Of Doctors, violence and entrances

"There are only two kinds of doctors. Those who practise wtih their brains, and those who practise with their tongues."- William Osler.

 I am an anesthesiologist. My job is to drug people to unconsciousness, as surgeons cut through muscles and vessels, correcting the diseased process. Most of the days I am happy with the specialty, I have pursued. Being an introvert, I do not find listening and talking to a patient, my forte. My lack of this envious skill is compensated by putting the anxious patients to sleep. As they begin pouring out their avalanche of concerns, sometimes even unnecessarily, I inject medicine into their blood stream numbing their senses to deep slumber. The process is quick and effective antidote to my reticent demeanor. As the patients open their eyes, they are already in the recovery room, under the able care of post anesthesia personnel. The certainty of pharmacology to some extent, helps my poor soft skills. In other words, it is not a grave scenario, if your anesthetist, is not an eloquent person.

But I have often wondered, if the same applies to people pursuing other branches of medicine. What woes would the doctor, who by nature is a "I-like-minding-my-own-business' type face, if his/her discipline demands kindness and empathy out of him/her? Can people who are reserved and calm reach the other end of personality spectrum by the end of medical training? Medicine can be taught but can concern be inculcated? How can people who are not compassionate deal with the demands of their job?

As the process of transition from health care to health industry gathers steam, the focus and onus of present medical education has shifted from making compassionate doctors to academically excellent ones. Excellence is a much needed quality. After all we cannot entrust our lives, in their most vulnerable state, to professionals who are mediocre. But is excellence, the only virtue that makes the greatest of doctors? The common observation among people especially the older generation is,"We used to have great doctors in the past. Now they have become a rarity." But that must not be true. Medicine has progressed in leaps and bounds. Diagnostic techniques have improved. Fatal diseases of the past have been eradicated and the armory of modern drugs is ever expanding. In spite of such advances, why are today's doctors in general being viewed with contempt and disdain compared to their predecessors?

The reason may be that we do not listen anymore. we are too obsessed with meeting deadlines, disposing out-patient charts, sorting out admissions, finishing work ups, finding the diseases, treating, discharging and  educating a society that does not have health as its priorities. We have become slaves of our own schedules. May be in the process of serving, we are all serving without doubt, we have forgotten whom we are serving.

  I thought we as a professional community were OK until, I myself had to see a doctor. One of my very close friends was diagnosed with terminal disease. Me being, medical professional was made his chaperone. The doctor in the chamber was excellent, well read, well versed in latest therapeutic options. He quickly scanned the MRI, explained the diagnosis and coldly declared that nothing could be done. There was an extremely professional etiquette about the whole encounter. In spite of being the best doctor in his field, my friend was not happy with the visit. " Was it about the diagnosis?", I  asked. " it's about the way he said it.", my friend mumbled. My daughter herself was born preterm and had to be in a nursery for a week. My doctors were very considerate and helpful. As we were praying for a quick recovery of our days old kid, all the differentials for neonatal tachypnoea did not make sense. All I longed for was a pat from my physician with a word "its going to be fine".

May be an ordinary Indian is missing those little words dripping with concern and kindness. With governments that offer budgetary allocations that range from insensitive to meager, the facilities in our country are just not adequate to deal with patients and diseases that we encounter. An ordinary citizen thinks, it is the junior doctor at the reception who is at fault when the entire system is rusted and wreaked. Seeking instant justice, they pounce upon us and attack like wild animals.

How do we prevent these incidents from recurring? How do we keep hooligans at bay? How do we regain trust of ordinary Indians that we are acting in their best interests? Uncouth elements can be kept at a distance by beefing up security for short term protection. But how do we deal with this menace in the long run? How do we restore faith on the Indian medical system?

I think it can start with finding the right people to become doctors. By filtering the academic cream, we are producing academically excellent doctors who, as the recent turn of events denote, people are dissatisfied with. We need people who are excellent in caring of which academics is only but a part. Do we need cold, distanced professional doctors or do we need doctors who are good not just at books but also at interactions?

That is why personality profiling is a necessity to make doctors out of youngsters. They have to be observed and seen whether they really have it in them- both at mind and heart to become physicians. Students who secure highest marks by rote learning may not always become the best doctors. The same should apply at post graduate level. The extrovert, the jovial, the verbose, the analytical will be good at community, primary care and medicine. The genre who love kids and beaming with smiles can be good at child health. The patient, the perfection obsessed and the laborious will be good at surgery. The compassionate and the burden bearing will excel in specialties that deal with terminal diseases.

Whether we like it or not, doctors are being trained for the society's needs and it is not the other way round. When right people do the right job, we will herald in an efficient system. Will NEET be able to fit the bill by bringing in the right people to take the Hippocratic Oath? Can we decide a student's ability to make a good doctor by mere examination of 3 hour duration? The only worry is that it is this young brigade to whom we are passing the medical torch. These will be our saviors in the future. These will be the professionals who will prescribe medicines, cut through organs, resuscitate to life, bring in life and declare its end, to us and our kith and kin. It is no ordinary risk we are taking here.