Saturday, April 8, 2017

Missing Manners on the Metro - Sharmila Kamat (Goa Today April 2017)

Subway Etiquette and the art of violating it:

Close Encounters with the Constabulary in the US - Sharmila Kamat (Goa Today March 2017)

Not all cops are trigger happy ....

When identity politics and Hillary hate combine to upend the established narrative - On the US polls (Goa Today February 2017) by Sharmila Kamat

Gifted Hands - Memories of Escola Médico-Cirúrgica de Goa by Dr Janvrubai Kamat (Goa Today April 2017)

Dr Janvrubai Kamat recalls the days when she had the good fortune to work alongside physicians at the Escola Medico-Cirurgica de Goa who exemplified the dictum: Medicine is the art of humaneness 

By Dr. Janvrubai Kamat

As the Goa Medical College completes 175 years, we recall its exceptional staff who taught aspiring doctors how to put humanity back into medicine.

In a recent Op-Ed piece in the national press, a professor from India’s pre-eminent medical institute suggested that disciplines from the humanities be introduced into the medical school curricula. In his opinion, physicians today are prone to rely on a battery of tests as a diagnostic aid, giving short shrift to the compassion, empathy and care-giving so critical in the process of healing. The need for doctors to identify themselves less as technical experts, and more as those giving succour, he argued, can be addressed by such an inclusion at the training stage.

Using the humanities to teach trainee doctors to be more humane is not new. In the US, many medical school admissions emphasise artistic expression and visual-spatial skills, besides critical thinking, as criteria for selection. These skill-sets are believed to aid  students in mastering both the science and the art of healing. 

That the medical profession has been undergoing a crisis of confidence is well-documented. Doctor-patient face times are shrinking. The number of lab investigations employed in a diagnosis is increasing. Medical referrals are oftentimes dictated by the desire to send business in the way of favoured colleagues. 

It is debatable if merely including art and literature in the MBBS curricula can address these aberrations. What is required is that students appreciate that what they practice is not a profession but a vocation.

One way medical students in Goa can do so is by taking inspiration from their predecessors in the field. A special mention must be made of medical practitioners at the time of Goa’s Liberation, particularly those who taught at the then Escola Médico-Cirúrgica de Goa, the present-day Goa Medical College.

I had the good fortune to study under, and work alongside, some of these physicians who exemplified the dictum: Medicine is the art of humaneness.

This year, we celebrate the 175th anniversary of the Escola Médico-Cirúrgica de Goa. The college was founded in 1842 to address the high number of fatalities to tropical diseases in the Ultramar Português, the Portuguese overseas empire. As Portuguese doctors hesitated to travel abroad to minister to the sick, it became imperative to train locals for this task.

The Escola Médico-Cirúrgica de Goa was the sole institute of higher studies in the Ultramar Português, reflecting poorly on the importance given by Portugal to education in its colonies. Over the years, the college provided trained physicians to fight sleeping sickness, small pox and other epidemics in the colonies. Many graduates distinguished themselves by pioneering research in tropical medicine.

For students like me, what stood out about the Escola Médico-Cirúrgica de Goa was the dedication and selfless work of its faculty. I will relate a couple of instances as illustration.

On completing my degree, I was appointed in the Department of Pathology as an Assistente, roughly equivalent to a lecturer. As part of my schedule, I was assigned clinical duty in the wards. One evening, a police officer brought in a trauma case – a beggar woman found lying by the roadside, bleeding heavily due to an abortion. It was touch and go whether she would survive.

As Dr João Filipe do Rego, Head of the Department of Obstetrics and Gynaecology, had completed his rounds and left for the day, I called him for advice. He would not have wanted it any other way. He bade me put the patient on life-support, collect her blood sample and wait for him.

On reaching the Emergency Room, he took the sample and, without waiting for the ambulance, left for the blood bank. Despite it being the weekend, Dr Rego was at hand throughout until he was satisfied that she was out of danger.

Our teachers were compassionate, but firm. Case in point – the Director of the Escola Médico-Cirúrgica de Goa, Dr João Manuel Pacheco de Figueiredo. Like all medical students, I was tasked 24-hour duty shifts in the clinical wards during my residency. On one occasion, I was assigned to a ward overseen by Dr Figueiredo, who was also Professor of Medicine.

It was 9:30 am on a Sunday, near the end of my 10:00 am to 10:00 am shift. As all was calm in the ward, I decided to leave a little early. Asking my colleague in the neighbouring ward to cover for me, I went home.

Unknown to me, Dr Figueiredo arrived soon after and found the ward unattended. On learning that I had left early, he sent an ambulance home to recall me to the shift. A mere 10 minutes were left when I came, but no matter. I had to fulfil my obligations. I learned a valuable lesson in the process.

When it was time to leave, as the ambulance on duty was unavailable, I took a cab home. The next morning, the office clerk was at my desk with the reimbursement for the fare.

Besides the Escola Médico-Cirúrgica de Goa faculty, several private doctors served as role models. There was Dr Shantaram Hodarkar, whose typical day was spent in the impoverished part of town, caring for those unable to go to the hospital. His briefcase laden with medical supplies, he would move from home to home, tending to their maladies. Whatever they could pay - a few notes here, some loose change there, they would tuck in his suit pocket. He never checked the amount, he just moved on to the next person in need.

During my childhood, there was the similar inspiration figure of Dr Govind Vaidya. In later years, there were exceptional physicians like Dr G K Salelkar and several others.

As the Goa Medical College celebrates its 175th anniversary, it is worth noting that, more than courses in humanities, it is the personal example set by dedicated doctors that puts humanity back into medicine.

Dr Janvrubai Kamat, a graduate of the Escola Médico-Cirúrgica de Goa, is a clinical pathologist. She pioneered the use of fine needle aspiration biopsy for the medical investigation of lumps and the detection of cancer in Goa, following her training at the Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal.