Sunday, May 27, 2012

Doctors are not bad always!

Waiting for the date of joining and hence some engagements to come it’s hard to pass your time sitting just idly at home. Nothing to do and nobody to meet fills you with utter boredom. Being in such a situation where every day is like a Sunday, you tend to forget the importance of a Sunday and then don’t even wait for one. Things are almost similar to me at this very point of time, yet, I was looking for a Sunday today. The reason, well, was Satyamev Jayate, the TV show. The way it has created huge news with its few episodes only, the waiting is actually worth it. Being a fan of Aamir Khan adds to the praise for the show and hence to the waiting too. What actually turned out to be the most interesting was the fact that today’s episode was based on doctors, who have actually, in many ways, commercialized the profession and practice of medicine. Coming from the same profession is what made it the most interesting to me.

The episode was, indeed, apt on the situation that prevails in our profession at this point of time. Many a things that were shown in the show were, more or less, experienced and observed by me at different times. Be it the needless operation of a leg abscess leading to amputation of a toe or the commissions demanded from the pathologists or other fellow practitioners in return for the references or the corruption prevailing in MCI (Medical Council of India) or the overpricing of drugs, everything is too very known to people in my profession and as well as to the general public. These are some of the evils that the profession has adopted as a cost to its commercialization. I am not supporting it. No, only trying to find out where, actually, it came from.

The episode dealt with certain cases where a surgery was performed even without the need of it. The doctor performed that only for the purpose of inflating the hospital bills. No doubt, it happens in our society at such a rate that if really studied, almost 20-25% of all surgeries performed will come out to be needless. In other words every one in four or five surgeries are kind of fake. Shocking, as it may sound, but indeed it is a fact that needs to be stated and needs to be confessed by every person in my profession. Having said all this, one should also remember and notice the fact that each such story in the episode, where there was one ‘commercialized’ version of a doctor, there was one doctor also who was firm in his opinion that what was being done was wrong. My point here is that not all the doctors are from the same league as the ‘commercialized’ one. To every one of them there are, still, tens of ‘true’ doctors in our society. So, the profession as a whole cannot and should not be blamed for this.

The part of the episode that dealt with the issue of dichotomy of fees was the most important issue that the show raised. Indeed, in return for the references that a doctor sends to a radiologists or pathologists for the purpose of investigations and also in return for the referrals that doctor sends to his fellow colleague, the doctor demands a cut, a percentage of the fee. This is a grave situation, no doubt. And this is also not something that people don’t know. They, the public, know it. We, the doctors, know it. This is something like bribery that is ruining the whole system of the country. Nothing much can be done to get free from this evil, except for raising the awareness. Nobody can clear the conscience of the whole society, it can only be done by clearing own conscience and that’s what is needed here. We have to have a firm conviction that we are not going to indulge in such practice. Raising our morality and changing the mentality to pureness is what we require to do. This is one of the simplest ways of how we can lower the monetary burden of the poor patients and we, the professionals, must come forward for this.

The issue of the MCI is not only an issue, it’s a scandal, maybe, a bigger scandal than the 2G spectrum or the Commonwealth Games scandal. But on this very issue these are not the doctors that are to be blamed. The main perpetrators of this scandal are the education mafias of our country who are running the various private medical colleges. They offer bribe to the MCI officials, they pay the doctors to pretend to be their faculty members and in return get the recognition to run the courses in their college. This is similar to anything and everything that, more or less, is running in all the sectors. It’s not only the matter of health sector and hence, should not be taken as particularly against doctors as taken in the show. The project manager of a dam in construction receives bribe from the contractors, the police department gets their cut from the ransom money of kidnappings, the DM has his/her share from all the relief funds. All these things are one and the same. Being rich in no time is the basic idea behind all of it and hence the MCI issue also should not be taken as a different issue, afterall, doctors are also human beings like the engineers, or the police officers, or the DM.

Lastly, the drug overpricing issue. The episode blames the doctors that they don’t prescribe the generic medicine that come as much as ten times cheaper than the branded medicine that they do prescribe. The show took an example from the state of Rajasthan where these generic medicine are being used. Maybe, the Satyamev Jayate team was a little short on its research on this. We in Bihar too have been distributing these generic drugs at all the government hospitals for over 5-6 years now. As far as our experience goes here (of the last 5-6 years of this and even before as I come from a family full of doctors), these generic drugs are not as effective as the branded ones. A same company manufactures both a generic and a branded version of the same molecule and the price range is completely different on them. The generic drugs, maybe due to government regulations, have to be cheaper and hence, maybe this is the fact why the companies don’t manufacture it with the same intent that they do with the branded ones. The generics are known for their ineffectiveness in treating a patient and I, as a doctor, would never prefer something that I have experienced ineffectiveness of to treat my patient even if it comes free to them. But then, the drug overpricing is a real problem that should be dealt strongly with. Maybe, a stronger regulation of taxes and price of the drugs from the government is what is needed the most.

