In search of Ali Jan: A case of our medical practice

When you feel your knees crackle most of the time. When they hurt climbing stairs. When you no longer digest the food well. When you can’t figure out your presentation at a distance in a conference hall. When you frequently falter to key in right numbers in a biometric machine. When you can barely walk 200 metres briskly without feeling drowsy. When you breathe bricks jogging. When you aren’t able to sleep well. All this, with many more conditions unnoticed, is what I went through a little more than 04 years back.

It was true that I was moving, nay limping, towards my 50^th birthday. ‘Bujer’, old age many would say. The truth was that I felt far older than the given threshold of 50. I had no wish to get younger, not at all. All I wanted was to just feel and walk like the flesh and blood half a century oldies I had seen in my teens. Don’t tell me those species are extinct now. We already know it. Anyways I nursed this thought of recovering at least some ground. To fulfil my wish I required to see the Ali Jan of the present era. Because I felt scared even on a thought of how many consultants I would have to see to even begin to experience a fragment of life that our oldies experienced. I did not even harbour any expectation because something no less than a tragedy has befallen our healthcare system. What’s that tragedy you may wonder? I like to call it ‘De-Alijanization’. Our current medical practice has de-Alijanized into specialities and super-specialities. And in the time of ‘De-Alijanization’ a role of a physician seems to have reduced to nazel & tchas (simple cold & cough).

I kept on ruminating. Do I visit an orthopaedician first or a gastroenterologist? Do I need an ophthalmologist on my side or neurologist first? Psychiatrist or a physician? This is just about a few specialities. As I fantasised, layer upon layer, about specialization and super specializations, it got scarier. A scribbled prescription will fright you before the investigating syringes pierce your flesh and beeping machines catch hold of you. ‘Khodah karin raham’ (God have mercy on us). A capsule and a tablet before breakfast, and one after it, one capsule & a tablet during lunchtime with a time gap of half an hour. 04 at dinner, two before and two after. And one tablet SOS. A pharmacist employed in a doctor’s chamber will read the doctor’s chit in a single breath to test your memory. When you can’t keep pace with what he says, you won’t ask for revision, knowing that you won’t remember even when he repeats. I get to recollect math tables in school days which we couldn’t commit to mind even after teacher’s reprimand. Same here. No wonder these drugs hurt you before they begin to treat you. Remember ‘myadas dagg’ (aching stomach) a broad-spectrum antibiotic gives you. The breakfast time drug vocabulary has now seeped down into our culture now. No woman or a man wakes up in the land of Kashmir unless some pantoprazole or a rabeprazole, omeprazole or esomeprazole, ranitidine or a domperidone slides down their oesophaguses into their empty stomachs. These must be classified as our Good Morning J&K drugs.

This not only paints a grim picture of what I was confronted with but it is a sordid tale of most of the people living here in Kashmir. I do not know anything about the rest of the country or the world. You don’t need to go to a hospital to see all this first-hand. It is so rampant now in most of the homes. Middle aged people have become more vulnerable. For them ‘Beymar gachun chu tavan’. No English translation for this obvious fact. Arthritis, osteoporosis, diabetes, hypertension, autoimmune disorder, irritable bowel syndrome, gastritis, prostatitis, dementia, and cancer. You just name it. Youth too is not immune to many aliments we didn’t even know in our day. Mental conditions like depression, brain fog, schizophrenia, OCD, ADHD are soaring. I can’t understand who is going to look into all this. It is already a healthcare crisis. Which professional body should sound a healthcare red alert I do not know? Believe me I am not exaggerating. Go and check rising cancer, diabetes and depression cases. I think doctors and professional bodies are sleeping over the matter. They need to give us solutions. Most of the doctors are over busy in their medical practice without having time to think about the issue. If medical science has reached the cutting edge of advancement why people are still suffering this ailment and disease tsunami? Or does cutting edge in medical science only mean how well we are able to cut organs from the bodies of patients? The alarming rates at which livers are being dissected, kidneys are extricated, stomachs and intestines are cut up provides a clear prelude to today’s role of hospitals. Tille pyot (gall bladder) is the first to go. Then liver gets to the table. Something is seriously wrong.

Being faced with widespread health distress for a decade now, half of the medical science terminology has been rote learned by our smart population. TG, liver enzymes and cholesterol is an elementary general knowledge here. USG is a favourite diagnostic reply. ECG is also famous. MRI & CT are trending. PET is gaining currency. Our general knowledge in medicine is snowballing. Great! Elsewhere to show off your knowledge you may discuss abstruse ideas of obscure authors, but here in Kashmir each one of us articulates medical vocabulary to flaunt our education. Whether you remember anything about telescope or microscope or not--your school time gadgets--you will surely know the medical endoscope, cystoscope, colonoscope or laparoscope. Medical education may soon become universal all by itself long before government succeeds in universalising elementary education.

Some time back I went to visit a patient. His son, not a medical professional, buried me under his knowledge of medical jargon. As I sipped tea I couldn’t help but nod each time he mentioned a complicated health condition with an accompanying treatment drug, including the substitutes. When I felt my face expression failing I raised my brows to greater elevation to compensate. He bamboozled me with his medical literacy about diseases and drugs. It felt wearisome and worthwhile at once. I didn’t want to know this much from him. But an afterthought made me more sympathetic: ‘If the guy didn’t process at least this much medical science in his head his father would surely have suffered more’, was my conclusion after listening to his story. You become a half doctor in Kashmir while attending and nursing your patient. This becomes more intricate when you consult many of them. This is the time when you wish to consult some Ali Jan, who, it has been heard in folklore, had a synoptic eye on diseases and diagnosis.

When you know that your patient will have to swallow pill after pill, each pill treating one condition crating multiple others, these drugs become creepier than the disease itself. Never mind, call them drugs not medicines. And don’t forget the rate at which hospitals are removing dysfunctional organs. Thank golden card as well. More golden than the gold. It grants us the ‘golden opportunity’ to remove organs. “Tille pyot is gone, out!” it feels like an Australian or English commentators roar in a cricket match. Are all these drugs and surgeries necessary? ‘Ammi khote haez chu marun behtar’, people complain tired of awful medical interventions. And the medical science, including the medical practitioners, seem to have no answer. The same situation dissuaded me from medical consultation which I direly needed. This doesn’t mean that medical science is not useful. It is. We cannot throw away baby with bath water. But it is high time to tell people what constitutes baby and what bath water. Doctors need to intervene here. Each one of us needs a doctor one day or the other. But the way things are going in healthcare, presents poor patients with more challenges than solutions. I found my solution albeit outside the mainstream medicine, but it cost me great time and energy. That merits a next story. But all people may not be able to do it themselves. It is not easy. So they suffer. And it seems no one is listening to them. And there is no Ali Jan around either!