What should be in a book to make
it a best seller?
A girl on the cover & no cover on the girl
Story of Doctor
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Me 12th me tha, wo 12th me thi
Me MBBS me aagaya, wo BSc me thi
Me MBBS me tha, wo MSc me thi
Me MBBS me tha, wo PhD me thi
Me MBBS me tha, wo Dr ban gayi
Uski Shaadi ho gayi, me PG entrance de raha tha
Wo 2 bacho ki MAA ban gayi, me MD Gync kar raha tha
Bachhe 5 sal ka hokar school jane lage, me SR kar raha tha
Bache 10th pass ho gaye, main hospi suru kiya
Afsos yeh hai ki Aaj uski
Tubectomy hai aur meri Engagement
Story doesn’t end here journey continues …..
Dr. P. C. Mahapatra
Professor, O & G
S.C.B. Medical College, Cuttack
PRESIDENT, FOGSI – 2011
Oldest Profession in Human Race
Medical.
Legal.
Prostitution.
Medicine Man
Priest
Herbalist
Magician
To bring relief to the sick in complete absence
of medical knowledge
Primitive Medicine
Magic
Religion
Magician
Priest
Anesthetist
Surgeon /
Physician /
Gynecologist
Medicine was conceived in sympathy
& born out of necessity
The first doctor was the first man
The first woman, the first nurse
Evolution of Medicine & Medical
Profession
 Prehistoric – Indian, Mesopotamian, Greek
 Emergence of organised medicine
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AMA, 1847
Emergence of Public Health
Generalist / Specialist / Subspecialist / Superspecialist
Technological innovations & Pharmaceuticals – Impact
Health Care Vs Medical Care
Doctor Patient Relationship – Change
Doctor & Society – Change
Medicolegal Scenario – A Curse
Health Care System Vs Health Scare System
Policy makers – Bureucritic & Political Hippocritic will
Changing Society, Changing Problems
Believe It or Not
 Noblest of the Noble Profession
 Changing System Changing Society & Changing
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Philosophy
Usually by choice not by chance
Strong believer of destiny
Mainly by labour not by luck
Live for others, don’t live for yourself
Balancing personal & professional life
 Easy to tell, difficult to practice
 Individually very strong & powerful, collectively very weak
& timid
 Tunnel vision personality
Believe It or Not
 3/4th of life spent for profession & don’t
understand the meaning of life
 Bound to be exploited from everybody –
Professional Hazard
 Highest ranking in society but unsocial
 Don’t think of future, only lives in present
 Head, Heart & Hand – A Real Amalgamation
 Art, Science & Commerce – Unique Combination
 No religion – Humanism
Sickness / Diseases
Emergency medicine
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10%
Minor illness syndromes
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30%
Doctor thinks you have a disease
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10%
Patient thinks he has a disease
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10%
Chronic illness syndrome
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25-30%
Drug or doctor induced (iatrogenic) -
10-15%
Pathy
Pathy
&
Pathy
Annubhutti Vs Anubhav
Introspection
Experience
My Introspections
 Only brother sandwitched between 6 sisters –
Feminine personal development to some extent
 From a lower middle-class family – Realising the
ground reality
 Born & brought up in remote sub-urban area of
Western Orissa
 Schooling in conventional Oriya Medium School
 Ambition to become a doctor from childhood –
Role Model
 God fulfilled my ambition Shifted from Engineering to
Medical – From REC, Rkl to MKCG, Bam.
 Mediocre medical student – involved in more
extracurricular than curricular activities enjoyed every
bit of studentship excepting studies
 Wanted to be gynaecologist
 Unpredictable, chance, competency
 Enter into PG Course in OBGYN, SCB by luck, not by
labour
 Started study during PG Course
 Inspired & stimulated by my the then teachers for
excellence
 I love my profession most
 Desire to have a family of Gynaecologist & could be
successful
 Wanted to settle in my own State & make the State
at par with place of professional excellence –
Struggling continuing …
 Wanted to be Teacher-Doctor and by God’s desire,
could ultimately be – Father’s inspiration
 My teacher’s guidance & effort and goodwill of Seniors &
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friends – Key
Enjoyed in Cuttack a lot & exploited in Cuttack a lot more
Blessed by having dedicated desciples
Done more mistakes in life than an average gynaecologist
could do
Stress has given stimulus to me to growth
Believes in life’s utilisation in different phases for different
purpose
I am proud of my Profession & derive pleasure out of my
work
I don’t know where God desires to take me till my last breath
Pre-Medicos
 Majority do have an ambition
 Change over a period of time
 Emergence of other alluring disciplines
 Personal Choice to Parental Choice to other’s
influence – Family Legacy
 Gender Role – Change
 Labour & Luck
Sense of Wellbeing & Satisfaction
High hopes & Aspirations in life
 The pinch is felt by many in the field, and one
university, the Brisbane University in Australia,
tries to pick medical students from among the
graduates in humanities – arts, literature, music,
etc.
