Art and Medicine, though much segregated in this country, are inseparably bound by the common purpose they serve in the context of human life- alleviation of suffering. While Medicine primarily focuses on physical suffering, art is meant to heal the suffering mind. It is only in recent times that Medicine has also shifted its focus to mental illness as the picture of disease has changed, and a good proportion of disease that finds its way to the doctor’s doorstep, takes the form of mental illness.
However, the irony is that the bulk of these mental illnesses reside in our entrance coaching centres and medical colleges- a fact that goes unrecognized.
The very institutions that are meant to train young doctors in the art of healing, are now pockets of suffering.
Recollect the face of the average doctor today. One can recognize numbness, frustration and boredom in that face.
Dr KK comes to my mind as the prototype of this species. A middle-aged doctor with many credentials to his name and a roaring practice, his day starts at 7 a.m. At his residence, patients have already lined up to see the doctor. By 8 a.m., he has dealt with most of them. For him, each patient translates to a fee.The chauffeur is ready with the car. Dr KK walks to the car, irritated with the stress of the first hour, and frustrated at the thought of the stress that lies ahead.
At the hospital, he sails through the drudgery. The first patient walks in, eager to talk about his illness.
“I have been coughing for the last 2 days…”, he starts.
Dr KK cuts him short and ushers him to the couch. The man moves to the couch, hoping that he can resume his story thereafter. But as soon as he reclines on the couch, he finds a thermometer being inserted into his mouth. The nurse notes the temperature. The doctor walks up to him.
“I can’t sleep all night…”, the patient makes an attempt.
But the doctor has already placed a stethoscope on his chest.
“Take deep breaths”, he orders.
The patient does as he is asked to. The doctor examines him and goes back to his table. He starts to write the prescription. The patient walks to his chair and makes the final attempt:
“ I have no appetite…”
“Any fever?”, the doctor asks him, without looking up from the prescription.
“ I feel feverish, but…”
“Any difficulty in breathing?”, asks the doctor.
“Occasionally, when the cough doesn’t stop, I have trouble breathing….”
“Take these pills. Come and see me in 3 days time.”
The nurse looks at the prescription. A tablet for fever and pain, an antibiotic, an expectorant, a bronchodilator, a vitamin tablet. By now, she is familiar with the doctor’s prescriptions.
The next patient is already in.
“ Doctor, my leg hurts!”
“The right one.”
“You are lucky. Both my legs hurt.”
The patient looks at the doctor. His face is serious. The patient does not know what to make of the statement. He looks at the nurse. She smiles at him.
“ Crazy people. They have no better work. Pain in the legs, hands, head…what not!”, the doctor mumbles to the nurse after the patient has stepped out.
By afternoon, Dr KK has seen at least hundred patients. The repulsion is obvious on his face. But the hospital is happy- he generates numbers. His credentials on his cabin gleam in bold letters. After lunch, Dr KK has a little nap. Then he goes for rounds. He talks and even jokes with the interns and nurses. But with the patients, he is serious and quiet. He refuses to talk…or to listen. Perhaps it is his way of defence- of coping with the numbers. The less you listen and talk, the more you can take.
By the time he finishes rounds, his chauffeur is ready with the car. He doesn’t need to be told; he is familiar with the doctor’s daily routine- a routine that is seldom broken. He chauffeurs Dr KK to the hospital where he is a visiting consultant. He then parks the car and heads off for some evening refreshment. Meanwhile, Dr KK ‘does away’ with his patients for the next 2 hours. By 7pm, the chauffeur is ready with the car. It takes him only ten minutes to reach Dr KK’s home. There are patients waiting impatiently. The chauffeur parks the car, hands over the keys, and steps out of the gate, whistling to himself. He is done for the day, but for Dr KK, it is another 1-2 hours of practice.
Dr KK has no memory of his patients. He is unmoved- by life, by disease and by death. In truth, it is not his patients that he hates. He hates himself- all that he has become. He seems to miss something, but he is not aware of what that is. He lives in the belief that this is what it means to be in this profession. Every day, he resents his life. But the ignorance compels him to continue- with bitterness, frustration and insensitivity.
This is the kind of doctor we often meet today. The doctor who has learned early in his life to ‘switch off’ his mind, so as to be able to handle the pressures of his profession. The doctor who has been taught to believe that work can never be joyful, and that we have no choice but to work, in order to earn a livelihood. The doctor who does not feel the joy of a doctor-patient relationship; the doctor who does not know how to transform his interactions with patients into beautiful and fulfilling moments. The doctor who has replaced this joy with numbers- traded quality for quantity.
These are doctors who have forgotten to live- who no longer know the meaning of life. These are the doctors to whom we entrust our lives and the lives of the people we love.
“That is my mother…my son…my spouse on the hospital bed!”, we cry.
But what difference can it make in the mind of such a doctor who is so alienated from life and from human relationships?
It is in this context that doctors like Dr V P Gangadharan transform into Gods in our minds. For they are the exceptions. So what is it that moulds our doctors into these walking corpses that are so alienated from life?