Writer By Chance.

Sandeep, undergoing deaddiction is an Upper Primary school teacher under suspension. He was taken into police custody on the night of May 9 2023 from his house following a brawl with neighbors. The inebriated and injured Sandeep was taken by the police to Government Taluk Hospital in Kotarakara in Kerala’s Kollam district for the mandatory medical checkup.

A 22-year old house surgeon Dr. Vandana Das tended to Sandeep’s wounds. She was on duty that night, as part of 84-days compulsory rural posting students undergo after completing MBBS. While being treated, Sandeep turned violent abruptly. He stabbed Dr. Vandana several times with the scissors available in the dressing room, injuring her seriously. Five others including accompanying policemen, the hospital’s ambulance driver on duty and a relative were injured while attempting to overpower Sandeep.

   The seriously wounded Dr. Vandana was rushed to a private hospital in the same town. She was then taken to a hospital in the state capital Thiruvananthapuram, 66 kms away, where she breathed her last.

A young doctor’s life and her aspirations to become a gynecologist were snuffed out by an alcoholic and a drug-addict.  Dreams of her parents, to whom she was their only child, lay shattered.

Doctors in Kerala went on a flash strike exempting emergency services. Customarily, politicians cutting across party lines descended like corpse-eating vultures, shedding crocodile tears, and expressing shock.

The Governor and Health and Cooperation ministers reached the hospital where the incident occured.  If only their visits miraculously brought back Dr. vandana to life!  

The Chief Minister visiting the hospital where Dr. Vandana’s body was kept, to console her parents condemned the incident and promised strictest action against the assailant.

Opposition leader V.D. Satheshan blamed police negligence for Vandana’s murder.

 Adding to the politicians’ makeshift concerns and heavy hearts, Kerala’s Health Minister reportedly did a faux pas by stating that ‘Vandana’s inexperience in handling such situations and resultant fear led to her murder’. Opposition politicians heckled the minister for her insensitive remarks, which she later denied of making, claiming she was misquoted.

Ironically, a young doctor was heinously murdered in Kerala, which boasts of superlative health indices comparable to Scandinavian nations, unlike rest of India. It is doctors like Vandana who won that crown for Kerala.

Dr. Vanadana isn’t the first doctor to be attacked in Kerala.  Police have registered 469 cases of attacks on medical staff including doctors, and 70 attacks on hospitals since 2012, confirming the fall from grace of doctors and hospitals.

What caused the patient-doctor estrangement?

• Privatization of medical education has given a wrong start to making of doctors. Private medical colleges offer Seats from undergraduate medical courses to super-specialization at exorbitant ‘donations’ and/or fees. The public accuse qualifying doctors lacking aptitude and attitude of attempting to reclaim money spent for their education by drawing huge salaries impacting hospital bills. Admission to medical colleges should be only through competitive exams, where only the deserving secure admission. It isn’t a profession for parents to add to their social standing by having their children pursue it.
• Pharmaceuticals-doctor liaison.  Doctors are accused of liaising with pharmaceutical companies through the latter’s representatives, who ‘visit’ them in hospitals and homes.  Pharmaceutical companies are called to sponsor medical conferences, and travel and hospitality bills of doctors attending them. Doctors are accused of accepting ‘rewards’ from these companies for prescribing drugs they manufacture, which patients buying them have to bear. This trend has waned significantly lately. Doctors must be sponsored for conferences by the hospitals they work in, as the hospitals would stand to gain through enhanced knowledge of their doctors.
• Corporatization of healthcare. This has unequivocally derailed healthcare. Patients are fleeced big money as ‘advance’ on approaching Emergency Departments of corporate hospitals. Even accident victims and those with life-threatening emergencies aren’t spared. ‘Temples of healing of old have made way to “wayside burglary centers”’ as a patient once told me! Here, Staff especially doctors are paid flashy salaries, than their counterparts in public hospitals. Patients are charged exorbitant bills in corporate healthcare centers, while the same treatment is provided free of cost from public hospitals with upgraded facilities. There are many hospitals in the public sector where complicated procedures like solid organ transplants, cardiac revascularization and others are offered to people at rates much cheaper than that charged by private behemoths.
• Inadequacy of public hospitals. Public ire against healthcare workers would be history if public hospitals gird themselves to provide healthcare of comparable quality, work ethics, and commitment at cheaper rates. Scarce government funding of healthcare retards modernization of public hospitals. For, it is governments spending on flashy weapons of war and super highways and other such ‘notable’ commodities that are known for ‘developing a nation’. Nobody cares about the common man gains access to quality healthcare.  Dr. Vandana herself was taken to two hospitals, loosing precious ‘golden hour’. The hospital where she was attacked couldn’t save her, showcasing urgent need to spruce up public hospitals.
• Lack of honest communication. The Corner stone of patient-doctor relationship is honest and transparent communication between the two, beginning from outpatient consultation.  Details of the disease including treatment, prognosis, expenditure and possible complications must be driven home to the patient and family realistically. In today’s crowded outpatient clinics manned by over-worked healthcare providers, this suffers, resulting in stunting of patient-doctor relationship. The communication must continue as treatment progresses. It is honest communication that cements patients’ trust in doctors.
• Inclusion of healthcare in the ambit of Consumer Services Act. Healthcare deals with one of the most unpredictable of commodities- the human body. Diseases it fall to and their treatment are too vagarious that they defy predictability. The science of healing for above reasons cannot ‘guarantee’ results. After all, politicians, advocates, engineers and teachers aren’t pulled up for ‘services that fall short’. Why are only healthcare providers made accountable for their services?
• Healthcare workers and centers are cannon fodder for antisocials, drug addicts and the inebriated like Sandeep for want of adequate security personnel to protect them, while politicians have armed security guards, and SPG forming human shields. An inebriated Sandeep wasn’t even handcuffed when he was taken to the hospital.

All these and many more have rendered the healthcare dispensation system sick. A crucial system which merits healing and restoration. Patient-healthcare provider estrangement must give way to intended sanctity of healthcare dispensation built on trust.

Doctors are considered a group drawing hefty pay cheques leading cushy lives at the expense of the sick. Charges of ‘treating unnecessarily’, and ‘ventilating dead patients’ fly thick and thin. While healthcare providers are considered punching bags for patients and families, healthcare centres are sitting ducks awaiting ransacking. This is resultant of the trust deficit people have for healthcare workers.

Dr.Vandana is a sacrificial lamp at the altar of a failed system.  More might be murdered and maimed at that altar (God forbid) if the sick system isn’t nursed back to health.