Sunday 4 August 2013

“Is your mother a Member of Parliament?”

Foreword: This piece is a salute to the best of systems in my country which continue to render their best despite a million constraints and obstacles;  and do so with the dignity of an indefatigable spirit.

“Is your mother a Member of Parliament?”

I was quite taken aback by the rather innocuous inquiry at the Central Government Health Scheme (CGHS) counter at the Nizams Institute of Medical Sciences (NIMS) in Hyderabad. The person who asked the question was the rather affable and endearing clerk, processing the admission of my mother into the private ward of the hospital for a major surgery for stomach cancer.

“Why do you ask?” I said.
“This is the most expensive ward, occupied only by VIPs”, he said.

It was then that I realized: my late father, who was a man of very humble means till his last breath, (his father incidentally was a doctor, an FRCS from London who served the last Nizam of Hyderabad), did attain a significant position in his government job; which entitled his surviving spouse to avail the facility of a decent room and world class treatment in a government hospital. 

A five star cancer hospital which my mother chose at first for its great ambiance and infrastructure (which had generated great confidence in her), hesitated to operate upon her due to the high risks involved in the surgery (read it as …. possible absence of a wide variety of experts in house, to treat complicated cases). However, the surgeons of the government hospital exhibited great confidence and sagacity in planning the surgery; considering carefully, all the risks involved. 

A month long association with the NIMS and watching the things around me; I write this piece even as my mother is in the Surgical Intensive Care Unit (which looks like a dingy rickety medical facility from medieval times). One even wonders, if anybody has ever emerged alive from it. The pre- operation surgical ward would have even the bravest, running away from the surgery at the last minute… But if the facility is good enough for my countrymen who flock to the hospital in large numbers… then definitely it should be good enough for me or my mother or even a VIP or even the Prime Minister of the country.

One might wonder what is the point I am driving at and who has compelled me to get my mother treated at the hospital whose facilities seem so bleak and moreover,

 What does culture have to do with this saga?

I went to NIMS; only for advice from the surgical oncology and surgical gastroenterology departments, which was mandatory; so that my mother could avail the government funding to get treated at a hospital of her choice (a five star facility near my home). 

I waited in the endless Qs of the sea of humanity at NIMS to meet the doctors in their ramshackle office (Some of their departments are now housed in brand new state of art buildings with plush interiors, but not the surgical gastroenterology department and the operation theaters.)

At the first meeting with the doctors I could not help but feel- Why can they not smile a tad more to make the patient comfortable? ( I have got used to an overdose of hospitality and PR skills travelling round the country as the representative of  a premier journal on dance, Nartanam and also having exposure to the  PR and HRD functions of the corporate sector by virtue of my education in Business Management.) 

But, here are the reasons why my mother and I chose the government facility over any other:

The tehzeeb of the doctors came through in the calm and yet the reassuring way they talked, minus any attitude and show off....

The senior most anesthetist, whom the surgeons wanted to handle my mother’s complicated case, looked positively unapproachable and his menacing steady gaze at the first sight did not seem very warm; and I could not but help wish again that the doctors smiled more often to let the patient know that the doctor is not a monster whom you have to bear with, to get treated. Is medicine with its human element and compassion not a subtle art in itself with its own aesthetic?

However, the calm and composed mannerism of the senior most anesthetist, as I observed him a couple of times more, had me wanting to believe in him. I could even appreciate the cultured personage behind a tad too spartan facade. I developed immense faith in him and in the affable head of the department of surgical gastroenterology and his able team - not just because of their professional credentials- but because of the stated elegance in their very presence.... which was  not misplaced; the way my mother's surgery was accomplished.

In arts, especially in dance, this very quality of calm or tranquility which translates into elegance as the dancer displays his/her skill is called Thehraavwhich comes from the self assurance emerging from intensive training in the art form and a deep understanding of nature, culture and ones own SELF.

The huge NIMS  runs quite efficiently with the support staff working like cogs in a wheel catering to large volumes of the sick who are also poor. 

But yes, enhancing the infrastructure and attempting to provide a more humane touch by training the support staff to be a little courteous (Maybe just a smile and a gentle tone of speech would do) would multiply the capable doctors’ magnificent efforts. Having said that, I wonder if hospitals are not considered a hospitality sector?

Culture is definitely an essential ingredient of all professions. 
I certainly have discovered that culture is very much a part of the doctors I have come across at NIMS. Moreover, the manifestation of culture in a person need not always be on overt display or be loud or voluminous or stylish in words or deeds; culture could rest in the smallest of ones mannerisms.

And if the Director of NIMS cares for the feed back of an ordinary citizen; he could arrange for the training of the support staff to be courteous and efficient;
and do well to immediately get better infrastructure to do justice to the efforts of the world class doctors working at the institute.

HRD (Human Resource Development) in corporate style is not what I am hinting at! 

May be a deep conversation with the sterling arts-  especially music, dance, literature and the like- right from ones early growing years is the only way to enrich a person with exalted human values. 


On a lighter note, maybe NIMS should begin by immediately replacing the table seen below:
Note the ingeniously bandaged legs of the table- to keep it from collapsing.

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