Rain

Though late, the South-West monsoon [the main source of Rain for this area] finally have been kind enough to my native state, Kerala.

Until this week, Newspapers were saying that this was the weakest monsoon in recent memory with a 43 percent deficit in rainfall in the first 7 weeks of the season. Power blackouts started [as the major source of Power here is Hydro-electric projects] and fear of failed crops were looming large.
This week everything changed. The sky started pouring and pouring. Even as I type, I can hear the wonderful sound of rain. Newspapers started talking about flash floods and landslips. Let us hope the monsoon will wipe off the rainfall deficit in quick time.

Rain or no Rain,Chikungunya epidemic continues relentlessly. In some families, almost all members are getting affected. I had an opportunity to visit a small town 15 kms away. I went there on invitation of a local Club. They wanted me to give a health education class about chikungunya fever.
When I reached there, the people were not in a mood to listen to a talk. They wanted prescription for medicines so that they can recover fast. Most of them were manual labourers, and the persistent joint pain and swellings were preventing them from working. Some wanted preventive medicines to protect them from the virus. I was helpless. There is no fast cure.The joint pains may last for weeks to months. During that period, they will have to continue taking anti-inflammatory drugs. Also, there is no preventive medicine or vaccine yet. I asked them to take measures to reduce breeding of Aedes mosquito. I also asked them to isolate the patient inside a mosquito net during the time of fever. At that time, maximum number of viruses are there in patient's blood and mosquito bite can easily spread the illness.
My team saw more than 50 patients. Some free medicines were distributed, but nobody was satisfied. As we drove back, my thoughts were on the enormity of physical and economic damage this virus had brought on the society, especially for the poor.

Craze for Specialist Consultation

Recently, I had an interesting experience. A-25-year old guy working in a Software Company in Banglore came to me with complaints of lack of appetite, giddiness, nausea and headache of a week duration. He had seen a doctor there in Banglore but the medicines prescribed did not help him.
Just looking at his eyes made me realise he was jaundiced. I examined him fully and came to a conclusion that he was having jaundice probably due to acute viral hepatitis. Before ordering a panel of tests to find out the exact cause of jaundice, I asked him to show me the Banglore doctor's prescription. He gave it to me little reluctantly. To my utter surprise, the doctor he had seen is a senior consultant in Neurosurgery at a posh hospital. The doctor had not spotted jaundice, may be because at that time [6 days ago] it was not as evident as it is now. He had given him anti vertigo and anti vomiting tablets.
I was curious.Why you went to a neurosurgeon? He said his friends told him it was better to see a top most consultant of Neuroscience as they all felt the problem was in Brain. Still why a surgeon? You could have gone to the neuro-physician? The reply shocked me.Only the neurosurgeon in that hospital had an American degree.
This craze for specialist consultation [after self diagnosis] is growing among the upper and middle income groups in India. Most often this leads to delayed diagnosis and delayed treatment. Many doctors also encourage this for selfish motives. The patient with headache go to a neurologist first and the one with chest pain will always go to the cardiologist first. The concerned specialist first rules out all the illnesses that he can treat by a panel of investigations. If all are negative, then only the patient is referred elsewhere.

With tons of medical information available on the Internet, many patients believe that they can diagnose themselves. They also believe that they can chose the specialist they want to consult. Many decides which medicines they will take and which they would not. Is this trend of patient emancipation beneficial to the society? Many believe so but I am not so sure.


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Alternative Medicine

Can I use this Ayurveda Medicine along with what you had prescribed for me for Diabetes?
Can I use this 'Insulin leaf' for controlling my blood sugar?
Can I use this homeopathy medicine to prevent getting Chikungunya fever?
I hear such questions again and again.The popularity of Alternative Medicine is ever increasing.As long as there are illnesses there will be Alternative Medicine.
Recently I read an interesting article in The Guardian' titled 'A bad week for alternative medicine' by Rose Shapiro.I agree with most of her points. For those who do not have time to read the article in full here are some excerpts that I liked.

