All this Medicare Business

Bibekananda Ray

The whole earth is our hospital!" So wrote T S Eliot in 'East Coker' (named after his ancestral village) in 1938,the second of his 'Four Quartets'. What prompted this morbid thought in the Nobel winning English poet, then fifty, is not known; it could be his own illness, or the memory of his first wife, Vivienne Haigh-Wood's (who separated in 1932, died five years later in a mental hospital), or increase in number of sick people at the threshold of World War-II (1939-1945). It came to my mind during a brief illness for which I underwent a series of tests and consulted several specialists in Kolkata and Vellore in September-November 2018 that yielded no definite diagnosis. If they do, or do not, if the patient is poor, multiple tests and consultations can leave him poorer, or heavily indebted. Gone are days when doctors diagnosed by looking closely at a patient, feeling his pulse, taking his temperature and blood pressure, checking the torso with a stethoscope, the eyes and the mouth and by asking a few questions. Dr B C Roy is said to have never touched a patient by hand; he used to write his prescription, looking at the patient entering through the swing door. These days, for nearly everything, a doctor prescribes one or more tests, in his favourite clinic, which often turns unnecessary and futile, like stones thrown in the dark.

Satyajit Ray during his terminal illness in 1991 said, modern allopathic treatment for critical diseases is not for the poor; they just cannot afford it.Criticism of renowned doctors and surgeons by a layman like me may not be acceptable or valid but they appear to me a confused lot; no two doctors make the same diagnosis in most cases. A noted neurologist in a south Kolkata multi-speciality hospital observed: "medical science is not mathematics where two plus two makes four". I wondered, why studying in the same syllabus and even when taught by the same teachers, how they could be so different in practice. A medical researcher in the USA gave an answer: "The difference is due to their difference in knowledge and experience, as between an ordinary and an extra-ordinary student. "What more can be expected when in India mediocre and sub-standard students get enrolled by donations and a high percentage of seats in medical colleges are reserved for scheduled caste, tribe and OBC students?"

Although the ratio of doctors and surgeons to the population in India is far below the WHO standards, visitors from other States and countries underline its reverse in the number of hospitals, nursing homes, laboratories and pharmacies etc.; they say, other States and UTs have much fewer of them. The OPDs of government and private hospitals and nursing homes are agog with patients and their kin of this and other States as well as from Bangladesh. Hospitals in Chennai, Vellore, Mumbai, Bangalore and Hyderabad treat more Bengali patients than other races. I cannot guess what it is due to; doctors say, Bengalis' spicy and high-cholesterol cuisine, water and air pollution and sedentary lives of many of them are among the reasons. Only poor people, firm believers and terminally ill or their kin consult homeopaths. Ayurveda is not very popular except in Kerala and its medicines are not easily available, everywhere. Wrong treatment by allopath doctors take a toll and juniors are often beaten up by patients' kin on suspicion of negligence and mistakes. West Bengal Chief Minister's zeal for cheaper (generic) medicines might have reduced costs of treatment but not every government hospital sells them. West Bengal's health care system in the government and private sector leaves a lot to be desired. The setting up of a State Health Commission, its penalties and the Chief Minister's surprise visits to premier State hospitals have not improved the ground situation. No hospital in the State has a geriatric wing for exclusive treatment of the elderly like the CMCH, Vellore; as a result, old and infirm patients have to vie with the younger to be in the queue for consultation. The government is considering to set up such a hospital in Salt Lake; a study will be carried out to examine its viability. The incomes of private hospitals and nursing homes and of renowned specialist doctors and surgeons are soaring; many of them amass a huge fortune, avoiding, or under-paying, income tax, attracting raids and huge penalty, from time to time. Hospitals, nursing homes, dispensaries, diagnostic laboratories and pharmacies, these days, are many more in urban and rural regions than 50 years ago but few rural health centres have facilities of modern tests and surgery. Diseases have become ubiquitous too; all around, every day, one hears of known and unknown persons falling ill, being hospitalised, cured, or dying, answering to T S Eliot's morbid perception. Why is this so? Have Bengalis become more prone to falling ill? Is their lifestyle at fault? Or because of increasing air and water pollution?Common people attribute diseases and diminishing (sic!) lifespan to partaking adulterated or junk food and drinks, which was unknown to elders, ignoring the fact that modern medicine is extending life. Life expectancy in the State is now 73 years six months, compared to 79.6 in J & K, 78 in Himachal Pradesh and all-India average of 73.2 years.

Are more people falling sick now than say, 50 years ago? In villages then, when insulin had not been invented, diabetes went undiagnosed and took a heavy toll; tuberculosis among the poor and hungry were more common. Many children died of toxin. Lack of pure and safe drinking water made many villagers suffer from gastro-enteric diseases but not many died for deviating from Nature and adopting unhealthy life-styles, as now. In haste, these days, urban people out of homes take junk food, both Indian and foreign and contract virus-borne diseases, like acidity, diarrhoea and food-poisoning. Cancer was there too but victims were not as many as these days. The need to go out early for attending shops, offices, educational institutes etc. and often leaving them late has cut morning and evening walks. Weekly holidays are taken up by shopping, or calling on kin and friends, or just lazing or over-sleeping. Out of schools and colleges, sports beckon youngsters no more. Mobile phones, computers and TVs are breeding a sedentary life and passivity of entertainment. Nearly a century ago, in November 1922, T S Eliot observed in a despatch to 'Dial' on the demise of the legendary music-hall singer, Marie Lloyd: "When every theatre has been replaced by 100 cinemas, When every musical instrument has been replaced by 100 gramophones, when every horse has been replaced by 100 cheap motor cars, when electrical ingenuity has made it possible for every child to hear its bed-time stories through a wireless receiver attached to both ears, when applied science has done everything possible with the materials on this earth to make life as interesting as possible, it will not be surprising if the population of the entire civilised world rapidly follows the fate of the Melanesians (who died of ennui following civilisation 'thrust' on them). If urban people make a conscious effort to emerge from the cocoon of civilisation and return to Nature, perhaps they will not fall sick as much as now and lead a healthy and robust life".

In many Western and other developed countries, people are avoiding allopathic medicines and seeking alternative modes of cure in homeopathy, herbal, Tibetan, Unani and other traditional medicines. Despite virtual ban on homeopathy by the Federal Drug Administration, Americans are trying it and herbal medicines and practices in Ayurveda, popularised by Deepak Chopra in his expensive clinics. India's Yoga, Dhyana and Pranayama are being practised all over the world. Seekers of alternative medicines and modes of cure are disgusted and disillusioned by allopathic medicines and surgery, based on elaborate researches and their global reach, just as the inventor of homeopathy, Samuel Hahnemann (1755-1843) was in Germany. In spite of researches, spanning over two millennia, from Hippocrates (c.?460 - c.?370 BC), human body has not yielded all its mysteries. Comparatively, research is less in homeopathy and traditional medical systems and is therefore, frowned upon as 'unscientific'. Just as pharmaceutical companies advertise their products and new medicines, there is need for the same in alternative systems and a global movement for taking humankind back to Nature.

avery.john.s@gmail.com

Frontier
Vol. 51, No.26, Dec 30, 2018 - Jan 5, 2019