Thursday, 21 April 2011

Dr Binayak Sen, Perhaps It's Time For 'Goodbye India'?

Dear Baba,

Everything pales to the warm feeling of returning home. If leaving home means the search for wisdom, then returning home means wisdom soaked under the skin. One hundred and fourteen days spent behind some crude bars, with a stone slab for a bed, a window perhaps to let the eyes travel far, watery or burnt rice as nourishment for the body, and those minutes and hours and days that crawl and whoosh by alternatively -- you surely need rest back at home. Your eyes looked tired in a video made almost immediately after you had reached home in Raipur. 

But Baba, as I like to address you with as much love and respect as the civil society does, I take the liberty of sounding like I have been hallucinating. Of course, with a country like ours where one feels empowered on receiving a pizza in less than 30 minutes, but feels impotent on having the ambulance arrive not before 60 minutes, words like 'freedom' and 'equality' and many other simple big words provide that hallucinating experience. But, I will let myself 'hallucinate' aloud: I think it is time you left this country where you were born, educated, worked, served, idolised, harassed, implicated, jailed, and finally freed, which gave the people of this country an illusion of a just judiciary. 

I know how you would cringe when people would shower you with laudatory words of praise. I know how you would just listen quietly to anyone who had much to say. You listened, absorbing every word, as though it were a patient's faint heart beat or deep sigh of pain. And when you spoke, not a pin would be dropped around. But I guess, that's the problem with idolising someone -- we listen, feel charged like that moment of orgasm, and then walk home enlightened but confused about action.

Yet, there will be many who know exactly what you are talking about. Doctors, for example. The website of the Medical Council of India lists 314 recognised colleges which offer undergraduate MBBS courses, and many more which offer PG courses. Your specialisation of Paediatrics alone is taught in 214 colleges. Now, let's assume that each college has an intake of 50 students, which is the number of seats available at the prestigious AIIMS in Delhi. In a year, we then ought to have a minimum of 15,700 MBBS doctors graduating each year. Even if we have half the number of confident Paediatricians graduating each year, why do we still see that of those infants who were lucky to be born alive, 63 of every 1,000 of them die before they cut their first birthday cake? If doctors remember what they had studied, how come do they forget the Hippocratic Oath ever so often -- when they insist that forms be filled before an accident patient is looked upon; when they write references faster than writing their signatures, when they know best that just one bottle of IV drip would provide much-needed instant relief to the dehydrated patient; when they confuse their diagnosis upon assessing the lifestyle and thus the class of the patient; when they give 2 Crocin pills and take Rs 150 from a farmer who can at best offer 2 handfuls of rice?

Despite this grim picture, I had heard of many doctors who chose to go to places where a majority of India resides. Yet when I met you, and got to know you better through your daughter with whom I share some enjoyable girly moments, my one deep regret in life began to resurface: why didn't I study few more extra hours to get into a medical school? Why did I instead write songs and poetry and stories? Why didn't I learn more about the difference between xylem and phloem to understand how chlorophyll would makes its passageway through them? (You see, even if I wanted to be a doctor for human beings, I had to learn about plants first. Never mind.) Why didn't I try to understand the intricacies of the carbon and nitrogen cycles? But I sure did enjoy poring over the diagrams, and would be waiting for the day when we would be shown the diagrams come to life and see the various mechanisms of our bodies play out before my eyes.

Most of my friends at that time drank Horlicks every morning to be able to cram up organic chemistry formulae. I hated Horlicks; a bottle of Bournvita was put on my table instead. I preferred to cut out the wrapper and make snow flakes out of them. I'd spend more time at the Zoology lab watching the different bottles filled with formaldehyde, which had many dead foetuses (would they have been cute babies with black eyes and curly hair?), during their different stages of growth. I drew each of them, while my friends listened to long lectures. I waited desperately for the experiment when we would have had to dissect a cockroach, goroi fish, and a frog's thigh muscle. I had made deals with some classmates: they would complete my magnetism and electricity experiments for Physics, while I would do all the dissection for them, draw all of their diagrams and leave the miniscule work of writing to them. I think I could have been a doctor.

