From a Doctor’s Home

Author’s Note

Well, it would be a shame if I do not write a bit of GNA for my final edition, so here it is. It is not strictly an analysis of the scenario because I believe a lot of it has been done already. This is meant to be something different, something that you, the reader, might figure out by the end of this article.

For those of you who do not know me, I am Monil Soni and my parents are doctors. My father is a physician and my mother is a general practitioner. Both of them have been practicing for quite some time. But this is no regular time, is it? It is the time of a global pandemic. This is the time when people have called out the World Health Organization for late action. This is the time when the supposed leader of the free world - United States of America - is spectacularly failing, and so are most of the countries. People are holed up in their homes (some of them are), and clashes are occurring in certain places in Ahmedabad (I am sure they are occurring in other places too). This is the time when the system that we have held onto for years has collapsed, and no one has a freaking idea what to do.

But our government has tried to keep up the morale and it initially seemed to me that they had succeeded in doing that save a few exceptions. While it seems that everyone is banging thalis and whatnot to praise the doctors working, most of them do not know what the reality is. And so yours truly has taken this opportunity to inform you, the reader, of such a scenario. These are the things that I have heard from my parents when they come home tired and disheartened at the response of the government and the people.

Disclaimer: Note that some of the things I write here might not have sufficient sources to back them up and you as the reader are free to discard such statements. Moreover, this article was written on 17th March so things might have changed by the time you read them.

There are a few things I would like to cover here and like all of my articles, this article is also going to be compartmentalized and divided into nice little sections.

Anyway, let us get to the topic at hand.

The situation of front line doctors

I define frontline doctors as doctors who are directly in contact with and treating patients with COVID-19. Note that the doctors who do not treat patients also can come in contact with COVID-19 patients. Now, in such testing times, it seems that the administration cannot take care of the people fighting on the frontlines.

There have been cases where the availability of Personal Protective Equipment or PPE kits was insufficient. Furthermore, even though the government does believe that prophylactic medicines help, the distribution of these medicines has remained insufficient and delayed.

Now, it is very easy to say that doctors knew what they were signing up for, but the question to ask is - is it not the responsibility of the government to have their backs? Think about it. In addition to this high-risk factor AND insufficient safety measures, they are made to work longer hours (12 hours instead of 8). I do not think such should be the actions of a government responsible to handle a crisis.

The situation of practicing doctors

My parents belong to this category, and hence, there is a lot to say in this area. For one, there is no proper treatment/diagnosis protocol, or rather the protocol is frequently changing. For instance, let us say that a patient is suspected to be a COVID-19 patient and he/she tests positive, then the protocol earlier said that the doctor was to be quarantined for 14 days, which was not enforced after a while. The direct consequence of this was a staggeringly decreasing number of practicing doctors. Consider this: all the doctors operating on patients, ENT doctors, and the dentists are not practicing. From the remaining set, some of the doctors are self-quarantined, and from those who are left, some of them might be asked to get quarantined for 14 days. Now, if they are not asked to quarantine themselves, they become superspreaders since they already have a high number of patients coming to them. And this is what the policy is as of now. In the case of the previous policy, the concentration of patients per doctor was higher than it is now, meaning that there is a chance of an even great number of the population getting COVID-19. And as if the increased risk of infection was not enough, the doctors are now overloaded with patients. This problem magnifies even more in the case of small private clinics where it is difficult to practice social distancing. Furthermore, it is disheartening to note that the government failed at both providing relief and controlling the price of the safety kits. Even if you buy the argument that the government could not produce such kits at a large scale, it failed in controlling the price that is many-fold the original price of the kits.

An important aspect of operating a clinic or a hospital is the staff. Many members of the clinic staff quit the job due to the risk of the infection, and the ones remaining also have difficulties in transportation. And if that was not enough, they also are not provided with protective equipment. It is funny how we are more prepared for war and killing enemies than we are for saving our own. And this is true for most of the countries and not just India. Furthermore, the doctors and staff of the private clinics have also not been provided with ID cards. How are they supposed to operate if they cannot travel without disruptions?

