Disclaimer: This article is an outpouring of emotions following the untimely and unfortunate homicide of one of my students by a deranged patient while on duty at a Government hospital.
Today morning, I was woken by a phone call from a junior colleague (in-charge of house surgeons aka interns) informing me that one of our interns posted in a nearby government hospital had been stabbed multiple times by a patient. She was still alive, but barely so, and I immediately informed my superiors. By then she had already been shifted to a nearby private hospital, and I rushed there with another colleague.
The half hour drive was tense, and I was grateful that there wasn’t much traffic. By the time we reached, she had been intubated and the ambulance had begun its journey to a tertiary care hospital around 60 km away.
A few hours later I received the news I had dreaded the entire morning: she was no more.
By then the news had been picked up by media channels.
Throughout the day there was much milking of the incident by various agencies, institutions, and individuals for vested interests. Everything was converted into a media circus.
Her body was brought back to my institution in the evening. By then there were several media channels, a large police contingent, several political leaders, and representatives of various organizations who had nothing to do with the deceased. Reporters sought ‘bites’ from those present- one spoke to me as well. Her tragic death had by now become a morbid media spectacle.
Eventually, everyone left. I was left with my thoughts once again.
I had known her since the day she joined MBBS in 2016, and had taught her till she passed Final MBBS Part I. It was during her internship posting in my department that she was posted to the Government hospital, and I feel guilty for her death. She was my responsibility. I was supposed to ensure her well-being. Now, I have failed in my duty towards her.
I cannot hide behind excuses and pretend to have no role in her misfortune. After all, she was posted in another institution- a government hospital no less. So isn’t it the responsibility of the government to ensure her safety? Maybe, but she was first my student. I was like her local guardian- didn’t her parents entrust her to our collective care?
Having worked in resource-limited settings and a keen sense of social justice, I have encouraged my students to serve in areas of need. If she were in another state where law and order is nearly nonexistent, I would have cautioned her beforehand. She might also have been more vigilant. Unfortunately, this happened in a state that considers itself as ‘God’s own country’. A state that prides itself on rule of law and a vibrant democracy.
What will I tell my students now? What can I tell my students? Do I tell them that they must be willing to be the next medical martyr? Should I tell them to expect death whenever they are on duty (and prepare for it)? Should I tell them to ignore the hypocrisy and double-standards of society when it comes to doctors in particular and healthcare workers in general? Should I tell them not to expect the system to work for them, or for it to be there when they need its security and protection?
After some time, her demise will cease to be a talking point. The media and leaders will move on to other issues. But this incident will be a turning point in the lives of many young students and doctors. Life will not be the same for me.
I am torn between emotions. Anger, frustration, sorrow, and a sickening feeling of utter helplessness alternate. But what to do?
communitymedicine4all 
Sir, if we need to do something, this is the time, like Amber’s mother in NY, who created amber alert for child trafficking in memory of her daughter, killed by a paedophile.
I think we could make something like a 24×7 helpline system to ensure safety of doctors in regards with cyber cell of govt, for reporting and responding to such incidents which could reduce the time lag, which is the main culprit everytime.
I think we need to do something sir, if possible this is it, so that her death doesn’t go in vain.
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Raise your voice at high and react in all possible ways specially through on line medias. Medical department has to take initiative, our political system is very weak, clearly showing from health minister’s very shameful opinion, as well as police department .
It is your responsibility towards our society.
Majorities blood is still boiling after minister’s response
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According to politician doctors should know how to protect themselves,so either they have to learn a lesson first regarding their own safety not about patients
Secondly if this is for doctors then why politician and so called VIPs require police security for them why not they must also be capable for their own safety
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This culprit should get a max punishment, as others will afraid to do the same. Atleast we will ensure it from government. A special punishment for the homicide of medical professional should be issued
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Can we not include this in the disaster management programme of health care centres? Why not set up protocols and train health care workers on what to do when someone attacks them or what are the minimun security requirements required when giving care to people with potential criminal mentality. Similar to any other disaster management programme, what are the steps 1,2,3 why not conduct mock drills , what should be each one of them’s duty in such a situation, where should they gather and so on?
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Very true.. We have drills and protocols for managing medical emergencies.. Likewise we should put forth a drill to manage an agitated/ violent patient / situation anticipating harm to medical staff and property.. And train the doctors and staff in the necessary steps to be followed..
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Sir, what we should is and will be a question mark. There is no proper way/ solution. The general public should have a common sense on the topic. We were people who were worshipped as god until 2 decades ago. Having a helpline number is not a proper solution. If we had a helpline number now.. do u think vandana wud have been saved? No, because that murderer as he should be called, is a addict.. there is no way that any one of us could have been saved from such a person.
