Bhaskar Parichha
When a female surgeon who has worked closely in both the public as well as private health sector picks up the pen to write on the state of the health system in the country, it is undeniably a revelation. Besides, when the book comes from someone who is a writer of fiction that is a double bonanza.
‘A Luxury Called Health’: A Doctor’s Journey Through the Art, the Science and the Trickery of Medicine’ by Kavery Nambisan lays bare the fact that the health of the citizens of a nation is an investment, that the health system is a part of nation building and effective governance and that it is time to learn from mistakes that have been made and continue to be made.
The book comes from years of working in the midst of the dust and the filth of government health care set-ups, from having witnessed the profit-oriented approach of the private sector. What’s more, the volume offers a ray of hope while asserting that things can, and must, improve.
Born and settled in Kodagu district of Karnataka, Nambisan worked predominantly in the rural parts of Uttar Pradesh, Bihar, Tamil Nadu, and Karnataka, and was a governing council member of the Association of Rural Surgeons of India. Obviously, she has a better understanding of the country’s rural health care system and the pitfalls therein.
Reads the blurb: ‘The miracles and tragedies of life, the compassion and cruelties of humanity are nowhere more visible than in the field of medicine. It is these that Kavery Nambisan—doctor and writer of immense sensitivity—explores in this memoir, drawing upon her work as a surgeon over four decades in rural and small-town India.’
What Nambisan essentially does is this: she picks up her patients’ stories and depicts the highs and lows of medical practice.How Sudha, in Mokama, Bihar, was left immobilized waist-down after being set on fire by her in-laws, but determined to walk; how construction workers in Lonavala, Maharashtra, who preferred the quick-fix of the ‘drip’, so that they wouldn’t miss their daily wage; how four-year-old Pavana in the Anamallais, mauled by a leopard, had to be driven over 40 kilometers of shattered roads to the nearest hospital.
And, in contrast, how the friend of a Tamil Nadu chief minister summoned a doctor repeatedly to attend to her stubbed toe. All the way through, Nambisan examines the evolution of medical practice and the state of India’s public health; and weaves in episodes from her personal life: learning from heroes and rogues.
In the introduction to the book, Nambisan quotes a passage from Fyodor Dostoevsky’s The Brothers Karamazov, where a doctor examines a terminally ill patient in a very poor home. This is an apt reminder of what happens when the poor try to access healthcare: the hope and despair felt by the patient’s loved ones and the disdain that the doctor projects. It sets the tone for what follows in the subsequent chapters.
Engaging and insightful, A Luxury Called Health shows ‘the sincerity and the deception, the valor and the cowardice beneath the white coat’. Without drama or exaggeration Nambisan’s three-hundred page book is an honest examination of the thing called healthcare, of the systems that are working and not working, of the people who are its faces and, at times, because of whom, healthcare turns into what it should be: effective, affordable and something that can be trusted by everyone.
In about three dozen chapters, she conveys how patients and their families often put doctors and healthcare staff on the pedestal of demigods and do not try to find out about the nitty-gritty of how illnesses are treated. This makes them resort to threats and abuse when things do not go as they should. In one chapter that details the list of medical procedures in a health set-up, Nambisan admits how easy it is to treat patients as mere technicalities, and that you cannot ask questions to a supervisor or senior colleague.
From the early traditional medical practices to the first steps taken in India to institute a medical institution to train and educate health-workers and medical staff, Nambisan puts the focus on how the poor health of individuals affects the overall well-being of a nation. She takes readers into the time the seeds of a new nation were being sown and, along with them, the hopes and aspirations that went to building the health care system.
The use of anecdotes from the history of medical practices across the world and in India, peppered with the author’s own experiences, makes the book informative as well as thought-provoking. ‘A Luxury Called Health’ is an important book, one that needs to be read and discussed. It exposes the shortcomings of the medical system in the country over the years, but it also sings the praises of the people who patch damaged organs and bring hope and relief to patients.
‘A Luxury Called Health’ Kavery Nambisan Speaking Tiger Books, New Delhi
(The author Bhaskar Parichha is a Bhubaneswar based senior journalist and columnist. Views are personal)