Alternative medicine users are apparently prepared to suspend all normal critical faculties when they encounter an alternative practitioner

Quacks often use language that is abstract and subjective but is ultimately meaningless. Words such as "quantum" sound impressive to those of us with only a weak grasp of theoretical physics, but are in fact nothing but pseudo-scientific window dressing designed to lure a gullible public.
Quacks will often tell you that feeling worse is a sign of getting better. Most detox regimes describe symptoms such as spots, bad breath, headaches and nausea as proof that the detox is working. Such a notion is central in homeopathy, which enables practitioners to rationalise away the worsening of their patients' symptoms

The orthodox doctor treats what you have, and the alternative practitioner says you have what she treats

Quacks are flattering and will appeal to your vanity. They tell you that you are unique and extraordinary and not like other people. On the rare occasions that they find nothing wrong they say you need maintenance treatment "in order to keep your energies in balance

Many alternative practitioners sincerely believe in what they are doing and want to help their clients. But there have surely been enough cases now of blatant recklessness if not outright deceit to confirm that practising alternative medicine is very often the last refuge of the scoundrel.

I live in an area of India were ancient Indian Medicine [Ayurveda]have strong roots. Even the name Charakan, I chose in respect of a great ancient Indian Physician called Charaka who lived about 2000 years ago. At that time Ayurveda was one of the most scientific of all medical systems, but it stagnated and went into decay as Scientific medicine within a few hundreds of years. Still, the Ayurveda practitioner used to uphold ethics of high standard. Now in the 21st century, Ayurveda is also fast deteriorating into a money-making business exploiting gullible public like all other Alternative Medical systems.
How do I answer the the above questions of my patients regarding Alternative Medicine?
I just answer 'I don't know'.
Then I explain saying, 'I have not studied Alternative Medicines. And as far as I know they don't have any scientific basis. So if you want to experiment on yourself you may take them.Otherwise don't take them.'
Then they will ask 'as there are no''side effects''what is the harm?'
My reply will be 'I have seen many patients who suffered from severe side effects due to Alternative Medicines.Also such medicines may interact with the medicines I have prescribed.'

Hearing all this most of my patients wont dare to take Alternative Medicine.

Acute severe joint pain

She was a 30 year old housewife. She was literally carried in to my consulting room by her husband and her mother. She was writhing with agony at each movement of her joints.

She was perfectly all right in the morning.She walked down to the river[which was about 1/2 kilometre away] to bath, came back and made coffee.At that moment,before she could serve coffee her joint pain started with shivering and she had to be carried from kitchen to bedroom.

She had pain in small joints of fingers, wrist,elbow, shoulders,hip,knee and ankles. All those joints were warm. Her temperature was 101F. Rest of the examination was normal.

Yes, this is the classical onset of Chikungunya fever. I send her out in a wheel chair to get admitted.She was given medicines to reduce fever and inflammation of joints.The next day she was sitting happily ready to go home. Her fever has subsided and joint pains less.She will continue to suffer from joint pains for uncertain number of weeks, and thus may need to continue anti inflammatory drugs.



The fever and joint pains in chikungunya infection start so suddenly that some patients are able to tell the exact minute of onset. I still wonder why the onset is so sudden and unexpected.

A positive feedback

I had a pleasant phone call the other day. The caller was the brother of the patient with acute leukemia in my earlier post.
He said his brother is much better now and has been discharged from the Hematology Centre after a month of hospitalisation. Chemotherapy course have to be continued for a year.He thanked me profusely for diagnosing the condition fast and sending them to that centre. It seemed the doctor there also commented that they reached there well in time.They reached there the next morning itself. The patient is still not out of danger,but chances of survival is more.
I shared the news with the lab team and the pathologist and we all felt good. I started smiling more at my patients and took more time to answer their seemingly silly doubts.
Such positive feed backs help a lot in raising your morale.

Thank you Chikungunya

You might be thinking that I am thanking Chikungunya virus for increasing my work and thereby my income.

No you are wrong.

Most people never care to visit a doctor, or check their blood sugar and blood pressure until they get some disease. I am thanking the virus because it helped in detection of type 2 Diabetes in many patients. Also, it helped a few who had undetected high blood pressure.

I know, the patients themselves may not have the same opinion. The pain and suffering they have to endure in Chikungunya fever is enormous. Still there is this compensation of detecting a chronic but manageable disease like Diabetes early before it can produce any serious organ damage.

I am amazed to find that most children of Type 2 Diabetics have not checked their blood sugar even once disregarding the strong family trait for Diabetes. India is now considered as the Diabetic capital of the World with about 40.9 million people estimated to be affected with type 2 Diabetes.Every fifth Diabetic in the World is an Indian.I feel everyone in India should check their blood sugar once every year after the age of 20.If the child is obese or have some other endocrine problem it is better to test even earlier.

