“ What is there to celebrate?” my colleague asked with despair when I mentioned that Doctor’s Day was around the corner. Clearly, he had not yet got over the ill considered comments of an acquaintance. The latter had begged my friend to arrange an ICU bed for his father whose oxygen had dipped dangerously after contracting Covid. My friend had made great efforts to get him admitted in a private hospital despite the scarcity of beds. A week later, after his father passed away, the same acquaintance was seen accusing the doctors of unnecessarily putting patients on ventilators and expensive drugs to make money. “ Maut ke Saudagar” he had scathingly called them.

The epithet “ Merchants of death” had me thinking and took me back to my introduction to this  ‘merchandise ‘!   I was a third year medical student in the midst of the rigorous month long maternity duty. Sadly, the lesson was delivered by a set of triplets born two months too early. They were tiny, under 800 gm each. One was still born, the second one gasped and turned blue, the third  died fifteen minutes later despite our fervent attempts to save her. For months afterwards I was jolted out of my sleep by the weak whimpering of these preemies who died before they were expected to be born. 

I was told that the guilt and grief of losing a patient  hits the hardest the first time around and then gradually becomes  easier to process. However the truth is that throughout his life, a little of the doctor dies with every patient he loses. That’s why I was apprehensive when  the government recruited medical students for Covid duties recently. Apart from the very real danger of being exposed to infection I wondered how their tender minds would cope with the turmoil.  Will they become cynical, suffer from post traumatic stress syndrome, be scarred for life as they watch   medical science kneel  before the might of a tiny non-organism? More importantly is it fair to toss them into situations of emotional and psychological distress before they have developed the requisite resilience?

I was struggling with this thought when reports of assaults on medical professionals started pouring in. The trickle  quickly transformed into a deluge.  Petrified, I talked to a friend who patiently explained that it was simple mathematics. In the first wave there were fewer patients and fewer deaths hence fewer assaults. With an increase in mortality during the second wave there were bound to be more dissatisfied people who need a target for their frustration and grief. Health professionals being the ‘front  line warriors’ are an easy target.  Irresponsible statements by the government and self styled healers adds fuel to this fire of discontent.

Health professionals will continue to be assaulted till the time the perpetrators  are not punished. Sadly, even if the miscreants are arrested they are seldom charged. The conviction rate for mob fury, arson, assault, lynching and even murder are abysmally low in our country. Laws are in place but till they are used they won’t be a deterrent and transgressors will continue to do what they can get away with.

Social psychologist need to delve and look for reasons for this increasing trend of violence against doctors. In most cases, money will emerge as the common denominator. If the monetary factor is taken out of the equation, the dissatisfaction will be considerably less. We as a society save for marriages and education, put money aside for houses and vacations. But do not account for expenditure on disease and disability. This unpreparedness can be blamed on the false promises of  ‘free health care’ made by successive governments. So when sickness strikes funds have to be borrowed or re-purposed.  It is pertinent to mention here that  the ‘free’ state run hospitals are considered incompetent and are often the last resort. Even government officials are known to prefer privately run hospitals for their kith and kin. If the high and mighty cannot trust the system they have put in place then how can a common man do so.

Earlier small nursing homes formed the backbone of the healthcare system in India. They were typically setup on loans by couples who worked day & night to provide patient care at nominal rates. Due to various laws and accreditation rules these are slowly being replaced by swanky corporates hospitals, that have better facilities under one roof. Setting up a tertiary care centre that meets the requisite guidelines costs money which will inevitably be recovered from the patients. In such a scenario, the the state is being high handed in fixing impossible rates for the private sector to function in. If the government with all its paraphernalia can’t provide reasonable health care to the masses how does it expect the individual to do so.

Medical professionals have faced the brunt of the Covid catastrophe. They have been subjected to the risk of exhaustion, illness and death. They have suffered moral distress while prioritising patients for ventilators and risked legal  liability when asked to work beyond their core competency. They have been demeaned, discriminated against and had their integrity doubted. There have been instances where they have been asked to vacate their homes in lieu of Covid duty.

As front line warriors they have been held responsible for everything- for empty oxygen cylinders,  non existent beds and scarcity of staff. They have been blamed for negligence if they lose a life  and fleecing if they save it. As they overextend themselves, stoically working non stop, facing the badgering of authorities,  the complaints of attendants and demeaning comments by social influencers, a burn out is inevitable. That is when the real tragedy will unfold, the shortage of life savers in a deadly pandemic.  

This impending collapse can be avoided if instead of focusing on the requisites of a good doctor,  leaders and commoners spend some time introspecting their role in the equation. How can society repay a community that risks their own lives to save others? Truthfulness, compliance, tolerance, trust and gratitude come to mind. In the end it takes a good patient to get a good doctor!

( published as a Sunday Read in the Hindustan Times on 27/6/2021)