Myths and facts about ICU ventilator: small boat in sea storm


 

 Some one who is drowning, a small boat can  save his life, till sea storm settles or the victim reaches a safe land. The boat will not settle the sea storm, but enough to save a person from catastrophe. In reality, ventilator is the invention, which should be worshiped. But contrarily, due to wrong projections and misguided perceptions, it has been hated despite saving lives.

     Although doctors and ventilators are in a similar situation, projected in a wrong way,  hated in spite of doing good work and saving lives. They are hated and despised, despite the only ones of help in life and death situations. Following are few myths and fact about ventilator.

  1. Myth : Once on ventilator, patients do not survive: common myth is that  once the patient is placed on ventilator, he will not survive.  Human body,  when  gets severely  diseased or  under stress, heart and lungs need to be supported for saving the life, till ailment    So, when the battle for saving live is ongoing, almost all the patients will have to be placed on the ventilator. It is a last ditch attempt made to save the patient’s life. However when the patients do not survive people feel that it’s the ventilator which has caused death, rather than a rational thought about severe disease as a cause.

             In reality, it is the severity of disease and possibility of death, when ventilator is required. It is necessary to support life.

  1. Myth : Ventilator is a modality for mere prolongation of life: every disease has a spectrum. Every disease can progress  from a reversible  to irreversible state. As an effort is ongoing while waiting to reverse the process, the patient will need  ventilator to sustain life. Unless the disease reaches a stage of  irreversibility,  ventilator is indispensible  for an  absolute need to maintain life. Since in serious condition, it is an uncertain prognosis.  In retrospect, combined with application of an average wisdom, the time of uncertainty and institution of ventilator   can be  interpreted  as a mistake.  As the whole exercise is labeled as futile and expensive by relatives.   it’s a grey area and the  negative thoughts are fuelled because of retrospective wisdom in hindsight.  The real prognosis can not be predicted in real time.

In reality, Ventilator is a machine which just  supports respiration and not  responsible for  heart beating. Therefore it   buys time for healing and treatment of primary disease.

  1. Myth : Ventilator will cause death:

one can understand this simple logic on the basis that patients are placed on dialysis when kidneys fail. Patients are placed in cast when bones are fractured for a fixed predefined period of time. Similarly patient is placed on ventilator when lungs fail. Ventilator is used till the time  lungs recover and become fully functional.

                        In reality; Risk is because of disease, which needs ventilator and not vice versa. Ventilator is a friendly machine which helps people who have failed lungs.

  1. Myth : Doctors and hospitals keep dead patients on ventilator for financial gains

Fact:  placing patient on ventilator is a very critical decision, taken in best interest of patient to buy time, to so as to treat the disease.  A patient needing on ventilator is actually so sick, that not  instituting ventilator will risk the patient’s life. Knowing all these facts, doctors take a decision to keep the patients on ventilator.

         As once the patient is on ventilator,  it is a stress for the doctor to take the patient off the ventilator. As such ventilator is a SANCTUM SANCTORUM life saving machine,  to be used only in life and death situations.

 

  1. Myth : Its miracle if the patient placed on ventilator survives.

Given the fact that placing the patient on ventilator on scientific facts. There are clear indications  for putting the patient on ventilator.   A much larger patients put on ventilator are actually saved and go home.

Fact:  Everyday thousands of patients are placed on ventilator and sent home to lead a normal life: Any patient who is given general anesthesia is placed on ventilator in the operation theater and then taken off the ventilator at the end of the surgery. In these cases patients are placed on ventilator so as patient can be put to deep sleep (called anesthesia) during which surgery on desired part can be carried out. Soon after the surgery patient are taken off the ventilator and soon thereafter discharged for home after few days of healing.

 

  1. Myth :Doctors place patients on ventilator at their own will:

Fact:   there are scientific parameters which decide when the patient should be placed on the ventilator and when the patient should be taken off the ventilator. So the decision to place the patient is scientific and based on objective parameters.

  Contrary to this popular myth, it is a compulsion for the doctor to put patient on ventilator to prevent death in serious situations.  Doctors are usually thinking several steps ahead of lay person about medical science.