 Their experience has shown that this class of
students would make better doctors; while the
physics, chemistry & biology students make better
technicians.
Ask Yourself relevant queries
 Can you smile at someone Naturally ?
 Can you touch someone Naturally ?
 Do you have an insight into another human beings
problems ?
If Yes – Ideal Candidate for Medical Courses
If Not – Other Profession
Medicos
 Forgets the toiling – Phase of amusement
 Changed behaviour by peer influence
 Residential effects – Newer environment
 Pressure of studies & torture of teachers
 Love & Romance – Failures & Success
Happiness & Frustration
 Acquiring newer habits
 Segregating into different groups
 Extracurricular activities
 Examination – Pre, intra & post
 Internship
 Phase of insecurity
 Indecisiveness
 Uncertainty
 Higher studies
 Thomas Babington Macaulay in the House of Commons on
the 2nd February 1835 says it all.
 “I have traveled across the length & breadth of India and I
have not seen one person who is a beggar, who is a thief.
Such wealth I have seen in this country, such high moral
values, people of such calibre, that I do not think we would
ever conquer this country, unless we break the very
backbone of this nations, which is her spiritual & cultural
heritage, and, therefore, I propose that we replace her old
& ancient education system, her culture, for if the
Indians think that all that is foreign and English is good
and greater than their own, they will lose their self-esteem,
their native self-culture and they will become what we
want them, a truly dominated nation.”
Medical Practice
 G.P
Specialist
Superspecialist
 From India to Abroad
 From Rural to Urban
 From Private to Government
 From Practice to Teaching
 From Medical Profession to Other Profession
Majority Settles & Continue
Very few dissatisfied till last
Pleasures & Pains
Benefits & Risks
 It is preposterous that medical science does not worry
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about health promotion, while it goes overboard about
disease intervention, many of which make the patient
worse !
Sir Willam Osler had warned us not to intervene when the
patient is doing well, but that is exactly what we do today !
Medicine does not believe in the wellness concept.
Everyone is ill unless proved otherwise is the present
paradigm, thanks to the total body scanners.
Routine check up is the biggest medical industry, while we
know that predicting the future is impossible in a dynamic
human system using a few data of the initial state.
 Even changing those parameters might not hold good as
time evolves.
 Changing those parameters might even harm patients in
the long run, while it is mandatory to do so if the patient is
symptomatic and is suffering, because doctors are here to
“cure rarely, comfort mostly, but to console always”.
 To quote the most authentic scientific body of the
USA: “The National Academy’s data attributes
100,000 deaths per year to physicians’ errors,
added to well over 100,000 deaths due to severe
drug interactions and another 100,000 fatalities
from hospital-based-infections.”
Key Issues to be Addressed
 Changing Society
 Legal issues
 Role of Media
 Practice & Malpractice
 Ethical & Moral Issues
 Professional & Personal Issues
 Management
 Administration
 Leadership
 Social Activist
 Other aptitudes
Last Phase of Life
 No End Stage unless incapacitated
 Change of Profession, but continuing activities
 Time for enjoyment of life
 Sharing experiences
 Social activity
 Religious issues
 Physical & Psychological disabilities
What is preferable…
Parkinsonism or Alzheimer?
It’s Parkinsonism…
It is better of spill half glass of bear
than forgetting where you had kept
the bottle.
Health System
Unfortunate deaths of nearly 3000
people in most inhuman 09/11 bombing in
New York brought the whole world
together to fight Terrorism, but the
knowledge that there are well over 540
millions in this world suffering from
malnutrition and 680 million living below
poverty line does not seem to bother any
of us.
Just about 40 millions of the World
people suffering from the enigma
called AIDS seems to affect $8
billion annually in research grants.
In some poorer country, more
children die of NIDS (Nutrition
Immune Deficiency Syndrome) than
AIDS.
Who Cares ???
Highest percentage of specialised
doctors – more is the disease
More Laws in the Court –
Less Justice
Health Tourism
Health Economics
Health Insurance
Proper education of future generation giving
them right attitude and aptitude of life could
keep all of us happy.
In addition to external objectives, intellectual
based knowledge that present educational
system imparts the need of internal intuitive
based, subjective knowledge of self that
he/she is born to live for others, not for self.
Blessed is one who expects nothing
for he will never be disappointed.
Jonathan Swift
Twenty-first Century is the best of
times, if one considers the so called
scientific development and the worst of
times when one critically looks of human
development.
Charles Dickens
Modern Civilisation – bringing man close
to his animal instincts and perhaps even
worse
God give me deliverance from:
Not letting the well alone
Treating suffering humans from cases
and
Making my treatment worse than his suffering
A fool thinks himself to be wise but
a wise man knows himself to be a
fool.
