MAY 16, 2007… a young woman is admitted to Rajshahi Medical College Hospital in the morning. Sima, 22, is in a critical condition; a case of encephalitis, inflammation of the brain commonly caused by viral infection, and pneumonia, doctors have told her relatives.
   May 17, 2007… Sima’s condition deteriorates in the afternoon. She starts bleeding profusely through her nose. At around 5:00pm, her husband, Shahabul Islam, a guard at the Chapainawabganj district jail, rushes to an on-duty doctor, Matuara Sharmin, and demands urgent medical attention for his wife. Desperate as he is, Shahabul tries to drag the doctor to Sima’s bedside at one stage. Dr Sharmin stumbles and falls. Other interns and medical staff get enraged at this, gang up and give Shahabul a sound beating. His mother and mother-in-law are not spared, either. The police have to intervene to rescue Shahabul and his relatives from the wrath of the doctors.
   The interns start work abstention, demanding punishment for the ‘unruly’ husband of Sima. The director of the hospital, a brigadier general of the army, rushes in. He calls in the Rapid Action Battalion and has Shahabul handed over to the elite law-enforcement unit. Members of the battalion knock Shahabul down to the ground and give him another round of beating. He is then admitted to Rajshahi jail hospital with multiple fractures in his limbs.
   The interns are not appeased still. They continue their work abstention. The director of the hospital convenes an emergency meeting with the employees at around 6:00pm and subsequently issues a notice asking the interns to resume their duties immediately or face legal actions. The interns do not budge at the threat of administrative action and the work abstention continues.
   May 18, 2007… Sima dies at around 6:30am, virtually unattended, with the doctors refusing to attend patients. Three more patients meet the same fate overnight. In the morning, many other patients start leaving the hospital. At around 11:00am, the interns bring out a procession in the hospital compound, demanding security and declaring an indefinite strike.
   Over the next few hours, five more patients die, including two children and an elderly person. A handful of doctors resume work at some emergency wards. In the evening, at a press conference, where some 60 of the 150 interns working at the hospital attend, the interns say they have temporarily withdrawn the strike, will sit with the director of the hospital over the issue
   of their security and resume the work abstention if the talks fail.
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   It is customary for doctors to take the Hippocratic Oath as they enter what is regarded as the noblest of all professions. The oath is widely believed to have been written by Hippocrates, the father of medicine in the 4th century BC. Classical scholar Ludwig Edelstein proposed that Pythagoreans wrote the oath but his theory has been questioned due to lack of evidence for Pythagorean medicine. Several parts of the oath have been removed or reshaped over the years in various countries. Most schools administer some form of oath but a great majority use the ancient version, which praised Greek deities and, obviously, do not address certain complex ethical issues that modern-day physicians face. What has not been changed essentially, however, despite the modification is that portion of the oath that requires medical practitioners ‘to come for the benefit of the sick, remaining free of all intentional injustice’.
   Many may wonder whether the interns at the Rajshahi Medical College Hospital are even aware of the Hippocratic Oath, let alone taken it, and they should not be faulted for having such misgivings. Not once during the disturbing developments over May 16, 17 and 18 have the interns behaved in a way befitting the practitioners of the noblest of professions. In fact, their indifference to the plight of the patients borders on the criminal. It is not to suggest, however, that what Shahabul may have done is condonable. However, it will be wrong to assume that when he approached the doctor in the first place, his primary intention was to pick a quarrel, let alone rough up a female doctor. Obviously, he was desperate and wanted the doctor to at least take a look at his dying wife. Unfortunately, his wife had to die to prove that her husband was right to be as desperate and frustrated as he was. The premature loss of his wife may not be the end of the affair for Shahabul. The jail authorities have already said they will punish him if proved to have done what the interns claim he has done.
   The question is: who will punish the doctors? Shahabul’s relatives have filed a case with the police, accusing several unnamed person of neglecting their duty that led to the death of Sima. Given the nature of the case and the fate of similar cases in the past, it is safe to presume that the case will not go any further. Similar fate seemingly awaits the inquiry the hospital has initiated into the incident. We have seen inquiries into incidents of greater seriousness doomed for oblivion in the past. There are no reasons for us to believe that this inquiry will lead to anything substantive. Even if it did and recommended disciplinary measures against the interns, how would it make up for the plights of the patients or the loss of so many lives? A doctor may have been misbehaved with or even manhandled but does it constitute the ground for them to go on work stoppage en masse and in the process
   condemn as many as nine patients to death without treatment?
   Since when has our society assigned the doctors the role of deities to decide whom they treat and whom they do not? Who has given the doctors the right to even think that their well-being is more important than that of their patients and that the patients are expendables when it comes to their safety and security?
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   Doctors at public hospitals across the country, especially the interns, seem to have made it a habit to call and enforce work abstention programme on the flimsiest of grounds. On May 3, doctors at the Dhaka Medical College Hospital, the biggest public hospital in the country, abstained from work for more than four hours after a clash with low-level employees of the hospital. As reported in the media, the trouble began when one of the gatekeepers of the hospital stopped some guests of a doctor at the gate. The doctor in question flew into a rage on hearing the news, rushed to the gate, quarrelled with the gatekeeper and at one stage slapped him in the face. Later, the gatekeepers and his colleagues ganged up and assaulted the doctor. The trouble soon spread across the hospital, as class four employees started assaulting on-duty doctors wherever they could find them. The situation was eventually brought under control at the intervention of the higher authorities. While the clashes stopped, the doctors decided to enforce an indefinite strike.
   In this case, evidently, the doctors were partially wronged, partially because it is the highhandedness of a particular doctor that led to the flare-up. Still, the class four employees were surely wrong for doing what they did. If they had any grievances, they should have gone to the higher authorities with specific complaints, instead of embarking on a revenge mission — slap for a slap, insult for insult, so on and so forth. The question, however, is: where did the patients do wrong? Did any of the patients join the employees in beating up the doctors? Or, did any of them express their solidarity with the employees? The media reports do not have any such suggestion. Then why were they punished? Why did they have to suffer the misery of having to go without treatment for several hours?
   To give credit where it is due, doctors at public hospitals do have to work within severe constraints. They do put in longer hours than is stipulated in their service contract. They do have to make do with limited logistic support. Also, in most cases, they do not have access to required medicine and equipment to treat the patients. Besides, they do often face hostilities from the
   attendants of their patients.
   Then, whosoever has promised the doctors that their life would be free of professional hazards? Most of them do get more than adequate returns for their work anyway. Maybe, the official salary is negligible compared to the hard work they put in; however, they are given ample scope to recoup the losses through private practice and consultancy. There is hardly any enforcement of the rules that guide their services in the public hospital. More often than not, we hear of and read about allegations that doctors of the public hospital spend more time on private practices than on their official work. In some cases, some doctors skip offices days on end if their posting is in an outstation. There have also been allegations that they take commission for referring their patients at public hospitals to have tests done at certain private diagnosis centres at exorbitant rates. While the authorities never dig dip into these allegations, the people in general seem to have taken such ‘intentional injustice’ as granted. What else can they do?
   The seeming indulgence by the authorities and resignation of sort by the people seem to have encouraged the doctors to drift further off their commitments to society, so much so that they no longer feel the slightest compunction to desert their ethical and moral responsibility, i.e. ‘to come for the benefit of the sick’, and be party to ‘intentional injustice’ on the pretext of threatened safety and security. It is about time someone reminded them that they are expected to worry more about their patients’ wellbeing than their own wellbeing.