Just imagine a situation of a brave soldier having to sacrifice his weapons on the battle field, against his wishes and dreams, and more so, as they were weapons that could easily conquer the enemy. Today I can imagine and understand the feeling. At the age of 68 , I have the knowledge that I can save my patients, I have steady hands that can perform difficult surgery and have sincere empathy towards my patients.

But I have decided to stop surgical OBYGYN practice from the last day of 2020. I will have only outpatient consultations from January 1st 2021.
The reason behind this difficult decision is an incident that occurred a few days ago.

I am sure nobody disagrees when I say I have been practicing for the last 42
years very conscientiously. Though I have earned my bread and butter practicing my profession, I can safely say proudly that money has never been the priority.

It is a lesson passed on to me by my elders. In the recent lockdown I continued to work lestmy patients suffer. No patient was sent back without treatment except when I had to quarantine myself for 20 days when I had covid. This is what all doctors did. I did not do anything special.

For someone who never buckled to any situation before, the death of a young woman defeated me. No one could be blamed for the death. Let this be a lesson to my colleagues. I do not intend to frighten them.

The young girl who died, was delivered by me 29 years ago – she used to repeat this fact every time she came for antenatal checkups. She got into labour at term and as labour was not progressing well and we did a caesarean after obtaining consent from her relatives. Mother and child were both doing well till the 4th post-operative day. On 4th P O day she breast fed her child and she was hungry for breakfast, she got up to go to the bathroom and just collapsed.

She was given the initial resuscitative emergency care and brought to the ICU, but her heart had stopped and she expired leaving behind her 4 day old infant. Such sudden death is usually due to massive pulmonary embolism. It is rare and even in the most well equipped hospitals it is difficult to save the patient.

By the time I reached the hospital it was too late to save her. The scene I saw was very disturbing – her mother and mother-in-law were rolling on the floor and touched my feet asking me to save her. I was helpless. Then her husband arrived and broke down. Do something he said and I stood by watching helpless. I can never forget the scene. Some of our staff were also in tears.

On that day, no one questioned our services. No one said a bad word against
us. I implored on them to get a postmortem done after informing the police. We need to know the cause, I said. I repeated it many times to the relatives but they did not want a postmortem. “She died infront of us, we cannot subject her body to more injury. We definitely don’t want a postmortem or a police complaint” they said.

The statement was signed and the body was released. An elderly man came to pay the bill. But my friend Dr. Vishwanath the head of the hospital refused the payment on compassionate grounds (as he always did even before when patient had died in the hospital).

Though such cases are rare they make us sad and dejected. Our
confidence is shattered. A patient’s death can kill us a 100 times as we relive the episode in our minds. So a postmortem was not done, but now a few days after the event, groups of relatives are conducting a postmortem on me and my hospital staff.

Groups of about 5 people come and shower me with questions. The sorrow has been replaced by anger and finding fault with the treatment at the hospital. “why did you not realize earlier?” “Why was treatment not given promptly?” “Why didn’t you send the patient to Manipal?”. These are questions they are entitled to ask and I listened patiently and replied with calmness.

But they had made up their minds not to trust us and our answers made no difference to their thinking. “You should have done a Postmortem, even if her husband and mother decided against it.” “How do you know it is Pulmonary Embolism?”. I repeated that I had suggested a postmortem so many times that day. But it all fell on deaf ears.

The people who refused a postmortem and had no complaints against that
hospital, were not to be seen at all. The people who were asking questions were people totally different. The only reason, we did not do a postmortem was because we respected the wishes of the close relatives who did not want it. Should we have forcefully done a postmortem with a grieving family who did not want it?

Luckily we had the written evidence from the near relatives stating they did not desire a postmortem or a police case. Their other accusation really astounded me. “Why didn’t you charge the patient?” “You must be concealing a mistake you did.” “In cities they don’t let you take away the body unless you pay the bill.” “Why did you urgently let the relatives
take away the body.” When I heard all this, I was amazed at the way people think now a days. The humaneness showed by us was not appreciated at all.

The quality of greed and callousness showed by some city hospitals seemed right. Should such behavior be the yard stick for us senior doctors to follow? Why can’t the public understand, that doctors cannot prevent, all deaths that happen in the hospital? That is why I have decided to sacrifice my surgical skill. Its suffocating to live amidst such thinking, where compassion and goodness is mistaken for negligence.

In such a society my experience is not required. We are not qualified to work in such a society. People like me are unfit to work in such a milieu.
I will miss my good friend Dr.Vishwanath Shetty’s Hospital. He used to come whenever necessary to help me in difficult surgical cases. I will miss CEO Vani who came running every morning to greet me. I used to ask Dr.Adiga my anesthetist only to question, one at the start of the surgery. ‘Ok Dr.Adiga?’ and repeat the question at the end of the operation. He always said ‘Yes’. I don’t remember him giving me any other answer.

All the doctors working at Vinaya Hospital and the visiting doctors respected me very much. I am grateful to all of them. My favorite OT staff (there never was any necessity to ask if OT was ready) and post operative staff who were competent and professional and cheerful, to all of them my sincere thank you. I will miss u all.

The staff in the labour ward who followed me with the patient files, announcing Ranjith Sir has come. These words will ring in my ears for a long time. Staff at the reception, helpers, pharmacy staff, lab technician, cleaners, I will miss all of them. The people of Kundapur who elevated an ordinary man like me into a position of respect – I thank you sincerely. I am not necessary for the world of obstetrics.

Deliveries happend before I existed and will happen after me. 42 years ago I was the only one who practiced in Kundapur. Now there are many qualified experts practicing obstetrics. So nobody is going to be inconvenienced by my sacrificing surgery. I am reminded of a poem by one of by my respected doctors. I don’t remember all the words. With apologies to Dr.Shivanand Kubusad here it goes.

When I have finished my role here on stage,
What else do I do.
Before someone pushes me out I should leave.
Before my face fades. I should leave silently.
I should disappear and surprise people
and appreciate the new actors in the field.
Let me retire before people ask me ‘Why’ instead of ‘when’ are you going to
retire?.

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