  1. Myth :All patients placed on ventilator are unconscious:

 

Fact: this is not necessary. Usually patients are sedated  for their comfort.  they can be made to walk, write and even perform small tasks when on ventilator, depending upon their lung condition.

  Patients are also put on ventilator in case of airway failure when unable to protect their airway for various reasons. Another reason why patients are placed on ventilator is inability of the patients to protect his or her airway. Conscious and alert patients can swallow normally formed mouth secretions.  When patients consciousness level is dulled the ability of the patient to protect his airway is lost or compromised. This causes secretions from mouth to enter into the lungs trough the airway i.e. trachea causing infections in the lungs. The only way to prevent this and protect the patient’s lungs is to place a tube in his airway and then place them on the ventilator.

 

  1. Myth: Patients can be kept alive by placing on the ventilator:

General masses  have a feeling that patient can be kept alive by keeping them on the ventilator. Even  a dead person can be kept alive by placing on the ventilator, which is not true.

In reality:  It is machine used only for breathing and not heart and brain.

  1. Myth : Ventilating the dead patients:

    this is a common allegation on medical profession.  This is no truth in this projected and perceived hearsay.

       Facts: Assumptions are based on thoughts of lay persons. Patients on ventilator, may look like dead, because of the disease, sedation and paralyzed by drugs. But their heart and brain are working, so they can not be declared dead.

    If there is some incident, it  needs to be proved by medical personnel. In reality, it can  be a very rare and remote  exception. These untrue projection are creating lots of mistrust about life saving machine.

The problem is about correct projection and  majority of people without  knowledge of medical science  do not  even  know the large  number of lives  been saved by the ventilators.

In nutshell: serious conditions  and life threatening situations need higher technical interventions, to save a life. If correct projections are made, ventilators are life saving machines.

About ventilator

History of ventilator

Pay millions to be a doctor?: welcome to “ring on fire” #NEET


Being a doctor has become a disadvantage in itself, thanks to our media and celebrities projecting the saviors  in bad light. They are now seen as harbingers of death. Morale of doctors has been at rock bottom and community is devastated.  A society that believes more in fairy tales told by “Reel heroes” has turned prejudiced and preposterous towards “Real  heroes”.  The medical profession reeks of desperation and desolation with apathy from government, indifference from courts and silence of human right commission to salvage them from decrepit state. At the best, they have been reduced to punching bags and scape-goats for inept medical systems or cheap labour to industry.

Problems faced by doctors are not only innumerable but are also so exceedingly complex and diverse that they are difficult to be analysed. It is common to listen doctors discussing these problems whenever one of these crop up. If so many doctors feel so disgusted about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession. The challenges in this profession are too many and difficult to analyse.
  1.     Medical courses are Comparatively lengthy and expansive study course and difficult training with slave like duties: that I have discussed in one of my previous article on “enslavement of doctors”.
  2. Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialize. Because of lesser seats in post graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice. They have to just flow with system ultimately.
 3. Hostile environment for doctors to begin: Suddenly young, meritorious and bright children who came out of training find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and prejudiced  beliefs of society.

  1. Difficult start of career of doctors: After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and half treats them as cheats and dishonest. Their work is seen with suspicion and often criticized.
    5.The fear and anxiety about the actual treatment,  favorable and unfavorable prognosis of patient, keeps mind of a doctor occupied.
    6. Doctors are blamed for all malaise:The society gets biased because of the media reports and some celebrity talking glib without proper understanding of inept medical system , administrative failure and complexity of medical industry.  These lead to formation of generalized sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
    7.Doctor’s personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
    8.Risk to doctor himself:     Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include tuberculosis and other bacterial and viral illnesses. Radiologists and interventionists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.  21 risks to doctor and nurses
    9.Unrealistic expectations of society: Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative  is enough to spoil the mood for the day.