1) Proper awareness and strict measures on drug usage and punishment for drug usage should be done. Let me tell something very frankly, the above said drug usage restriction and awarness should start from our medical colleges, as we do have tons of people using these in between us.
2) In case of community posting as such that happened, interns have to be trained to take care of themselves. Locking rooms and safe guarding themselves, even if its as small as a pepper spray, should be told to follow.
3) when a patient is bought in by police, ask the police to cuff him up, if not then tell them on their face, that you wont treat them.
4) in case, you understand that the patient is violent or under influence.. please please your 1st priority should be you.. and just you. Stay far from his/her reach.. make sure the police officers and their in that same room.
5) i knw medical ethics is what we follow.. and live for.. but unfortunately from the incidences that are happening.. i think we should get the authority of saying NO to a patient until unless that patient/ bystanders will cause a threat to the doctor.
I really dont want to lose another soul among us again.
Like we hear during a flight takeoff, make sure you are secure and safe, then assist the others. Because if you pass away from your good act, you are just gonna be a matyr for a week. Only ur parents and true friends suffer.
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This is the best time to make a change in the current health system. strike with interns and PGs should go on until proper action is established from the health ministry. Otherwise, as usual with all other hot news, this will also get weaned off. We lost a young, energetic future doctor, and their parents lost their daughter. Strike should be done in such a way that people get to know that all 80% of work in medical clg is done by interns and PGs. in fact, working overtime without adequate payment. This time, we have to go aggressive. All the time, we step back from strikes since patients should not suffer. Let’s not allow our sympathy and empathy toward patients to be utilised by the health system.
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Maybe to bring a new subject called “martial arts”, just like how veena george said.
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Boycotting for a week, so that public understands what a doctor is actually for. Not to b killed .
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Nothing will change this society, its only going to get worse, like how hs dr nadiya said, please do come to join mbbs as it will only kill you.. either thru depression or thru people you treat.
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Sir, Despite of every security measures we take, we will get beaten .Because , This is Our society. People who feels proud of living in a state with high literacy rate, However, lack of common sense is the main issue with them.This is not only about Keralites. Indian public doesn’t even care about the life threatening attack or murder of a Health worker.Because , till now,no one is been punished.The day ,when there will be a strict LAW, Strict punishment, Public will fear to touch any one of us. And giving them proper knowledge about risk of every medical procedure,side effects of every medicines,importance of time,knowledge about every medical condition .And mainly,LET THEM KNOW ,THAT WE ARE NOT GOD.I will request to stop all Emergency services in every centres expect MEDICAL COLLEGES for one day.Let them know the value of Hospitals and Health workers.Or let them Google the treatment and do themselves.From what happened with Vandana,am personally afraid of treating a patient.I will want to wear bullet /stab proof scrubs in ER with personal securities. We are in Rage to this public sir, to this system.We want Justice.
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Thank you for sharing your emotions Dr Roopesh.
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Definitely a change should be made. And we should identify where can the changes be made than simply shouting at the top of our voices for a week, and then forget about such a tragedy. We can , blame the government , police , the community or even the system. Or we can make a real change by securing our safety as Medicals professional, practicing in an area of need.
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One of the key things that was striking about this particular case was why was the patient who was in alcohol withdrawal, not identified and proper measure ( such as restraints or sedation ) to secure the safety of the patient and the care provider not done. Was their supervisor available to the house Surgeon ? why did he or she not identify alcohol withdrawal ? If the patent was violent why was benzodiazepines sedatives not administered to calm the patient before a procedure like wound cleanly with sodium chloride. Did the police inform ahead such a pateint is being brought and the medical team is prepared to handle , accommodate a violent patient.
Was excessive stress ( heavy influx of incoming patients or long duty hours ) involved that clouded judgment. How can we address that?
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Poor kid is house surgeon. It is the primary responsibility of the immediate supervisor (medical officer) , medical superintendent and the principal. To make sure a student under training, have the comfortable and working atmosphere to train and work.
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Thank you so much for a response which we expected from the private medical College management or teachers association. Ensuring doctors safety at work place is a cause we have been striking for time and again, need to be ensured.
But at this time is it not necessary to rethink the need for sending interns and postgraduates to government hospitals sacrificing their loss of hours of work and experience in their respective specialties and that with payment of a fee to the government. How are we ensuring the safety of these children while they are away from their hostels?
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