My family in Assam is full of doctors. Almost all of them had cleared their exams with nice numbers before they began to practise medicine in a hospital or in private clinics. Almost all of them would bring their own loved ones to places like Delhi and Mumbai for treatment -- they never trusted themselves or their colleagues. Every news of a relative's death would be followed by either of these statements -- the doctor couldn't diagnose on time; the doctor diagnosed the myocardial infarction (heart attack) as acidity; the doctor wouldn't come late at night because it was raining. And this isn't because the relatives live in villages -- they have good jobs with the government, they own at least one car, they have palatial houses, they eat meat and fish daily, they throw big weddings for their children. The Guwahati Medical College spews out 156 doctors each year; 170 doctors graduate from the Dibrugarh Medical college. Yet, doctors within the family were sceptical of the idea of my father visiting Assam, after he had had a bypass surgery, a failed kidney and pulmonary oedema (water in the lungs) -- they knew that no doctor would be able to touch him if there was an emergency. But I wonder, is it really possible to make palatial homes by just treating patients with Crocin? So what did they really study in the medical school?

Okay I understand the need to make decent money, to live up to the dream of a glowing India. And I do understand that it is much easier to work with bottles of blue Sterillium around, to sanitise the hands before entering a patient's cabin, before wearing the gloves, after wearing the gloves, after shaking hands with an educated and English-speaking patient, after taking the gloves off, and after leaving the patient's cabin. But what about the 'type' of people you worked among, Baba? They may have at best offered you just a 'lota' of water to wash your hands after you had wiped the phlegm and blood off the nose of a little crying thin doll. But you know, every now and then, when I read those philosophical musings that one ought not to regret anything in life, I make this plan in my head: suppose I zero on this little village (or even a slum settlement in many of our shining cities). Suppose I am able to convince 12 doctors working in some Sterillium-smelling and sea-viewing hospital to bring for themselves a lot of genuine blessings. Suppose I am able to get a lot of doctors to give me the free sample medicines that they get from MRs. Suppose I am able to get each of the doctors to sacrifice their one month's salary and comfortable life in the city. Suppose I am able to get a room free in that village, from among the relatively richest person there, for the doctor to stay. Suppose that doctor is given his food on time, while he meets patients, talk to the poor, offers them advice of ways to have a healthy diet within their limited grains and vegetables and the occasional egg. Suppose I am able to continue this every month, year on year, with the same set of doctors or new ones. I am not asking anyone to sacrifice any lifestyle for all their lives. I am not asking any doctor to offer his daughter's bed to check an emergency patient, like you have done so many times. All I am asking for is a chain reaction for health. Is this possible?

But I think it would be best that you not spend more time thinking of solutions or possibilities of my mad ideas. It is best that you leave for a foreign university, and spend your days talking about malnutrition in India, and spend the evenings discussing it again during gatherings meant to honour your release from the jail. I guess you should have done that years ago, like most doctors have done. Because if you continue to stay here, we the young and the not-so-young will continue to idolise you, talk about your work, but would never venture to walk your path. Other than campaigning for your release and then shouting slogans further idolising you (which embarrasses you no end, for you are just a doctor doing your work), it is time you expect something more from the middle class Indians. 

Very soon, you will be invited to talk at different forums about your stint in the jail. You will be asked to comment on Anna Hazare's fasting with a fixed smile which gave the media enough fodder to be sandwiched between the World Cup and the IPL. (Oh, while you were behind bars because the patriot in you couldn't bear to see violence, India won the World Cup, and we celebrated on the streets by scaring the Sri Lankan team and their families on the bus while they were leaving the stadium. We went a step further in being patriotic: we shouted slogans against Pakistan, and we yelled out "Leave India" to any 'gora' that we saw on the streets. The cops were out to ensure that we would have a peaceful frenzy to celebrate, and the next day, the site for most revolutions - Facebook - was filled with colourful abuses against the teams that India defeated. The 'patriotism' was reaching unbelievable heights: people spent Rs 25,000 for a ticket that was originally priced at Rs 10,000.) You will be asked to comment on a book written about you. You will be asked to comment on Jaitapur, Dantewada, Kashmir, Forest Rights Act and much more. But I know you will patiently reply to each of them, choosing your precise words of expression. But that's about it. Your words would stir some, but not the students from the medical colleges across the country who have been agitating against being posted in rural areas. They prefer to treat lifestyle diseases like diabetes and hypertension, rather than really prevent illnesses in the first place. 

