Doctors

Shatamárii bhavet vaedyah sahasramárii cikitsakah [“If one kills a hundred people, one may qualify as a quack, but if one kills a thousand people, one can qualify to be a doctor”].

It is both amusing and infuriating, yet it is true. Like an old barber, a young doctor cannot be trusted.

But this is not the end of the matter.

It is possible to earn the name shatamárii [one who has killed a hundred people] or sahasramárii [one who has killed a thousand people] by killing mice or guinea pigs in laboratory experiments, but is it not tragic if the killing continues after one has qualified as a doctor?

No matter what country you belong to, tell me honestly, how many doctors can you really trust and respect? Among the doctors you know, you may believe in one or two at the most, but those who have won your faith may or may not command your respect. In other words, the doctors whom you believe in, who can cure a patient, are not accessible because they cost too much. In such circumstances your confidence in the ability of doctors remains intact, but you cannot consider them as friends; nor do you have any real proof of their humanity, hence you cannot give them your respect either.

Moreover, the medical profession as such has more to do with social service than with professionalism. Social service is the main aim of the medical profession. But then social workers cannot live on air, so they have to accept some money for their livelihood from the government, autonomous bodies, public institutions or ordinary people: in short, from those they serve. To be a doctor may appear to be a way of earning a living to an unemployed person, but it cannot be categorized as a business under any circumstances. A helpless person, no matter how great his or her financial, social or intellectual capacity, considers a doctor to be a ray of light in the darkness or a lifeboat which can save him or her from drowning.

Of all the doctors you have come across, how many are idealistic and dutiful? If you visit a doctor, he or she will prescribe strong medicines for a light illness. This will inevitably be the case if he or she owns his or her own dispensary. But the same will be the case if the doctor operates a “chamber practice” out of his or her home; he or she will force some patent medicine down the patient’s throat. The doctor’s special “mixture” will also be prescribed as a matter of course. Here, of course, I am referring particularly to allopaths. The most disconcerting thing is that they frequently diagnose a case by guesswork. An examination of the blood, stool or urine often reveals that their diagnosis was totally wrong; yet the patient depends on the doctor’s guesswork and as a result is required to swallow medicine after medicine. Is this not deplorable? What a cruel joke that doctors do such things to helpless patients!

Methods of medical treatment

Current methods of medical treatment can be roughly divided into 3 groups.

1. The most common method is to fight disease with strong pills and injections.

Allopathy, ayurveda and hekemii (hakims) can be included in this group because they use strong medicines and also poison as a medicine, although their methods of diagnosis and remedies differ. In this method of treatment the selection of medicines involves great risk, because more emphasis is placed on the indications of the disease than on those of the patient, and because of the possibility of causing death.

The great danger in diagnosing illnesses and prescribing medicines according to the germs and diseases present in the body is that it is nearly impossible to arrive at a firm conclusion about the precise nature of germs. Whether diseases are caused by germs or germs are created from diseases which are caused by other factors is a matter of controversy.

The symptoms of one disease may be identical to those of another, and the remedy for one may prove to be completely ineffective or even harmful in the case of the other. Moreover, as poisons are used, they may seriously affect the vitality of the patient. Just imagine, if the doctor is incompetent or is completely motivated by a business mentality, what will the plight of the public be?

There was a time when diagnosing illnesses and prescribing medicines were not very difficult because diagnoses were based on three constituents of the body – air, bile and phlegm – with blood as a fourth constituent. But increased physical and glandular complexity has led to a corresponding increase in the number and complexity of diseases.

So to what extent can this method of diagnosis be useful to a doctor? Is it not simply guesswork to prescribe medicines for a particular disease when the medicine is prescribed for the disease but the disease is diagnosed according to the bodily constituents? If you mentioned this to an allopath, ayurvedic doctor or hakim he or she would probably hand over his or her stethoscope or mortar and pestle and reply, “Here you are, sir. You had better treat the disease yourself.”

This, of course, is an angry remark. While I recognize that a lay person should not have the audacity to counsel a doctor, I must also point out that everyone has the right to consider the merits and demerits of a particular type of medical treatment.

