Medical donation

While in the UK, I was fortunate to enjoy good health.  So much so, I had to visit the local health centre only once in 5 years.   Nonetheless, I am also aware that in some centres, getting an appointment was sometimes so delayed that by the time your appointment date draws near, your ailment has either naturally healed or aggravated to such an extent that one would have to call for an ambulance.  

The primary reason for such delays was because some (particularly elderly) would book appointments practically everyday.  And that too for small petty health issues, which actually need no medical intervention. Their health anxiety and fear of mortality was so high that they needed constant treatment. 

Luckily in India, we are a bit more resilient.  Perhaps it also has much to do with the financial burden that one would like to avoid.  We visit a doctor or a hospital only in extreme cases.  Otherwise, most of us resist going anywhere near a health centre.  When all home remedies and suggestions of every aunt has been followed, but with no improvement; or rather, one is totally bedridden, then we think of visiting a doctor. But among the Salesians there seem to be a few who prefer this medical tourism. Every other day they come asking to be taken to some doctor or the other, on the pretext of some ailment or trouble. To one such, I had the joy of saying, "'No!  There is no need of visiting any doctor or going to a hospital.  There is nothing wrong with you!" But I'm aware he is approaching everyone, in the hope that someone will actually take him or let him go by himself to the hospital.  

I have a better proposal: offer him to Gandhi Hospital (government hospital of Hyderabad) for medical research.  He can stay at the hospital itself, offering his illness for experimental treatment. It would do a lot of good to everyone! 

Medical tourism

The latest and growing trend is that of 'medical tourism'.  There seems to be some confreres who are eternally obsessed with their health.  So much so, any sneeze or scratch is blown out of proportion to be related to some life-threatening ailment.  

Then there are those who wish, by any and all means, to visit every doctor and stream of medicine available, anywhere in the country, at any costs to address the same health concern.  Thus we have confreres who visit every ayurvedic therapy centre in Kerala, then return and within two months visit another therapeutic centre in another part of Kerala, and in another two months visit an orthopaedic centre in some part of Telangana, and all this while continue taking the strong doses of medicine prescribed by their first doctor whom they visited two years ago (but never again even mentioned to him about the rest of the medical journey)! 

On the other end of the spectrum are some who stubbornly refuse to visit any medical centre, even though they have some serious health issues which need medical intervention.  

Add to this list the growing cases of mental well-being and health issues.  Of course, some of the above issues are mostly because of mental imbalances!! 

The most comic angle of this scenario is that most (not all) of those 'sick' and expecting medical attention, are the first and most to travel places... any distance, any time, by any mode, for no significant reason!  

Respect life

The ongoing case of Alfie Evans and the efforts of his parents and a few activists is quite an alarming indication of the stance of the law, the medical practice and the society as a whole.

I thought the motto of medical profession was to 'improve the quality of life', not 'ensure death'.  And if one cannot improve the quality of life, one ought to be put down.  Going by that dictum, most people even the healthy ones, should be put to sleep once and for all.  Furthermore, the standard of a society is measured by the way it looks after the marginalized, especially the weak and the disabled.  If measured by that standard, the UK would not rank high in this and related episodes.

Following the logic of the hospital and the judges, even George Young a four year old who has dementia and is expected to soon lose sight and other vital organs, should be left to die, without any further medical intervention - not even food and water!

On the one hand there is the whole celebration of the birth of a new prince, and the royals paying homage to the dead at the Anzac ceremony, and on the other a concerted effort to end one life.  Seriously, the dead are revered and the living murdered?  Wonder if the law would prevent a royal family from taking their child to another country for treatment, even if that treatment is no guarantee of better health? So if Alfie can be taken home, he can well be taken to Italy - go for a family vacation, if that be!

In Alfie's case, the doctors had initially claimed that Alfie would not survive long without the ventilator. But he has outlived their prediction and made it on his own since three days.  So there is a possibility - a very wild one - that science has got it wrong.  Yet it need not be a defeat of science.  There is nothing called good science or bad science.   The fact that science has not yet found the cure does not mean that there isn't one.  Furthermore, some remedies used today were experiments some time ago. Only when they've been proved beneficial have they become 'life-saving' today.  So even if one gives into the logic of the hospital and the judges, that Alfie's condition cannot be improved, one can at least try unexperimented modes of treatment with the sole intention of improving his health.  It is not as if healthy people are cheated into being experimented on - which is ethically wrong.  But here is a case where every possible means of available treatment has failed, so why not?

In most such cases where there is no visible sign of agency, human life is considered not worth continuing.  Actually it speaks not so much about the sick person but of those healthy and those taking decisions on behalf of the sick.  In passing judgement about the worthiness or non-worthiness of their continued existence, we are passing judgement on our own ethical and moral standard.

How can taking someone's life be for the betterment of one's life? 

