Conversations

About the Author:

Before retiring, Professor Mohankumar taught for two decades at TAPMI, Manipal. He is an electrical engineering graduate from the College of Engineering, Trivandrum, Kerala, and has a Masters in Computers and Information Systems from the University of Michigan in the US. Although he has experience working in both academia and industry, his main passion is applying knowledge and technology to practical, social situations. Since August 2021, he has been volunteering with the PMD, Manipal.

 

After my retirement, I started volunteering with the Department of Palliative Medicine and Supportive Care (PMD) at Kasturba Medical College and Hospital, Manipal, Karnataka. The hospital holds a special place in my heart as it is where both of my parents received end-of-life care.

As a department, PMD is still quite young, having turned four in September 2022. Staffed by a small team of competent doctors and nurses, PMD exudes dedication, passion, and empathy. The department is already noted for carrying out work that’s different. The overarching focus is of optimizing quality of life of the ailing, followed by its delivery to the ailing patients as well as to their caregivers.

The following is a slice of my conversation with Dr Hitesh (name changed), a senior doctor in the department with a track record of rich experience in palliative care.

Hitesh and I were walking back from the Nephrology ward, where he had just finished a detailed conversation with Mr Rajaguru (name changed), a senior citizen who has been on dialysis three times a week since September 2019. We entered our cabin as our work day was coming to a close.

Me: I met Priya the other day.

Hitesh: Oh, how is she doing?

Me: Fine; she said she no longer has those nightmares.

Priya was one of the six volunteers at PMD who used to work with us until she withdrew over six months ago. She found the going tough and felt she could not cope. After careful consideration and detailed discussions with a senior doctor from PMD, she opted to discontinue volunteering for a while.

This was before Hitesh joined.

After listening intently as I filled him in, he said, “That was an apt decision. It’s important to remind ourselves that not all of us can do the different tasks of our work equally well, nor can we enjoy every aspect of it.”

“Agreed. Then there’s the case of Jomon (name changed),” I added. “He stopped volunteering because of the surgery he underwent. The reason for not returning to work after recovering, though, is something else. Two and a half decades of non-stop, sincere work put in at the hospital’s Cath lab has left him jaded with these hospital settings, he confessed to me.”

No sooner had the last syllable of the last word dropped off my mouth, the words, “Who knows, in a few years I may also get burnt out, given the way things are going,” shared Hitesh.

That hit me. Hit me so hard, I found myself staring at him nonplussed.

I blurted out, “What! How can you, you of all people, speak so? You are in the palliative care space for so long, and doing excellent work. And you are so passionate about it – I don’t understand.”

His response, a detailed one, helped open my eyes.

“I come from a family of doctors. Parents, siblings, cousins – all doctors. I grew up listening to dining room conversations on medicine, patients, surgery, and so on. When the larger family got together in a function, for an outing, to travel, or whatever, then, too, one could only hear people talk on medical topics, problems. When I was to get married (to a doctor, of course) my name was printed as “Dr.” Hitesh in the invite. I protested. I wanted the “Dr.” salutation dropped,” he paused.

He continued, “I am a doctor and enjoy what I do. When I am with a patient, I love to bring my knowledge and skills to help them as much as I can. I am empathetic. But if I have to have empathy, if I wish to put myself in their shoes and converse together with them, I need to be kind. Kind to them. But here’s the thing: before I can be kind to them, I need to be kind to me. Without being kind to Hitesh, as a normal, ordinary human being, there is no way I can empathize with another human being. Doctors, as a community, have to be humanized; Isn’t a doctor a human being too?”

Hitesh went on to add, “I thoroughly enjoy being a doctor, but I am not ‘only a doctor.’ My personality is larger. And I often miss my non-doctorial life. Listen to this – My wife is a doctor, her father is a doctor. But her mother is not. She is a homemaker. She complains that she does not know what to talk about with her mother. Why? Because she keeps asking about food, what she had for breakfast or lunch, whether the house is being kept clean, and other ‘trivial’ things. I say to her, ‘What else do you expect of your non-doctor mother? And, more importantly, what’s wrong with those queries? These are important questions to consider for any human being. Aren’t these some of the topics that bring us doctors back to normality and help us retain (or regain?) our sanity?’”

“That’s why I enjoy my Kannada classes. It is an hour spent learning about something non-medical, when I can forget, for a brief pocket of time, that I am a doctor.”

As we were leaving, he concluded the conversation and said, “First and foremost, I need to be kind to myself. This is a must. Unnegotiable. Otherwise, my sanity could be at risk. And when I am conscious of my humanity, just as anyone else is, I’ll be in a position to relate with my patients as human beings – thus breaking the ingrained doctor-patient hierarchy. This hierarchy is unnecessary, undesirable, and toxic. It puts up a barrier obstructing patient-centric healthcare and healing.”

Now I stared at him once again. But this time it was different. I understood.