This last year, two friends of mine lost their fathers to Indian healthcare.
In the first case, my friend X’s father was taken to Safdarjung Hospital at mid-day with what they didn’t know had been a cerebral stroke during the night. The doctors yelled at X’s shocked and terrified mother for bringing him in so late, and said that it was her fault that he probably wouldn’t make it. There were no ventilator beds free, so the family was told that they would have to keep his lungs working with a manual ventilator that must deliver shots of oxygen (breaths) at precise intervals.
The family was expected to do this. They and their driver took turns pumping oxygen into X’s father’s lungs as best as they could while they made frantic phone calls searching for an affordable hospital with a working ventilator and available beds. It was not until 10pm that they were able to secure a bed at Holy Family Hospital, through the kindness of a doctor known to the friend of a friend. The doctors at Safdarjung refused to let the patient go except under Left Against Medical Advice (LAMA), and not only refused to provide a ventilator van but also demanded that their manual ventilator be returned—the equivalent of taking the patient off life support—and would not entertain the idea of letting the family pay for a replacement that the hospital could get.
As X contemplated how to acquire a new one from the market, Holy Family’s ventilator van arrived with a doctor to transfer the patient. But by then X’s father was no longer breathing and was in a semi-comatose condition; the damage had been done. A week later, despite the best attempts of the doctors at Holy Family Hospital, he died.
My other friend Y’s father, a heart patient with renal problems, was rushed to the emergency room of the private Artemis hospital in Gurgaon in the evening, with symptoms of cardiac distress. It was the closest to their home, and in the ambulance that came to fetch him the family made a phone call requesting the attention of a cardiac doctor. When they got there, however, there was only a junior resident on hand, who said they’d first have to pay the Rs 50,000 fee. Since they only had Rs 10,000 on them they asked that doctors attend to the patient while they arranged the rest of the money, but it was a couple of hours before he was taken to the ICU, suffering cardiac pain the whole time.
It wasn’t until mid-day the next day that the cardiac specialist showed up. Various procedures were carried out as they should have been, but throughout that evening Y’s mother was not allowed to visit her husband, nor would anyone tell the family what the patient’s condition was. Enquiries revealed that the doctors who were supposed to be monitoring him were eating dinner; when the family called them, they were told not to worry because the patient’s parameters were the same and he was being taken care of. Then, at 2.45am, the doctors suddenly said that the family should go into the ICU because the patient was slipping away; a few minutes later he died.
These stories show up a whole range of systemic diseases that have nothing to do patients. Both families realise that their loved ones might have died anyway, despite everyone’s best efforts. Nobody expects hospitals and doctors to be able to save every life. But we all expect them to try their damndest. We certainly don’t expect callousness and negligence and casual indifference to the family’s feelings, and we don’t expect them to put bureaucracy above life.
Pain is entirely abstract until it happens to you. From the stratospheric heights of policy-making and economic theory, these things happen; but tell that to X and Y and their families, whose worlds stopped turning.