It was more than a couple of decades ago when I met Dr. Das in a fishing suburb of Bombay. Jyoti Basu, the Communist Chief Minister of Bengal was his idol, and I, then a chronic patient of malaria, his favourite patient.
Das charged the fisherfolk Rs. 2 in the name of consultation and Rs. 3 for medicines he kept in stock, if he prescribed any apart from kind words. To me, he charged Rs. 10 for consultation and advised me to buy quinine and vitamin tablets from the pharmacy next door. After a couple of visits and getting used to his effective medication, I visited him in the evenings to discuss politics and religion. His clinic opened at 6 PM, patients streamed in after 7, so we had much time for the verbal duel we both enjoyed.
One of those evenings, while I was getting ready to leave, a thin, run-down fisherman came to visit Dr. Das. His shoulders shook in what appeared to be a violent shiver, his fever radiated from the patient’s stool where he sat to my chair a meter away. Terrible back and joint pain, too much fever and shiver, he said; but only when the sun sets. In the day, he said, he felt weak and had a headache but still went fishing. He had to make a living, he explained, for he had a wife and five children.
I didn’t need a doctor to realize that the man had malaria.
Das gave him a packet of quinine tablets and told him to take one with food as soon as he reached home with some food, then another late at night with water. Then on, a tablet in the morning, one with lunch and one late in the evening for four days.
“If you see no improvement, come tomorrow. Even if you feel better, take the medicine for four days and then come to me,” Das cautioned.
The fisherman swung his head left and right, Indian style, but didn’t get up to go.
As if on cue, Das picked up a syringe from the boiler beside his table with a long tweezer, fixed a needle, drew out a fluid from a large bottle. The man knew the drill. He turned around, pulled down his pyjama from behind. While wincing with pain when the long needle entered his fleshless buttock, he let out a grunt of satisfaction.
He then unrolled a dirty piece of cloth, counted out five coins and placed it on the table. While passing by my side, he confided in me:
“Doctor Khoop changla ahe.” His mixed-up language, I guessed, meant that the Doctor was very good.
When the man was gone beyond earshot, I said: “An injection for signs of malaria? You never gave me one.”
Dr. Das shuffled in his chair and drummed the table. “If you noticed that, you also noticed that I didn’t charge him for the injection. Pure distilled water. For these poor illiterate folks, a sui – needle – is the only sure assurance of cure. They believe that modern medicine offers better cure than folk medicine because we give injections, not many local medicine men do that. If he didn’t get that needle on his bum, he’d never believe he would be cured. His faith rests on the needle, not the doctor. If I didn’t oblige him, he would go to a quack and get the sui – more likely with a dirty needle, with dirtier water and made to cough up ten or fifty rupees. An injection is like a religious ritual. It’s the final seal on their assurance of a cure.”
“You could educate them, rather than go along with their superstition,” I said, already guessing the answer.
“You think they would believe me? They would call me a quack who didn’t know how to give an injection. I like to think that I take care of these fisher people’s health by going along with their beliefs. For a living, I practise in a couple hospitals – one in the morning, another after lunch.”
He named two well-known hospitals in Bombay.
I protested, “I’m sorry, but that’s a cowardly argument. Like give them what they like, not what they need. I know many people who believe that smoking cigarettes clear their brains. Some believe that they must smoke to get a proper bowel movement. Would you offer them a cigarette for a headache and another one for constipation? Would you offer drug to an addict to assure him that you are a better doctor?”
Till a few years before, offering a cigarette to a visitor was considered good etiquette. Office and restaurant tables sported beautifully styled ashtrays. The practice was fading as the government advertised on radio and television that cigarette smoking led to sure-fire cancer. Dr. Das still had an ashtray on a corner of his table, piled with cigarette butts sinking their ends into a heap of ash.
He fished out a packet of Panama – a popular brand of cigarettes those days – from his pocket. with the speed of a cowboy drawing his Colt in old American movies, and pointed the packet at me, half a cigarette enticingly sticking out.
“Take one, if you wish to feel better,” he said.
I wagged my head, left and right, Indian style, this time to say No.
“Ever heard of West Bengal’s Subhas Chakraborty? He’s a minister and a leader of the governing Communist party, and an atheist. Yet he leads Durga Pujas, Vishwakarma celebrations, Diwali and publishes photo of himself praying at a Kali temple. That’s how he used to win hugely religious Bengali vote for Jyoti Basu and his Communist party, election after election. Basu is a rank atheist, but he appreciates the need to go along with people’s beliefs if he needed the votes. You can’t wish away God or cigarettes – or even drugs – so serve them moderately while also serving good services.”
