India is no country for doctors

The doctor was in the A-shift—8 am to 2 pm—one day and found a dead man brought before him. The man had been hit by a speeding vehicle and had died before being brought to the hospital. The dead man’s party, a mob of 10-12 men, demanded that the doctor treat him immediately. The doctor examined the badly mangled body and realised that the man was already dead. He tried explaining this to the mob, but they just wouldn’t listen.

They alleged that the man had been brought to the hospital alive and he died because the doctor did nothing. The nurses and ward attendants tried to calm the unruly mob and they demanded that they be given an ambulance to transport their dead man home. This the doctor could do, so he started looking for the ambulance and its driver. And then he realised—the ambulance was not there in the hospital at that time!

There was just one ambulance at that hospital and it had, in the previous shift, been taken to a distant town with a serious patient. The ambulance had not returned. And it was neither the fault of any of the doctors nor of the driver of that ambulance.

But, in a matter of seconds, someone from that rowdy mob had dealt one tight slap on the face of the helpless doctor. After that, someone else from the mob grabbed that doctor’s collar as another blow fell on the doctor’s body.

The ward attendants freed the doctor from the clutches of the mob who took their dead man away, shouting profanities at everyone. Someone in the mob was politically connected—he walked away loudly vowing to fix the hospital and whoever worked there.

The doctor was not grievously injured, but he was certainly scarred. In some corner of his mind, he must have thought, “Is this why I spent nearly a decade studying in a medical college? So that my opinion that a man was already dead before being brought to the hospital would not be accepted? So that I would be slapped and heckled by a mob for no fault of mine?”

The local association of doctors submitted a complaint to the district collector; but their complaint went unheard. The politically-connected man in the mob submitted a complaint to the DC that the doctor on duty had failed to treat their patient, hence causing his death, and had misbehaved with them. The DC issued a show cause notice to the assaulted doctor seeking an explanation. With no one to back him, the assaulted doctor had to submit in writing that whatever happened in the hospital was his fault, that it won’t be repeated, and that he be pardoned.

Treat people who attack doctors as terrorists

A couple months ago, I signed on Change.org a petition that was filed after a doctor at a government medical college in Maharashtra was beaten up mercilessly by the relatives of a patient. The petition says, “Doctors can guarantee best treatment, but doctors cannot guarantee 100% results… There is gross lack of Emergency and Intensive Care facilities in smaller towns and cities alike”, and seeks to have people who attack doctors to be called ‘terrorist-like’ because they are creating terror in the minds of doctor against good work. People assaulting doctors should be punished like terrorists.”

Ours is a country of heroism and glorification of extraordinary—not exemplary—doings. Any person who claims to work 18-20 hours a day apparently for the betterment of the country is immediately hailed as a hero. It never seems to occur to anyone that working 18-20 hours is not human at all, however romantic the notion of working round the clock might seem. And in the case of a doctor—where lives of human beings are concerned—this seemingly heroic feat might actually be counterproductive.

The Indian healthcare system is already among the most counterproductive in the world. India spends merely 1.2% of its GDP on healthcare, has just 0.7 beds per 1,000 people (the WHO recommends 3.5 hospital beds per 1,000 people), and only one doctor is available in India for 1,700 people. One can guess how tired and overworked doctors must be, especially in the government sector.

India is also a country of great expectations. Doctors are treated like God here, but only as long as they do what the ‘Great Indian Public’ expects them to do—cure a dying or even a severely malnourished or anemic patient in a jiffy, agree with the Great Indian Public’s ideas of medical treatment, perform any miracle that the Public expects—no matter how tired, how under-equipped a doctor might be. And when the Public’s wish is not fulfilled, the God-like doctor becomes a villain. It must be one of the greatest paradoxes of our civilisation that, in India, a doctor—considered God just moments ago—is brutally attacked by the common people the moment he fails even for no fault of his.

The Medical Protection Act—aimed to protect doctors and both government hospitals and private hospitals and nursing homes from assault and damage by anyone—has been passed in 18 states in India. But, political considerations and demands that the Act be made more patient-friendly have come in the way of enactment of the law in the other states.

Politics apart, it often makes me wonder if the safety of providers of healthcare and medical care is even a priority in India. When doctors ask for protection and are forced to protest when their grievances are not heard, a court of law says that doctors are not factory workers that they should resort to protests.

Well, a doctor may not be a factory worker, but is certainly as human as a factory worker, as human as any other human being. A country that considers its doctors to be either God or scum—depending upon the circumstances—but not as human beings who are liable to fail and capable of performing only as much as his own capacity and resources would allow him to. Does such a country even deserve its doctors?

Hansda Sowvendra Shekhar is a government medical officer and an author