How do you differentiate between the ethical and the unethical?

This is a simple question. I have a thumb rule: whatever you tell people proudly is ethical; whatever you want to hide is unethical.

What does it mean to be a doctor?

Dr Mishra of Apollo Hospital said this, which I quite liked. You take a piece of paper and write down, on one side, what society has done for you. Then turn the page and write on the other side what you have done for society. You will find, invariably, that your contribution falls short. We receive more from society than what we will ever give in this life. You can’t always be thinking of recovering investments, especially in terms of education. The patients on whom we learnt and trained — in a way, we are more indebted to them than they are to us. Somebody else does the research, somebody else does the marketing and we hand it over to the patient. It’s a postman’s job. So we need to be essentially humble.

From where do you draw the inner strength for practising ethically?

Our teachers deserve credit for imbuing us with good values. I passed out from KEM Hospital in 1955. I had registered for an MD in Medicine. But I had to decide then whether I was for the classes or for the masses. In those days there were fewer consultants and more practitioners. As a practitioner, one had direct contact with the community.

What were the high points in your career?

I realised that besides treatment, communicating preventive messages was of importance. While the focus on preventive medicine is lacking in the current curriculum, it is the most important part of practice.

The best way to communicate was to write (beyond writing prescriptions), because that way you can reach out to more people than you can come in contact with. I have written 18 books so far. I took to writing after turning 50. We also translated Where there is no doctor by David Werner into Marathi.

Would you like to describe situations in which you felt challenged, whose resolution affected the way you practice?

My practice of sexology started after I read about a girl committing suicide on her wedding night. It was a shock to me. She was ignorant about the act. I decided that there was too much ignorance about marriage. The reasons for divorce usually have to do with selection of the wrong partner, and with wrong norms. Further, just explaining anatomy is never enough. In India, marriage is holy, motherhood is holy but the act bridging the two is taboo. We have all been conditioned that way, including doctors, who are embarrassed to talk about it.

Similarly, I heard of a death of a child by tetanus in 1970. I decided to do my bit to prevent preventable deaths and morbidity. I have immunised 75,000 children so far, free of cost. It gives me satisfaction. One may have money but also sleepless nights. I probably have less money but sleep blissfully. While I had no expectation of returns, the majority of my practice was paediatric practice thereafter. Overcoming the usual resistance to new ideas, I started under-five clinics.

What gives you satisfaction in today’s world?

The role of friend, philosopher and guide that I have enjoyed in 42 years of practice can never be translated in terms of money. I understand people’s need to earn money and have a good quality of life. But then black marketers and bootleggers will make more money than we ever can. If you were to win a lottery and never have to work again, you would be most miserable. We have accepted this profession with certain principles and we should be true to them.

Learning is another great source of satisfaction. When I visit patients in the hospital, I learn. So why should they pay me? I should pay them. Doctors don’t spend enough money on books; books have no resale value and do not fetch immediate dividends.

How do you cope when others get ahead because of unfair practices?

Is there any doctor who starves? There is no end to how much you want. If you are unethical, you will look back on your life and find that you have earned money and very little else. Medicine, education and the judiciary are the three pillars of society. If these are corrupt, society is ruined. Every individual is a small cog in the big wheel of the nation. You cheat someone in your profession; you will find that someone else cheats you. It is a vicious circle. It is very easy to go from good to bad, but the return trip is very difficult. My teacher, Dr Baliga, would say: “Run after money, and money runs away from you. If you run away from money, money will run after you.” Our profession is such that people are indebted to us. They come to us when they are in trouble. If we don’t do our job well, they lose faith in us, and that is what is ailing this generation.

What would you advise young entrants to practice?

Honesty finally wins. If a patient realises that a doctor is not honest, he knows there is no way he will treat the patient’s body with honesty. If he is corrupt how can he ever be trusted with anyone’s life? Ethics is continuously evolving. While I would not like to say what others should do, I call on each person to determine it. Every generation is on the shoulders of the earlier generation. Every generation has a responsibility to do something worthwhile, to pass on the benefits to the next.

(As told to Nobhojit Roy)