The principles, application and philosophy of homoeopathy are completely different from the above medical treatments. Homoeopathy treats the symptoms of the patient, not the disease or its symptoms. So there is very little possibility of causing harm, even if the diagnosis is not quite correct.

A doctor with good powers of observation and a subtle sense of discrimination can easily prescribe remedies according to the patient’s symptoms. Another speciality of homoeopathy is that medicines are administered in subtle doses, not in the form of strong tablets, and such doses quickly become active in the molecules of the patient’s body as well as in his or her mental sphere.

The greatest difficulty with homoeopathy is that it is based upon the subtle intellect of the doctor, and to achieve such a degree of subtlety regular, sustained effort is absolutely essential. Yet homoeopathic treatment is generally quite slack, and slackness is particularly evident in the proficiency of homoeopaths. Anybody can become a homoeopath by studying a few books. No one will object. In most countries there are no proper regulations either.

Surgery and injections are not acceptable to homoeopathic philosophy, but in certain instances the need for surgery as well as injections cannot be denied. Nowadays of course surgery is gradually being incorporated into homoeopathy. This is definitely a positive development.

Naturopaths do not believe in using medicine. They think that it is possible to cure patients through the gifts of nature only – through earth, water, light, heat and air, together with a proper diet. I do not deny that this is possible, but it is also often difficult to gradually and completely attune the body to nature. People should recognize that medicine does not cure disease, rather nature cures disease with the help of the body’s own healing power.

Medicine only helps to accelerate the activity and speed of the healing process.

In cases where disease is caused by unnatural activity, I do not see the harm in using medicines to help nature. Just as earth, water and air are medicines, are not various types of medicines also prepared by selecting ingredients from nature? Of course precautions must be taken when using medicines to help the healing power of the body, to ensure that they do not cause physical side-effects or psychic disturbances.

Where a person has not engaged in unnatural activity, he or she may still contract a disease due to pollution in the air, earth or water. In such cases is it possible to attune the body to nature? Furthermore, the diets and lotions prescribed by naturopaths are often very expensive and beyond the means of the poor.

Ápascavishvabheśajii [“Water is the universal remedy”]. I do not disagree with this assertion of the Rgveda. However, although I have a deep regard for various aspects of hydropathy and naturopathy, I do not see any reason to support the view that all types of medicine and surgery are harmful. Biná cikitsáy yata lok mare tár cáite beshii lok cikitsáy mare [“More people die with medical treatment than without it”] – nor am I prepared to accept this view, because in the acute stage of an illness even very poor people get or try to get medical treatment. I do not think such views are worth commenting on.

Nevertheless, there is no doubt that the majority of those who die while under the care of doctors die due to incorrect diagnoses and wrong prescriptions. All medical systems can be equally faulted for wrong diagnoses; but as far as wrong prescriptions that lead to death, in my opinion more blame should fall on those who use heavy doses of medicine.

The welfare of the patient should be the main aim of the medical profession, regardless of the philosophical or logical ramifications of a particular system of medicine. Doctors may find it somewhat difficult to work with such a principle, because it is unreasonable to expect them to be experts in all the medical systems. In reality, it is highly unlikely. Nevertheless, what is not possible in a doctor’s chambers may be possible in a hospital.

In the hospitals of some countries the welfare of the patient is given top priority and the patient is treated accordingly. Immediately after being admitted, he or she is thoroughly examined by an appropriate board of doctors who determine the most suitable system of medical treatment.

In other words, if the patient’s disease can be easily cured by allopathy, he or she will be treated by an allopath; if by homoeopathy, by a homoeopath; if by naturopathy, by a naturopath; and so on. If various types of treatment are available, changing from one type to another will not be difficult in the event of the patient not responding to a particular type of treatment.

The healing power of nature: The healing power of nature cures disease; medicine only helps nature. The mind of the patient helps to activate the healing power of nature. If a doctor in whom the patient has complete faith prescribes water instead of medicine the patient will be quickly cured, but if the patient regards the doctor as a quack the disease will not be cured, even if the purest medicines known to medical science are prescribed and properly administered. It is obvious then that the disease is actually cured by the power of the mind, the medicine being secondary.