Extreme experiences at Osmania Hospital

I returned from the hospital this morning, after what was supposed to be a simple drop for one of our ailing boys at Nampally home.  One of our boys was complaining of acute pain in the abdomen since midnight of Sunday.  Rushed him to a nearby hospital and the doctor suspected appendicitus.  Yesterday I took him to the city hospital for further examination and soon the emergency of the situation dawned upon the doctors and he was lined up for a surgery for a perforated intestine caused due to a burst ulcer.  Cutting the long story short, he is now recuperating post surgery and me too!  It has been quite sometime I spent time in the hospital accompanying someone and I am glad I could be of some assistance to Sai in this crucial moment.

However, my impression of my maiden experience of Osmania hospital is a very mixed one. I just couldn't imagine how a hospital, of all places, could be so filthy!!  Really, the stench, dirt, waste (human, clinical, and everything else too) does not in anyway, qualify it to be a hospital.  I was horrified to see a dog and a few puppies on the second floor of the hospital... and from the way they were walking around, it does not seem that they had wandered there but that they were living there!! And of course, there was a cat in the surgical intensive care unit, the place where I was the whole night.  Gosh!!

Photo originally found here.

That said, I was trying to understand how could such a supposedly hygenic place be so pathetic.  It did not take me long to notice that beginning with the patients to the visitors, everyone gladly adds to the filth in the hospital.  Spitting everywhere and pissing around the corners seem to be something normal and the right thing to do! Naturally, the dilapidated sections of the building too does not help much improving the hygiene factor.

Well that's one side of the picture. Balancing - or rather, out-weighing - this ghastly side, is the dedication and the work spirit of the team of doctors in the hospital.  I was only there for one day and a night and all along I saw the same team of doctors working, meeting, checking on the patients, performing surgeries and all that stuff with quite an expertise and enthusiasm.  And those free, even if for short intervals, were keenly discussing or reading thick journals and books concerning medicine! That was really something.  

Motivation (from movies?)

We people, especially in Andhra, have an issue with motivation. Our motivation factors are most often wonky! This is not just a hunch but a time-tested and experientially verified fact (personally, though!).

As I sat for meditation this morning, an insight crossed my mind. In the Hindi / Telugu remake of the English movie Patch Adams, Munnabhai MBBS/Shankardada MBBS, like in the original English movie, the protagonist enters the medical college, but for very different reasons.  Patch Adams enters the medical college because he is passionately in love with healthcare and medicine; he has a vision for the health of people, for which he believes medicine is but only one requirement. Though weird, by regular standards, his practice soon begins to bear fruit.  Eventually he falls in love and pursues her and convinces her.  However, in the regional remake of the movie, the reason the protagonist enters the medical college is to prove someone wrong!! He, of his own accord, has no passion or even liking for healthcare.  Eventually he does some good and in the end all is fine.

But I'm asking myself what message are the youth being conveyed by this?  Is motivation always from outside, the best motivation?  What about 'seeking the spring' within?  Why is it that the motivation for doing anything, if done at all, is sought in external factors?  How about the fire within?  What about quenching that 'fire within', rather than being driven by the 'heat outside'? 

Sermons and medicine

During the Holy Mass this morning, the sermon time, to be particular, I had an insight - or rather an analogy. It was again about the length and purpose of a sermon or homily.  A sermon ought to be like medicine shot.  Medicine is never administered in large dosages.  They are given in less quantity and are supposed to effect a change for the better.  If one understands practice of medicine as promotion of good health and not merely prevention of sickness, then certainly medicine is of great value.

One might suggest that instead of medicine a sermon ought to be like water, after all the Word of God is living waters!  Well, I do not disagree with the latter part of that. But water is something we take of our own, without which life itself is impossible.  It is not something administered to us.  So if we compare a sermon to drinking water for health, then we ought to take it ourselves - we need not have a professional (qualified, prepared, 'formed') doctor - minister? - tell us that.  We need the 'minister' to help us with guidelines, not lectures!

(I think I'm obsessed with this ideas of short meaningful sermons!) 

Where to... ?

I went to the hospital to 'finish up' with this lump under my ear, which has been irritating me for quite a while now. Unfortunately it wasn't to be.  The doctor who was supposed to operate upon me fell sick!  I'd have to report again on Wednesday, hopefully. 

While at the lab, and later, waiting for nearly two hours, I could not but help watch several people come to the hospital with bag and baggage.  Most of them looked like they were from Orissa. The bag and baggage suggested that they were prepared to spend some time in town because most probably their loved ones were or would be in the hospital for some time.  The immediate thought that crossed my mind: what of those who cannot afford to come all the way from Orissa and cough up the hefty hospital bills?  

What if the one who was to do the surgery on me (mine being the most ridiculous of all!) was to do some urgent operation for one of these? Would they also end up waiting for a couple of days?  I surely had my vehicle to get me back home and a home that was atleast reachable within two hours of travel.  What of these people? Where'd they go?

Puncture

This afternoon I watched the movie, Puncture (2001).  It is based on the true story of how the American medical community made a major shift in its policies regarding health care especially of those in the service of health care.  The decision was to switch to the use of single use syringes and thus prevent the spread of epidemics and deadly diseases to a great extent.  Besides the script, editing and the characterisation of the actors, what struck me was the person of Michael Weiss (played by Chris Evans).

The fact that he choose to take on the nation's powerful health department lobby with its far reaching tentacles, while he being a guy with his own demons with regards to health, is something quite challenging to understand.

