They say, “You have to be crazy to be a goalkeeper”. I say, “You have to be crazier to be an Emergency Physician!”
My interest in Emergency Medicine started very early, in the 2nd year of MBBS itself to be precise. The EMS & the Trauma centre at Sion hospital, Mumbai where it all started is among the best in the country, dealing with the entire spectrum of medical and surgical emergencies.
I still distinctly remember and smile, thinking about the time spent as a medical student / intern putting hundreds of IV lines, collecting blood samples, inserting Ryle’s tubes, Foley’s catheters, collecting ABGs, taking ECGs, accompanying trauma patients to CT scans, counseling patients, etc. Whenever I was free after daily lectures or while taking a break from the library, I would hang around in the EMS. I would look forward to the ‘Emerg-Double Emerg-and Triple Emerg’ where the unit in which you were posted had the call day for the weekend and the following weekday/s and you would end up continuously working 56-60 hours at a stretch in the EMS.
No matter how busy it got, the Doctors, nurses, the mamas and maushis, security continued to do their best – day after day.
Over time, I realized that being a government hospital, with the limited resources and the financial capability of most patients presenting there in the EMS, they were not being offered the best modality of treatment, nor was the treatment protocol based– Eg. There was no PAMI for an acute STEMI or thrombolysis for an Acute Stroke, no management of trauma patients as per ATLS protocol, procedural sedation, drug assisted intubation, etc.
At the same time, there was lack of communication skills, compassion, empathy & sympathy towards patients and their relatives by the resident doctors.
There were many instances during treatment by my peers which shook me and had a huge subconscious impact – seeing amputation of the hand being done under local anaesthesia with the patient howling in pain, pneumothorax while doing blind central lines, breaking multiple teeth while intubation, intubating awake patients with just a shot of Midazolam, patients requiring emergency surgery spending hours for an OT slot, etc to just name a few.
I had kind of made my mind then and there – the people deserve good Emergency care, which does not include only the medical aspect, but of the overall patient experience, satisfaction and quality in terms of ethical and affordable treatment, protocol based, supported by the latest equipment and cutting edge technology. I had vowed to practice ethically, not being money oriented, for the best interest of the people and provide them with the highest level of care. Not even once did I ever think of working abroad where it is possible to earn 4-5 times more money than in India, just because people here too deserve good emergency care.
Over the last 10 years, I have worked exclusively in the Emergency Departments of the top hospitals in the country, setting up 3 Emergency Departments so far, being actively involved in the teaching and training of young doctors, nurses and healthcare professionals. And the journey has been satisfying. More so because I have seen myself grow and learn, everyday.
Even to this day, I remain excited and enthusiastic about going to work. I look forward to the patients I would be seeing in my department. A well managed resuscitation, a smooth intubation, emergency procedures, STEMI, strokes, and everything in the Emergency – THE DRAMA, THE TRAGEDY, THE WORK PRESSURE, THE STRESS & THE URGENCY still excites me like it used to 15 years ago and keeps me going.
If ever I feel low, there are 2 feedbacks that reverberate in my ears. One was by my security guard who after seeing the many post CPR ROSCs said, “Sir, aap toh murda ko bhi zinda kar dete ho” and the other by another hospital staff, “Sir, God forbid, kabhi mujhe ya mere kisi family wale ko kuch ho gaya, I wish you are present on duty in the emergency”.
My current focus is on developing Emergency Medicine as a specialization, providing world class-quality care to my patients and to train healthcare professionals of tomorrow – of integrity, passion, honesty and discipline.
I now have confidence in my Emergency department, our current protocols and policies, the excellent team of Consultants and staff, that in a life and death situation, if we can’t save a life, nobody else can!