3. A lesson in Humility

I remember my first day of medical school as though it were yesterday. There were 200 of us packed in a lecture hall – fresh-faced teenagers, unsure of what lay ahead. And, in the first 2 hours of our medical careers, we were congratulated by the senior faculty for having been enrolled into one of the top academic institutes in the state. We were informed that we were on the enlightened path of becoming medical doctors, who would be shining examples in society. Although the faculty meant well and hoped to instill a sense of responsibility, it did not help us keep our feet on the ground. My colleagues from other medical colleges confirmed that this was the usual pattern of “orientation lectures”, year after year.

Medicine, as is well known, is one of the longest and toughest fields of academics. During the process, we slowly but surely tend to become less human. The emotional detachment helps us function rationally, but it sometimes produces a sense of infallibility and an egoistic nature. This display of superiority is clearly evident in the attitude of a doctor towards his/her junior colleagues, the hospital staff and patients. And I would be lying if I said that their attitude did not rub on to us (I would like to meet a single medical student who does not agree with me on these two points).

By the time we were finished with medical school, we all believed (in at least some small measure) that we were prepared to face the world on our own. A few days in Poladpur made me realize how wrong I was.

In India, we have two broad categories of medical doctors – firstly, the MBBS & MD/MS degree holders (the “allopathic” doctors), who are authorized to prescribe regular medications. The others are those trained in alternative medicinal sciences – clubbed under the category of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Tibi, Homeopathy). The AYUSH doctors actually form the major backbone of the rural health services, where allopathic doctors are short-staffed.

Recently, the state government announced that the AYUSH doctors should receive a one year training course in Pharmacology (the science of medications – their mechanisms, uses and side-effects), so that they would be able to serve the rural population better. This was met by stiff opposition from the allopathic medical fraternity, who felt that this “magic bullet” solution would not solve the long-term inadequacies. The topic has been debated by far more experienced people and I would not like to go into the details, but like others, I too believed that this move would not be in our best interests.

What I learnt in my initial days of the rural posting was a simple yet much-needed lesson – a MBBS degree and a “doctor” tag does not make a person intellectually superior to an AYUSH practitioner or a staff nurse. It is clinical experience - and experience alone - that makes all the difference. The AYUSH doctors have conducted multiple deliveries, performed innumerable wound repairs and being a part of the community for many years, have a deeper understanding of the patient psyche. This helped me bridge the communication gap with my patients during my initial days.

The staff nurses have decades of practical knowledge and have worked with many senior doctors, so their inputs to problems were always valuable. Most of the nurses I have worked with were extremely helpful, knowing that we have yet not faced real crises situations. Learning from them has been a humbling & enriching experience, something that I did not get a chance to experience during medical school.

A quote from the Christopher Nolan directed movie Batman Begins is sufficient to sum up what I have to say – “It’s not who you are underneath, but what you do that defines you”.