On our first day of orientation in college we are repeatedly told that medicine is an esteemed field. Sadly, it doesn’t stop there: Everywhere we go from the moment we get our NEET percentiles, we are constantly reminded of our nobility and standing in society. Predictably, we get used to the celebrity adjacent treatment. I have always said that only a doctor could stand next to probably Meryl Streep and still have the nerve to feel superior.
Isn’t there an entire genre of television entertainment made after us?
We’re constantly told that we’re the “crème de la crème of the nation” and that a 99.96 percentile in NEET must mean that you are the pinnacle of human intelligence.
Does it get to our heads? Do you see our egos reflecting in our little interactions with patients? Do you see how our posture suddenly changes when a light-skinned English speaking patient turns up in the emergency? Do we know enough about trans folks to even decide the correct sample collection room to send them to? We study demographics as a part of community medicine for seven semesters and yet we forget how many homeless people turn up at our hospitals when we so casually accuse them of wanting muft ka ilaaj?
In the age of late stage capitalism, doctors are known more for how much money they make, and the neighbourhoods they live in, instead of their role in patient care. Yes, we do not control how the society sees us, but how many times are we not ourselves enamoured by the glamour and power that comes with being a doctor?
When the world is constantly reminding you that you are the smartest lot of the country, you start feeling content in all that you already know. That’s where the indifference begins.
BJ Miller, a well-known US palliative care physician, said in his TED talk that “healthcare was designed with diseases, not people at its centre. Which is to say, of course, it was badly designed.” We mug up the causes of pancytopenia, without realising that since a vitamin deficiency is its most common cause in India, we also need to treat poverty and hunger first.
We keep giving this excuse of not having enough time to read up, which, for the sake of the argument, I am ready to accept. Fine, we probably do not have enough time to read up. But how many of us demand an education in humanities during our course of 5.5 years? There is no medicine without humanities. And the lack of humanities in our education is particularly the reason why we have gotten to this point where neither sides want to empathise with each other.
Doctors have changed the world. India could not even dare to dream about winning the battle against polio had Dr Jonas Salk patented one of the biggest inventions in the history of mankind. Che Guevara learned about poverty as a medical student. The people most directly affected by the system are the marginalised, who do not have alternatives to access healthcare and who seek healthcare later into their ailments, with lower frequency and with much more trepidation. Very often, we end up alienating those who need our help the most even if we do not do it out of malice.
And it is also not hard to understand why the same marginalised groups are hesitating today before giving us the support they have been begging from us for the past three years. A third wave of COVID-19 looms over our already broken healthcare system. We have remained grossly understaffed due to the delay in counselling.
Our first year post graduate students (will be referred to as PG1s hereafter) are so overworked, it has led to a type of burnout that we have never seen before in government medical setups. Post graduate students from surgical branches suffer even more because during every COVID-19 wave, all government hospitals shut down their operation theatres. They have three years to learn how to perform surgeries and we can now see operation theatres being shut down for months at stretch for the third time in two years now.
An internal medicine PG1 in GTB hospital manages an average of 30 immensely sick ward patients, all at the same time (besides OPD patients) on their own per week. In such a scenario, how can one expect a doctor deprived of sleep, social and personal life to take optimum care of everyone that shows up at the hospital doorstep? It is almost like we feel entitled to the mental health of government medical doctors.
Today, we feel abandoned by the country in our most desperate time of need. Junior government doctors are exploited and constantly shat upon by their seniors. Even as an intern who is constantly exploited, the thought of being a PG1 in medicine in a government hospital sends shivers down my spine.
This poses another question: How much of this pressure is the fault of the people?
Even in the absence of PG1s, it is important that the protesting doctors reflect on this: Why cannot the senior doctors pitch in a little bit and make it somewhat easier for you? Why have we bought into our own oppression so much? And how many of us, who complain about this today, will become comfortable contributors to the system the moment our PG1s arrive?
Now that our movement is finally getting some mainstream attention, we find ourselves at a crossroads. We can go back to being the same apolitical apathetic crowd that we were yesterday or we can re-evaluate our system as a whole. The choice is ours.
Healthcare has always been political so it is only necessary that we are too.
Implicit bias in healthcare professionals: a systematic review, written by Chloë FitzGerald and Samia Hurst:
Unhealthy Attitudes: The treatment of LGBT people within health and social care services, written by Catherine Somerville Survey by YouGov Plc.
The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School, by Hojat, Mohammadreza PhD; Vergare, Michael J. MD; Maxwell, Kaye; Brainard, George PhD; Herrine, Steven K. MD; Isenberg, Gerald A. MD; Veloski, Jon MS; Gonnella, Joseph S. MD
Tackling poverty through medical education by Matthew J. To Colin Van Zoost
The intersections of gender and class in health status and health care, by A Iyer et al. Glob Public Health. 2008.
Health Disparities By Race And Class: Why Both Matter, by Ichiro Kawachi, Norman Daniels, and Dean E. Robinson
Sana Khanam is an MBBS student, currently working as an intern at University College of Medical Sciences and GTB hospital.
Featured image source: India.com