A Year End Rant - IIT Salaries And Idiot Doctors

A Year End Rant  - IIT Salaries And Idiot Doctors

The other day my dad was reading the paper aloud in the morning hoping to catch my attention with the news "IIT student gets 1 crore starting salary (that’s like 10 million dollars in American currency) in a software job" he said and looked slyly at me as I was tying up my shoe laces preparatory to leaving the house for work. I didn’t say anything to the obvious sarcasm, for what could I say? An amount that big? To tell the truth I haven’t even seen such a big amount of money leave alone make it even after so many years of working and earning and here was a kid just out of his teens earning such an obscenely huge amount every year. Point made to his satisfaction my dad went back to reading the rest of his paper.

All day that day i felt an irritating itch in the back of my mind that i was a failure in life and to avoid explanations for my gloomy face i spent time alone -whenever i could get away from the crowds outside- analyzing where i went wrong in my life to end up here - among those who didn’t earn one crore a year. Of course it was blindingly obvious where it had all started going wrong - in my utterly stupid (in hindsight) choice of education and career. And to think that i had turned down an engineering admission to select a career in medicine is what made it all the more galling. If only I had had more sense at that age. If only I had not lusted after those stupid two words "Dr" in front of my name. If only i had not been seduced by the coolness of wearing that white coat. If only i had been clever enough and selfish enough (like those IIT students) to put myself first rather than some abstract concept called society or people, I too could have been making a crore an year. Hell I could have made even more given that i am not exactly a dunce and was more than a match for any engineer when it comes to intelligence.

The fact is on an average basis doctors are as good as and intelligent as any other field of specialists- like software engineers, like nuclear physicists etc. Besides doctors are trained to work long hours continuously without complaining, to get by with whatever is available at the moment by employing their initiative and to make difficult decisions in real time and implement them confidently. Pop a doctor into any unfamiliar work environment and he or she will most probably pull their weight around far sooner than you expect.

This is because the medical profession has not only a very steep selection process they also train the hell out of you to mange any kind of situation coolly- a skill which is translatable to any field. Despite the long, hard, years and years of training even the best doctors- even those at the top of the profession- never get to make the kind of money you read about in the papers as being offered to young software engineers in their twenties. Face it, even a cardio-thoracic surgeon or a heart doctor who can remove a dead heart and replace it with a live heart bringing a dead person back to life- never makes the kind of money offered to a fresh software engineer- for think about it, how many patients have to actually get an heart attack (and nearly die) for the doctor to make so much money in the same period?

 

And can you honestly say that the value to society of a senior and talented cardio-thoracic surgeon is less than that of a kid who just graduated with a engineering degree. Such easy money offered as starting salaries to beginners has another un-looked for effect on society beyond the obvious financial implications. For kids who see and hear about the humongous salaries being paid by IT jobs will naturally gravitate towards such jobs - and even those who don’t have an engineering degree want to work in the IT field as support staff for services. For face it, who would say no to more money? As time passes the other professions like medicine, science and even finance would attract less and less intelligent people. In fact I already see this in my field- most of the new practitioners in the field of medicine are those who already have a secure job at home - either their fathers/extended families own large/multiple hospital chains and wouldn’t mind paying any amount of capitation fees to make their kids a doctor (to carry on the family business) whether the kid is interested or has an aptitude for medicine or not.

Intelligent kids with no family background in medicine are already avoiding joining the medical profession. I myself have personally advised two of my neighborhood  kids - bright fellows- to avoid joining medicine at all costs but to go join any engineering college/course and to get an software job -because there is no future in medicine. If after a certain period of time all the intelligent kids go away to become software engineers and only the dumb ones become doctors think how society would be? If god forbid you fall sick and you have an absolute moron operating on you -who only became a doctor because his dad could afford to pay whatever money was required to make him one? This is not a farfetched scenario- it is happening even as we speak.

And this is an inexorable process- no one can stop it. If the market determines every individual’s value then people who have value will naturally gravitate towards the highest bidder. For a large salary translates into a comfortable life, a good profile in the marriage market - haven’t you seen those ads in the matrimony columns of newspapers specifying grooms with MS degree/Green cards and onsite in USA? - and maybe a house in the city with a vacation home for the weekend- the perfect American dream in a poor country like India where other people struggle to find a tiny flat on rent as they cannot afford the high rent rates being charged by householders who assume that everyone is a software engineer and earn such large salaries- a perfect recipe for social disturbance. And that’s why I feel that disproportionate salaries in an otherwise poor country where everyone else earns very less is a recipe for disaster.