10.Retrospective analysis of doctor’s every action continues all the life-It could be by patients and relatives every day in the form of “ Why this was not done before” ? Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. Unfortunately, if there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.
In these court cases, the doctor is at disadvantage since his decision which is now being questioned was taken at that time in good faith using all his wisdom. The decision in retrospect may not turn out to be the best one, but later retrospective analysis along with wisdom of hindsight over many years, may label it as faulty if a fault-finding approach is used. This along with general sentiment and sympathy with sufferer makes medical profession a sitting duck for punishments and lawsuits. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation will be full and almost permanent. No doctor has time to pursue such things all the time. Even if such events don’t happen to everyone, the very fear of such possible scenarios and their possible complications always lurks in the back of their mind.
11. Physical assault , routine instances of verbal abuse and threat  happen for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. The threat of physical assault is quite real as well. Recently, even female doctors have not been spared by mobs. Silence of prominent social people, celebrities and society icons on this issue is a pointer towards increasingly uncivilized mindset of society.  Even female doctors  are being assaulted.
12. Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community, is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.
13. Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: I have seen zero fee and fixed commission ads on television by lawyers in health systems in certain developed countries. They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations. This encouragement and instigation of lawsuit against doctors is a major disadvantage for medical profession.

14.Overall, a complex scenario for doctors: There is increasing discontentment among doctors because of this complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients. They are also supposed to maintain meticulous documentation and also supposed to work under norms of medical industry. They are supposed to see disproportionately large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, who use pressure tactics to get their own way.

With so many adversaries, the situation is like sailing a small boat in a tornado.
At present, with this mind-set, the losers are the doctors and medical profession. But the society should be able to foresee its overall loss in the long run if these practices continue.

 

Burden of Mistrust: A Curse generated by media for medical profession


Every news item presented on TV about medical profession creates an anxiety in minds of doctors. As almost always, these  are  cooked for media business to  create sensations. Medical profession can not fight with media power and remains  at receiving end always.  Painful burden of mistrust against them grows further.

News article or TV programs are created so convincing  and so capable of  sway public opinion against  doctors. while the fears in the minds of patients  is not without basis, but risk to life of patient does not really comes from doctors, but it is from mistrust generated from inexorable creep  of media into our lives.

Even the most enlightened humans have biases. Media by negative publicity enhances and multiplies negative bias and propagates mistrust, beyond reasonable limits. These negative and uncertain prejudiced feeling in the mind of patients is difficult to identified , and more difficult to correct and treat .

Prejudice against doctors 

While the news being aired, gave an impression like a judgment  is passed, which is unable to take into account, the large good work being done by the medical community at large. As if the treatment done and life saved every minute is of no consequence.  Such judgments are not based on any objective measurable data, and therefore they are highly susceptible to human biases. Unfortunately, a vicious cycle of mistrust and misfortune and more bias is created and   there is no circuit breaker or any assessment of the  mistrust thus  promoted, whether it was good for society  or  patients. It can be at the best a late or remote  afterthought by few wise ones.

Growing awareness about risk of medical interventions or its limitations, has not slowed the rapid ingestion of toxic negativity into the fabric of society. We are living in times, where media  tends to influence what people see, hear, feel and buy. Spread of negative news rapidly spreading into nooks and crannies of minds of masses, but in the guise of magical optimization of medical profession and treatment. Masses rely on the one example presented before them, without knowing it was one of millions, a rarity rather than routine, without factoring in the biases and problems underlying that one patient. In majority of such cases, biases are hidden, hindsight analysis are baked, submerged and woven into an emotional fabric that is wrapped around  business under the banner of  better medical services optimization.

These  sensational news, promoting mistrust against medical profession,  if unchecked will put lives of patient more at risk than real benefit to society. People will suffer because of  a relationship of mistrust with doctors, will refrain from seeking treatment. But still no one will know that it is  “a curse  generated by media”.

Silence of  REEL Heroes: #Aamir-Khan, when REAL Heroes  #doctor/nurses are thrashed #NRS-Hospital


                    When  examples of stray incidents were portrayed as general phenomenon on television and a great mistrust was created, the existing gap further  widened between  doctor – patient, the REEL hero #Aamir-khan got a great applause. Society believed  and trusted  the stars, who entertained , enacted stories and danced to make them happy, keeping them entertained. Masses believed easily, what  Reel hero, while entertaining  told them and not trusted the doctor, who was awake at nights to save their  lives. REEL heroes earned name,  fame and money  by unilateral poor projection of doctors in filmy stories, right or wrong or just stray incidents. Larger good work and hard work of doctors was of no consideration. Sad  era for medical profession, where reel heroes, who merely act are trusted more than real doers. Now when doctors are being nearly killed, just because  for being on the bedside of patients, the silence of REEL Heroes,  proves the  hollow applause, they have generated for themselves.