However, I do not support orthodox psychologists who believe that all diseases can be cured by psychological treatment, because psychological treatment does not work in all cases; it just cannot. Those who believe, as idealists do, that only the mind exists and not the five fundamental factors(2) (of such idealists Lenin said, “They believe that there is a mind but not a head”), argue that the mind is responsible for all diseases.

But does mind alone determine human existence? Does not the mind, which becomes agitated when the physical body is pinched, depend on the physical body? Taking hashish, marijuana, opium or wine causes a peculiar change in the mind. This is but one proof of the mind’s dependence on the body and its nerves.

A disease can be mental or can be physical. Similarly, medicine may be mental or may be physical; hence it is most desirable and productive if both kinds of medicine are administered simultaneously in all diseases, whether they are physical or mental. Those who only believe in psychological treatment for mental disease know from experience that such treatment will not permanently cure the disease and the patient will soon relapse.

Only where, along with psychological treatment, guidance concerning diet, bathing and behaviour is given, and to normalize the diseased glands of the body medicines prepared from the five fundamental factors are prescribed, can the disease be permanently cured.

In the same way, if patients suffering from a physical disease are given proper medicine, food, light and air but at the same time are subjected to constant criticism and humiliation, it will be difficult for them to fully recover.

Even though some people have everything they physically need, they become mentally debilitated, like a worm-eaten, withered flower. So it is evident that patients suffering from a physical disease need proper psychological treatment and a congenial environment in order to maintain their mental health.

The conduct of doctors and nurses: The patients’ faith is more important than medicine in curing a disease, but where does their faith come from? From the conduct of the doctors and nurses, who have to win their confidence and inspire them with faith.

Labourers perform manual work in order to earn their livelihood; they therefore dig the ground without regard for the earth. The relationship between doctors and patients should not be like this. Doctors must use all the qualities of their minds to win over their patients. It will certainly not add to the glory of any country or government if doctors and nurses complain, “Because of the tremendous pressure of our work, we have lost all our sympathy, tenderness and sweetness.”

But to become mechanical due to the pressure of work, on the one hand; or on the other hand to show a lack of humanity by selling hospital medicines on the black market in collusion with dishonest traders, or by illegally using food, such as fruit and milk, allocated for patients; are certainly not the same thing. Can doctors and nurses involved in such activities defend themselves against the accusations of the public?

Exasperated by such dishonest, exploitative bloodsuckers, the public often severely criticizes the government. However, in my opinion the government is in most cases not to blame. Of course it is quite a different matter if the government sanctions insufficient money to properly maintain hospitals, but in most cases this is not the problem.

In medical institutions where the public is made to suffer, you can be sure that improper dealings exist from top to bottom (that is, from the chief medical officer down to the orderlies and sweepers); there is an immoral association among these thieves, regardless of their rank. They are all experts in the art of exploitation – they all share the spoils. Needless to say, in such places neither the doctors nor the hospital can ever inspire faith or confidence in the minds of the patients. This is the reason that today, even after the lapse of half the twentieth century, I notice that in many countries people are still as afraid of hospitals as they are of prisons.

People try to keep out of the hands of doctors just as earnestly as they try to avoid the claws of a tiger. Doctors who operate “chamber practices” out of their homes we may be able to tolerate, but those who themselves dispense patent medicines never let a patient leave without selling him or her ten or twenty rupees worth of medicine, whether he or she needs it or not.

These words may seem harsh, but anybody who has had such an experience will agree with what I have said.

Our complaints are endless. In every sphere of society there is a terrifying conspiracy. Patients are completely helpless. When we discover deficiencies in those who have made it their life’s work to cure patients of their diseases, we naturally become all the more offended and begin to complain bitterly. But while complaining we fail to notice all the difficulties that doctors and nurses have to face in their daily lives. If we discuss such matters not as patients but as human beings, then perhaps we might see that those against whom we have a long list of complaints have been forced by society, consciously or unconsciously, to get involved in antisocial activities.

