DMH in the spotlight

 

There was an incident last week in Pune where a young woman lost her life after delivering twins at a private hospital. The family alleged that another hospital had refused to accept her without advance payment. This incited heated debate in the media and acts of vandalism against the hospital that had supposedly refused to treat the woman without proper financial arrangements. 

When facts were revealed it was evident that the story presented by the family had major deficits. The woman had undergone prior surgery a few years back for cancer treatment at the accused hospital. At that time she had availed of 50% discount from its charity fund. The remainder 50% dues were also unpaid after the treatment. Post surgery her treating gynecologist had informed the family that a future pregnancy would be very dangerous and should be avoided. Instead adopting a child was a safer option suggested. Disregarding this warning the family proceeded to seek fertility treatment from an outside IVF center. The woman got pregnant but did not follow up with a gynecologist for regular antenatal care. She presented to her previous gynecologist after the seventh month of her pregnancy. At that time her twin fetuses were found to be much underweight compared to the gestational age. The gynecologist tried to give the family an idea of the need for NICU care for the babies and surgical costs they should anticipate. A relative of the family reached out to the medical director regarding the quoted costs and advance payment requirements. The Medical Director was in the midst of surgeries and reassured the family that he would speak to the gynecologist later in the day. He told the family to pay whatever money they could at the time and make arrangements for the full amount at a later date. The care of the patient would not be delayed for lack of immediate payment, he assured. Despite this communication the family abruptly decided to sign out against medical advice. The woman was not in labor at the time and walked out of the hospital on her own. She underwent a cesarean section delivery subsequently at a private hospital and died 3 days later from pregnancy related complications. A local newspaper published the story putting in negative light the hospital from where family had shifted her out. That was the beginning of the drama. 

Angry mob came out and vandalized the hospital premises. Social media and netizens went ballistic in their comments about the hospital which is administered by a charitable trust. The state government got involved in the enquiry. In this whole process the hospital authorities have been extremely transparent about the series of events that transpired. The same cannot be said about events pertaining to the family outside of the accused hospital. Did they pay full charges to the other hospital? Did they pay out of pocket for the fertility treatment? Was there negligence during and after the delivery at the outside hospital? 

There are reports of a press conference where the medical director of the hospital in question had presented to give his side of the story. Yet the journalists were so absurd, rude and unwilling to hear from him that he simply saw the futility and left the room. There was no conversation happening, just premeditated attacks on him. 

There were meetings held within the hospital by the administrative team and a letter was released by the director stating what was discussed. In that letter he has described how the team tried to figure out what they could have done differently and as if in a flash of lightning it struck them that “ perceived, though unintentional, insensitivity” due to focus on technicalities of maintaining accounts has perhaps a lot to do with the grievance from the family. The team made a resolution that hereafter no advance payments would be required for any emergency cases in the hospital. 

The entire cycle of recent events surrounding DMH has weighed heavily on the minds of many people and I am no exception. Not only does it pertain to the medical profession of which I am a member, it also is directly linked to the hospital where I worked over the past two years trying to introduce preventive medicine to the people of India. I know the institution and its doctors. I have firsthand knowledge of the high principles on which they operate. Their current ordeal seems personal to me at many levels. 

So many issues come to the forefront from this debacle. Issues about doctor patient relationships, mainly trust issues surrounding this relationship. Integrity of consumers in paying for services they receive. Interference of  power and influence in the business of health care. The tough day to day circus of doctors as they serve their clients and seek a life for themselves and their families. The easy attacks from unruly mobs at the slightest provocation. The onus of transparency on the doctors without any reciprocity from the side that stands against them. The ability for introspection in the doctors and complete lack thereof in the adversaries. The price society pays to destroy good institutions due to such reckless behavior from miscreants. 

I strongly believe that there is a calling on citizens to think deeply about this fiasco and recalibrate their sensitivities for the sake of larger good for the society they live in. Of course one can only hope that Dnyaaneshwar Mauli’s prayer “ दुरितांचे तिमीर जावो, विश्व स्वधर्म सूर्ये पाहो” ( May the darkness of evil drop off from the evil minded, may the world see the light of their righteous duty) comes  true. These are times when the doubt creeps in whether that day will ever arrive. Yet after the short lived moments of doubt, mind reverts back to its optimism because HOPE is its default setting. 

After all things considered, the doctors will put the present period of challenge behind them and go back to serving humanity because that’s their life. They know no other religion. 

As Muktabai has aptly said 

शब्द शस्त्रं झालें क्लेश । संती मानावा उपदेश ॥

From all the pointed attacks, moving forward, these noble doctors will uplift the lesson of nurturing greater awareness about patient perception and that’s going to be good for everyone. Time will tell whether other elements in the society will show similar growth within their core. If we are lucky, they will have the capacity to imbibe wisdom from the saints and stop foolishly following leaders whose message is selfish and small. If we are not going to be that lucky, we still continue to become better human beings out of the challenges they make us go through. The light of swadharma shall shine upon the good doctors always.