 NRS hospital 

Reblogged: #Soldier/Nurse/doctor vs Filmy superstar: Reel Heroes or Real Heroes. what does the   society Need/desire/deserve?

The old adage  “All that glitters is not Gold” is particularly relevant  in current era of media domination where media  projection shapes the perception and may defy  the  reality.  Media has dominated our lives and can sway the  opinion formation of masses.  Written media, television, social media  can collectively influence the mass opinion.

Society, in general, needs to be wise  enough  to realize the importance   of  getting  rid of  these blinders in  real life . One such factor that causes an illusional mist in the  thoughts of masses is projection in films. They create a mirage of illusional glitter wherein  there is blurring of real life from the reel life of heroes. The larger-than-life unreal persona of the celebrities on screen looks too charming and sometimes becomes undeniable and dominates mind of masses. The super-human characters played out in films appear to be real. The problem arises when the imaginary characters of the reel life stories are emulated in real life. Individuals as projected character fill in  peoples’ imagination and are perceived as real and   becomes ingrained in mind. The naivety of masses to perceive the projected character as real one  goes beyond a reasonable thought process and imagination. 

These roles played in films are  not  really act of   inspiration  in real life  as  the actual purpose accomplished in the end of a movie  is entertainment of society and business for themselves. A recent  candid  admission  by the actor # Mr-Irrfan-Khan  that film stars should  not be role models  was impressive (Hindustan times) .

   At the best, a particular projected character  (and  not individual acting star) may be a  role model. An actor or super star, is simply doing his work of “acting” in  the end. This work of acting may bring an entertainment of few hours at the most.

One  cannot stray away from the wisdom to  choose between what we consume merely for our entertainment and  what we believe or face in real life. One needs to differentiate between rationale truth behind the celebrity gimmicks in the media and exaggerated sensationalism. Sensation created merely for a commercial successful venture should not be allowed to overpower the judgments of real life.

But the problem starts, when these false perceptions created merely   by a projected  glimmer    takes the shimmer  away from the real worthy. The real  professionals and people who are worthy of glory become invisible behind  the glittery mist, a haze, which is unreal and unhelpful in real life.

   A  soldier contributes to our society much more in real terms. Even a junior doctor saves many lives in a  day in emergencies as compared to work of a superstar in films.  A teacher, nurse or scientist have contribution which is more fruitful to our generation. Also the scientists, who contribute immensely and bring about the  real change in our lives. Their contribution is huge to our society and much more than doing just acting on screen. The reel actor merely imitates the real life lived and actual work done by real heroes like soldier, doctor or teacher. Someone who only acts and  behaves like one, is respected and paid thousand times or more than the real one. In reality, people need  more than mere entertainment and reel role models and actors in their real lives.

 

Compare the trivial  amount of  remuneration, fame  and respect the real worker  gets  as compared to the film stars, who merely imitate their actions. Reel projection for purpose  of entertainment is more easier to enact and more profitable  than actual performance  in real life.  It is easier to become a reel hero, as it requires little hard work or just connections to get an opportunity.  Some one can be a reel hero just  by  dynastic factor  easily. Hard work is definitely required but that may or may not be prerequisite.

 

Even good films  may raise some social problem, which everyone knows already and offer no practical solution in reality. Therefore what good it brings to the public, beyond entertainment, is any body’s guess. The persona, actors usually  project on screen, may actually be far from his or her real personality. In most of cases, what he does in movies and reel life, is actually away from  possibility of real life . But strangely in present era, people lose sight of what is mere perception. It is clearly a story, tale, a drama, a myth and is not the real identity of the people, we see on-screen.

 

 

In present era, real contributions by people, who are saviours of human life and  the real heroes, remain unappreciated. People are so besotted by  fame and money that they fail to appreciate the sacrifices made by real heroes. Filmy super hero  just imitates  a doctor, soldier,  dacoit or a street hooligan and just pretends to be one on the screen.

