Dear Public Health Folks in India!
I moved to Delhi when i was ten years old, back in the 1990s. For most of my life, I have consulted one doctor in particular, who is an excellent homeopathy practitioner. I remember being really young, around 15 years old, when i bought myself a punk, masculine necklace. When i got back home, my mother got really worried. Now, let me give you a little background. I am born a girl, had short hair most of my life, atleast till the point of this incidence. Mostly wear jeans and T-shirt, and love to play sports. To my surprise, this necklace was an alarm for my parents. My mother right away took me to our family doctor, and expressed her concern. I don’t remember much, except that he did not look bothered. He asked me a few general questions, which again I don’t remember. That was that, my parents never tried to take me to a doctor with any further correctional expectations on my dressing and likes.
Over two years back, I was in Delhi, doing the final round of preparation to leave for US to pursue masters. I have been underweight, but healthy, all of my life. In the process of getting through a few medical formalities, as required by the university, I ended up at Max Hospital in Saket, where I stumbled upon a lady doctor. She has a strong, (coercively) caring manner about her. Her medication to me was nutrition-oriented. I was prescribed an energy powder to consume on daily basis, which proved to be very helpful. I gained 2 kgs in that month, a huge progress considering my weight history. Soon, my cousin would also take her underweight daughter for consultation.
July 2018, I took an off from work to see my family back in Delhi. One of my best friend is now a fitness trainer, and wants to know my exact vitamin levels before suggesting some nutrition supplements. I know i am vitmain-d deficient, but she wants to know the exact figure to decide on the frequency. So I go back to the (coercively) caring, lady doctor and see if she can direct me to apt blood test. My father is along with me; my mother prefers that someone is accompanying me to the doctor, and we were also returning from somewhere so he happened to be along. My father and I, both have been fond of her approach. Happy to see her again, and beyond my intention yet again, she looks at me and sighs — I am still underweight. She declares that i am stressed and that is affecting my body weight. “Yes, I have started taking alternative treatment for it”. “Your alternative, natural treatments are not working for you, and now you are going to do exactly as i tell. Sir, she has tried her things, and now I will take care of her, if that is okay with you.” My dad gently nods. Let me make it clear, I am thirty years old at this point. You don’t have to take my parents permission, but mine. Women are to be treated as adults when they are one (not by your logic, but the fact that I am 18+). “What is the problem with you, why are you not settling down? You must get married.” Well, I am quite caught up in my career and I don’t really have any time for marriage and things like that”. “Career! I am a doctor, I have children; women are like durga, we have many hands, we balance all our work and roles, and we do it very efficiently. You don’t take care of things, and it starts affecting the whole family. Entire family is stressed out.” Baffled at this point, not just because she is looking more at my father than me during the conversation, but also the way she is trying to build the pressure on me. Build a guilt-trap, make me feel terrible that i am not marrying and getting settled, hence stressing myself and the whole family out. Look at my never-improving weight, it is written all over me, and maybe she is judging my father’s weight too at this point, he has always been thin as well. “I am not into men!” I splurt out in an anger that she cannot see yet. “Well, I am not saying marry a man, just settle down with anyone you like”. It was a mantra this 30-year old had never thought of, why don’t I settle down with the one I like! Nevertheless, this consultation ends shortly; I get the supplements she prescribed from pharmacist apart from giving my blood sample. I go back home and there is a particular medicine I am not so sure of, and I wonder what nutrition it has.
Three years back I had consulted a psychiatrist who prescribed me anti-depressants. These were tiny 10 mg tablets. I was supposed to start by taking half of it each night, for the first week, and then take the whole for subsequent weeks. I never took those, I had read and researched about SSRIs long back, and am completely opposed to its usage. It suddenly striked me that this mysterious medicine from the (coercively) caring, lady doctor were just as tiny as those. I googled the medicine name and voila, there it was, a god-damn anti-depressant! I was infuriated and offended at so many levels. I was certain that i am not going to consult this doctor ever again. She is not a psychiatriast, I did not go for a mental health consultation, and she prescribes me an anti-depressant without telling me it is one, on the context that I need to do as she says as I have exhausted my ways of dealing with stress and it’s time for my family to now sleep in peace. And then the other big problem — how can you pressurize or demand from someone to get married or settled down when you are perfoming the duties of a doctor? Especially someone from the LGBT community. It was so stupid for her to presume I am sailing in the same boat from last two years and getting married will fix all my depression. Even a mental health consultation is taken in private, not in front on your parent or anybody else, and not by building more pressure, exhibiting sheer lack of sensitivy and understanding towards this area of medical services. A sensible doctor would have rather requested a private conversation, and suggested seeking medical help for mental health, if they really felt the need.
I would not say that all the doctors in India are insensitive and untrained to handle mental health issues, especially concerning LGBT community. But most of them are. I have been fortunate in terms of having a family doctor who is far more sensible. Four years back I was dealing with acute depression after having a terrible breakup. I visited my doctor, the same one my mother took me to when I was a kid, and he asked me a lot of questions. He gently urged me to open up about what the actual problem is. I was reluctant, I did not expect him to take it in the right manner; he has been a regular doctor at free clinics at dera sacha sauda, a homophobic spiritual sect in India. I expected his values to be homophobic too. But there was not a flinch or awkwardness or change in tone in his manner or approach. He prescribed me medicine for my depression, while trying to advice me on how I am looking at things. He suggested that nothing that can push you to such extremes of depression, be good for you. I must grow out of that relationship and those circumstances. I still visit him when I am in Delhi and when I need medication. Sometimes even through a phone call.
How one contrasts the stereotypes one may associate with them! My family doctor, who served patients at a homophobic spiritual community, part of a typical family living in west delhi, is so understanding and sensible on issues of mental health and depression. There is not a speck of judemental attitude. The lady doctor from south delhi who works at a progressive hospital around the same area, who looks confident and in-charge of her things, is coercive, insensitive, and immature in handling cases like mine.
This was still a very subtle experience for me, and I believe that people seeking help with mental health, especially from LGBT community, feel a lot more vulnerable, violeted, and frustrated. Maybe most of them don’t even know where to go, or cannot afford it. In recent times, a lot of people are trying to spread a very important message that mental health consulation should not be seen as a taboo. There is also a strong need to train and sensitize doctors on dealing with mental health issues, and LGBT community patients. Max hospital is a huge medical entity in Delhi, with significant turnover each year. The management of such organizations need to invest on training of their doctors. The governments of each state should also stop resisting to these really imporant needs of general public in health domain, and take the responsibility of capacity building, and safe space provisions for people dealing with these issues.
By Soumya Tejas