And let me conclude by talking about what many of you who read this will be itching (are your fingers already poised over the comments column?) to advice me- that medicine is a noble profession and i should be happy to serve people even  if i make no money and such feel-good dialogues designed to make me feel better. The truth is those who say that medicine is a noble profession and doctors should not mind serving the poor for free - those people who mouth such empty platitudes - are most often those who earn in crores too. It is easy to preach moralistic platitudes on behalf of others and tougher to practice it. Those who earn in 7 and 6 figures are those who advice others to be happy with 3 or 4 figure salaries. That’s why I always avoid anyone who tries to preach to me about "MY" duties as a doctor. Hell, I already know them all, for i chose to become one didn’t i? While you who preach to us did not opt to. 

Let me remind you that doctors are human beings too- we need to eat too, to buy/wear clothes and take care of our families and those who depend on us. You cannot force anyone else to sacrifice himself for society- maybe one or two saints will be there like that- but the majority of doctors would like to manage a comfortable living along with their social responsibilities. A working balance between ethics and earnings is what all doctors’ aim for and any disruption of this will lead to adverse events like overcharging and unnecessary treatments - something we are already beginning to see everywhere. So instead of blaming the medical profession for not standing up to the arbitrary standards of "noble profession" determined by society let society too reflect on why doctors are necessary for societal well being and why chasing kids away from medicine as a profession would be a bad idea for the further generations. Please think on that- a future where everyone is a software engineer and there are no doctors.

And as for me personally, having thought all day about it, I can only come to the conclusion that my dad is right. Society respects money and as long as doctors make less money than, say software technicians, we will always be seen as second class citizens with no real respect from anyone in the society. To regain respect from people I feel I have no other option except to resign my job, tear up my degree certificates and using my high school qualifications- apply again for an engineering degree- to start from the basics again. And four years into the future - I will probably be offered a software job with a starting salary in the crores too. That seems the wisest course right now- a mid-life course correction for an error made when young and innocent. So what do you think? Can I become a software engineer now? Or is it too late to do so?    

Missed Calls but Best Friends Forever

Missed Calls but Best Friends Forever

The nurse to me: Doctor your phone is ringing in your pocket.

Me : Ah, yes, I heard it too (how can I not? it’s in my shirt pocket for god’s sake) but I am talking to this patient and can’t pick it up right now, I will call back as soon as I am done here.

10 minutes later, I dial and the phone call is connected and keeps ringing and ringing - but is not picked up. I disconnect after 4 or 5 rings as the nurse signals if she can call the next patient in.

Me: He is probably seeing patient's and will call back when he is free, I suppose. Well, send the next one in.

15 minutes later, my phone rings again. And Rings and rings.

Nurse turns towards me. I hold up my hands to her and grimace.

Me: Well, i am examining this patient and got gloves on...nearly done here, i will call him back again after I finish. Can’t touch the phone right now, won’t be sterile.

After 15 minutes I finish, remove the gloves, wash my hands and pick up the phone to dial back.

The phone rings and rings and rings....

Me:  Oh he's probably got another patient on....guess he will call me back if it’s anything important.

I disconnect the call and ask for the next patient to be shown in.

15 minutes later, my phone starts ringing again.

I glance sheepishly at my nurse and signal her to silence it while saying "there, there, Mrs..So-and-so….Don’t weep, we can put it all right easily, it will just take some time and money you know"

Nurse grins while putting the phone on silent mode.

30 minutes or so later, I call back again- the phone continues to ring but is not being answered. Nurse looks askance at me, clearly intrigued.

Me: Another patient? (I ask nurse with raised eyebrows. She shrugs)

Me: Funny, he seems to be so busy today. So many patients in one day? He is getting better than me or what?

(After an awkward pause with no answer forthcoming from the nurse)

Me: Nurse, I guess I have gone soft and lazy. Please send the patients in as they come, don’t make them wait outside while I have tea. In fact, I have decided to have tea only once a day. And also, please inform Dr.So-and-so that I am very busy and can’t be disturbed, if he keeps coming here for company to go the canteen. 