But there are  real life heroes that exist around us. Doctors awake at night saving lives every minute or soldier in freezing cold are worthy  of more respect and are real heroes.  And it is up to the society  to look beyond the superficial and reel story, and focus on the real life actors. There has to be an true effort to make, respect and appreciate  real heroes.

Point to  ponder  is that whether society needs people  just  acting  ke   doctors,  soldiers  and not the  actual and real ones, who saves lives. Does Society need  only  entertainment, because respect  which is paid to someone who is  just  an   actor, is  not extended to real doctors, soldiers or other altruistic professions.

 A reel hero who acts like a soldier, is famous  and richer and than the  actual soldier, who dies unnamed and in penury.   Children of today’s times will strive  to become, who is worshiped and paid respect  by society and  therefore will prefer  to become reel heroes.

 

A  society truly needs the real people, who work and act for them, more than just entertainment. It will need total change in attitude of people to deconstruct the perceptions, which are based on mere projections and are away from reality.

It is time to recreate and worship real heroes, who have become invisible behind the glittery mist.

Society needs to envisage the bigger real picture, and should not be mistaken for another projected story.                          

The perception of the projection will decide, what does the   society actually  need- or desire-or deserve , “Reel Heroes or Real Heroes”.

Blatant cruelty & #oppression-of-doctors: Re-entering Hammurabi Era (1750BC)


Every doctor knows that some thing is really wrong happening against the profession.  Not only every day minor irritants but there  are recurring episodes of blatant cruelty against doctors. The whole profession is being criticized openly in the garb of stray incidences or in cases of genuine poor prognosis. Each and every doctors  wants  to react.  But no one knows  really “ how to do it”. There is scant  unity  amid this chaotic problem. The community has been broken  and pushed to behave as single suffering   individuals. whatever way  they choose to react ,  the slightest reaction may  invite the ire of many unknown people, may be mighty and revengeful.  

          By showing cruelty and being revengeful towards doctors , our society is in a way re-entering the realm of an ancient medical regulatory  system, Hammurabi Era (1750BC). Certain aggrieved health care consumers may welcome a move toward harsh penalties in the name of justice and simply for revenge but we need to keep in mind the  poor outcomes in complex diseases, limitation of science and of course the idiosyncrasies of the human body.  Fear factors and  Impact  of present legal complexities,  on doctors  is  already on a par with that of  Hammurabi  era.

Then why  doctors  be  made a punching bag for venting out emotions of the bereaved relatives. Nothing and really nothing can justify this barbaric act. Emotions should not be allowed to take such a demonic form.

This is simply jungle raj, goonism and  expression of a most  uncivilized kind of society, which simply cannot be excused by any sort of reasoning. The incident is being  protested by the professional bodies as is the routine and after few day things normalized for everybody else except that terrorized doctor .  

If the courts, the commission for women’s rights, and the human rights commission are maintaining silence, is it because the rights of doctors were never clearly defined and outlined.  The duties of a doctor have always been enumerated but the rights have never been discussed.

           Human rights of doctor and medical community have been grossly violated by physical assaults. It is painful to see that the authorities that are supposed to take action have maintained a silence all these years about this issue.

What is role of human rights commission, if rights of a hard working community like doctors are violated and what is it supposed to do? I really fail to understand what else will it take to shake them out of their stupor ?

NRS Hospital Violence

Hammurabi era

female doctor assault

#Choosing-to-be-doctor in lawless society: A self inflicted disaster #uncivilized-society #Govt-apathy


There is increasing discontentment among doctors because of  present complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients.  They are also supposed to maintain meticulous documentation and also supposed to work under norms of  medical industry. They are supposed to see large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, who use pressure tactics to get their own way.

Enslavement of doctors

NRS Hospital doctor assault

Young doctors  complete  training and find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They  face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.

       They face physical assault , routine instances of verbal abuse and threat for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. The threat of physical assault is quite real as well.  Even female doctors have not been spared by mobs. Silence of prominent social people, celebrities, human right commission  and society icons on this issue is a pointer towards increasingly uncivilized mind set of society. 

