All my stories are set in an imaginary country, as you know. All the characters are pigments.
Pardon me; figments. That is right- figments of my imagination.
But there was little imaginary about Shiv Kumar, a year senior to me In Medical School. Tall, Dark and wiry, he was endearing and hilarious; and not so good at studies. He would sleep off in the hostel and miss the first theory class of the morning.
But he will be there at the hospital clinics when it starts, as regular as the lizard that appears when the light in the hostel room is switched on. But the lizard devoured insects, while Shiv devoured patient information. The lizard ate up its prey, but the patients were delighted with Shiv who talked to them while many of the consultants treated them like furniture.
I remember him diagnosing a pneumonia in the surgical ward. The patient had come with abdominal pain. He was lying in the ward, with the Surgeons clueless.
Shiva wanted the government service; he did not want an MD or an MS.
“I come from a poor village. I want to go and work in the Primary Health Centre there.” He would say.
He married Sandhya, a classmate. She shared a similar vision.
After passing, both joined the Service and started working in the same PHC. Both would go, morning at eight, and return at night. It was a large centre that conducted deliveries. Only two of them were there, and most nights would have calls.
“Hey- it is a tough life!” I exclaimed; when I caught up with him a few months after he had joined the Government.
“See, man”- He explained, a trifle patronizing- “when you want to do genuine service, in a developing country like ours, you can’t just go in the morning, do your job and come back in the evening. You can’t be just part of the system. You have to jump into the mud; get your hands dirty. You have to change the system. You have to push; and shove.”
Shiv had to see hundred out patients a day, sometimes two hundred. This left one or two minutes for each patient. In between, he or Sandhya had to attend to inpatients, deliveries, emergencies and administrative work.
“No human being, however well trained, can treat a patient in one minute” – He wrote to the authorities. He pestered them for more hands, more facilities.
The local politicians were irritated. “Nobody else had a problem, till now!” They thought. Shiv oversaw every purchase, and that prevented many from pocketing commissions and he was immediately unpopular. When the local bigwigs in the administration came, or brought their relatives, Shiv and Sandhya gave them the same one minute as the other patients, and this enraged them a great deal. Equal treatment was a horrible disgrace in the country.
Meanwhile, a lady died of post-partum haemorrhage, and the local chiefs egged the relatives to attack Shiv and wife. They smashed his scooter, and stopped with shouting obscenities and threats, along with a few punches and slaps. This, all of us know, is not a big deal. Just a part of the routine.
It didn’t stop with that. Shiva got a ‘punishment transfer’. He had to go and work in a place, two hundred kilometres away. Sandhya was pregnant by that time.
“Hey- you guys are so busy. How did that happen?”- I had asked.
“The duty room has a couch” – Shiv had explained, with a sardonic grin. ‘Risus Sardonicus’- we medical men call it.
Sandhya was left alone, with Shiv working away. She had to manage alone, and after a patient became unexpectedly bad, a crowd gathered around her and pored black ink on her face. Then they gheraoed her for a day. Gheraoing is a form of keeping someone hostage, not even allowing them to go to the bathroom. This was one of the few original modern inventions of this purely imaginary country.
Shiv lobbied for a transfer back to the place to be with Sandhya. An agent approached him.
“It is only a question of eight lakhs, doctor.” He spoke. “For you, I will try to get it done at a discount. Five lakhs.”
“I don’t have that much money!” He exclaimed.
The agent was nonplussed. Many doctors were willing to give more for plush postings, in centres where private practice was lucrative.
Well- That was how Shiv and Sandhya resigned and started a small private hospital in the same place, in a rented large house. They had persistence- I have to admit.
It clicked. Of course! They were good. It ran well for seven or eight years, as I remember. Once a patient with progressing stroke came to the hospital, and a steroid injection, a standard of care that time, was given, and the patient was referred. After reaching the bigger hospital, the patient’s deficit had become more apparent. Relatives alleged that the injection was responsible. They came back and trashed the hospital. Fortunately, Sandhya and the two children was at her ancestral house. Shiv ran, jumped a fence, broke a leg and became permanently lame.
Still, they soldiered on. Shiva had made many enemies with his upright temperament, and a slew of cases were pending in court. The Income Tax Department, the Enforcement Directorate and the GST inspectors were hot on his heels for some nonsense or the other.
A local big man’s unexpected death at the hospital brought things to a head. A group of goons attacked the hospital, and then came to the house where the family was staying and broke in. They gave some affectionate strokes with a rod to Shiv, Sandhya and the children.
Once we commit to the noble medical profession, in an ideal frame of mind, one should not mind all this. This is part of the job. When the system is screwed up, it will remain screwed up. No politician will ever be accountable. But the Doctors and nurses on the ground have to bear the blame. This is pure routine. All of us know that. The society knows that; and wouldn’t give a damn.
But this time, Shiv, for some reason, had had it. He legged it, and along with his family, moved to the city, and joined as a junior doctor in a corporate hospital. Then I had heard that the entire family had moved to one of the gulf countries.
Recently I met Shiv. “Hey what’s up, man?’
“Life is good, dear chap”- He said- “I made some money, came back and started a factory for traditional medicines. I have a resort for those in need of massage and alternate treatments. Yoga, Naturopathy, Magneto therapy, Hydrotherapy- you name it, we offer it.”
“Oh? But what about jumping into the mud and getting dirty, and all that sort of thing?” I couldn’t resist that.
“Yeah. We have mud therapy, and cowdung therapy. We smear it all over the bodies of patients and let them stew in a tank. This is what our countrymen really want. Now there are no attacks, threats or smashing up of the hospital. Life is bliss. I have also teamed up with Gaba Bamjee, for exploring our glorious past to improve the health of the people.”
That was news. Gaba Bamjee was a towering figure in the country in the field of healthcare. All the politicians listened to him, and the health policy of the country was largely decided by Gaba Bamjee. We have to pity people like the Americans. For formulating health policy and for national medical solutions:
They look at the NIH. We look at Gaba Bamjee.
They look at the CDC. We look at Gaba Bamjee.
They ask Antony Fauci. We ask Gaba Bamjee.
“The moment Gaba and I teamed up, the Income tax people, Enforcement and the GST inspectors are off my back.” Shiv had relief in his voice.
“We are doing a great job in developing new medicines”- He continued- “Right in my rented house facility in the village. ‘Bund Corona’ is a lotion that has to be applied to the buttocks twice a day to treat Covid 19. ‘Attacknil’ prevents heart attacks. We even have ‘jan gadhe’, a tablet used by politicians to increase their intelligence.”
“Oh. Ok. Let us get together for a drink.”- I said. But he had already started to limp towards his BMW.
“Some other time”- He was apologetic. “I have to take Gaba to the US for both knees replacement. Very important. One knee of Gabajee is more important than a million, ordinary people of this country.”
He said, with a sardonic grin. ‘Risus Sardonicus’- That is what we medical people call it.