The news of mob violence at NRSMCH, Kolkata has shaken the entire medical fraternity. KMC is no exception. To showcase their unflinching solidarity with the institute, the OPDs remained closed on June 17th. Doctors and doctors-in-the-making donned black attire in the spirit of ‘Black Monday’.
From 7pm, a crowd comprising of medical students, interns, postgraduates and staff participated in a candlelight march, as ordained by the Indian Medical Association, Udupi-Karavali region. Joining hands and hearts in peaceful protest, they made their way from the fountain area near TMA Pai Halls to the OPD block, candles alight, holding placards cautioning the public against violence while raising awareness of the unfortunate incident at NRSMCH.
Here’s a bird’s eye view of the incident in West Bengal that sparked the doctors’ protest:
On the 10th of June, an 85-year-old man was brought to the hospital in a critical stage. The doctors intervened but couldn’t save him. His relatives alleged that the treating physicians were negligent and around 15 people tried to assault the interns in the ward. This was however safely averted.
Later that night, the family of the deceased allegedly brought in about 200 people onto the campus and launched an attack at the students, interns and residents. Two interns suffered grievous head injuries. They were operated for the same and currently are under intensive critical care.
The police dispersed the mob with a lathi charge that night. The students, traumatized by the incident, closed all gates of the college including emergency care facilities and began a strike demanding for increased and better protection from such incidents in the future.
The call resonated all around the country in various medical colleges as the incidence of violence against medical practitioners is on a rise. Various student fraternities and medical forums have conveyed their support to the students of NRSMCH. Many other medical colleges in the region also shut down expressing their solidarity. The Indian Medical Association also called for all doctors across the country to wear a black badge on the 14th of June.
The West Bengal government, however, has done little to reassure the students. Although the state’s medical education director and Minister of State for Medical Education visited the premises, their attempt to convince the students was all in vain. The students are pressing for stringent and substantial action from the government and not mere promises.
The media coverage and reportage of the incident is dismal and political support has been even worse. No major leader came out in support of the students from any side of the aisle and the Chief Minister, angered and probably ill-informed, lashed out at the students for protesting. Her ultimatum was defied by the doctors.
This created an even bigger furore, giving opportunists a dangerous political and communal vantage. Mobs gathered around medical college campuses with absolute anarchy presiding over the system.
Negligence is inherent to the medical system as in any other profession. But, there is a well-structured system to approach it. Acts of violence against doctors should not be considered avenging the dead. Safeguards should be in place to protect doctors in case of such incidents. The claims of the students and doctors of NRSMCH although reactionary, isn’t irrational. A plan of action is of utmost necessity.
All this being said, let us ponder over the possible reasons for the lack of support for the profession:
Exclusivity is something doctors enjoy in Indian society. Some sections of doctors possess or inculcate a superiority complex alienating them during such incidents.
Incidents of mob violence are generally on the rise all over the world. We must learn from this experience and express solidarity to other aggrieving sections, more often.
As professionals, doctors should inculcate a stronger and more holistic social outlook. Other social problems like communalism, poverty, poor education and infrastructure cannot be ignored. A poorly informed and unequipped society cannot be expected to understand the limitations of medicine.
Poor medical infrastructure should not always be a doctor’s excuse. Government institutions especially are infamous for playing this card. As informed individuals who know the needs of this system, healthcare professionals and the educated public must fight for better infrastructure. Passivity is an open invitation to misinterpretation.
Education at a primary level on how to use a tertiary care hospital is pivotal. Standardized protocols must be made and the masses must be educated on how to follow a referral system and how long it takes to avail care in the current setup. If a person knows the standard response time, he’s less likely to get agitated even if it is long.
Here’s a guide on how to navigate through the inner workings of a medical college:
If you present to the out-patient department:
- The unit head and his entire unit of associate and assistant professors, residents, interns and undergrads go on rounds to the intensive care units and wards.
- They then come to the OPD and stay put until lunch. The only next break is at 5 which is the end of OPD hours.
- The standard time per patient in India is about 2 minutes. The doctor has to take a history, examine, diagnose and send for investigations as promptly as possible.
- Teaching hospitals usually don’t have an appointment system. So if you’re coming to the OPD, it means you can wait.
- You have a right to know of undue delay or question any preferential treatment to other patients. Question the staff confidently with dignity and maintain the decorum of the hospital.
- You have the right to ask for a prescription of a generic medicine in case of economic constraints or other reasons.
- You have the right to refuse treatment, but have to give an informed refusal form stating the same.
If you present to the emergency:
- There is a triage system in place where each patient is colour-coded based on the severity of his condition.
- This protocol is standard and most hospitals follow WHO guidelines. If you are made to wait, be assured that the doctors have it on good authority that you can. It could also mean that the other patient is in a more severe condition.
- Only emergency investigations and treatment will be provided here. You will be referred to the respective department for further evaluation.
Presentation in labour:
- The situation is always tense in government hospitals as this will be the first presentation for many women.
- Doctors have very little time for evaluation and will hence try to speed up the process based on which stage you are in.
- There are standard guidelines for performing c-section and the treating doctor is duty bound to inform you about the same in non-medical terms and in a language you understand.
- Hear them out carefully (especially about the complications) and give consent.
- You have the right to second opinion and are free to take one if you see the need and have the time.
Presenting for an elective surgery:
- You have the right to be informed of the condition you have, treatment options available, cost and outcomes in non-medical terms in a language you understand.
- You have the right to take a second opinion. You can ask to be referred to a government institution if they offer a similar surgery at a cheaper price.
- You have the right to refuse treatment/surgery but have to give an informed refusal stating the same.
- Surgeries are performed in the order of special, semi-special and general ward patients in private institutions.
- There can be intraoperative complications because of which you might be delayed or postponed.
- You have the right to know the cause but do so in a calm and dignified manner.
Any complaints about the hospital staff, doctors or amenities should be addressed to the medical superintendent or chief of medical staff. Complaints must be given in a written form and an acknowledgement receipt will be sent. You can follow up on the same in person in most cases.
In case you suspect gross negligence and inaction on behalf of hospital staff, you can file a complaint in the district, state or national consumer forum. Accordingly, you can argue your case providing the necessary evidence. Use of an attorney is your choice. The case will also be referred to the state medical council and a board will be set up to investigate the matter. Taking all aspects into consideration, the consumer court will award compensation while the medical council will take disciplinary action against the doctor.
The law is quite empowering to the plaintiff in case of consumer affairs. In fact, the onus of proving innocence lies on the doctor. There is absolutely no need to resort to threats or violence.
Remember the Sanskrit shloka: Dharmo rakshati rakshitaha
(Righteousness protects those who protect it.)
And a strong appeal from every doctor; forget the shloka: Vaidyo narayana harihi
Doctors are not gods, nor do they claim to be. They do not want anybody to place them on a pedestal – a pedestal from which the fall is inevitable despite efforts, because life is neither perfect nor permanent. They don’t ask for praise. They ask for understanding.
They are humans just like everyone else, with some knowledge and some skills, caught in a crucial but risk-ridden profession, trying to contribute to society to the best of their capabilities.
-Written by Vinay Reddy
-Edited by Niharika Dixith