The Madurai Medical College was started in 1954, and 50 of us were admitted in the first batch. Small in number, we were looked after and instructed with care and intimacy. The examinations were strict. At the end of 18 months in I MBBS, about 50 per cent were detained; for, prima facie knowledge was insisted upon.
When we entered the clinical years we were taught the art of taking history, making observations and drawing inferences therefrom. Laboratory investigations were only supportive. At every stage, filtering students in examinations was rigorous.
Our teachers led simple lives and lived in rented houses and bought, if at all, second-hand cars. Our pharmacology professor came on bicycle. Truth and integrity were instilled in our minds. In fact, our professor of medicine, Dr. M. D. Ananthachari, used to say that if we used medical profession for becoming rich we violated our mandate.
The British had just left our country and the characteristic British conservative modest style was practised in life and profession. We used mostly British medical books which taught us both medicine and English.
The expectations from medicine and from the various procedures were modest. The emphasis was on prevention, patience and simplicity that were in tune with our poor and overpopulated country. The profession cured sometimes, but always gave patients comfort and support and they did understand us.
Admittedly, things have changed now. Globalisation has brought in new knowledge. We receive machines and methods from all over the world especially from affluent countries like the U.S. It may be good for a growing country, but the application of such medical practices must be embarked upon circumspectly. A large proportion of our population cannot simply afford all the expensive investigations and treatment modalities. Such indiscriminate offers can be tantalising but also distressing. Selling cows and huts in order to live, often in agony, for a couple of years more does not appear kind and ethical to my mind.
The twin reasons
In our country, people fall sick due to two opposite reasons. The neo-rich due to affluence and the poor due to dearth. Both require to be helped, the first with advice and the second by providing the means of health like cleanliness, safe drinking water and elementary nutritional needs. Sans these basic fundamentals, the bombastic rhetoric about healthcare is absurd.
Time was when patients were really patient. In the 1940s when typhoid struck, students had to lose one academic year, but now the demand is for immediate relief and cure. People's capacity to withstand even minor discomfort is absent, hence the overuse of hospitals and medicines. Further, panic about diseases is spread by the media. What is not realised is that our body itself is a self-repairing machine. Above the many self-contrived measures, our body's innate immunological mechanism saves us from many illnesses. Discipline in seeking health is as vital as in other fields. It is said that by a disciplined way of living, i.e., cleanliness, sensible eating, adequate exercise and rest, one can extend one's lifespan by 14 years.
Seeking medical remedies for all kinds of self-created illnesses is counter-productive. Only the country's economy is kept booming. Trivial self-limiting diseases get elaborately treated. Sometimes, one wonders whether medicines come first and diseases are discovered later!
Earlier, we were selected and educated by the government at public expense and the notion that we were beholden to the public ruled our hearts and minds. Now medical education has been privatised. By hook or by crook admission is obtained and medical degrees are earned. The ethos has changed. The motive to earn back the money spent directs the manoeuvres. The powers that be and the public at large have to be vigilant in the present scenario.
And, finally, a word from Benjamin Franklin: “Nothing is more fatal to health than an over care of it.”
( The writer is a consultant physician, Chennai )
