A few days ago, while the RG Kar medical college at Kolkata offered its normal services to patients in the hospital, something terrible happened to a lady post graduate student, who fell asleep in the seminar room of the hospital, after doing 36 hours of continuous clinical duty!
In the early hours of that night, this lady doctor was assaulted, physically abused and killed by a group of men, likely to be from the same hospital, who were in different stages of training in medicine!
This news with different versions, is now circulating in the media, which is currently addressed by the honourable High court of Kolkata, pointing out the multiple lapses in protecting the life of that lady doctor and inaction on the part of the authorities to book those who were partners in crime. The suspicion is that the mail assailants left the country.
This lady doctor, probably an only child to an elderly couple, was known to be diligent, responsible and lived upholding high values in the practice of medicine. She was a voice of reason and conscience on matters of conduct and character, because of which, some health care professionals had found her uncomfortable for their corrupt and criminal practices.
For the above reason, this lady doctor was on a lonely path, yet, highly motivated and inspirational even after some in the hospitals had harassed her. It seems she was posted on duties more often than others and was reprimanded for unjustifiable reasons. However that did not deter her from being faithful to her responsibilities.
Since this news, there is a state of shock and fear among the lady healthy care professionals. There were increasing incidents of assaults on health care professionals for trivial reasons, by mob attacks and planned intimidatory behaviour in different parts of India. The lady doctors normally encounter indecent behaviour and suffer or cope, often unprotected by those in the authority.
( The front page paper cutting above is from Times of India, published on 18.8.2024 )
Let me respond to this event with sending condolences from Anna and me with flowers from our garden, to the parents and the members of her family. Their loss is our loss. The lady doctor is a martyr of conscience! Her absence from our midst, which was a light in darkness, adds to the intensity of darkness with regard to the safety of lady doctors in health care practice in India! To the family, we offer our profound sorrow and express our togetherness with them in the lonely path they shall tread!
Anna and I light the candle below, in memory this lady doctor who suffered torture and died! She still lives on in our midst as one, who yielded her life fighting cruelty, calling rest of us in the profession to continue this mission, till health care practice returns to its noble calling!
A lady doctor who narrated her woes of about 20 years in health care training and practice in a Youtube channel yesterday, told about the several inconveniences and adverse treatments she suffered from men ! Except her colleagues who stood by her, she received no protection. In fact, some of her remarks pointed to misbehaviour of men teachers towards her. There were relatives of patients who harassed her. She felt let down by her teachers during her post graduate training, when she was struggling to be a mother to her eight months old child.
When I saw this rose flower yesterday in our garden, drooping after a heavy rain fall, I felt that the noble profession of health care is now drooping under the heavy weight of multiple adverse pressures. The ethos of the profession and ethics in the practice of medicine seem to decline! Its profile is turning to be a commercial service, where a patient is a client or a consumer in a hospital, who receives attention through a protocol of service guidelines. The 'heart level' feeling of the health care professionals towards patients, is now less of a mission inferior to the commercial success of the hospital!
I grew up in health care, from the time I started my undergraduate studies in 1967 in an ambience of values of social justice, diligent service, self-giving approach, conduct of honesty and integrity, fraternal regard, and utmost consideration for the wellness of others with whom we work in a team! I have a suspicion that the health care profession is less alive to these foundational values in the contemporary setting!
Some friends contacted me during this week wondering about my response to this terrible situation of loss and grief! The medical students and doctors in thousands are in the streets in different parts of India, to protest against this murder and inadequate response from the authorities to protect life and take prompt action to pursue justice! There is enough reason to suspect that the cover-up action is active to protect the guilty, about which the honourable high court of Kolkata has made critical remarks.
For the last 24 hours, the hospital services were discontinued except emergency services in all parts of India as a mark of protest to this murder. Few hospitals did not consent to discontinue the regular services on account of their hesitation to 'strike work', when the health care profession professes to take care of the needs of others at 'all times'. This is also my conviction.