The real Michael David Weiss

Secondly the movie does not in any way try to portray him as the 'saviour'.  He is just an ordinary guy who has this gut level feeling that what he is up to is the right thing... even if he has to face evident defeat at the hands of the rich and powerful.  I wonder how many of us would have that courage - or lunacy? - to stand against a structure or established institution?

The movie does not hesitate to accuse the American administration, especially its shrewd and insensitive health policies, of being the cause of spread of epidemics in the developing countries of Africa, Asia and South America.  Though being  a major cause, of course behind the curtains, of the spread of diseases, the American government then acts as a great Samaritan doling out medicines and 'health care'... it is like trying to tame your own creation.  When would that one time use syringe find its place in India, is something that I look forward to... (I also admit, that there has been a significant shift already in health standards, but the basic issues still remain unanswered).

The most amazing fact that really caught my attention was one of the final frames of the movie which showed his age: just plain 32!  That's two years younger than I am as of today.  To have the brains and the balls to effect a change so intense and significant in spite of such uphills in his own personal life, seems too real to believe and accept.  But true it is. 

Price of a Miracle

Tess was eight years old when she heard her Mom and Dad talking about her little brother, Andrew. All she knew was that he was very sick and they were completely out of money. They were moving to an apartment complex next month because Daddy didn't have the money for both the doctor bills and for the house payment.

Only a very costly surgery could save her brother now and it was looking like there was no one to loan them the money. She heard her Dad say to her Mom, "Only a miracle can save him now."

Tess went to her bedroom and pulled a glass jelly jar from its hiding place in the closet. She poured all the change out on the floor and counted it carefully. She counted it three times. The total had to be exactly perfect. No chance here for mistakes. Carefully placing the coins back in the jar and twisting on the cap, she slipped out the back door and made her way 6 blocks to Rexall's Drug Store with the big red Indian Chief sign above the door.

Tess waited patiently for the pharmacist to give her some attention but he was too intently talking to another man to be bothered by an eight year old at this moment. She twisted her feet to make a scuffing noise.

Nothing.

She cleared her throat with the most disgusting sound she could muster. No good. Finally she took a quarter from her jar and banged it on the glass counter. That did it!

"And what do you want?" the pharmacist asked in an annoyed tone of voice. "I'm talking to my brother from Chicago whom I haven't seen in ages," he said without waiting for a reply to his question.

"Well, I want to talk to you about my brother," Tess answered back in the same annoyed tone. "He's really, really sick, and I want to buy a miracle."

"I beg your pardon?" said the pharmacist.

"His name is Andrew and he has something bad growing inside his head and my Daddy says only a miracle can save him now. So, how much does a miracle cost?"

"We don't sell miracles here, little girl. I'm sorry but I can't help you," the pharmacist said, softening a little.

"Listen, I have the money to pay for it. If it isn't enough, I will get the rest. Just tell me how much it costs."

The pharmacist's brother stooped down and asked the little girl, "What kind of a miracle does you brother need?"

"I don't know," Tess replied with her eyes welling up. "I just know he's really sick and Mommy says he needs an operation, but my Daddy can't pay for it, so I want to use my money.

"How much do you have?" asked the pharmacist's brother.

"One dollar and eleven cents," Tess answered barely audible. "And it's all the money I have, but I can get some more if I need to."

"Well, what a coincidence," smiled the man. "A dollar and eleven cents...the exact price of a miracle for little brothers." Then he said "Take me to where you live. I want to see your brother and meet your parents. Let's see if I have the kind of miracle you need."

The pharmacist's brother was Dr. Carlton Armstrong, a surgeon from Chicago who specialized in neuro-surgery. The operation was completed without charge and it wasn't long until Andrew was home again and doing well. Later, mom and dad were talking about the chain of events that had led them to this.

Her mom said, "That surgery was a real miracle. I wonder how much it would have cost?" Tess smiled. She knew exactly how much a miracle cost...one dollar and eleven cents.

Another quote from 'Patch Adams'

I remembered another lovely quote from the movie 'Patch Adams':

You treat a disease, you win or lose. But treat a person, I guarantee, you always win, no matter what the outcome!

Medicine, life and living

Health has become a business - mighty profit-making business. Once upon a time, I was captivated by medicine - especially after watching the movie 'Patch Adams': Medicine is more about improving the quality of life than delaying death. But in the last few days, I feel more will die of medicine (or lack of it) than really 'improve the quality of life'.

Last time it was our gardener, Tirupathi who had to dole out one month's salary for a night in the hospital. This time it is another person known to very many of us who has to burn not just his pockets but himself... a whooping Rs 8 lakhs!! I'm told that in one of the prestigious hospitals in the city, the starting fee is Rs 50,000. That's just the initial deposit. The fees are built on it!! I'm sure, there must be hundreds of people who must have walked out of the hospital 'happily willing to die' than even dream of pouring out so much money. In such cases when medicine and cure is simply beyond the affordable limit, the patient either is happier than before or dies then and there!! It is only the dear ones who have to live with the guilt of not being able to do anything other than see him/her slowly die. Living in such conditions is maddening!