Every story has two sides. That is why, I was always told, if as a practising journalist I don’t capture both of these sides, I fail not just my profession, but I am being intellectually dishonest as well.

Two weeks after writing a piece in an earlier edition of Mint on Sunday, in which I dissed medical doctors for lack of empathy, I stand guilty on both counts. In my fit of pique, I neither saw nor heard a version of the truth that is their preserve. It is only appropriate then that I try to mend fences even as I continue to maintain vigil outside the ICU where dad lies comatose.

To put it mildly, I had underestimated how difficult it is to work at an Indian hospital and try to maintain either sanity or compassion. In attempting to write this piece, I tried my damndest best to talk to the doctors and nursing staff. The intensivist at the ICU, for instance, continues to be somebody whom I want to spend time talking to. But all of his working and waking hours are devoted to caring for either the critical or the dying. He had more pressing matters on hand to accomplish than to talk to a journalist on what his working day is like.

Eventually, I looked up Dr B. Rajendran, a senior neurologist now based out of Kochi. Until sometime ago, he used to be the managing director of West Side Hospital, which he had founded in the city. The two of us had bonded in the past, discussing single malts and the finer nuances of sushi. He is still to forgive me for giving up on the occasional drink.

“What is it like," I asked him, “to be a doctor in India?"

“Godawful," he retorted.

I asked him to put that into perspective. He pointed me to a study published in the Indian Journal of Critical Care Medicine. The results were startling.

• 21% of all doctors consume alcohol in copious quantities

• 18% are on antidepressants

• 14% smoke heavily

• Both doctors and nurses working in the ICU routinely report auditory hallucinations. What it means is that even when they are off work, they hear the sounds of emergency beeps

To get a sense of what these numbers mean, I asked him to open up and get into specifics so that I could understand the profession better. “The working hours aside, the pressures are enormous," he said. In large part, this has to do with the corporatization of hospitals. The pressure on the heads of various departments to deliver profits are obscene, he points out. By way of example, he talks of two large hospitals. The first is a huge facility in the western suburbs of Mumbai; the other, one of the largest in Kerala. What binds them both are that they are run by trusts that border on the social and spiritual and whose stated aim is to offer quality healthcare above all else.

But at the end of every quarter, when the CEOs look at the books, “and the numbers are not on the credit side", says Dr Rajendran, the heads of the departments running up a loss are taken to task and hauled over the coals. In turn, this compels them to prescribe tests and medications completely unnecessary, just so that they may turn in profits.

Things are so horribly unethical at the Kerala-based hospital at whose helm sits a so-called spiritual leader, he says, that they compel pharmaceutical firms to part with 60% of samples intended to be distributed among physicians in the state. These are then sold at the maximum retail price across the counter at the hospital’s pharmacy. “That is why a lot of us from the fraternity would much rather have private practices than work at hospitals like these." That is also why it is often difficult to find the good sheep at places where the motive is almost exclusively driven by profits.

That said, profits are not a bad thing and are essential if any healthcare facility is to run efficiently. But given the nature of what hospitals are, this means walking a very thin line and adds to the pressures on hospital administrators and department heads who have the best of the patients’ interests at heart. At some level, it puts into perspective why stress levels and substance abuse of the kind I articulated above is so high among doctors.

Then there is the quantum of work itself. Dr Rajendran talks of the time he had enrolled for his master’s in neurology at the premier National Institute of Mental Health and Neurosciences, or NIMHANS, in Bengaluru. On any given day, each doctor handles at least 60-70 cases. He thought it a regular part of any physician’s life. But that changed when he went to acquire a deeper understanding of the neurosciences in Vienna. “They were stunned to hear of the numbers we deal with in India," he says. At the outside, a west European doctor sees no more than five patients in a day. “Any more and they are considered overworked," says Dr Rajendran. A sedate physician in India, he points out, is one who sees no more than 20 patients on any given day.

When used to these kinds of workloads, Indian doctors are clearly a cut above their counterparts in the Western world. To understand that better, he directed me to a few veterans in the profession, all of whom spoke to me on condition of anonymity. Their anecdotes range from the bizarre to the telling.

A battle-worn old dog at the All India Institute of Medical Sciences (AIIMS) in New Delhi, spoke to me of an omertà-like code that exists between the institution and those at private hospitals in the city. Each time a political leader falls ill, they are often rushed to the nearest private hospital because these are ostensibly “better than any government-managed facility". In medical parlance, these are the “VIP patients". They are inevitably accompanied by their cronies and an entourage, who are a nuisance to both the hospital and others admitted there.

After running the routine battery of tests, the administrator calls in the VIP’s closest associates and tells them that they don’t have the wherewithal to handle the “medical complications" involved. And that the patient be taken to AIIMS instead, where all of the facilities to deal with them exist.

Often, when such suggestions are made, the entourage that accompanies a political leader creates a ruckus at the hospital and goes on a rampage. A senior doctor who has seen it all told me that is why most hospitals likely to be frequented by the political classes do not have expensive fittings. “After they’ve broken a few windows and damaged a few chairs, they settle down. It happens all the time. So why waste money on what will be broken in any case," he says.

On their part, the doctors at AIIMS have developed a thick skin and don’t give a rat’s backside for all of the sloganeering that accompanies such patients. They simply get on with their jobs and lives and do whatever it is they can do. This, apparently, is true of pretty much every government-funded prominent hospital across the country.

That explains why when the former chief minister of a south Indian state was rushed to a private hospital after suffering a heart attack, the doctors in charge told his caregivers that they don’t have the muscle to handle the case. And that he ought to be rushed to the state capital. They did just that.

Then there was the patriarch of one of India’s richest families in Mumbai who suffered a stroke. One of the city’s most prominent neurologists was called in. He placed a condition. Two floors at a prominent south Mumbai hospital ought to be booked exclusively for him and that all of his personal belongings and staff be moved into the facility. They promptly agreed. The patriarch recovered and went on to live for some more years. What it did though was queer the pitch for others at the hospital who thought they had it in them to deal with the case and that they weren’t being given a fair chance. It is a common grouse held by most physicians whom I spoke to.

Then there are the exploits of legends such as Dr Noshir Wadia and Dr B.S. Singhal, both of whom are Mumbai-based surgeons. “These are exceptional people with IQs in excess of 150," says Dr Rajendran. “It is impossible for the likes of us to measure up to their intellectual capabilities. Most of us doctors are regular people with regular IQs who crammed bloody hard to get into medical school and chose this as a vocation. We try our best. But every once in a while we fail as well and take wrong calls. We should be cut some slack."

Conversations done, I head out of the ICU to have a cup of chai. The intensivist from the ICU is there as well. We nod in acknowledgement. I suspect he knows what’s playing on my mind. He is perhaps hoping I won’t walk up to him and ask what his prognosis is on dad’s condition. I let him be, smile feebly, and leave him alone for his two-minute breather.

Charles Assisi is co-founder and director of Founding Fuel (www.foundingfuel.com), a digitally-led media and learning platform for entrepreneurs. He tweets on @c_assisi

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