Let me end with a happy note. The old lady who stopped insulin on her own and got admitted at 3 am with a blood sugar of 800[DKA ] came for review with her 2 hr after meal Blood sugar value of 170.She is on 30/70 premix Insulin.She promised me never to do that stupidity again.

A smug smile

You might have seen doctors having a smug smile on their face while they look at the investigation results. The patient sitting opposite may think that the Doc is going to tell them some good news. The patient may expect the doctor to tell that the result is negative or the illness is cured. But most often it is the opposite.

Such smile comes on a doctor's face when the diagnosis he thought of is proved by the test result. The smile becomes bigger if some other doctor or doctors had missed the diagnosis.

I also had smiled like that many times especially early in my practise.Now a days I smile only if the result meant it is a curable or treatable condition.

Today I had a reason to show my smug smile.

She is a 65-year-old woman. She was admitted one year ago for altered behaviour and drowsiness following an episode of severe gastro-enteritis [diarrhea and vomiting]. Lab tests showed her Sodium level was well below normal. This was attributed to lose of salt due to vomiting and diarrhea. She was re-hydrated with sodium containing fluids and she recovered well.

I did not see her till last week when she was admitted for extreme tiredness,lack of appetite and vomiting. Her son told me that after last year's admission, she was not keeping good health. She needed frequent hospitalisation for various ailments.

When I examined her, she looked pale and swollen up. She was not listening to me properly and was very lethargic. Her sodium was again low, but other routine tests were normal. I did a Thyroid function study suspecting low level of hormone production from thyroid gland. The result showed I was right, but surprisingly her thyroid stimulating hormone which is produced by the pituitary gland was also low. This meant she is having Central Hypothyroidism and there is something wrong in the pituitary gland. When I did a series of other hormonal tests to evaluate pituitary function the results were equivocal[not helpful to reach a diagnosis].



So finally I ordered an MRI Scan of the pituitary gland.It was while reading that MRI Scan report that I broke into a smug smile.It showed an empty sella meaning pituitary gland is not visualised as it had shrunk in size.

As there is no tumour or injury visible in MRI, it meant that this is not a life threatening problem. She needs only replacement of hormones that is deficient. So I could smile liberally.
I gave the prescription for hormone replacement tablets. I also gave a reference letter to an Endocrinologist in the near by City so that a second expert opinion can be taken.

Many times I have got excited at the possibility of rare and exotic diagnosis.But immediately I try to curtail my excitement and try to think about it in the patients view point.
For this cute old lady the smile meant good news but for many others the news wont be good.

Why?

A 25-year-old male walked into my consultation room with a reference from a Dental surgeon. Dental surgeon wanted my opinion about the patient's excessive gum bleeding.
He was well built, handsome and looked cheerful. He told me that he got married only recently. He said that the oozing from gums started only 2 days ago. I examined him, but could not find anything grossly wrong. There was no active bleeding. To confirm that there is nothing wrong, I asked for blood counts and peripheral smear test.
I did not think about him until the pathologist called me on phone 3 hours later asking whether there was any positive findings on clinical examination. I replied negative.

Then she broke the bad news. The lab tests were suggestive of acute leukemia, that too a bad sub type. I was stunned. I did not know how I could break the news to that smiling young man.
As the patient was dizzy and still bleeding from gums, it was his brother who came for the report. Telling him was more easy for me, though still painful.Giving sometime for the harsh truth to sink in, I told him the need to get the patient immediately to a Hematology Centre. I gave the reference letter and a little hope by saying the last patient I send there few months ago was doing well.
Acute Leukemia strike suddenly. It is so dramatic that it is found in so many film scripts. Why it occurs? It has no known reasons in most of the cases.You accept it as a part of life.
But when it comes to you or to a dear and near one, the question arises.
Why me? Or as the patient's brother asked me "why him?"
I did not have an answer then or even now.

Another sad 'positive' story

He was working in one of the Persian Gulf countries, and was one among the millions of Indians who went there to work for those oil rich economies, so that they can earn some decent wages.

There came a routine medical exam for migrant workers. He was put in a jail after the result of a Lab test. When asked what is wrong, there was no answer. Within days he was deported to India.

Utterly clueless to the reason for his deportation, he approached a local doctor. A panel of blood tests was done. He was found to be HIV positive. A second confirmatory test gave the same result. The doctor referred him to a Govt facility. Fearing stigma he never went there.

