GLORIOUS GMC

The Goa Medical College is the favourite punching bag for all and sundry. But how many care to know the sacrifices the doctors undergo in personal and family life while attending to their call of duty? By DR. V. N. JINDAL.

VINITA MARD-OLKAR (name changed), a four-year-old child is brought to Goa Medical College (GMC) in a serious condition. The parents of the child are very poor. Professor of Paediatrics, Dr. Mina examines and admits the child under her care. After appropriate tests and examination the child is diagnosed to be suffering from blood cancer. She requires expensive drugs for the treatment and the treatment has to be commenced immediately. There is no time to complete the formalities to indent these medicines. Dr. Mina makes a request to an NGO for assistance and the drugs are bought immediately and handed over to the Department of Paediatrics. A team of doctors under the able guidance of Dr. Mina administer these expensive, very toxic but life saving drugs to the child. As these drugs have side effects a strict watch is kept on the baby and also the team of nurses and doctors very painstakingly keep the child in good humour during the treatment that lasts for many days. Slowly the child starts responding to treatment and starts normal eating and other activities. The whole department is jubilant.

After a few weeks the child is discharged from the hospital with an advice to come at regular intervals for the administration of these drugs that are supplied by the same NGO. There are hundreds of such children treated by Paediatrics department since the time Dr. Mina came from special training received by her at Tata Memorial Hospital a few years back. Some of these kids are provided drugs by the government and others by NGOs. However no child has suffered due to non-availability of drugs and other facilities. A highly satisfied and proud team of Paediatrics department organized a get together of all such kids who survived more than five years after treatment. The NGOs entertained the children and gave them gifts and sweets.

An unknown person is brought to GMC casualty in the middle of the night by the police. He was found on the roadside with marks of injury on his head, legs and chest, probably a case of hit and run accident. A team of resident doctors immediately swing into action and arrange blood, start a drip and administer all the medicines in the casualty. The patient seems to be very poor and is stinking. It seems he did not have a bath for many a days. Nurses in Trauma ward give a thorough scrub to this patient. A C.T. scan is performed immediately that reveals a clot in the head. He also has a broken thigh bone and chest injury. After transfusing blood in trauma ward to stabilize his blood pressure, he is wheeled into emergency operation theatre in the night and after a four hour battle of life and death, the patient is brought back to trauma ward in a much more stable condition.

Gradually he improves and revealls his name as Yellapa (name changed). He is a beggar from Santa Cruz. He is ready to be discharged, but does not have clothes, as the clothes he came with were torn. I tell the nurse to let him go with the hospital clothes, but she cannot do that as the hospital clothes have to be accounted for. Next day the patient is not in the bed at the time of rounds. He has been discharged. I was told that one of my residents gave him his almost new jeans and a T-shirt. Not only that they also managed to collect some money for his bus fare to go to Karwar.

Joseph Braganza (name changed), a middle aged patient, has a tumour around his right knee. A biopsy revealed a malignant tumour that in any other institute would have resulted in amputation of his leg. Dr. Bandekar, Professor of Orthopaedics, is very determined not to sacrifice his leg. He first removes the tumour in total. This leaves a large gap between the two bones of his leg. The patient now requires a tailor made prosthesis to bridge the gap in these bones. This prosthesis is made in Singapore (at a cost of Rs. 2 lakhs) from the x-rays that were sent to Singapore and Dr. Bandekar fixes the prostheses in the leg of the patient. The patient is fine, can walk on his own and has thus saved his leg. Dr. Bandekar has performed a rare and difficult surgery for the first time in GMC, and it has cost the patient nothing.

These are just a few examples of what happens everyday in GMC. All this brings a lot of professional satisfaction to GMC doctors. A successful surgery, a cured patient from a serious medical illness and a few blessings from the grateful patients are the biggest reward for the grossly underpaid doctors of GMC. This academic and professional satisfaction keeps the highly qualified and dedicated doctors from GMC glued to their jobs with meagre salaries in spite of very lucrative offers from the private sector. Otherwise each of these senior doctors is capable of earning in a day what they are offered in a month at GMC.

The sad part of the story is that no one appreciates the good work done by these doctors. Their sacrifice of personal and family life in attending to their call of duty is wiped away in just a few minutes when an influential patient dies or does not get what he expects in GMC. Suddenly in the morning, one finds bold headlines in the news paper – ‘Patient dies due to negligence of GMC doctors’. Take for example, a few days back an old person suffering from Parkinsonism was knocked down by a vehicle. He was quite influential. He had sustained multiple injuries. He was brought to GMC but due to multiple injuries and advanced age he succumbed to his injuries. Instead of blaming the vehicle that knocked him down, the relatives blamed the GMC doctors for giving prescriptions to them to get certain medicines and appliances from the pharmacy.

This also happens quite often. Many a times it is not the patient who is unsatisfied, but the relatives who wish to get attention. They complain about the cobwebs in the wards (of course not willing to pay for anything for the treatment of their near and dear ones), they are critical of doctors and nurses behaviour as they were not received with a smiling face, they are critical of non attendance of their patient from minute to minute. But as these are the people who can approach higher ups, the next day an explanation is sought from the doctors and nurses for their behaviour. Doctors, who were basking in the glory of their achievements till yesterday, are suddenly made to realize that treating patients is not enough; they also must learn to please the influential relatives. This is not a rare instance, but happens at regular intervals and demoralizes the staff. The result is that many highly talented doctors are on the verge of leaving GMC and younger doctors are not willing to join.

Somehow, the politicians, bureaucrats as well as the media find GMC a convenient whipping post. The staff is branded as inefficient, corrupt, negligent and careless. Why is this so? Mainly because doctors do not contradict or react to these flimsy allegations. This is not because of any guilt, but is because of the fact that doctors inherently have poor communication skills and also because medical ethics forbid them from discussing the details of the patients treated by them in public. But it is important to know, if the public also has the same opinion of GMC. After all in a democracy, the opinion of public is supreme. In the next few articles, we will examine what the facts are, why there are allegations against GMC, what are the areas in which GMC excels and what are its weak points. We will also delve into the public opinion about GMC and lastly, we will deliberate what the remedial measures to improve upon the existing facilities at GMC are.

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