There are multiple ways to indicate our distress and protest except by denying the care for patients, for whom we exist and are committed to, even when the health care professionals feel vulnerable! The distinct feature of the health care profession is that we exist for others. The health care professionals take such an oath at the time when they are commissioned to practice as doctors.
I happened to revisit this photo above, taken in our garden, of an Oriole perched in a safe branch for its shelter in an evening time. Perhaps it was its shelter for the night. This Oriole felt protected by the branches and foliage around it and is perched in a restful position!
This sight made me ponder on the safety measures our lady medical students and doctors need for their wellness and comfort, while engaged in the health care delivery services !
Let me share seven thoughts, on supporting ladies in health care training or working in health care!
1. I found this family of Parakeets perched on the cables at dusk time. They were together for most of the evening, during the one hour I was in the field to watch their movements. I am not sure whether they stayed there for the night shelter. But they were together at the evening time!
The health care professionals work in a team. From the student days, a sense of belonging develops between friends, as most of our clinical learning takes pace in a group setting. This transcends friendship when we start our professional work. We become a fraternity of co-workers committed to the wellness of each other. Prof. Malati Jadhav used to start her morning clinical rounds in children's ward by turning to all the residents and interns, asking whether they had their breakfast. This to me is a symbol of mindfulness we are called to carry, towards others in health care who work with us.
It seems that it was others in the profession, working in the same hospital who harmed the lady doctor above!
A greater care and attention is needed to restore the sense of fraternity among health care professionals!
2. I regularly watch these Bulbuls, in the photo below, in our garden, who co-feed from the same bowl with equanimity and comfort! They communicate in between their feed. They behave communally and cordially!
I have a suspicion that lady medical students or women doctors do not get such a support of protection or affirmation from the medical fraternity. I know of occasions when boys and girls sometimes resort to oppositional attitude between them while in training. I remember occasions, when as residents, some men did not show sufficient consideration towards their women colleagues.
One example of three men residents taking turns to do the duty of their lady colleague, when she had to take leave due to personal reasons, was the talk in the college, which highlighted how men colleagues often came forward to understand some special situations which ladies might go through. I know of a situation when men residents came voluntarily to be with their lady colleagues, when they faced a difficult situation of harassment from relatives of patients in the emergency room.
It was the contrary that happened in the case of this lady doctor. It was the other health care staff, who tortured her to death.
How do we create a fraternal and hospitable attitude towards women students and lady doctors among the medical teachers, men students, doctors and other men health professionals!
The first level of protection and safety comes from co-workers.
3. I watched this Bulbul comfortably perched, suddenly showing signs of stress, conveyed through its body posture! This happened when a few crows came towards its perch. It flew away to safety!
I have a suspicion that sufficient self protection plan is not introduced to lady medical students or women doctors as a part of their formative education in health care. The intimidation like that of the crows above, are all around them, as the societal moral values are less absolute, more relative or pervasive.
I know of a warden of the women's hostel in a medical college, inviting the lady students to leave a message with two of their friends when they leave the campus as a precaution. This helped, when the students had difficulties, to fall back on their friends to support them. In a resident's group the support for the doctor on call, came from her friends as they were aware of her whereabouts.
I am uncomfortable to accept that all men can be sober in their behaviour, towards women in a post-truth climate, where sensuality is projected as the acceptable norm. There is an addiction to self gratification among some men, that we come across in all walks of life.
It is prudent for lady medical students and doctors to take extra care for self protection, as in the health care practice, men and women work in close physical proximity to each other!
The lady doctor in this case, resisted the invasion to her body all alone while asleep and succumbed while fighting her solo battle!
4. The period of time the health care professionals spend in training is about fifteen years, till a person completes specialty training. Most women get married sometime during these years. The lady doctors carry a dual responsibility of professional and family responsibilities. That journey is long and sometimes it would take turns and twists at unexpected times.
There are the vulnerable times, when lady doctors might drop their guard under pressure to cope and overcome. I wonder whether there is any process in place to support women training in health care, with de-briefing and pastoral care!