We are all happy that the Supreme Court has released you on bail. The activist brigade is singing and dancing, before hitting the road with slogans that nobody wants to read or hear, for the next big 'mudda', or writing long petitions to be sent to the President hiding behind her Kaanjivaram veil. But it would be practical that you stay safe. It would be practical that the country decides to wake up to the grim realities you have been talking about. If your work was so good, why are we so lazy to be inspired to really work like you have done? Haven't we all read enough of human rights abuse reports and newspaper articles and theories about 'paradigm shifts'? When will we stop reading and start implementing on what have we read? Hence I say, because I love you, and idolise you, and want you to feel content that hordes will walk up to the weak of our society -- you need to pack your bags for a long holiday. Unless you stop working, nobody else will. 

Would I have been a good doctor? I don't know. But today, where I stand on my life's quicksand, I do know this: when I see your eyes well up each time you talk about violence, I know that those tears are juices of strength to keep you walking where you walk. And I am glad that my tear glands are functional too, each time I sit down to write about yet another smiling bony tribal kid. Three days ago, I heard children from the Bareli tribe in Madhya Pradesh singing out songs of revolution in their language. And then, to honour my presence in their soul-rich and belly-poor lives, the sung to me Joan Baez's "We shall overcome." No, not the Hindi "Hum honge kaamyaab", but the English "We shall overkummmm". Through the hot tears, I was fortified with hope again, just when I was swinging between losing my head and losing all hope. But I have wiped my tears for now, and hence I say this -- unless you make your visits to the embassies, nobody will make their visits to real India.

With love, and in anticipation of your ever-warm hug,
Just another fan -- Priyanka


  1. I have an answer for your big WHY in your blog. Change the WE with I. And Please stop, "If only I were a Doctor, if only two more would have come along?" This may soothe your ego for a few more years and then you will use these statements to justify what you would be then and not what you could have been -to someone sitting in front. Binayak Sen will go nowhere and will work even after your suggestion because he never asked the above mentioned two questions to himself. Not the first one, because he is a doctor, not the second one because he waited for nobody else to help him do what he wished to do.If he would have been a carpenter then he may have made homes in the same place because he wished to do sth for others. You stuck to yous desires-because you want to do that not because poor need you- like you have stuck with the idea. Lots of love (Lots to compensate if I have turned rude)

  2. Dear Yoig, thanks for being a patient reader. Yes, this letter to him was uncalled for, just as the many letters that were sent to him when he was in jail. Why do people do what they do? I really do not know. This is just my anguish upon seeing the dismal "health sector" in our country.
    About the bit of me wanting to be a doctor: I do not myself know if I would have been cooped in a AC cabin or a village, or just been married off. These were my desires then, and each time I visit old sick frail, I feel what I should have done. Just my honest thoughts.

    I know we will all continue to do what we do. Why I write? I really do not know. Why we watch films? I do not know. But these are my views, and it may perhaps resonate with someone too. Or it may not, like the way it has pissed you, and propelled you to sound a little rude :-) But it is okay.

    My idea is exactly the same as yours: to see a WE of India, rather than just one person. Yes, it soothes my ego to look up to him and down at myself. But it is ego of the masses that prevents any work from getting done. We end up in this ego tussle, while nothing gets done. But your comment also gives me the message that I ought to just do my work too, which I have been doing. Someone said, at least write to bring out the reality to the fore. Will continue with that. And I do hope you will continue to be my consistent reader.

    Love :-)

  3. Your choices have made you who you are today. Don't patronize those who have made different choices, or believe that you know what they have gone through to get where they are.

    For almost all the questions that you ask, the answers can be found in some or the other branch of economics. It is not so much a question of "why" (that has never been unanswered, for those who look with open eyes) but of "how" - how to use the principles of behavioural economics to achieve good for mankind.

  4. Samudra, I am not quite sure of that branch of economics. All I know is that people do something because they want to, and then find ways for the same.
    For the rest of what you have said, please refer to my comment just before you posted yours. Thanks for reading nevertheless.

  5. priyanka, you've done well to bring into persective all the topical matters of today
    ... congratulations on so succintly enumerating it with your own down to earth interpretations. I have shared in on fb. thanks.

  6. Rhetoric, irony and sarcasm are all fine to read but I wonder if they can sway people like Mark Antony's speech after the death of Julius Caesar. What makes you think that only doctors are required in rural India? Are there not others doing their bit? Are you not doing what you can by telling the truth? If you think you can do more and should be doing more, who prevents you? If you are not keen on being judged and prescribed to, why must you do this for your baba or for anyone else? I think Dr. Binayak Sen is wise enough and mature enough to take his own decisions without being influenced by your recommendations, however well-intended they be. I think you need to temper your emotion with some pragmatism. Don't get carried away. Love. - Ravi

  7. simply brilliant...keep asking the difficult questions - you may not get answers all the time but it may wreck some nerves somewhere...and the more it disturbs people, the better it is.

