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Rediff.com  » Getahead » 'But who do we blame? Who do we beat up? Doctors!'

'But who do we blame? Who do we beat up? Doctors!'

Last updated on: March 24, 2017 18:07 IST

Dr Rohan Mhamunkar, a senior doctor at the Dhule Civil Hospital, Maharashtra, was recently assaulted by a patient's (15 to 20) relatives.
Dr Mhamunkar requested the family to shift the patient to another hospital because there was no neurologist at the civil hospital.
This was the third attack on doctors in a week in the state.
4,000 doctors went on a strike demanding security after these incidents.
Maharashtra Association of Resident Doctors President Yashowardhan Kabra told the Indian Express, 'It is difficult to work under such life-threatening conditions.
Condemning the strike, Justice Manjula Chellur, chief justice of the Bombay high court, said in her judgment: 'If you (resident doctors) think you can behave like a factory worker, then you are unfit to be a doctor. It's a shame. How can you say first give us security and then we will work?'
A resident doctor (who understandably wants to remain unnamed), 27, who works at a government hospital in Maharashtra, upset by the poor response from the state government, offers his side of the story to Rediff.com's Divya Nair.

IMAGE: In the wake of recent attacks, doctors in government and municipal hospitals in Maharashtra have gone on strike to demand security at the work place. Photograph: Sahil Salvi

I'm a third year resident doctor working in a government hospital in Maharashtra.

I'm deeply disheartened by the lack of understanding and compassion towards us from the common man and the government.

Dear irate fellow Indian (who has little knowledge of what we doctors undergo in a government hospital) and hospital authorities (who know what's happening but tend to save face by blaming doctors), please spare some time to listen to our side of the story too.

I would like you to know what we undergo to reach this position. Then you can gauge what is driving some of us to give up everything we stand for to fight for what is just and right.

In India, after completing four-and-a-half years of (study towards and passing our) MBBS (medical school) and one year of internship, we take a (gruelling) exam in 19 subjects.

Only about 3,000 to 4,000 students are (chosen and are) privileged to pursue post graduation from (the state's) prestigious government institutions.

But these four-and-a-half years of medical education don't prepare us for the reality.

That there is an indifferent, unreasonable, mob waiting at the other end of it to pounce and punish us for doing our duty. For doing what is right.

The life of a medical student in India, particularly one who chooses to study on merit in a government hospital, is full of risks, sacrifices and selflessness.

Each year, the level of challenges and responsibilities (increase) and put you to test.

It all starts from the day you enter medical college. And no, we don't study for free. We work hard to get through on merit and the struggle has only begun for most of us.

In my first year, I was introduced to housemanship or (what is called) accompany day, which happens every Monday.

On Mondays we accompany the patients, admitted in various ICUs in the hospital, to maybe the dialysis centre, or the MRI, CT scan centre, which might located at a distance from the ICUs.

Our responsibility is to ensure nothing happens to the patient along the way. There are times when I have had to pull the trolleys (stretchers) on my own, handle emergencies all alone along the way, whenever an unexpected situation has demanded so.

No one to help. No one to complain to.

On an average day, I look after the treatment of about 70 patients admitted to the ward I am responsible for.

Next comes Tuesday, (reserved for work) in the out patient department. Four hundred patients gather around me as I reach the OPD at 8 am.

I have to finish my ward work before I come to the OPD.

So basically no sleep, no breakfast and no rest till I clear the OPD duty.

If you have ever visited a government hospital, you would know how the OPD functions.

There is no proper channel, no rules followed, no proper queues maintained, no security, no triage of patients (the process of determining the priority of patients' treatments based on the severity of their condition).

On any given day, you (might) deal with a bunch of miscreants who break rules and queues (citing her/his connections), could be an MLA, a corporator, someone higher up in the hospital administration.

Even if this person is suffering a minor injury, like a pain in his/her little finger, s/he commands treatment on priority basis.

The other patients, waiting their turn, lose their cool and abuse the doctors, disrupting our work.

There is obviously no security to stop them or protect us.

The option of turning down this 'VIP' -- who breaks rules and is the source of the trouble -- would be as good as inviting a warning memo from the administration.

Wednesdays and Saturdays go by in similar fashion.

Thursdays are for emergencies.

The average numbers coming for admission on Thursdays are about 70 to 80 for a bed facility of about 40 to 45 in the wards.

The patients who don't get beds sleep on the floor. They have nowhere else to go to.

Patients and relatives who are irritated by the lack of beds show their fury at us doctors.

Emergency duties go on for as long as 24 hours, without sleep, followed by post-emergencies, during which we are supposed to (enforce) the advice (treatment regimen) of our seniors for the admitted patients (the newly admitted 80 patients plus the earlier 30 to 40).

You think abut it: Forty-eight hours of no sleep and proper food and the responsibility of attending patients with accuracy with no scope for error.

You might have read about doctors working in extreme conditions succumbing to multiple drug resistant TB at these hospitals?

Did I mention that we also have to collect urine bags, stools and vomitus to make up for the lack of nurses or helping staff?

In emergencies, our responsibilities double.

Second year goes on with similar intensity.

A special mention to the emergency/casualty postings here. The beds in casualty are inadequate. The patient numbers are always huge.

The relatives come to visit the patient in herds. They don't heed our instructions, even if it means risking the health of the patient.

This is the place where maximum assaults on doctors occur. There may be a maximum of one security personnel for say 400 to 500 people.

As a doctor I am always in a dilemma. Should I control the incoming crowd of relatives? Or give my 100 percent to my patients.

In third year, we report to our seniors at the hospital.

If there is any time left at all, we prioritise it between finishing our studies, catching up on sleep or having food.

The lack of resources in a government hospital is worth mentioning here.

There is one MRI centre for thousands. Sometimes appointments take months to happen. This is clearly an administrative failure.

But who do we blame? Who do we beat up? Doctors!

How many news reports have you read about resident and junior doctors helping the financially deserving?

Or succumbing to an illness contracted while on duty? Rarely.

The hostel rooms where doctors live should give you some perspective.

There are about six to eight students cramped in a room with rats loitering around. The beds are filled with bed bugs.

There are times when students like me have slept in canteens and side rooms, when empty.

The less I write about the hygiene of the toilets in government hospitals, the better.

On Sundays, sometimes, we are sent on camp duty. During elections, the aim of these medical camps is to supply patients with free medicines.

At the end of all the legwork and tireless hours of service, a local politician enters and takes centrestage.

What do we doctors demand? Not money. Not fame. But security for government property and ourselves.

How do you expect a doctor to work given all the above conditions?

If we are not safe, how do you expect us to serve you?

The incident at Dhule was heinous. The doctor lost an eye because he referred the patient to another centre which had a CT machine and a neurosurgeon for the benefit of the patient as it was not available in the civil hospital.

Is this the doctor's fault?

Security assurances have been given to doctors on paper since last year. There is no implementation by the administration.

This is not a strike. It is a wake up call.

To make people listen to our plight.

Senior doctors have been taking leave fearing for their safety. That leaves us resident doctors. We have no option but to strike and bring attention to the situation.

But that hasn't stopped us doctors from attending to emergency cases.

And how does the administration and government respond? They throw us out of our hostels, reduce water supply and deny basic security.

Do you know the doctor patient ratio in our country? There is one doctor to 2,000 patients.

Yet, instead of improving basic amenities, we continue to force doctors to follow their duties without complaining.

Each time a patient dies due to lack of facilities or administration failure, a doctor's life is at risk.

Divya Nair / Rediff.com