I will narrate a youngster’s maturation as a gastrointestinal surgeon. The narration isn’t intended to claim that the surgeon alluded to is a big-timer or an acclaimed and a famous one in the community he serves. He’s only an also-ran along with many others. His journey commenced from Medical College, Kottayam in the Indian state of Kerala where he obtained his MBBS degree in 1989.
After internship, he left medical college with the MBBS degree and the heart of one of his classmates, who would later become his life-partner. Soon nagging questions from ‘well-wishers’ about pursing post-graduation overwhelmed the youth trying to come to terms with challenges of practicing medicine in the hospital he secured employment as junior Medical officer in Urology and General Surgery.
The ground reality of ‘practicing medicine’ was a far cry from what he studied in medical college. It was miles away from what he read from the pages of those voluminous medical textbooks. Proctorage under a senior urologist who retired as professor of Urology from his Alma Mater and a senior general surgeon had him hold the scalpel and the forceps with reasonable ability. Seniors under whom he trained taught him basic tricks of ‘surgical trade’. For example, it soon dawned on him that decision ‘when not to operate’ a patient was more important than ‘when to, what how to’! Surgery, he realized was a craft perfected not from textbooks or lecture halls but through experience. Mastered not only at the operating table, but at the bedside of operated patients. Guided by more experienced.
He soon decided to pursue post-graduation in Surgery-his second love, after his wife! While his wife found anesthesia as her calling.
They returned to their Alma Mater and secured post-graduation of their choice. The surgeon who had just qualified was attracted to the super specialty of Surgical Gastroenterology. In 1996 He secured employment as junior specialist in a hospital in his hometown, which housed arguably one of nation’s best Digestive Diseases Centre. He found the surgical gastroenterology Unit of that centre an ideal launch pad to set his ‘Surgical Gastroenterology dreams’ soaring high. The unit was headed by a never-say-die taskmaster, who like a proverbial school teacher of yore with a cane in hand set about training the toddler struggling to make his first baby steps in Surgical Gastroenterology.
It has been about 25 years of intense training under the expert. And the surgeon is still learning. Honing his skills at decision making and providing post-operative care to get operated patients home. This took spending hours at the operating table, and much more at the patients’ bed side in the ICU. Anticipating and treating postoperative complications- An exercise as important as and more challenging than the craft of operating patients.
I narrated my story neither to flaunt. Flaunt the reasonable ability I managed to acquire as a surgical gastroenterologist down the years, nor to claim ‘I’m the greatest’ . I’m no Cassius Clay!
I narrated my story, distraught at what the Indian government is up to. The government recently tabled a bill in the Lok Sabha which allows doctors pursuing Indian medical systems including Ayurveda and homeopathy to practice Allopathy after clearing a ‘bridge course’. Post-graduate Ayurveda physicians can now perform General Surgical, ENT and Dental procedures after Ayurveda postgraduates receive ‘formal training in such procedures’.
At the outset, to me who toiled hard to find my place in this vast terrain of ‘the art of healing’, the idea of a ‘bridge’ to cross over into specialized disciplines of modern medicine, and attempts to enhance the interface between Ayurveda,Unani,Siddha and Homeopathy(AYUSH) and Indian medical systems was nothing but a bypass to national disaster.
When Indian healthcare itself is infirmed due to various reasons viz; over-corporatization, commercialization of medical education, botched patient-doctor relationship and mutual trust, which are fallouts of exorbitant healthcare costs, inaccessibility of common man to quality healthcare, besides others.
Making a concoction of various medical systems, and creating a ‘mixopathy’ is an outlandish exercise. Various medical systems operating on entirely different principles are simply immiscible. Just as oil and water are!
After all, the government was trying to make short work of hard work of generations of healthcare providers to play ‘medical pluralism’ to the gallery-clearly an area which is absolutely out-of-bounds for a government specializing in dramatics, loud- mouthing and hyperbole.
Though the government’s move maybe well-intentioned to augur AYUSH medical systems, the proposed methodology is self-defeating. The Indian sage and physician, Sushrutha from 500 BC known as ‘father of surgery’ in his treatise ‘Sushrutha Samhitha’ had referred to numerous surgical instruments and techiques being used even today. This is the platform on which Ayurveds base their argument to practice surgery practiced by Allopaths. But, nuances of surgery in terms of technique and complexity and demands of surgical diseases per se strip ‘mixopathy’ of scientific temper because;
- Surgery is not mastered from textbooks or in lecture halls. It takes years of apprenticeship under vastly experienced experts both in operating theatres and surgical wards.
- The dangerous and hotchpotch mixopathy is likely to be cheaper, and therefore might become a favorite ‘healthcare mall’ exclusively of the poor and those who cannot afford its richer cousin- modern medical Surgery practiced by allopaths. An unfair and dangerous trend modern healthcare can ill-afford.
- Quality Surgery and its fruitfulness revolve around other complementary and vastly developed specialties like Anesthesia and critical care.
- Surgery in Modern Medicine is not a one-stop supermarket for diseases. Cancers for example calls for multi-disciplinary approach involving surgery, radiation and medical oncology radiology and pathology.
- Surgery cannot put on a one-man-show. Surgical Complications call for other highly specialized disciplines like interventional radiology (often to control hemorrhage), nephrology, cardiology, neurology, gastroenterology and endocrinology for their inputs in management of complications and co-morbidities pertaining to their organs systems post-operatively and often intra-operatively. services of microbiology too is vital in these times of dreaded infections.
- Attempts to create an immiscible concoction of various medical systems eventually deny them individuality, sanctity and distinction.