In the end, I must here reiterate the fact that not all of us doctors are the business tycoons that the society has now started to think us like. I admit that there are some people who are doing things that should not be done but then they only make a small percentage of the whole population. Everyone of us doctors want to treat poor patients free of cost but then most of our patients are these poor ones so how would we get our living from them. The amount of time and labour that we put in the rigorous studies before becoming a successful practitioner is not only for getting to be known as the ‘god on earth’. We don’t want to become one. We want to be human beings only. We want to use our skills that we acquire with so much of pain and labour in helping others but then we have stomachs of our own and our families too that need to be filled. Doctor as a profession has been the most respectable profession ever in our society and it will remain to be one. The onus is now on us ourselves to make it as respectable as it ever was.


Friday, May 25, 2012

To Kill a Mockingbird

Being an Indian and being a movie buff, I have already seen a lot of movies that have been adapted from many other works of art. Mostly they have been (without any reference) taken from a foreign film and hence the use of the word stolen instead of adapted won't be much wrong. However, having said that, there have been quite too many indian movies that have taken a prior work of art as their bases and with due respect and reference too. Movies like Guide (from R.K. Narayan's novel of same name), Devdas and Parineeta (both from Sharat Chandra Chatterjee's novels of same name), Bees Saal Baad (from Sir Arthur Conan Doyle's The Hound Of Baskervilles) and a whole lot of other well known hindi movies are amongst them.
Having said all this about the hindi movies, there have been a whole lot of movies in the foreign language that are based on some literary works. With me not having a habit of reading much, most of these movies (as well as the hindi ones) were seen by me before having read the novel or the story. Contrary to the normal course of action that most people follow, I have always drawn parallels in a novel from the film that is based on that novel. Comparing the novel with the film already seen, observing the differences that the scriptwriter has made in his adaptation, and then quantifying and then balancing the impact left by the novel as well as the movie is what I usually did. The difference from most of the people being the fact that they do this with the novel as their baseline whereas I used to do this as the movie as the baseline. After doing too much of this 'reverse' thing, I finally got to watch a movie that was based on a novel that I already had read. 'To kill a mockingbird.'
The Harper Lee's novel is about the neighbourhood experiences of a young girl from an imaginary city of Maycomb in Alabama. The story deals with the issues like racism and rape and the reaction of the small neighbourhood to these happenings. Despite having such bold issues as the backdrop, the story, having written from the point of view of a young girl, never leaves its tone that for the most time of it is calm.
The girl's father, Atticus Finch, a lawyer, is defending a black man, Tom Robinson, from the allegations of rape of a white lady. The white people of the society are opposing Atticus' this action but he stands firm with his principles and presents to the court of law a case where clearly the alleged is not the convict. The jury, all consisting of white members, still, pronounces Tom as guilty. Surprisingly, no one is surprised. The whites laugh at Atticus for taking a case he knew he was to lose and the balcks applaud Atticus for atleast trying. They all knew the result of the case, the whites, the blacks as well as Atticus Finch except for the young girl and her older brother. They could not understand the jury's decision. They stand by the side of their father all through this and believe in him and hence are shattered when he loses the case and thats how they start to see the ugliness of the society they live in. Despite all this, Atticus, a wonderful father that he is, manages to keep the innocence of the children. He talks to them, tells them the truth about everything, passes on to them his own principles and really lives like friends to them.
The character of Atticus Finch has been one of the most influential characters that has left some impact on its reader. A model for the lawyers for his principles, he has been a model father that every child would like to have and on the other hand, every father would like to become to his children. The novel was first published in 1960 and went on to become the international bestseller and also won the Pulitzer Prize. The movie adaptation was released in 1962 directed by Robert Mulligan having Gregory Peck in the role of Atticus Finch. The movie is an able match to the beauty of the novel and there must be only a few examples where both the novel and the movie adaptation are as wonderful and acclaimed as this one.
Being one of the very first novels that I completed reading, I was much happy with it. And then having got the opportunity to watch the movie so soon after added an extra curve to my smile. And also reading the novel before watching the movie, being a new experience to me, was too wonderful to explain. Surely, this is a practice that I definitely want to acquire in me and hope that I continue reading and then also watching the movies.