Recently, there has been a new development in testing. But in a bad way. Despite the lack of infrastructure, the government is not allowing private laboratories to test for COVID-19 independently. Basically, if the private hospital decides that the person has the possibility of being COVID-19 positive, they cannot admit the person until the government institute certifies that the person has COVID-19. So here we are, in a pandemic, slowing down the use of AVAILABLE infrastructure. One of the possible reasons for this is: “you can’t have new cases if you don’t have new tests”.

I have also heard that some doctors who operate in private clinics are being pressured to operate the clinic by the police. While you can ask them for the sake of humanity, there is no law that requires such doctors to operate clinics at all times. And come on, threatening the lifesavers? How low do you have to stoop to not respect the doctors?

The people

This is the worst part for me. I had expected the government to not be kind to doctors since that has always been the case, but the people - the people are the worst. Because you see, you have to deal with the government once in a while, but you cannot magically make that neighbor uncle disappear (if you can, please contact me). The major problem that I see happening is the social exclusion of the people associated with any form of the medical field. Not just doctors, but their staff too. There have been cases where entire societies have decided to ask the doctor to stay elsewhere, and not politely. Even the relatives of these doctors are treated with scorn that they do not deserve. And these are the societies that don’t think before waking up the doctor in the night for some cold they have been experiencing for the past few days. One thing which is absolutely certain is that the caller tune did not help.

There is a case of a certain travel agent in Ahmedabad. He put out a video claiming that the prices that certain hospitals were charging were unjustified and asserted that he did not care about the explanation but just wanted to get treated. I mean, genuinely, what kind of bullshit is this? Anyway, when I heard that the treatment of COVID-19 takes lakhs, I asked my uncle, who is head of marketing at a certain hospital chain, about this amount. Following is the list of sources of costs incurred to the hospital to provide the best possible treatment and take care of the doctors and nurses involved:

• PPE kits are disposable. Hence if the patient is admitted for 14 days and is checked twice in a day by 2 doctors and 2 nurses, you have the cost of 112 PPE kits.
• The doctors and nurses are made to stay in a hotel for their safety and care.
• Nurses are given food by the hospital to ensure that their health is taken care of.
• The operating charges of the infrastructure, including ventilators and air conditioners.
• Isolation, equipment disinfection, and cleaning costs.
• Bedsheets, pillow covers, blankets, etc. are disposable materials.
• The hospital staff is to be provided twice the regular salary.

And it goes on and on.

This travel agent went on to call these hospitals a slaughterhouse. And this is not just this one person, newspapers pick on this "hot gossip" and defame doctors left, right and center. Why expect only doctors to do their jobs for free? Especially when they risk their lives, work overtime in times of crisis, and bear the contempt of their neighbors. Is this not an unrealistic expectation to make? The education process for becoming a doctor is anyway messed up, and this is what happens after you graduate. Another thing to ponder upon is why isn’t the government able to assist with the treatment fees despite receiving a lot of monetary support through various funds?

Miscellaneous

And finally, I write about myself. I had not realized how much risk being a doctor’s son was. Not that anyone is complaining. I should and have realized that if I am enjoying the perks of a doctor’s son, I should also be up for the responsibilities and risks that come along. Lol, there is this one instance where two people came up to our house at night without any mask to ask for help from my dad. Hence, putting not only him but all of us at the risk of getting infected.

Now all this begs the question: what can you do to help? First, take care of the doctors around you. They do not have helpers at their homes so they have to fight the battle at two fronts. Secondly, try to change your mindset towards them. They are not money hoarding machines who keep taking bribes, for God’s sake. They are normal people who have struggled to study and make ends meet and people who have the task of facing diseases every single day. What more? When the entire world is asked to practice social distancing, these people have to touch the patients to examine them. So yeah, have a little compassion towards them and their relatives. I know these are trying times for everyone, but a little empathy towards the people who are taking care of you will go a long way. Thank you for reading this article. Stay safe.