Dr Janvrubai Kamat recalls the days when she had the good fortune to
work alongside physicians at the Escola Medico-Cirurgica de Goa who
exemplified the dictum: Medicine is the art of humaneness
GIFTED HANDS
By Dr. Janvrubai Kamat
As
the Goa Medical College completes 175 years, we recall its exceptional staff who
taught aspiring doctors how to put
humanity back into medicine.
In a recent Op-Ed piece
in the national press, a professor from India’s pre-eminent medical institute
suggested that disciplines from the humanities be introduced into the medical
school curricula. In his opinion, physicians today are prone to rely on a
battery of tests as a diagnostic aid, giving short shrift to the compassion,
empathy and care-giving so critical in the process of healing. The need for
doctors to identify themselves less as technical experts, and more as those giving
succour, he argued, can be addressed by such an inclusion at the training
stage.
Using the humanities to
teach trainee doctors to be more humane is not new. In the US, many medical
school admissions emphasise artistic expression and visual-spatial skills,
besides critical thinking, as criteria for selection. These skill-sets are
believed to aid students in mastering both
the science and the art of healing.
That the medical
profession has been undergoing a crisis of confidence is well-documented. Doctor-patient
face times are shrinking. The number of lab investigations employed in a
diagnosis is increasing. Medical referrals are oftentimes dictated by the
desire to send business in the way of favoured colleagues.
It is debatable if merely
including art and literature in the MBBS curricula can address these aberrations.
What is required is that students appreciate that what they practice is not a
profession but a vocation.
One way medical students
in Goa can do so is by taking inspiration from their predecessors in the field.
A special mention must be made of medical practitioners at the time of Goa’s
Liberation, particularly those who taught at the then Escola Médico-Cirúrgica de Goa, the
present-day Goa Medical College.
I had the good fortune
to study under, and work alongside, some of these physicians who exemplified
the dictum: Medicine is the art of humaneness.
This year, we celebrate
the 175th anniversary of the Escola
Médico-Cirúrgica de Goa.
The college was founded in 1842 to address the high number of fatalities to
tropical diseases in the Ultramar Português, the Portuguese overseas empire. As Portuguese doctors hesitated to travel abroad
to minister to the sick, it became imperative to train locals for this task.
The Escola
Médico-Cirúrgica de Goa was
the sole institute of higher studies in the Ultramar
Português, reflecting poorly on the importance given by Portugal to education in its colonies. Over
the years, the college provided trained physicians to fight
sleeping sickness, small pox and other epidemics in the colonies. Many graduates
distinguished themselves by pioneering research in tropical medicine.
For students like me, what stood out
about the Escola Médico-Cirúrgica de Goa was the dedication and selfless work of its faculty. I will relate a
couple of instances as illustration.
On completing
my degree, I was appointed in the Department of Pathology as an Assistente, roughly equivalent to a
lecturer. As part of my schedule, I was assigned clinical duty in the wards. One
evening, a police officer brought in a trauma case – a beggar woman found lying
by the roadside, bleeding heavily due to an abortion. It was touch and go
whether she would survive.
As Dr João Filipe
do Rego, Head of the Department of Obstetrics and Gynaecology, had completed
his rounds and left for the day, I called him for advice. He would not have wanted
it any other way. He bade me put the patient on life-support, collect her blood
sample and wait for him.
On reaching the
Emergency Room, he took the sample and, without waiting for the ambulance, left
for the blood bank. Despite it being the weekend, Dr Rego was at hand throughout
until he was satisfied that she was out of danger.
Our teachers
were compassionate, but firm. Case in point – the Director of the Escola
Médico-Cirúrgica de Goa, Dr
João Manuel Pacheco de Figueiredo. Like all medical students, I was tasked 24-hour
duty shifts in the clinical wards during my residency. On one occasion, I was assigned
to a ward overseen by Dr Figueiredo, who was also Professor of Medicine.
It was 9:30 am
on a Sunday, near the end of my 10:00 am to 10:00 am shift. As all was calm in
the ward, I decided to leave a little early. Asking my colleague in the
neighbouring ward to cover for me, I went home.
Unknown to me,
Dr Figueiredo arrived soon after and found the ward unattended. On learning
that I had left early, he sent an ambulance home to recall me to the shift. A
mere 10 minutes were left when I came, but no matter. I had to fulfill my
obligations. I learned a valuable lesson in the process.
When it was
time to leave, as the ambulance on duty was unavailable, I took a cab home. The
next morning, the office clerk was at my desk with the reimbursement for the
fare.
Besides the Escola
Médico-Cirúrgica de Goa faculty,
several private doctors served as role models. There was Dr Shantaram Hodarkar,
whose typical day was spent in the impoverished part of town, caring for those unable
to go to the hospital. His briefcase laden with medical supplies, he would move
from home to home, tending to their maladies. Whatever they could pay - a few notes
here, some loose change there, they would tuck in his suit pocket. He never
checked the amount, he just moved on to the next person in need.
During my childhood, there was the
similar inspiration figure of Dr Govind Vaidya. In later years, there were
exceptional physicians like Dr G K Salelkar and several others.
As the Goa Medical College celebrates its
175th anniversary, it is worth noting that, more than courses in humanities, it is the personal example set by
dedicated doctors that puts humanity back into medicine.
Dr Janvrubai Kamat, a graduate of the Escola
Médico-Cirúrgica de Goa, is a clinical pathologist. She pioneered the use of
fine needle aspiration biopsy for the medical investigation of lumps and the
detection of cancer in Goa, following her training at the Instituto Português de Oncologia Francisco
Gentil, Lisbon, Portugal.
