From a doctor’s diary: the authentic physician’s voice
Kabra SG. From a doctor’s diary. New Delhi: National Book Trust; 2013. Paperback, pp 101 ISBN 978-81-237-6928-8 INR 70
From a doctor’s diary by Shri Gopal Kabra is a small volume about the size of the Indian Journal of Leprosy, and like the journal, arrived wrapped in a sheet of plain brown paper tied cross-wise with white string. It stared hopefully back at me from my table for a few days until my curiosity got the better of me, and I cut the string to look inside. The front cover is designed tastefully, giving the appearance of parchment splotched with dried blood-stains, with drawings of a vertebral column, a brain in saggital section, a stethoscope, and fading, cursive text in the background. The back cover details a frightening list of the author’s qualifications and interests, ranging from medicine and law, anatomy, surgery and medical audit to medical journalism, and authorship of collections of short stories in Hindi. Not quite certain of what lay ahead, I started reading with some trepidation.
The book is a collection of short stories written in the style of a narrative in the physician’s voice. Law and medical ethics are the common threads that run through the stories, which the author states are true, and they certainly seem to be. Occasionally the writing is stodgy, and sometimes verbose and devoid of humour. The recital of events suggests a writer who is reluctant to indulge in artistic licence; however, this leads the reader to believe the authenticity of the events described. The individual stories have been put in a suitable sequence and they sustain one’s interest.
The stories cover diverse areas: honest errors turning into horrors and providential escape following medical errors; a whodunit; medico-legal ignorance and ethical problems; points of law and propriety; false-positive laboratory screening tests and their damaging consequences; the law and abetment of crime; devotion and dedication to duty; professional negligence; fortitude and dignity among the terminally ill; treatment aimed at comfort rather than cure; illness and the intellectual; euthanasia; the grotesque side of medicine; and overwhelming human kindness.
Often, ethical dilemmas do not have clear yes/no answers. Much depends on the point of view offered in the narration. Switching protagonists and viewing the same events from another perspective may open up new vistas of understanding. As I read on, I found myself waiting eagerly for the author’s observations and interpretations of the medico-legal and ethical dilemmas described. Here are some that caught the eye.
“…in an acute life-threatening condition, it is not always easy for a doctor, and especially a surgeon, to decide on what is the appropriate course of action. Not infrequently, he has to walk on a knife’s edge.”
“…mistakes do save lives.”
“It was miraculous in the quiet sort of way that everyday miracles happen.”
“It is weird how one’s opinion depends on the way the case is presented.”
“The milk of human kindness is more than just a figure of speech.”
“Human endurance is unfathomable.”
“Gloom descended on the family. Even though her two children had not been told anything, the sudden change in their parents’ behaviour, the subdued voices in which they talked and their show of extra affection made them uneasy, as if something sinister was about to descend upon the household. They wanted to know what had gone wrong but didn’t know how to ask.” (So true!)
“…das Kabir jatan sun odhi, yun ki yun dhar deeni, chadariya jheeni re jheeni.” (A nice touch, giving the story the appropriate cultural context. I wished there had been more of these.)
Some of the stories touched a personal chord. One of them reminded me of my father’s auditory hallucinations in the early days of his battle with dementia. A doctor himself, he knew that hearing voices in his head was not right, but he could do little to stop them and feared that he would lose his mind. Another provoked the pathologist in me. Was the diagnosis really rodent ulcer, as the author would have us believe, or well-differentiated squamous cell carcinoma? Not that it mattered to the story.
The print is easily readable and the page layout is pleasing, but the copy-editing could have been better. Occasionally, the usage of words and the construction of sentences are odd (eg, “one should know what is sciatic nerve”, “on the horns of ethical dilemma” and “…would fool the passers-by into believing he was standing…”). At places, the tenses are mixed up.
After the first few stories, which held my attention because they are well written, there is a sudden dip in the quality of several stories in succession. These are preachy and contain too many laboured explanations. Moreover, the plots are not properly developed and the manner in which the stories end leaves much to be desired. The stories which have HIV as their theme could probably have been combined, to better effect. Some stories are illustrative, but seem fragmented. Perhaps this is a deliberate attempt to provoke the reader into thinking. Nevertheless, I felt that the fragments had the potential to be developed into a gripping story. It is here that the book is in danger of losing the reader.
On the brighter side, the author expresses his appreciation of human qualities with great eloquence. The admiration he feels for Chhotu and Sister Nicolette is heart-felt, and has given rise to heart-warming stories that reaffirm our faith in humanity and human resilience. Readers of the IJME and those who are inclined towards the medical humanities will find much to appreciate in the book, besides the ridiculously low price. Having read and reviewed the book, I made a quick online search for Shri Gopal Kabra and stumbled upon “Adhikar”, the Hindi version of one of the stories in this book. Unsurprisingly, the story is much more powerful in the vernacular than in the English translation. However, for those who cannot read Hindi, I would recommend that they read From a doctor’s diary.