The de-briefing is a process when a senior person offers to be a supportive listener and participant in the situation of a trainee. It is a process by which there is an undergirding and uplifting support, to endure difficult times. The conversation times provide catharsis and shed light to move ahead with wise choices.
The pastoral care, is more of dependable friendship, offering wise counsel and affirming care. That is an essential support for personal development of the trainee professionals.
I wish there is a proactive group in every medical college and health care environment, a group of senior women, who engage in de-briefing or pastoral role, towards women students in training or lady doctors in service!
In the case of the lady doctor, whose loss we mourn, seems to have left entry in her personal journal and indicated to a few friends about the stress she was facing! I wonder whether she received enough support or accompaniment!
5. On a quiet mid-day I noticed the Bulbul below, perched, in the feeding corner in our courtyard. It was not wanting to feed.
The way it looked all around showing extra vigilance, suggested that it was facing some threat. It was alone. Often Bulbuls move about in small groups. A threat gets heightened when alone!
I wonder whether we look out for lady students or women doctors who seem to have an orientation to be alone! Being alone is a risk for loneliness! It is loneliness that plays a heavy emotional toll on a person. Sometimes such people suddenly drop their grade of performance or avoid work because of the burdens they carry.
I happened to know about such a phase of some women students from a warden of a women's hostel. A professor with whom I worked had a habit of inviting lady residents to her room during tea time for conversation. Having witnessed such practices, I wonder whether the senior doctors look out for lady students or residents who behave differently from what they were used to and slip into loneliness!
The lady resident who died last week, seemed to have been facing a difficult phase in her life! I wonder whether she felt supported or enabled!
6. I feel that work environment in health care is changing with more women joining the professional service. I noticed this changing trend during the last 20 years. In some medical colleges, about sixty or more percent of medical students are ladies. This is likely to go up as men students seem to opt for other professional paths. I personally feel that it would change the complexion of the work force in health care.
There are some specialties, women would not normally choose due to certain demands which make some women uncomfortable. Soon with congestion in the specialty training, where women are more comfortable, women would be forced to move into different specialities beyond their natural option.
We would have a complex situation when work related stressful demands would be heavier on women doctors. As of now, part time work is not a preferred option for many. A doctor's work span is about thirty five to forty years. It is a long time of multiple demands on a lady doctor- marriage, child birth, children's education, supporting ageing parents....!
I know of senior women doctors who thrived because they had a Forum for Fellowship, to share their experiences and grow in a sense of belonging.
I wish women doctors would belong to such a Forum of Fellowship during their career! I confess that we live in a patriarchal society, where women are yet to be equal in opportunities or prospects!
7. I watched this Oriole protecting itself under the foliage, during a spell of rain. Its body was wet and trickling with water. But it was safe. The foliage and its perch provided it the safety.
I feel that we ought to foster a women friendly health care training setting and hospital lay out! I got a close view of this reality when a new building was planned in a hospital. After the architects gave a drawing, after all the inputs they received from the professionals, the drawing was given to a team of women professionals to consider if the drawing took care of all the safety measures, which were special to women. They suggested some modifications to add physical safety and to position certain facilities in locations which ensured more supervision and access space. It was then I realised how two or three layers of safety can be created in places, where women work so that the intruders have multiple physical barrier to cross!
I noticed how in one hospital, the emergency service area is well protected to avoid public intruders!
I am not sure if the lady doctor who is no more with us physically now, was sleeping in a safe environment!
Let me conclude this long reflection.
The rose flower in the centre is bright and colourful. I want to remember the deceased doctor who lived her life fully! The flower is surrounded by many buds yet to open! They to me, are the symbols of all women in health care training and health care professional services in India. The background in which they exist is darkness, as it is in the photo above.
They study, work and serve in an environment hostile to them. I wish the policy makers, administrators, and health care workers join together to make the training places and work places friendly for lady medical students and doctors!
M.C.Mathew (text and photo)
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