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Bitter Medicine: Like it or Lump It

Shubada Deshpande

As Her Own Medicine: A Woman's Journey from Student to Doctor, Sayantani DasGupta's book, was about to be published, she received invitations from several south Asian organizations to address them.

But within few days of the hard-hitting book reached the public, the invitations were being cancelled.

"I truly didn't expect it," Dr DasGupta says, referring in particular to the South Asian Medical Association. Its representative told Dr DasGupta that it did not want to be associated with her.

"They could have disagreed with me, questioned me about the book, that way I would have got a chance to defend my position," says Dr DasGupta, whose book is published by The Ballantine Publishing Group (a division of Random House).

Written during her college years, and sold before her graduation, the bittersweet book tells the medical establishment that the emperor has no clothes.

"Don't just silence me," she says. "It's a pity, I always attend south Asian community events, art exhibitions, book readings, and meetings. I don't always agree with their ideas, but I like to show my support to my community.''

There are many books in the market that are critical of the medical establishment but this is the first book by a south Asian doctor that not only questions the medical establishment's ethos but also reviews the position of colored women in medical schools and hospitals. Though the editors at Random House found in her book "a remarkable account of medicine on the cusp of the twenty-first century," some of the south Asians did not want to embrace it.

Her parents and her husband knew what was happening. "You should have expected this reaction, they told me," Dr DasGupta says. "You haven't exactly written love notes, they said.''

Dr DasGupta cannot understand why south Asian doctors want to distance themselves from the book. After all, it is a study of the American medical system, and not a condemnation of south Asian doctors. Perhaps the book is too bitter for the doctors. Perhaps they are too uncomfortable with its observations, particularly about racism in the medical field.

A graduate of the Johns Hopkins School of Medicine, Dr DasGupta, who is in the residency program in social pediatrics at The Montefiore Hospital (Albert Einstein College of Medicine in the Bronx), New York, says she wrote the book to survive medical school.

"It was like therapy,'' she says. "I had to work through the issues that I saw, analyze the power structures, and express my anger."

"While I was a student, I would discuss a lot of these things with my women friends'' she says. "And we often thought, 'Oh my gosh, if only we could share our experiences it would fill a book.' So this book was meant to be an anthology with each person penning their experiences but then everybody got busy with their hospital schedules and I finally got down to it."

Her book reinforces the many things we know about the grueling life of interns -- and how it affects patients.

"The language of militarism is much used in medical practice. In keeping with the germ theory, the enemy of choice is usually disease," she writes in her opening chapter.

"However, too often the enemy is the patient. Indeed, in the much-beleaguered life of the medical intern, incoming patients are 'hits' to be avoided. This mentality, while a coping mechanism for a stressful job, too often translates into physician behavior."

Right from the first year onwards, medical students, Dr DasGupta notes, giving her own example, go through the rigors of `boot camp' where like the military, medical establishment tries to mold individuals and change their persona into its own idea of what a good physician should be.

Disenchanted with the activist groups at Brown University, and wondering what good protesting were if one were not practical, she hoped medical studies would help realize some of her idealism.

Medicine seemed to her a concrete way to effect social change and through it, impact the lives of women and children, minority communities, and the economically disadvantaged.

Her years at Brown, where she studied anthropology, literary criticism and biology among other things, did not prepare her for the medical environment which was certainly not as socially conscious or female friendly as she had expected.

"After my liberal political atmosphere in college I was so spoiled that when I entered med school I initially thought people were joking when they displayed a bias or prejudice," she says. "I had to relearn.'

"Nobody in my family or even friend's circle has been a doctor so I entered the field with totally different notions,'' she says.

Dr DasGupta is not new to writing. Many of her articles are published in medical journals and she has also won prizes for her essays. She has been featured with her mother, feminist Shamita DasGupta, on the cover of Ms magazine with an accompanying article on her mother. She is a co-author with her mother of a folk tale book, The Demon Slayers and Other Stories: Bengali Folktales.

Shamita DasGupta is associated with Manavi, a New Jersey support organization for battered and discriminated south Asian women.

Her own medicine, is written for the general reader. "People in the medical field are also general readers," says Dr DasGupta. The book does not confine itself to the American medical system.

During a stint at the All-India Institute of Medical Sciences, New Delhi, she found echoes of her American system.

"The hierarchy was evident even there; in fact, much more so, as I could see how people didn't question their superiors," she says.

"In India, class becomes such an issue, invariably the people who come for treatment are from lower economic classes. The kind of power dynamics is similar to what it is here. Here too, the patients at Johns Hopkins and Montefiore are mostly from the inner city area.''

How did she develop her politics?

"My mother has always been political, so my politics grew easily," she says. "The race issue, for example, hit me, when I was in elementary school in Ohio. I was the only brown kid in my neighborhood. It was a potent experience.''

At high school, she managed to find like-minded friends, but it was Brown University that really nurtured her ideas and politics.

"I grew up with Manavi. I had that backing. Politics was part of our meals," she says. She has a series of book readings lined up and will be traveling across the country and looks forward to meeting people, especially medical students.

"Now that the book is out I feel comfortable," she says.

"In my medical college days it was anger that I felt. Finally I have come to peace as a doctor. With my temperament in mind, I have chosen to work in pediatrics and it's a very socially aware environment that I am working in now. It's a sort of compromise that I made. I felt I should do what I could survive doing."

She is glad that patients are becoming wise consumers, and there is a lot of media attention to how health organizations are performing.

"Be challenging and aware," she says. "Actively seek a doctor that suits you. The best relationship is like a partnership, you should demand full information, take ownership of your own body."

And what does she have to say to women students in medical college?

"I would tell prospective students to get into medical profession only if you want to, because it's a long road," she says. "Once you are in it try to keep your idealism intact. Be kind to yourself because only then can you be kind to your patient. Find an environment of support. Don't be afraid to challenge and protest if you have to. Don't give up. It's a tough field and it is a matter of life and death, so first be a master in your field. It is rigorous but it is also possible to be sensitized to issues of women and minorities for example."

Given her passion for public health, she would also love to be a mentor to young women entering the profession and she hopes to find like-minded doctors who share her beliefs.

"People deserve to have a system that is in keeping with the times. Hopefully, I can participate in that change," she says. "I also want to go back to university at some level and teach and see some of the changes implemented."

But at the end of it all she is hopeful of change in the medical system, even though it will be slow. The weapons of the new revolution, she says, are observation, communication and perhaps, ultimately, humor.

"The emperor is powerful but even he will turn and run at the people's ridicule," she says.

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