This happened 10 years ago. He never told anybody about this. He told his family that he came back because he cannot tolerate the weather there. Even his wife did not know the exact reason. He began working near his native place as a driver. His wife gave birth to 2 kids. He never had any major health problem until now.

For the last few months, he started losing weight and getting recurrent fever. After a detailed evaluation, he was diagnosed to have Lung Tuberculosis. The Chest Physician suspecting something more, asked for an HIV test. Then he revealed his 'positive' status to the doctor. The doctor promptly referred him to me.

I gave my positive talk [that I usually give to the 'positives']. I told him there is nothing to worry,I will take care of him. First we will treat and cure the Tuberculosis. Then we will attack the HIV virus. I emphasised the importance of compliance with treatment.

I was afraid for the wife, but he said she was tested negative before both her deliveries. I asked him to test her again. He came with his brother-in-law and a cousin. Both knew the truth and was supportive. I asked him to come back after few more lab tests, so that we can start anti-TB treatment. He seemed relieved and hopeful of future when he left my consulting room.

Deportation of migrant workers as if they are criminals as soon they are found to be HIV positive, is a common practise in Persian Gulf countries. The person concerned are never given a proper explanation of the test result. According to WHO/UN AIDS HIV testing guidelines , there should be a pre-test counselling and also a post-test counselling. If these guidelines were followed, after a positive test result the person will be able to understand the implication of the result and he will be guided to the proper health care facility for further management of his condition. The testing and deportation with out any explanation are clear violations of these guidelines.

Can anyone intervene to stop this inhuman testing and deportation of hapless migrant workers from Persian Gulf countries?

Respecting the elderly

We are all taught to respect the elderly and we all do it, but are we respecting their wishes?

A 70-year-old lady sits sheepishly near me in my consulting room. Opposite to us on the other side of the table sits her son. He scolds her for her high blood sugar and cholesterol. He says that his mother does not like an old, sick woman. She eats everything disregard her condition. Son also complains that she does hard house hold work and goes out to the fields to supervise the agriculture work. All these were unnecessary as there are others to do it. The lady has a guilty smile, but denies most of the accusations of her son.

This happens very often in my clinic. The younger generation wants the elderly to live a schedurled life.They will be happy if they just sit and watch TV all the day and eat as bland and tasteless diet as possible avoiding everything. They believe that elderly should behave themselves [as old and sick]. By leading such a life, the children feel that their parents can live long and happy. As they are [most often] footing the bills for their health care, children expects obedience from their parents.

After hearing from both sides, I usually take a middle path. I advice the children that even though their parents are old and have some health problems, don't make them feel they are sick by your reprimands [like don't do this, don't do that ]. I will tell that some restrictions in food and activities are needed, but do not put them in 'house arrest'. Try to understand what they like to do and allow it in such a way that there is no harm to their health.

I tell the elderly patient not to indulge too much in unhealthy food. I tell them to be active but protect themselves from extremes of weather.

Usually as they go out of my room, the elderly have a broader smile.

Chikungunya fever on the rise

Rainy season[monsoon] is here and more and more patients are coming with fever. Many come with sudden rise in temperature, chills, and severe joint pains. As the fever subsides, in few days a itchy skin rash develops. In many, the joint pain and swellings last for weeks to months and sometime years. This is Chikungunya fever.
Chikungunya fever is an easy diagnosis for doctor working in an epidemic setting. After seeing a few patients and following them up it is difficult to miss, but it is a painful diagnosis for the patient. Some who had it last June are still suffering from joint pain and stiffness.

Today I saw about 8 acute chikungunya fever patients and a few chronic joint pain patients due to chikungunya.

More patients now are coming from within 2 kilometres of my clinic/home.
Hope I wont be the next victim.

Blood sugar of 800mg%

I was having a good sleep till 3 in the morning when my telephone rang.

Sir,there is a patient here with a blood sugar report of 800mg percent. The duty doctor from my hospital was calling me.

How is she now and what is her past history? I asked sleepily.

She is drowsy and breathless. She is a known type 2 diabetic 65 years of age.She stopped her Insulin injections on her own 1 week ago was the reply.

Yes this was a Diabetic emergency. She is having diabetic ketoacidosis.In my mind I cursed her for stopping Insulin,but rapidly fired orders to be executed.She needs intensive care,lot of fluids and lot of Insulin and strict management of her electrolytes.



By mid-day her blood sugar levels came down to 250mg% and she became alert and less breathless.

