Sour Grapes

“If we had nothing but pecuniary rewards and worldly honors to look to, our profession would not be a desirable one. But in its practice, you will find it to be attended with intense peculiar privileges; second to none in intense interest and pure pleasures. It is our proud office to tend the fleshy
tabernacle of the immortal spirit, and our path, if rightly followed, will be guided by unfettered truth and love unfeigned.”
This speech given by Lord Lister, in 1876, to the graduating students at University of Edinburgh is given in the textbook Bailey and Love as ‘Sayings of the Great’. Although said 140 years ago, his words ring true to this day. If money is what you are after, then Lord Lister says this profession is not for you. This profession is a higher calling, where we tend to the temple of the immortal spirit.
I have often been asked why I continue to work in a medical college, when I could be working in a private clinic, making more money. The answer to this question is neither easy nor simple. A part of the answer would be that it takes a specific measure of courage to fly solo, which I probably lack. If I was in Government service and I was allowed to have a private practice then I might have to change my answer but that situation is hypothetical. The bigger part of the answer would be that it is difficult to practice the art one has acquired over the years in the manner it should be practiced; there are too many
constraints: time, finance, and logistics to name a few.
A dear friend of mine recounted his experience when he started a private practice, a small clinic he did his best to maintain. As days went by, he noticed that he was disappointed with a simple procedure, yearning larger, complex surgeries, as the latter brought in more money. A patient with abdominal pain enticed him to consider the Rs.20,000 costing appendectomy but disappointment hit when it was only a simple dressing for a surgery done elsewhere, and saw the fatter check reduced to a paltry Rs.200. At that moment, he said he stopped to consider what a monster he had become, desiring sicker people for self-gain. He quit private practice soon after and joined a medical college.
I do not necessarily mean to say all private practice is bad. A recent newspaper headline carried the sad demise of Dr. Balasubramanian in Coimbatore, whose funeral was attended by thousands of his patients surprising his own family. Charging only Rs.20 per head and only from those who could afford it, he spent more time talking to his patients rather than prescribing medicines. Candles were lit in front of his clinic, as people gathered to pray for his departed soul. The police had to come to control the crowd at his funeral. Working in ESI, this was just his evening clinic, where he practiced medicine for the love of it.
As another year comes to an end, and another eager batch of interns leave the college to face the world, I pray that they will look into their hearts and souls as they pursue this noble profession as it was intended to be pursued; with truth, integrity , honesty and above all, love for their patients.

By Dr. Jacob Jayakar

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