30 minutes later. The phone rings again - in vibration mode- like a frog jumping around in my pocket. I glance at the patient sitting in front of me, an upcoming actress and very pretty at that and for once am thankful that I keep the phone in my shirt pocket and not in my pants - imagine what she will make of it if the front of my pants start jumping around (misunderstanding averted or what?). I slightly lean forward towards her, incline my head and gesture her to continue talking as she goes on telling me her life story. And that phone call, oh, I will call back as soon as this is over- I assuage my conscience.

Final count for the day:

1) Missed Calls- 10 (on each side)

2) But Friendship's - Forever.

And this is how doctors spend quality time with friends- on missed calls. We understand each other intimately and don’t mind communicating with missed calls. So next time you call me and I don’t pick up immediately, rest assured that i will see the missed call and call you back as soon as I can, scouts honor.

How to Spot a Fake Doctor

How to Spot a Fake Doctor

Fake or Real? How to tell?

 

Last Sunday on a sudden whim I went to the gym - well maybe not that sudden a whim- for on Saturday my favorite pair of pants had failed to button itself onto me and so to assuage my guilty conscience about my expanding waistline and also due to the multiple phone calls from the gym trainers threatening to close down my membership if I did not put in an appearance at least occasionally. Once there I got down to it with gusto and at the end of a ten minute walkathon on the treadmill was totally exhausted and decided to take a water break.

As I stood there by the water fountain waiting my turn for the drink that revives, an old acquaintance, one of those regular iron pumpers who live for the gym, wandered over to  say "hi" to me. After making the usual jokes on my nonexistent washboard abs and irregular gym visits he introduced to me someone standing beside him as "this guy is a doctor too". I turned and said a polite "hi" to the stranger and that would have been an end to that if only the water fountain had been free but unfortunately the crowd around the water hadn't diminished yet and I found myself in the awkward position of having to make small talk with the new acquaintance.

So perfunctorily I asked the other doctor where he had studied. He hesitated a bit and dropping his voice in a shifty way said something like "in shankhurrah naturally". I thought I had misheard and asked him to repeat again and he murmured the same in an even quieter voice than before. I was genuinely puzzled for the name he gave me was the name of an eye hospital and not of any medical college. As far as I know, and I do know a few   things, a medical college is where you study and a hospital is where you work, you cannot study at an hospital anymore than you can work at a college (or maybe you can- if you already have a degree from somewhere else).

Something was definitely not right here or maybe it was my just my nasty suspicious nature, so I decided to go for broke and asked him right out "So, are you an ophthalmic surgeon?” He took his time weighing his answer and so to help him along with the process I volunteered with a "I probably know a couple of doctors there- colleagues of yours I presume?" that made it clear to him he had had it and could no longer dissemble and it was better to tell me the truth, so he mumbled "I am an optometrist". Ha-ha, I thought that explains it, so why couldn't he have come straight out and confessed this in the beginning and saved himself all the trouble. Anyway, not being an insensitive type who humiliates others, I decided to go along with his story and so said a loud "thank you, nice meeting you doctor" in front of the others and then I moved away from there to go and lift my burdens (for my sins) from the weight rack.

And now for those  wondering what was it all about -an optometrist is a technician who examines the eye for defects in eye power- just like a lab technician or a x-ray technician or an ecg technician - what we call a  para-medical staff and definitely not a real doctor qualified to do eye surgeries. But in a worrisome new trend a few greedy corporate hospitals have started short term Para Medical courses where they train people to assist doctors and to make more money by cheating the poor trainees they inform them that at the end of the course they may call themselves as doctors, which is strictly not true.

But in our country where anything goes we have quacks everywhere and anyone who has assisted a doctor for a couple of years or for that matter anyone who has read half a dozen health related articles on google- considers themselves a medical expert. So doctors are dime a dozen and it is up to each patient to identify if the person they are seeing is a real doctor or not. The best way to make sure- is to ask to see their original degree certificates but as most doctors mortgage this certificates with their banks to get loans for establishing their clinics we need a better way to judge if its a real doctor or just a pretend doctor, so i have taken the trouble to offer you a few hints on how to identify fakes

Hints to spot a fake doctor

1) I know OT but OR?