Those doctors who continue to treat patients as their friends and serve society as genuine social workers while living in an antisocial environment deserve our deepest respect. But what should be done with those who are incapable of doing this, who are full of sin and can be described as antisocial bloodsuckers? According to criminology we may find among such doctors criminals due both to instinct and to poverty. To rectify them corrective measures will have to be taken, such as providing them with a proper education, imparting a proper ideology and creating a proper environment. A dishonest doctor or nurse is more harmful to society than an ordinary criminal, because such doctors and nurses not only harm society directly, they also add to social problems by not performing social service according to their capacity. Their problems should be seriously and sympathetically considered and their difficulties should be immediately solved.

I once knew an extremely honest and capable doctor who suffered greatly due to lack of money during the last years of his life. While active he was a dedicated, exemplary social worker, but when he became physically incapacitated society failed to recognize this. Is it any wonder that such circumstances force doctors to become mercenary?

I have encountered some doctors such as this who did not exploit their patients. Not only did they not take fees from poor patients, sometimes they provided medicine free of charge as well. But some patients think, “If a doctor distributes free medicine, he or she must have an ulterior motive,” so they would rather not visit such doctors. Some of these doctors are forced to maintain their families by private tuition. Perhaps that is why we hear many people say, “The medical profession is a business like any other. Can such a business prosper without doing anything wrong? It is impossible to run a business if one is totally honest.”

In 1940, I went to a homoeopathic pharmacy, with a 12-year-old boy.

I had gone there for some medicine for the boy. The doctor took pains to examine the boy properly, then prescribed some medicine.

He said, “Please return with his medical report on Saturday afternoon.” I replied, “Will Saturday morning not do? On Saturday afternoon I will be going out of town; I will be going home.”

Further discussion revealed that we came from the same district and our homes came under the jurisdiction of adjacent police stations on opposite sides of a river. The doctor then asked me to return the medicine and said, “I am giving you another medicine.” When I asked why he said, “Both medicines are good, but I give the first medicine to people I do not know because it takes a little longer to cure the patient, hence I sell more medicine.

Sometimes I am requested to make house calls too. What can I do, sir? Character is the first casualty of want.”

This incident is neither to the doctor’s credit nor to that of society. The doctor is losing his character due to poverty, caused in turn by a defective social system – isn’t this true?

Sociologists will agree that it is not desirable for those who are involved in saving lives to face financial difficulties.

If in any country the people believe that they have more doctors than necessary, the study of medicine should be strictly supervised so that only competent and talented students have the opportunity to become doctors. That way, by reducing the number of unwanted doctors, those who enter the medical profession will be able to earn sufficient money with the cooperation of society and the state. In the absence of want, there is no risk of their losing their character.

But what is the situation in the world today? How many countries can claim to have more doctors than they need? In most countries there is a shortage of capable doctors. And in those countries where there is little or no shortage of doctors, ordinary people are often unable to get medical help because of financial difficulties. As a result capable doctors also experience financial difficulties which compel them to become involved in antisocial activities.

To eliminate the financial difficulties faced by doctors, temporary arrangements can be made. For example, young doctors who have financial difficulties can be sent from countries with surplus doctors to countries with insufficient doctors so that they can get the opportunity to earn a living and serve society. Education will be necessary to overcome attachment to a particular country.

Criminals are of many types and so are criminally-inclined doctors. As with criminals due to poverty, there is also no dearth of criminals due to instinct in the medical profession. These monsters in the form of doctors (colloquially speaking, cámár d́áktár [vile, low-class doctors]) are the scourge of society. Sometimes they behave so atrociously with helpless people – manipulating dying patients for the sake of money – that I really do not like to consider them as human beings. Such hellish creatures can be found in nearly every large or small city. Very strong measures should be taken against them with the active cooperation of society, the state and socially-concerned doctors.

Once I heard about a doctor, standing by the bed of a poor, distressed patient, who said in an authoritarian way, “You must pay my fees at once. I won’t listen to any excuses.” A poor relative of the patient left the house in despair, borrowed money by giving an IOU, and paid the doctor’s bill. I doubt whether a country can be considered civilized if the strictest reform measures are not taken against such human demons.

I once saw with my own eyes a well-educated doctor snatch a bottle of medicine from the hand of a female patient who had offered twelve instead of fourteen annas for the medicine, saying, “Must I wait till you bring me the two annas from your house? When I was studying in medical college, would the college authorities have allowed me to continue studying had I paid my monthly fees in arrears?” As she was an uneducated rural woman, she could not fully understand what he was saying.