If managed well Diabetic ketoacidosis [DKA] is a rewarding experience to a doctor. I still remember how I monitored and helped in managing Diabetes patients [mainly type 1]with DKA as an intern in medical college. The principles of management are the same even now though the technology used has improved a lot.

Though my sleep was disturbed, in the end I felt happy and satisfied in managing that patient.

Patient taking money from the doctor

When you see the title I am sure you will be frowning. It is always the doctor who takes money from the patient, not the other way round.

But sometimes it can happen. Today it happened to me not once, but twice.

First it was a 50-year-old lady, an agricultural worker and a long-term patient of mine. She used to bring fresh vegetables from her kitchen garden often, and I used to waive the consultation fee. This time I had ordered a few blood tests, and she had to spend all her money for it. After consulting me, showing me her test results and getting a prescription, she wanted a loan of RS.20 for buying the bus ticket that will take her back to her home 15 kilometres away. I readily obliged, and she said goodbye promising me to return the amount when she come next time.
After an hour came a man whose face I remember only vaguely. He introduced himself as the son of a long-term patient of mine who had passed away 2 years ago. I could recollect the patient very well. He lived in another town 40 kilometres away where I worked previously. He was suffering from Chronic obstructive lung disease and was a regular visitor to my clinic.Even when I shifted my practise to my home town[where I work presently] he continued to consult me till his death.

The son of that patient wanted my help. He had come to my town [which is the District headquarters] to get a certificate from a Government office.While he was travelling in bus, his pocket got picked and he lost his wallet. He lost all the money he carried. He needed money for paying the fee for the certificate and to get back home. He said I am the only person he can ask for money in this town. Again I obliged.

For me this happens once in a while. Most of the cases are genuine and money is returned promptly, but some try to dupe me with false stories. Early in my practise I had fallen for some fake sob stories,but now I am more careful.
So remember, it is not always the doctor getting richer with the patient's money, the reverse also happen.

Relief in death

Many of the patients admitted to my hospital are old and of course they are sick. When you are both sick and old and if you are dependent on your children or some other relatives ,you may become a burden to them.

I have many patients in their 80s, very sick, living in and out of the hospital. Most of them are taken care of well by their children, but when I talk to the son or daughter who is taking care, I can feel the burden they feel.
"How many more days Sir?
Why so frequent admissions?
Will some thing happen all of a sudden?
Will these medicines really help?
Is ICU admission really needed?"
In those questions I can feel the financial burden. Also, the strain on the family due to disrupted schedule, lost working days, sleepless nights etc. etc.,.

The death when it finally come is a relief for all. Relief for the patient from misery and also from being a burden to their kids. Relief for the children from the expensive task of looking after their parent. Relief for me so that I need not see both the patient and children suffering.

How to greet a patient?

We doctors meet large number of patients everyday. How should a doctor greet a patient?
Different doctors greet patients differently. It may depend on many things. How busy a doctor is may be one of the important factor. Also, the local custom play a role.

How do I greet my patients? I never open the door for my patients. Either the nurse ushers them in or they come in by their own. I will be sitting at my desk and nodding my head with a smile. Then I will start the interview asking How are you? or what happened? or what is the problem?
If I am too busy, I may be taking down some notes of the previous patient or attending a telephone call in between patients. Then, I may look at the patient's face only after he/she is seated. May be it is rude but.....
How your doctor greet you? How would you like to be greeted by your doctor? Comments and suggestions are welcome

Health Care in India

India is supposed to be one of the fastest growing economy in the world. How does the growing economy help the poor in India? How it affects the health care situation especially for the poor?
An article bringing light into the true facts regarding the health care situation in rural India is there in The Hindu. The village Dhasai is only 150 kms away from India's commercial capital Mumbai.
Such villages are not an exception but the rule in rural India. Still our Government spends abysmally low amounts for health care, less than 2 percent of GDP.

So much political and media attention is there on the Indo-US nuclear deal.Will our politicians ever look seriously at this question of providing affordable and easily accessible health care facilities for all Indians?

A happy family

Two days ago a family came to meet me. A 32- year-old husband with his wife and 3 year old son. They came to see me regarding a minor fever for the wife. They seemed to be happy, especially the kid who kept on exploring my consultation room for treasures. My thoughts went back to the time they visited me the first time.