   If he/she says OR instead of OT - he/she is a fake. In India or for that matter anywhere else in the world except in the US of A where they do things perversely just to be different (don’t they even drive on the other side of the road?) - Any surgical operation is conducted inside an Operation theatre and not in an Operation room. We have places called M.OT- minor Operation Theater, G.OT - general operations theater or S.OT- specialty Operations Theater or doctors just generally refer to it as "the theatre". So if your doctor says "take the patient to the OR" run from there without looking back for he has seen too many episodes of the American Medical Sitcoms like Scrubs or House MD-  where they use the fictional term "OR"  when they meant to say "OT". So anyone who says OR and not OT is a TV doctor who got his degree watching the TV serial Grey's Anatomy which brings me immediately to my next red-flag.

We call it a Theater

2) Is it Gray or just Grey?

      If ask your doctor to spell the word gray’s anatomy and he uses the "E" instead of the syllable "A" for Gray then again run from him for he is just a TV doctor. The name in question "gray" originally refers to a very famous (and very dead) anatomist called Dr.Gray who wrote a big fat book of anatomy called Grays Anatomy- a book which will always stay on the library's dust laden shelf- for who (except body builders) will have the strength to lug around a 5000 page giant sized book when slimmer versions of recent authors are available. They call gray’s anatomy the bible of anatomy for a reason- like the bible it is only read by preachers or pastors- and never by the laity. So that’s about Gray with an "A's" anatomy. If your doctor refers to the other Grey's anatomy with an "e" rest assured the only anatomy he studied is the body of a female sitcom actresses called grey from the TV serial.

The Original Gray with "A"

The TV series with "E"

3) The Wiki-warrior aka the Google-worshipper

      This is someone who thinks that he knows medicine better than doctors because he owns a desktop, a laptop, a tablet and a phone with Internet connection. These people will astound you with facts and figures pulled straight out of recent research papers and offer gratuitous advice to all ailments, even unasked and they won’t stop dosing others with their medical opinions until they finally kill someone with their advice. Be aware that they are just well intentioned idiots who don’t set out to deliberately cheat you but do it only out of ignorance trusting to their half-baked understanding of medicine gained from reading questionable online medical websites.

Remember there is a reason that a medical education takes so many years to complete- doctors literally can kill you with their wrong (or even well intentioned) advice- so are you going to trust someone who read a few medical articles on Wikipedia yesterday and offers free advice on social media today? Real doctors rarely speak about such hot medical news because they don’t go by the most recent internet reports - they wait for the treatment or medicine to become standardized and widely accepted (however long it takes) and then only will they recommend it - making sure that even if the treatment doesn’t work as hyped at least their patients don’t get to die. So if someone starts with a "you know what, i read just yesterday in google/pubmed ...." just close your eyes and delete that chat thread.

Is this your Doctor ?

4) The white coat carriers -

        Doctors wear a variety of dresses but one thing that typifies them is the ubiquitous white coat. But not every doctor wears one all the time. In fact, doctors try not to wear these when not seeing patients. For one thing, wearing white coats in our hot Indian climate, especially over your everyday regular wear, is hot work and you are bathed in sweat all the time. For another the white coat is a dust and dirt magnet and it is so difficult to keep it spotless white all the time- as expected of a dutiful doctor. So when the doctor is not actually seeing a patient the coat is draped over the back of his chair or safely folded inside his locker - to keep it dust free. No doctor or at least no real doctor ever carries the white coat on his shoulders everywhere he goes to show that he is a doctor- only fakes do that even at bus stops and roadsides. Real doctors, by the time they graduate hate wearing those coats so much that only the threat of the chief doctors rounds makes them hurriedly don that coat. So if you see someone walking and showing off a white coat all the time- he is a fake.

Wear it or Fold it....NEVER carry around

5) Scrubs Vs Dress.

        American medical sitcoms often show doctors, all doctors, walking around in what they call scrubs. In India we call it theatre dress, never ever scrubs. And only surgeons get to wear it- not regular doctors who just wear their white coats when seeing patients. And even surgeons never walk around in it all day- for it is supposed to be worn only inside a sterile environment- an operation theatre and not where dust and germs can collect on it. Even the busiest of surgeons don’t actually live in that dress like they show on TV serials- we wear it only on entering the theatre and change out of it when leaving the theatre at the end of the surgery. And male and female doctors (in India) change in separate rooms unlike what they show on TV, which is a pity because the surest way to kill any in-house romance is to see a colleague in their (often weird) undies. So watch out for people who say "Scrubs".

Who wears this ALL DAY?

 So these are just a few of my ideas on how to identify a fake doctor who got his degree from watching TV serials. Please feel free to add your own methods of identification in the comments section below.