Being revengeful against doctor is very easy. They have become sitting ducks for revenge. Verbal abuse, physical harm, legal remedies, disciplinary actions, punishments, social mudslinging, court cases and legal harassment are common remedies easily available. In absence of support, lack of law and order enforcement, physical assaults and even murder is also not a distant possibility. Here it was just a treatment failure or may be a poor response to treatment, which resulted in killing of doctor’s family. If trying to treat some one can result in harm to one self, why should the doctors will choose to treat. More over why should one become a doctor at all. Such incidents of extreme violence are not merely disaster for a family, but  are warning signs to whole of profession.

     Many in such unfortunate situations must have a thought in mind “ why should one become a doctor  and serve an uncivilized society?”

 

Deadly doctor assault at #NRS-Hospital-Kolkata: doctors- save yourself


The condition of the intern, who was admitted to a hospital, was stated to be critical . After Death of Patient, Relatives Clash With Junior Doctors in  #NRS-Hospital-Kolkata-west-bengal Hospital Over ‘Negligence’

An intern was injured in the clash and regular services at Nil Ratan Sircar Medical College and Hospital were disrupted as clashes broke out over the death of a 75-year-old patient.

        Unwillingness or failure of government to prevent such attacks on doctors will have deep ramifications on future of medical profession. Silence of authorities, human right commission is really appalling.  Role of doctor associations, parent institutes have been spineless and not encouraging.  Media, celebrities, film stars in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable, where stray incidents were portrayed as normal routine just to earn money and fame. Ultimately doctors have been left to fend for themselves individually or with friend groups. 

Kolkata: A clash erupted between junior doctors and relatives of a patient at a state-run hospital here late Monday night after the 75-year-old died due to alleged negligence, police said Tuesday. An intern was injured in the clash and regular services at Nil Ratan Sircar Medical College and Hospital were disrupted as the junior doctors began a sit-in, demanding better security, they said.  Family members of Mohammed Shahid, a resident of Tangra, allegedly assaulted some junior doctors at around 11 pm last night after he died. As a result, a clash broke out, virtually turning the hospital premises into a battleground, the police said. Shahid’s family members were also angry over a delay in handing over his body, they added.

A large team of police personnel from Entally police station intervened and restored to lathicharge to bring the situation under control, a senior Kolkata Police officer said. More than 50 doctors shut the gates of the medical institution and began a sit-in on Monday night, demanding “protection”, the police said. The condition of the intern, who was admitted to a hospital, was stated to be critical, they said. Services at the hospital, including the emergency services, were affected on Tuesday as the junior doctors’ continued their protest.
West Bengal Medical Education Department director, Dr Pradip Kumar Mitra, visited the hospital and tried to persuade the doctors to withdraw their protest, but in vain.


    Empathy, sympathy, compassion and trust  of the doctor towards the patient, will definitely get a hit after these incidents. Everyday  the news of assaults on doctors, court cases against doctors, negative projection of the medical profession   in the media are viewed  by doctor’s community anxiously. Recent senseless attack  on doctor  at NRS Hospital Kolkata again a warning to children, who wish to be doctors.

      Merely taking some token  action and showing  protest will not solve the problem. It does not compensate for the  damage done to medical profession. Sympathy, compassion and trust of the doctors towards patients will definitely reduce. Who will be  the ultimate sufferer, does not need a Einstein brain to predict.

                    This insecurity or fear of the uncertainty tends to affect the thinking process of doctors and the way they practice medicine or deal with the patients. Many will like to be defensive in practice, or try not to treat very sick patients.  Why would someone try complex surgeries with risk involved? Few will limit themselves to follow protocols. Going extra mile with risk, which not everyone will like to take. Many will become health managers or  do something else than do active clinical work. Who should risk his life while doing routine work?

     Patients might get their revenge for the  naturally occurring disease, but they will lose compassion and trust of doctors in the long run. If that is the way to impart justice in this era, doctors will have to find some way to save themselves.