Shakespere
Health is a state of holistic
wellbeing of man emerging him to be
enthusiastic, to be creative in
society for his own good as well as
good for others
Health – A State of Work and Love
Richard Smith
S. Freud
↓ Epidemic Disease
↑ Degenerative Disease
Accidents, drug addiction, violence, new
infections
Power of Prayer
Fear of God or Love of God
Intellectual Intolerance is the worst
kind of terrorism
Poverty & Illiteracy will breed
terrorist
I keep six honest men
Serving Me
They have taught me all I know
Their names are:
Who, Why, Where, What, When,
How
R. Kipling
World of Living
World of Dead
Unbreakable bridge of human love
Doctor as a Healer
Quality of Head & Heart
 Imperturbability:
 Under no circumstances you should get perturbed while
dealing with patients
 Aequanimities:
 Keep your mind cool
 Cool mind rationally think in emergency situations
Medicine as a Business
Is academic medicine for sale
Trouble is an integral part of living
but Care is what makes it worth
living
Art of Giving
is the
Art of Living
Disease based
Medical Education
Vs
Patient based
Medical Education
If you listen to your patient long enough
He / She would tell you what is wrong with him
/ her
Lord Platto
The ear says more
than any tongue
Tongue has no bones
But it has a capacity to break bones
Don’t allow your tongue to say
Be wise like a Serpent
But harmless like a Dove
Jesus Christ
If there is no problem
There is no joy
Happiness is living dangerously
Students are scheduled to mistake
medical treatment for healthcare,
social work for improvement in
community life, police protection for
safety, military poise for National
sanctity and the rat race for
productive work
Ivan Illtech
Wise people learn from their own
mistakes
Wiser people from the mistakes of
others
Continued Professional Development
Vs
Continued Personal Developments
Medicine is a wonderful profession,
if practised ethically
It could be a curse if is
transformed into Business
The whole world of Medicine
revolves around two human beings
A human being who is ill or imagines
being ill comes to seek advice of
another human being in whom the
first has confidence
Expectation Effect
Sir James Spence
Learning Medicine from books alone
is like swimming on uncharted sea
While learning medicine without
books is not going to sea at all
W. Osler
Let’s not take the world for a ride
with our scientific halo.
While the world is suffering from
Giga problems like hunger, poverty,
ignorance & illness killing millions.
We, in the scientific community are
bothered about our nano problems
of trying to kill germs & producing
self replicating nanobots
Young Doctors
 There is a pill for every ill
 Surgical correction for any anatomical deviation
 Scopes & Scanners – Be all & end all
Well man would be one who have not
been properly investigated
Euboxic Medicine & Dysboxic Deaths
Try to be A man of Value
Rather than
A man of Success
Albert Einstein
Love All
Trust a Few
Do Wrong to None
W. Shakespere
Learn to be Wise
If Not, you will be Otherwise
I would rather be strongly wrong
than weakly right
God give me deliverance from
treating suffering human beings as
cases not letting the well alone and
making my intervensions worse than
his disease
Patient doing well
Don’t Interfere
W. Osler
Read Little
See Much
Think More
Do Much
As doctors write Prescriptions
Drug Company will write a Cheque
Treatment Abuse
It takes 5 years to learn and do
surgery
It takes 25 years to decide not to
do surgery.
Malignant Medical Myths
 Screening industry
 Artificial epidemics
 Hitech interventions
 Health Care Vs Health Scare
 Technology driven research
Pharma driven treatment
Modern Medical Delusions
3 Blunders in Life
 To become a Doctor.
 To Select Doctor as life partner.
 To create doctors as progeny.
“Anonymous Doctor”
By Choice or By Chance
Advances in Medicine
 2000 BC
 1000 AD
 1850 AD
 1940 AD
 1985 AD
 2000 AD
- Here eat the root
- That root is heathen say this prayer
- That prayer is superstitious, here drink this
potion
- That potion is snake oil, here swallow this pill
- That pill is ineffective, here take this antibiotic
- That antibiotic is dangerous,
Here eat this root
Anonymous
Change in Medical Profession –
A Close Look
 From healthcare to medical care
 From disease to diagnosis
 From social identity to disease identity
 From generalist to specialist & superspecialist
 From healing to treating
 From clinical sense to technologic dependence
 From rational use to irrational abuse
 From faith to court
 From pleasure to pain
 From charity to business
Needs Serious Introspection
From We Concept to I Concept
10 reasons why I choose to be a doctor……
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
I hate sleeping
I have enjoyed my life in childhood
I can’t live without tension
I want to have disturbed family life
I believe in Geeta “Kam Karo, Phal Ki Kamana Na
Karo”
I don’t want to spend time with my family
I want to take revenge on myself
I wanted to break up from my friends
I want social boycott
I love to work on Sundays & holidays
Last Words ….
 Continue to be one of the best profession in all
centuries. Past, Present and Future
 Amidst Pains, Pleasure
 Ethical, moral and human
 Amalgamation of Head, Heart & Hand
 Amalgamation of Art, Science & Commerce
We are the Winners
Coming Together is the Beginning
Staying Together is the Progress
Working Together is the Success