am currently pursuing my PhD in computer science at IIT Kharagpur. So i don’t think i will be able to fund your NL Sena projects any soon, but I hope you will be able to cover the story on political Killings happening in Kerala. Of course Ms.Deepanjana Pal will be missed.
Hi Madhu/Abhinandan,
I am deeply saddened that the reason for not publishing a doctor story because of lack of reporters.
I am going to give you some context and then you will understand my solution. I used to work for Vedanta Hindustan Zinc. One thing HZL did very well was recruiting upto 150 college graduate every year. We had a team of 25 people who started a Roaster plant (google what it is) of which 16 were college graduates (engineers and BSc’s). We commissioned the Roaster in 3 months and throughout the zinc refinery the ratio of experienced to graduates was roughly the same. We commissioned the zinc smelter, start to finish in 24 months which was a world record at the time.
So you have 6 reporters , get 3 college pass outs under each. Trust me even the economics will work.
An experienced reporter of 10 years will cost you 8-10 lakhs. You could get 3-5 graduates for that price …… 80% of all work is documentation . These kids will be faster than you guys, trust me. All they need is guidance. And more than anything else they won’t have the preconceived notions of an experienced journalist.
There was a lot of talk about why the finance bill did not get the required attention it deserved.
Back when I was in engineering, I had got the opportunity to interview Ashok Mahadevan the then editor of Readers Digest. This was in 2003 when Sallu and Ash hogged the headlines on TOI front page. That was the same time when TOI changed from a proper newspaper to sensationalism. I had asked him about it back then. He gave me this interesting anecdote of USA today. USA Today was in the dilemma of whether the death of the Libyan president or the death of Grace Kelly. All it took the editor to make the decision was a visit to the nearby pub. Everybody was talking about Grace Kelly . The front page next day was …… Grace Kelly. Would the Aam Janta be interested in Romeo squads or the Money Bill. The answer is RoMeo squads for 3 reasons :-
1) They relate to it.
2) They understand it.
3) They don’t need to tickle the grey cells to understand it.
With each passing day, the eye for detail is losing its significance.
I am not suggesting you to go that way. Please don’t even think about it. But the solution to your reporters problem which I elaborated above is a solution. You will be creating the next generation of the dying breed of journalism. Madhu/Abhinandan, think about it long and hard. This will truly be your legacy to take forward. The mindset of people above the age of 35 (actually above 30, I am 33) is very difficult. You will be able to spread the Newslaundry message only with the young and inexperienced.
Anyways all these are just thoughts .
Enjoy!
Best Regards,
Dhiraj