MEDICINE IN BOMBAY

New Zealand Listener, Volume 15, Issue 388, 29 November 1946, Page 8

MEDICINE IN BOMBAY

THIS article, like a recent one on the education of women in India, has been written for "The Listener" from the personal experience of a New Zealander, Aroha M. Hardcastle who, by marriage into a Deccani. Hindu family, became Aruna Yeshwant Gupte. She is a a graduate, of Canterbury University College, and Sa: returned to’ this country.

O one should lay down the | \ law even. about what she has experienced personally. Circumstances alter cases. But, in general, I and my husband have

good reason to distrust the professional ability and integrity of the average doctor in Bombay. As you may know, the principal Indian medical schools are in Bomhay. Students come from farther India and even from across the border to study medicine and surgery at Grant Medical College in Byculla. The standard of education demanded for entrance is B.Sc. Honours. The professors have all studied and obtained diplomas in Europe. The college is wealthy and very well endowed. All modern facilities are there, and the students are also well endowed. "Yet, medical treatment is very unsatisfactory, compared with what our New Zealand medicos do as a general rule. "Money Comes First" First comes the money question. When a family or a community have paid to get a young man or woman qualified to practise medicine, they naturally expect to get a fair return for their outlay. Generally the doctor has a large clientéle of his family, friends and relations. His charges are low, and are often left outstanding, to be collected when convenient to all concerned. Along with’ his visiting patients, he keeps a dispenser and runs a very lucrative dispensary. This is how he really makes doctoring pay all the year round. There are not many dispensing chemists in Bombay. There are plenty of chemists, who sell all the fashionable imported nostrums, injections, vitamin and hormone preparations, ad lib., and ad nauseam, Indians are addicted to taking the latest medicine and treatments, and the doctors and chemists naturally do very well out of these proprietary scientific charms and spells. But, since the dispensary is a busi-. ness, Mrs. Doctor is likely to interfere. I have had Master Doctor turn up half-an-hour after I have left the dispensary, with a note asking me to pay the bearer of the note immediately! Followed by an even sharper note when I told the child that it was not convenient at that minute. Tell Him Yourself Doctors in Bombay will, in my experience, not treat a patient who looks as if he cannot pay: They like the fee to be put down on the desk before they proceed to examine the unhappy victim. They frequently refuse to take a case if they think the woman or child is in a bad way and likely to die. The excuse is that people get very angry and blame the doctor) if he cannot cure the disease so he prefers to do nothing and save his medical reputation. The ordinary G.P. in Bombay is no good at diaghosis. You had best tell him yourself what is ailing you, otherwise he will treat you for whatever is most prevalent, or most profitable. My husband is the pathological photographer at Grant Medical College. All the doctors (continued on next page)

(continued from previous page) and students meet him at one time or another. He became miserably thin and ill, during the bad years after 1940. He was invited to have calcium injections, and even offered the Wasserman test! I induced him to have certain teeth removed, and wrote to New Zealand to enquire about his alarming symptoms. Now I know, and have written to tell him, that he is suffering from enterocolitis, caused by long-standing malnuvutrition; and I have learned, here only, what diet he must stick to, to avoid further pain and weakness, till he can get out of the country! The doctors who s.w him daily, and were his friends, either did not know, or did not care. Rich patients, officials, titled families these are excellent clients. Why take a patient who will not pay? The very low, who have alarming tropical diseases, or V.D., are collected, treated, and studied, by those who wish to make a name, and collect a fortune, as specialists. I have heard very little about surgery in Bombay. Medicine and treatments are far more general and profitable. Positive and Negative Gynaecology Also gynaecology! This is practised in two ways. There is the positive side, which sets up maternity homes and obstetric hospitals. That is a very good average sort of practice. There is the negative side, for the’ wealthy, which prevents little troubles from being born at all. That is very lucrative. That is a specialist’s game.

When I was really ill, I met Indian men and women doctors at their worst. It was 1941-42, when anti-British feeling ran very high. One young man positively refused to do anything for me at all. "You live a long way from my place, and if anything should go wrong, I would be blamed." Another, a relation of my husband, living near by, flatly refused to prescribe even an ordinary bromide powder. "I will not -give you drugs," said he.

A sudden rash of large, painful water blisters, like a bad scald, came out on my shoulder. I bought a well-known British proprietary ointment and went to Doctor. "What do you want me to do?" said he. "I want you to put this ointment on my arm, and bandage it so that I can put on my blouse without hurting myself," said I. "Why don’t you go to J.J. hospital?" "Because, until you bandage this arm, I cannot dress decently enough to go there." Well, he did exactly what I asked, no less, no more, and had the decency not to charge me for that service. After that we cut each other dead when we had the misfortune to meet. When I was going to have a child, which we lost,in a very miserable and untimely manner, I should have carefully avoided these people. Instead, I went to a celebrated obstetric hospital, hoping for advice and proper examination from their women doctors. The Irani (Persian) woman who subjected me to very rough handling told me she did not like the English. She also, having

hurt my back so that it was not right till after I had lost my chance of having the child, told me that I was not "carrying," and needed only a purgative — which subsequent events proved to be a crashing lie. I became so afraid of them all that I feared they would kill not only my chances of having a child, but me as well! 4 I know of one young woman who slipped and fell, heavily, so that she damaged her kneecap. Unfortunately. her mother took her to the hospital, and called on a local G.P. as well. The result was, one permanent scar from an ultra-red treatment burn, two months in bed with (alleged) fever, and a delightfully costly series of injections for something or other which was never exactly epecified. Since she was employed as secretary to the group of doctors who did all this mischief she had to go through with it, looking grateful, to keep in with them. To Sum Up Probably one could complain to the Medical Council; but probably the Medical Council knows all about this, and prefers to keep up the general high reputation of the Indian medical schools and profession, by making everybody keep quiet. Our own verdict js that the medical training is quite up-to-date, and thet Indian conditions make it possible for a man to become a specialist, very easily, if he can afford to pay for the course, and to live in the broad-minded fashion of the rich man’s sons and daughters who take up this line. But Indian social and economic conditions also make it almost necessary for the ordinary G.P. to become a moneygrubber. Gynaecology — meaning midwifery, abortion, and treatment for various kinds of venereal disease-is a very profitable business. Fevers due to malnutrition keep the dispensary ‘running nicely. And, in sum, you would do well not to be sick in India. You would do best to die there, if die you must, quietly in a corner somewhere, without bothering your head about a doctor. My experience led me to believe that they are all probably very nice people, privately, but that profe$sionally they do not understand either Western medical etiquette, or ethics.