  8. Dear Ms Priyanka,

    I have read your letter with interest. Its right that heart of any sensible person will cry for the 'health' of the health system in India. But one thing i want to add. Do you think mere postings of doctors in rural areas will solve the problem? No my dear, its a matrix of economics, priortization of government, fund allotment to health sector, corruption, competition, market forces, privatization, administration( rather lack of it) and societal moral erosion. where does the doctors are coming? Its the same society where you and me has came. you can't imagine every doctor to put on the robe of a saint. Only a few makes history by doing ordinary things in an extra ordinary method just like Dr sen has done.I fully agree with you that some social service must be adhered to by the doctors.They should keep human dignity and life above anything else.

    Don't get disheartened. We will surely make this earth a better place to live..."Hum honge kaamyaab"....

  9. Hello Priyanka,

    There can be no doubt Binayak is a very fine person. And his plight at the hands of the state machinery makes one both angry and sad. In order to make full use of the emotions raised by his travails, I use them to remind myself that there are thousands of people wrongly imprisoned in India at any given point of time. And thousands more are wrongly killed every year by state agencies, or because of connivance of these agencies. We need to generate some momentum on their behalf. Else Binayak's sacrifices, like those of many others, will also be in vain.

  10. Imagine if Mahatma Gandhi had used violence to fight capitalists and imperialists. The fact is he did not and he succeeded.

    Good people like Binayak need to continue their good work out of the maoist/naxalite syndicate. You might counter as to what about state violence. But the Mahatma also faced state violence yet his ahimsa movement succeeded.

    Ahimsa works and is a proven fact.
    Himsa does not work in the long run and there are so many examples all across the world.

  11. Dear Priyanka,

    I recently spent the day at Calcutta Medical College, Asia's oldest medical university (and it does not hide its age with wrinkle reducers). There I sat with several disillusioned and cynical medical students who have decided not to do their post graduation out of contempt for the profession. Even if they chose the field at all (which is rare), the students are disgusted with the profit-driven attitude of their peers, the pressure of older generation to join corporate medical institutions, the complacency of the administration, the list goes on. It is hard to believe that this same university was the site of a vibrant radical health movement in the 1980s.

    The group of activist doctors that emerged from this struggle are rarely in the news, and they are certainly not heads of prestigious NGOs like PUCL, yet they are waging a quiet revolution in rural India. They too like Binayak have left the comforts of the cushy AC cabin city job to do the grimy and unromantic job of transcending the way rural medicine is done. Their work is founded on two basic beliefs: 1. Medical care is a universal right. 2. Health care must be used to support social struggles for self-determination everywhere.

    They do this with the understanding that any movement cannot sustain without winning the trust of the people, and providing health in non-exploitative, affordable and rational way is one of the most efficient ways to do so (as was proven true in the case of Chattisgarh Murkti Moorcha, one of the most successful labor movements in India). Further, they believe that medical information should not be the guarded secret of an elite few, which brings me to my point that one (You) does (do) not have to go to medical school to be a good health worker...One only must have empathy and will power (two things you are totally set on). I recommended you get involved with people like Dr. Punyabrata Gun who is running the Shramik Krishak Maitri Swastha Kendra. He is providing almost free trainings in health to anyone and everyone who's willing to learn. Even those disillusioned medical students I was talking about have joined the hospital in Chengail to get away from the medical educational industrial complex and learn how they can contribute to the "real India". I had written a blog on my first visit there:

    I will post again on my recent 2 week training when I get a chance. Sending lots of love and good energy your way.

  12. Dear Sam, thanks so much for those kind and enlightening words. I am glad you could so perfectly read what I had meant to convey. I have known there are many like Dr Sen who have taken the unbeaten path, but there seem to be fewer instances of such brilliance, and fewer younger doctors taking that route.

    It was amazing to read about Dr Gun, and your words were apt enough to make me want to go and visit him, write more about him, and spread his work as testimony of perfect example. Thanks so much for writing that piece! Hope you have a memorable and enriched training. Will enroll myself for it too, soon, if Dr Gun finds me fit enough to undertake it :-)

  13. I love this piece Priyanka!! Written with great feeling.