 

#Doctor-wife-killed-by patient #Warning to Doctor/medical profession- becoming a victim of easy revenge


Any patient who visits hospital carries a static or progressive risk of death, howsoever little his illness looks to be . A genuinely poor prognosis or progression of disease or routine complication can cause or result in death. But by application of average wisdom of the people who do not have an idea about complexity of medical field, can easily blame doctors. So doctor even when doing his best is at risk of revenge or harm from public as well as authorities. A fundamental question about such situations will come to doctor’s mind naturally. What happens when doing some good work by our self causes harm to ourselves? Here you are trying to save some one. It is a happy situation for him if you are successful. But due to some reason patient dies or there is poor outcome. He has all the rights to harm you in more than one way. What if he happens to be a powerful person, a VIP, criminal or a goon. What if he becomes revengeful towards you. Doctor will turn into an object of revenge. Money a doctor receives in “what so ever risky situations” or even for saving a life is peanut. But if patient decides to sue him, court may ask to pay something , doctor may not earn in his life time. Or in extreme cases physical violence and even killing the doctors is also some thing which is not unheard off and is on the rise. And this process can happen any minute, any day and continues for years till he continues to work the whole life. Even single mistake in entire career, that too unintentional is enough to cost name, fame or even life. Even it may not be a mistake, or just be a naturally poor prognostic disease, which can be interpreted as an error easily. For people who do not treat patients, how so ever learned they may be, are unable to recognize the difference between the negligence or genuinely poor prognosis. Thanks to media and our celebrities, who have created a doctor- patient mistrust for their own populist gains. An impression is being created, as the poor outcome is because of doctor’s mistake by selective projection in a certain manner.

not-satisfied-with-treatment-man-kills-doctor-s-wife Irritated that a doctor, who wasn’t able to cure his itch for six months, was away in Delhi, an Indore man stabbed to death the doctor’s wife and injured her son. According to the police, the incident happened at the clinic of Dr Ramakrishna Verma in the Malwa Mills area of Indore, on Thursday morning. The doctor ran his practice from home. Tukoganj city superintendent of police (CSP), BPS Parihar said, “The accused Rafiq Rasheed (45) was suffering from an itchy skin disease for which he was getting treatment from Dr Ramkrishna . Verma for the past six months, but without any results. When he went to the clinic at about 11 a.m, Verma’s wife Lata informed him that her husband was in Delhi. This apparently angered Rafiq who got into an altercation with Lata (50) and stabbed her repeatedly with a knife he was carrying. As Lata screamed for help, her son Abhishekh (19) came out and Rafiq stabbed him too and ran away. However, some people who came hearing the screams managed to nab Rafiq and handed him over to the police.” The locals took both mother and son to a nearby private hospital where Lata was declared brought dead. Abhishekh’s condition is said to be critical, police said.

Being revengeful against doctor is very easy. They have become sitting ducks for revenge. Verbal abuse, physical harm, legal remedies, disciplinary actions, punishments, social mudslinging, court cases and legal harassment are common remedies easily available. In absence of support, lack of law and order enforcement, physical assaults and even murder is also not a distant possibility. Here it was just a treatment failure or may be a poor response to treatment, which resulted in killing of doctor’s family. If trying to treat some one can result in harm to one self, why should the doctors will choose to treat. More over why should one become a doctor at all. Such incidents of extreme violence are not merely disaster for a family, but they are warning signs to whole of profession.

Many in such unfortunate situations must have a thought in mind “ why should one become a doctor and treat patients?”

“Dog lover” but lack love towards human child? #straydogs #Rabies #dogbite #infections


In a very recent incident, while out  for a routine morning walk in a Delhi park, I was suddenly jolted by violent barking sounds of dogs. The loud barking sounds were intermixed with cries of a child. I just saw the child running and screaming  for his life. Two stray  dogs were near him,  trying to hunt  him as a prey. As they got nearer to him, I somehow managed to get some stick from a plant and managed to save the child and shoo away the dogs. The nine year old child just clung to me, almost pale, dizzy and his eyes closed with fear. His football was in his lap, which he was trying to use as shield. A shield which society, government, courts and so called “dog-lovers” failed to provide. This child must be the life for his parents and could have been in a great trouble that day because of apathy of few “Animal Lovers”. For whom animal love is like a hobby to be projected for hollow public applause. I looked around, a gentleman was comfortably sitting  with his small dog and reading newspaper. He did not even bother to look at what was happening. He was the person, who used to feed these stray dogs and claimed himself to be a “Dog lover”.  He was totally unperturbed by the fact that a child was about to lose his life because of these wolf like dogs roaming freely. Fed by him, the stray dogs were like friends to him and used to attack others who did not feed them, or were new or  oblivious to the danger. What was bothering was his apathy to the child and victims  and the fact that he continued to feed that violent stray, unperturbed during  the incident.  Similar apathy has been displayed by government and courts with a result that thousand suffer from dog bite every day.

Is it not hypocritical that you care for a violent stray who is a threat to the society? Problem is not about loving and feeding dogs, but simultaneous apathy towards safety of humans.  Such dog lovers most of the time, totally ignore the fact that these dogs are a threat to children and older people. An immediate  sense of hatred towards such dog lovers is a consequence and  a natural thought.

Apart from the injury part, Rabies is a disease spread by dog bite, which is not treatable. Getting anti-Rabies serum becomes another Herculean task.

Courts have also upheld animal rights. That is right  but they did not formulate  policies to ensure guard safety of  humans from these violent strays.

           Government has not made out any policy to safeguard public from such attacks nor have courts come up with any solid guidelines, which can save public, children, women and older people from such bites.

Animal lovers  while pretending  of “dog love” have  formed NGOs and have  donations and accumulate money. But have failed to create shelters for stray dogs. Neither have any steps been taken to save people from dog bites. So consequently, people especially vulnerable are children and older people who are mauled and eaten alive by stray dogs. What responsibility and accountability these animal lovers and NGO bear towards such incidents? Why people who collect money in name of animals do not take care and form shelters for these strays? every single death from  such preventable cause raise a question on this issue.

    Apathy of these so called dog lovers towards humans is appalling. 

Besides dog bite and injuries, animal and dog poop is an health hazard. Following are the diseases which occur in community because of animal poop.

Problem of animal poop with dust : It is all around us.  It is actually even a bigger health problem than open defecation by humans. Humans defecate in country side and in open fields. But stray animals and dogs are everywhere. Even owner of pet dogs make them defecate outside their own houses and on the roads and wherever their dogs chooses. This poop dried and mixed with dust, acts a source of infection to the community.

       Life threatening infections : dog’s and animal faeces is a big health hazard. It is even worse than a dog bite since it spreads infection in entire community. A dog’s digestive system can handle just about anything that it eats and this makes its poop very toxic. Animal faeces contain pathogens, which are known to cause severe diseases, infections and organ failure. These heavy loads of bacteria increase the risk of infections in the community. But pregnant women, children and people with suppressed immune systems may are more prone to these infections. Many diseases may be spread by millions of these dogs and other animals like pigs, cattle as their faeces contain parasites, bacteria and viruses. These include life threatening bacterial infections by E. coli, MRSA, Leptospira, Salmonellosis, Campylobacteriosis, brucellosis, Rickettsia and parasitic infections like  Giardiasis, Whipworm, Hookworm, Roundworms, Tapeworms,    Cryptosporidiosis, Echinococcosis, Leishmaniasis etc. Viral infections like rabies, influenza and other viruses may also spread through these animals.

Environmental health Hazard: Storm water runoff due to extensive rainfall can wash off all these droppings into drains, many of which are connected to river systems and water sources in our country. This can lead to a widespread source of waterborne illnesses. Dry  poop on the roads is mixed with dust particles and in the air. So everyone is living in a highly infectious environment.  This may be an important cause of high rates of community acquired infections among our population.

SUGGESTION: the Government, NGOs  and people who claim to be “animal lovers” should create shelters to save strays “as well as people”. It should be mandatory that all the  dog and animal (stray or pet) droppings are properly collected and disposed off. This single step can do wonders as it will reduce infections, people’s suffering, save lives  and eventually reduce use of antibiotics. A rationale mind will definitely appreciate the danger due to strays, and can initiate proper steps rather criticizing above said facts in the name of animal rights. An animal has no sense of responsibility, so rights  should be limited accordingly.

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