Feeling somewhat upset at the cowardly logic, I got up to leave.
“Bishu Dada, one minute,” said Doctor Das. Dada was Bengali for older brother. He called me Dada because I was and probably looked ten years older. Like a true Bengali, he called me Bishu instead of Vishu.
“I consider myself locky to have a friend like you. Please stay for a little while more.”
Locky for lucky, Bishu for Vishu.
“Where did you do your MBBS, Dr. Das?”
“Both MBBS, and MD in All India Institute, New Delhi. Passed out with a gold medal. You may not know this, but I am a surgical specialist, not a general practitioner. I live in the block across the road. I opened this clinic when I noticed the condition of the fisherfolk here. It is a disgrace that these hard-working people have to live in chawls made of jute and salvaged tin sheets with a view of the sea on one side, towering apartment blocks on the other.”
“You think the five rupees I charge them pays for their medicine? No, I make up the difference and money for the rent of this dingy room from my earnings from the hospitals. My wife and a few of her friends hold classes for their children. A few days ago, a couple of men from Shivsena threatened them for teaching them English instead of Marathi. All the volunteers are from outside the state, no one knows Marathi well enough to teach, so they slog on, regardless, with English. English is for the elite, Marathi for those who serve them. We wanted to change that – well, to the extent we could.”
He blew out a pall of smoke and crushed the butt in the ashtray.
“In the hospitals when a patient is rolled in for surgery, the relations crowd outside the door with folded hands, begging the surgeon to save his life. If the operation is successful, they rush to Siddhi Vinayak temple, Mount Mary Church, Haji Ali or some other place of worship to thank their God for saving their dear one’s life. If we see them again, it’s only when they haggle for a discount in the bill. God gets all the credit, and maybe some flowers, fruits, laddoos and money. But if the patient dies, the hospital helps us escape by the stairwell to the basement car parking. Angry relations break glass windows of the Intensive Care unit, destroy costly machines and beat up nurses and ward boys. With rods in their hands, goons roam the wards searching for doctors to thrash. There’s no complaint against God, only anger against the medical staff. Head or tail, God wins.”
I gave him a sympathetic smile. “Must be tough for you doctors,” I said.
“Not all of them do that. Some of them are goaded by local goons or party men. I know of a few cases when doctors and even ward boys were beaten up, the hospital was destroyed. That hasn’t happened to us – not yet. I could have gone abroad, but I chose to stay back. Money is not bad, if you agree to take some in black. Black money makes it possible for me run this clinic,”
I took a long breath. “You are lucky, then. Maybe there’s a God who guides your hand while doing a surgery and protects you when you come out.”
I didn’t let my cynicism show.
“Locky? If you ever have to work on a child writhing in agony with 70 per cent burns, you wonder if you wouldn’t do him a favour to let him die under anaesthesia. You don’t do that, although you know that If he survives with no nose or jaw, he faces a future full of misery and humiliation. The young woman set on fire by her in-laws for not bringing enough dowry, the teenaged girl whose eyes had melted into their sockets and face had become a fleshy mess after battery acid was thrown at her by a rejected lover. You decide that there’s no way but to amputate the crushed limbs of a day-labourer, but your conscience hurts since you know that he would never be able to earn a living after leaving the hospital. He might eventually die of hunger or crawl dangerously under the traffic of Bombay with a bowl., begging for a rupee in the name of God.”
He sighed, lit another cigarette, and went on:
“Two days ago, I operated on a boy of ten with broken skull. His father smashed his head against a brick wall for not saying the fifth of the day’s prayer before going to sleep. The man who did it kept crying for what he had done, and sat praying on his folded knees all evening. His God didn’t save his son. I had to call the police and have the man arrested even before the boy was buried. That’s the law. No, Dada, a surgeon feels all alone with a scalpel in hand and a human being on the table, his unconscious face begging you to save his or her life. Though there are a couple of other doctors and nurses around and are trying to help, you still feel lonely and helpless. You sense no God guiding your hand or whispering consolation in your ears. No, you find no God to help the dying patient or the sweating surgeon. Not a single focking God.”
I shook my head in a gesture of sympathy and gently eased myself out.
“Not a single focking God to help a helpless human or the sweating surgeon,” I repeated under my breath. The smoking doctor does a better job than the focking God, of that I felt sure. Then why did he have to surrender to an illiterate and innocent people’s whims about the need for an unnecessary injection?