They were referred to me by a Gynecologist when a routine HIV screening on the pregnant woman was found to be 'positive'. They were in tears, the husband and wife. They did not want the baby but it was too late to abort. They wanted to end their lives as the husband also turned out to be 'positive'. I tried to talk to them in a positive way. I assured them that with proper treatment for the mother and the newborn, the baby will be negative. I also told them that HIV/AIDS is now a well treatable condition, and they will be able to continue living with a good quality of life indefinitely. They did not want any of their family members to know. I promised that I wont tell anybody.

Next day itself I started Mother to Child infection prevention medicines. Her pregnancy period was uneventful, and she delivered a normal boy by Cesarean section. In case of a 'positive' mother, it is always better to avoid breast feeding if the parents could afford formula feeding. So the paediatrician while giving the newborn the medicines for prevention of infection asked them not to give breast milk. This advice produced a commotion among women members of the family. The guy (new father)called me frantically warning me that both Grand mothers are coming to me to ask me about breast feeding. He pleaded with me not to say anything about HIV.

Meanwhile I called the Gynecologist and pediatrician and discussed with them what to reveal and what not to reveal. We decided that we will tell a lie as per the wishes of the couple. The Grand-mothers arrived in front of me. I told them that a virus that can cause jaundice is there in the mother's blood. If she breast feed, the newborn will get infected with dire consequences. So, it is better to give formula feeding. If they have any doubt they can ask the other 2 doctors. Some how or other, I was able to convince the two women. Later I learned that they did not go to other 2 doctors.

All was seemingly well for a few days when suddenly I heard that the guy was hospitalised for attempted suicide. The young mother one day told her mother all the truth. On hearing that, the husband not able to bear the thought of stigma tried to kill himself but fortunately was unsuccessful.

After 18 months, the couple came to me with the kid. They were very happy. They just got the result showing that their boy is HIV Negative. I asked them how is it with their families. They told me that both parents know the truth and they are very supportive.

Later last year, I referred the guy to the ART centre as his CD4 count was below 200. Now he is on ART for last 9 months. His last CD4 count showed steady improvement.

All these I remembered as I watched the son happily playing with a paper weight on my table.
Then the mother said, 'He has not been given any shots'.
I was shocked. The 3-year-old child has not been given any vaccines for immunisation. How could it be like that?
She said that when they went to the nearest Govt Health Centre for immunisation, they saw the HIV positive status written on the mother's medical record. The doctor there was confused which all vaccines to be given. So he referred the child to a Higher Centre some distance away, but the couple fearing stigma never went there.

I asked them to get the child vaccinated immediately, told them to take ART regularly, also reminded them about measures to prevent further pregnancy and said goodbye.
It was a pleasantly satisfying interview for me.

Poverty and Medicine

Being a doctor you come in touch with the economically weaker sections day in and day out. When ever you write a prescription or order a test you have to keep in mind the financial status of the patient.
In India very few have health insurance. The very poor go to the Government run Hospitals and clinic. Those who can afford to spend some money from their pocket go to privately owned Hospitals and clinics. But many times the poor may have to go to private Institutions as the Govt Hospitals may not be accessible or the one near to their home may not be adequately equipped to deal with their problem.
So the treatment that is given in private Hospitals [like where I work] differ according the monitory status.Intensive care, frequent blood monitoring,expensive imaging tests like MRI etc may be offered but not insisted upon in case of poor patients.We doctors try to diagnose using all our experience and many a time rely on empirical therapy[ie presuming the diagnosis and treating].The drugs prescribed will not be the newest and expensive ones. Even among poor patients there is discrimination.Families tend to spend less for older people. Many a time they discharge and take home the old before complete recovery. Ventilators and other life saving equipments will be switched off on request.
Though it is expensive many poor people like to get treatment from private Hospitals.One of the major reason is lack of dignity and personal care in Govt Institutions.Over crowding and lack of funding is the cause for this undignified treatment for patients. Severe shortage of infrastructure,staff,equipments etc make the matters worse.
Is Health Insurance for All the solution?

Doctor's Day

Today, July 1st is celebrated in India as Doctor's day. Today is the both the birth and death anniversary of Dr.Bidhan Chandra Roy a renowned freedom fighter, administrator and a physician par excellence.

What do I like about being a doctor?

You are able relieve sufferings of some and is able to reassure many and to make so many people happy.Even minor things like speaking to a patient for few extra minutes,or giving a reassuring look or touching a patient or patting them give so much happiness and hope.It gives good exercise to your brain[though not much to your body] and it pays well too.It is even now a prestigious profession and you meet so many different kinds of people in your work. You can contribute a lot to the well being of the community in which you live.

So still I am happy being a doctor