Social Responsibility of Doctors - Guest Blog - Dr. Srimathi G.

 Dear Comrades,

I hope this letter finds you well. I recently had the privilege of coming back to the Uyirmei Muthamizh Mandram and meeting friends who are currently studying UG. What started out as a sharing of my experience as an intern, turned out to be a fruitful discussion on the social responsibility of doctors, with an engagement beyond what I had imagined. My sincere thanks to Vijay Sir for inviting me and the members of the Mandram for showing up and holding a respectful and safe space for discussion. I write this letter in the hope of reaching people beyond the confines of the time and space of our meeting. The following is what I had prepared, processed and penned down as my contribution to the discussion.

I want to share with you a story from my days as an intern in the Department of General Medicine at ESI Hospital, Chennai. On March 8, 2019, I was posted in the Female Out-Patient Department and I thought there couldn’t be a better way to celebrate the International Working Women’s Day. Amidst a busy OPD, a woman in her forties came to me with complaints of pain in her arms and legs. Although I had made up my mind to prescribe painkillers, I decided to listen to my training and the feminist inside my head to evaluate her completely, because I believed she deserved it. When I proceeded from menstrual history to sexual history, I was in for a shock. My patient started to cry inconsolably. I would go on to learn that she was facing intimate partner violence and was not allowed by her husband to get treated for her gynaecological complaints and pain during sexual intercourse. She confided in me that he feared judgement from the treating doctor and their community, if people knew that they were getting treated for a suspected Sexually Transmitted Infection. I gave her the painkillers and referred her to the Gynaecologist. I don’t remember her face or her name. I only have this story.

Why did this story stick with me? Why, out of so many things that are wrong with this situation, the fact that she cried to me disturbed me deeply? Probably because as someone in my early twenties, I had not witnessed my elders cry at all, much less come to me and cry. It was a spot older people hadn’t yet put me in. I see this woman in her mid-forties carrying a wounded soul with the pain of betrayal up to the brim, cry to an absolute stranger who is almost half her age. I do not say this to make her look weak. Rather, I want to express the horror I felt when I realised it could have easily been my own mother who is crying there. I have come back to this story several times over the last few years. Today I would like to collect my thoughts and put them together for you. Please stay with me.

I want to look at this situation on two levels- personal and social. On a personal level, why is a person sitting in front of me crying should be a matter of my concern? Because, we as humans have always been deeply bothered by fellow humans’ suffering and rightly so. We all become squirmy when people cry to us. We find ourselves quickening our pace whenever we cross caregivers grieving the loss of their loved ones in the corridors of hospitals, outside the ICU and behind the ambulances. And we are not alone. Vallalar, a great Tamil saint and poet, says “Vaadiya payirai kandapodhellam vaadinen” meaning “I wilted whenever I saw a wilted crop”. Subramaniya Bharathiyar, a renowned Tamil poet and social reformer, says “Manidhar noga manodhar paarkum vazhkai ini undo”meaning “Are we still going to live a life where we silently witness our fellow humans suffer?”  It is in our nature to empathise with our brethren. So, if this incident disturbs you, good- because it should. 

Periyar E.V.Ramaswamy, the Father of the Self-Respect Movement, says “Maanamum Arivum Manidharku azhagu”which means “Dignity and Intelligence are the beauty of being human” By dignity, he does not merely mean a civil conduct or the esteem one holds in one’s society. He means the agency we (should) have to live our lives in our terms, with self-respect. In this story, the woman, in addition to facing intimate partner violence, has been denied her right to a healthy life as her agency to seek treatment has been taken away. If seeing a fellow human’s dignity being robbed doesn’t make us uncomfortable, congratulations to us on successfully distancing ourselves from our innate sense of humanity.

I hear you saying, “Thank you, Srimathi. You have managed to ruin my perfectly beautiful/already terrible day”. Hold on a little bit. Now what do we do with this discomfort? If you are anything like me, you will nicely wrap it into a story, tie a philosophical bow and bother people on their perfectly beautiful/already terrible days. Some will choose action and help those suffering in front of them, materially and/or be with them in spirit. Their kindness, of course, makes the world a better place. But what of the zealous who want to help all the people, everywhere? Why are we called ambitious and unrealistic when we care for all of society? This is where I want you to pick up the second lens to view this story. The social level, yes.

Aristotle, the Greek philosopher says, “Man is by nature a social animal”. Let us forgive the gender insensitivity for a second and focus on the term ‘social animal’ with the emphasis on ‘social’. What is the vitality of this adjective here? He means that the significance of evolving into humans from animals lies in the social nature of our species. Sure, but what does this have to do with being a doctor? And why should doctors bear the social responsibility that makes us ‘ambitious and unrealistic’? Rudolf Virchow answers this question by saying, “The physicians are the natural attorneys of the poor and the social problems should largely be solved by them”. Okay, who are the poor? What are the social problems he is talking about? Why should we solve them? To contextually understand, ‘the poor’ stands for the oppressed- the differently abled, the people who are marginalized based on their gender, caste, class, religion, sexuality, etc. The social problems refer to the injustice and oppression we as a society inflict and allow to happen to others. If we take a moment and read between his lines, we will also realize that the roots of ill health lie in social injustice. By calling doctors the natural attorneys, Virchow makes this fight against social injustice part of our job profile. Then again, I have heard some of my friends asking, “Why should doctors ALONE carry this weight?” Now, I want you to stop and stare back at this mad dog called loneliness in its eyes. Are we really alone? If I may be so bold as to suggest otherwise, I request you to hear me out with patience. The professional loneliness we feel is a grand illusion created by the uncaring hands of neoliberal capitalism to siphon off any hope we have at creating a caring society. We are left to believe that the individual only has themselves to fall back on and fend for. The more we give in to this illusion, the more helpless it renders us. We are all made to feel alone and helpless, together- if that makes sense.

Great, we understand that as health workers, we should come together in this fight for social justice but how do we do that when we are hardly trained for it? At this time, we can start by training for it, by assuming a little more social responsibility with each day, by reading and listening to the stories of the oppressed, by choosing to be on their side, by caring. It does not matter where we start. It matters that we do.

In solidarity, 

Srimathi.