But with that humiliating rejection, she had to return home weeping without the bottle of medicine. Although this incident took place a long time ago, it remains indelibly etched on my mind.

Good and bad exist everywhere.

But regrettably, among the multitudes of the “bad,” the “good” are in danger of being lost. The harshness of reality becomes glaringly apparent if we consider the medical profession as a reflection of society. On the one hand there are good doctors sincerely serving poor patients on their own initiative, and on the other hand we may observe immature young doctors proudly boasting to each other about their career prospects.

Regrettable though these things may be, I do not feel that there is any reason to lose hope.

Countless complaints can be made against doctors and the medical profession.

Patients have to settle for adulterated medicines unless they bribe the pharmacist; sweepers, orderlies and nurses do not take proper care of a patient’s needs unless they are tipped;

A patient writhing in pain may be rebuked instead of being given medicine; if one does not call the doctor at least once for a personal consultation so that that doctor can earn some extra money, one may be unable to secure a bed on one’s next visit to the hospital;

A medicine that is supposedly out of stock in the hospital can be illegally purchased in a nearby shop at an exorbitant price

Without bribing the doctor a sick patient will not be admitted to the hospital;

during the compulsory medical examination for a new job, all the medical staff put out their hand for a bribe; the doctor in collusion with the optician fails many people in their eye tests so that they will have to buy glasses;

hospital patients are served food which is cheaper and of poorer quality than what they are entitled to;

milk and fruits reserved for patients are consumed by the hospital staff;

spurious drugs and injections are administered to patients. Such grievances are endless. Some are extremely serious, involving accusations of such irresponsibility that it is difficult to believe that people actually have these experiences.

Usually the public blames the government for such lapses, but in my opinion, if anyone is to blame, it is the public itself. The government is not an individual who accepts bribes or encourages immorality. The government does not support the distribution of spurious drugs. If the distribution of spurious drugs ever does get sanctioned by the government, it is due to the mistakes of immoral officials. They surrender their humanity to the rich out of greed for money.

Dishonest businesspeople are aware of their own guilt and are constantly troubled by it, but they receive encouragement from greedy and mentally-weak police and anti-corruption officials.

Why not earn a hundred thousand rupees by paying a bribe of a thousand rupees! Most business people wait for the right opportunity with this type of outlook. For these reasons I do not blame the government for such immorality. Now, let us return to our topic.

The key to solving the medical problem is in the hands of the public. This is the actual truth of the matter. One may ask, “Why does the public not do something to rectify the situation?” Some maintain that these problems only occur in underdeveloped countries and that the people there tolerate evil because they are unaware of their rights.

But is this correct? In underdeveloped countries there are educated people who staunchly support the different political parties and who can provide the people with leadership. Although they cannot inspire the whole society, they are certainly able to solve some of the problems. So why do they not do so? The reason is perfectly simple. A large section of the upper stratum of society is involved in corrupt practices.

That is why uneducated people do not have the courage to raise their voices in protest, prevent immorality and take corrective measures against the corrupt elements active in every sphere of society.

A large number of clerks, teachers, engineers, government officials and business people who comprise the so-called educated section of society indulge in immorality and corruption in their respective professions. Their weak minds indirectly criticize injustice but cannot directly confront it.

Thieves can criticize other thieves in a society of thieves, but they cannot offer suggestions in a society of honest people because their lips will quiver and their hearts will palpitate; the condition of corrupt educated people in the upper stratum of society in underdeveloped countries is similar. The Second World War has further complicated the situation. The characters of such people have to be transformed and they will have to become honest, otherwise none of the evils in society will be eliminated, none of the problems will be solved.

The government alone cannot eliminate the problems in the medical profession.

To turn people into real human beings is the burning issue today, the greatest challenge. There are very few people who can take the lead in this undertaking, this sacred endeavour. Today tormented souls look to the purodhás [spiritual vanguard] of society with great expectations.

Politicians cannot provide what is needed.

During the last 6,000 years of human history, they have failed at every step.

Hence, it would be wise for them to resist the temptation to try and take the lead in any sphere of society.