“Surgery for me has always been a metamorphosis; a realisation of the metaphorical stone blooming into life as a sculpture.” — Dr Shubrajyoti Das
Jorhat (Assam): Tucked in familiarity of lives and an exceptional higher ground to educational quality, Jorhat, a district in Assam, has to its credit, brilliant doctors, engineers, teachers, lawyers, filmmakers and politicians. Dr Shubrajyoti Das, with 27 years of experience in medicine, in ways many more than one, helps establish the same. He (MBBS, MS) is a laparoscopic surgeon and the only oncologist in the district.
Dr Das has had his primary education from practically all over Assam, traveling tremendously with his father as he was stationed in various districts. The very first question that propped up in my head as I set out to have a conversation with him was whether he’s ever had anything else on his mind, other than his present field of workmanship. His answer came even before I could realize the rhetoric of the question, as his family sees him week after week spent completely in an overnight surgery that varies in all degrees of complication; it could be a common case of appendicitis that needed urgent and delicate handling or an emergency wound bind up.
Recalling days at his residency and the internship he took up before post-graduation, Dr Das reminisces his professors, talking of the art of surgery and the utmost satisfaction of healing the pained. “I had a professor, named Dr K V Mathai, in Christian Medical College and Hospital (CMC), Vellore. We would sometimes assist him in neurosurgery and the man had a way of working that superseded the mechanizations we make of curing a person. He made it look like art.” Dr Das echoed as he adjusted the crevice between his glasses.
Oncology, as such, is a mismatching flip between dread and inadequate interest in Assam. People are terrified of a terminal disease, and where the social situation is actually better than HIV/AIDS to begin with, it is still a disease which is referred to mostly as ‘the bad disease’. Blame it on the inadequate awareness regarding the difference between malign and benign tumours and the possible cure of malign ones or the lack of even technological development, neither of that solves the problem. When asked about a surgical case that he has clearly etched in his mind, Dr Das says that every doctor has bits and parts of every surgery, which he would have conducted, etched in his mind subconsciously. Some were just more memorable, or haunting for that matter, for situations that boarded beyond the obvious ailment. He remembers a Whipple Surgery of Carcinoma that he led performed, with two assistants by his side, in Jorhat. The tumour lay stubborn in the pancreas, complicating the surgery further. The surgery lasted eight hours, and though they were all drained of energy, the success of the surgery was what remained with them afterward.
Mostly while I studied the lives of doctors on surgical duty or residents who toil and assist surgeons in hospitals, I wondered what would come of keeping a doctor, who would be treating another ailing patient, up on his feet for 15-18 hours at a stretch. Dr Das, on the other hand, has an amazingly unbreakable stance on that. According to him, to begin with, though the number of doctors is increasing, the ratio is not proportionate to the number of patients. And that is an entirely secondary argument here; when one enters a field of work, be it any field of work, one needs to know that there’s going to be a considerable part of their personal and public life at stake but one has to take the chance for what they sought out for. “When you work, your focus must be on work. Sleep will come when it has to. As far as biological needs are concerned, they don’t keep me on my feet for 24 hours, seven days a week. I always get my time to sleep when my body really needs it.”
Dr Das points out, sipping at his glass of juice, that there has been a definite shift of paradigm in the technology that deals with medicine and surgery. “I mean it really makes my work easy if you hand me a stapler instead of a thread and needle. But with the precision and ease of technique, there also has come a huge pile of work and cases that arrive at the hospital. So, though I take lesser time, I have more patients.”
Robotic surgery, according to Dr Das, is a fantastic advancement in the field of medical technology; however, it’s yet to catch up and become completely acceptable in India, let alone in Jorhat where he works with a few assistants preparing for complicated surgeries. “I have been through this transition, while at work. Senile diseases are not as common as lifestyle disorders anymore. I have more diabetic patients, patients with hypertension and cardiovascular diseases induced due to obesity.” In the midst of this realization, Dr Das also feels strongly that no disease, no matter how commonplace, can ever be called a ‘simple’ disease. “Our body doesn’t work simply, to begin with. Our systems are complex, and so are dysfunctions,” he says.
Dr Das was recently in news for helping in the treatment of patients in Majuli, the world’s largest river island, tucked snugly but endangered in the middle of the Great Brahmaputra. The river seasonally erodes, though momentarily minuscule, parts of the land, washing away a little more of the local people’s hope. Manpower falls short, and the government hospital has requested Dr Das to look at a few patients on a weekly basis. “It’s a tranquil place, less cars, more air kind of pleasure. I agree, communicating and transportation is a huge issue. I have to take ferries to reach the island. And these ferries aren’t exactly what one might call the luxurious cruises to the world’s largest river island. But these are people just like us, living, breathing, fighting problems and diseases. Now this, you can call a simple life in comparison (smiles). But it isn’t like they don’t fall sick or have any less health problems. They too suffer from cancer, diabetes and cardiovascular diseases. It’s a global epidemic.”
This article began with a quote by Dr Das, because that’s what I precisely remembered from the conversation, without having to note down the details. But there’s a lot more that I remember from the conversation than I consciously realized then. He’s a man of utmost conviction and dedication, someone who believes in what he does and does not break his head over what he cannot. He’s a doctor who knows his limits but treats expectations like benchmarks, no matter how unrealistic. He thinks young doctors today must not get into the profession thinking they will make a lot of money. “That comes much later; if they know what they already should by the time they’re into it, they must take it like a patient. Every patient is a human, just like us, on the other side of the solution that they expect from their doctors. If a doctor doesn’t love humans, I don’t know who will.”
As he comforts himself on his couch, finally opening up completely for a conversation, Dr Das smiles, “I am an old man trying to better an old art-form. Unlike what a lot of people think, medical science is not an absolute science. I can’t take my worship from a textbook. I need to honour it. But at the end of the day, I am a doctor. I have my duty to attend to, my patients to treat and a good night’s sleep, promised (to myself), if I succeed.”
by Sriparna Gogoi