• Users Online: 123
  • Print this page
  • Email this page

 Table of Contents  
Year : 2022  |  Volume : 2  |  Issue : 1  |  Page : 66

Finding meaning in medicine – The rural urban divide

Department of Pediatrics, Choithram Hospital and Research Centre, Indore, Madhya Pradesh, India

Date of Submission28-Oct-2021
Date of Decision23-Jan-2022
Date of Acceptance27-Jan-2022
Date of Web Publication25-Feb-2022

Correspondence Address:
Dr. Gouri Rao Passi
139, Indrapuri, Indore - 452 001, Madhya Pradesh
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ipcares.ipcares_328_21

Rights and Permissions

How to cite this article:
Passi GR. Finding meaning in medicine – The rural urban divide. Indian Pediatr Case Rep 2022;2:66

How to cite this URL:
Passi GR. Finding meaning in medicine – The rural urban divide. Indian Pediatr Case Rep [serial online] 2022 [cited 2022 May 27];2:66. Available from: http://www.ipcares.org/text.asp?2022/2/1/66/338488

“What is the problem with your little boy?” I ask. The man in the white turban, skin deeply tanned from toiling many summers in the fields, looks flabbergasted. It is an unfair question. “You tell me – you are the doctor!” he finally retorts. After two decades as a pediatrician in Madhya Pradesh, I now know that often when a villager plans a hospital visit to the city, everyone gets bundled into the jeep. Sometimes, the mother gets left behind; a little wonderstruck child reaches the doctor with no one to explain why and the doctor simply has to do his best. “Village” eyes ensnare you. They are clear and true. They know that you will do the right thing. “City” eyes are muddy, as the river after the monsoon. When the city child comes in; in walks a cloud of anxiety, mistrust and fear. But my village patients are full of peace. Even in the Pediatric ICU. “You go ahead Ma'am.” They tell me as I unhappily explain that I have to ventilate their child. “Do your best. God is always there.”

A couple of years ago, ten of us (several doctors) decided to cycle out into the countryside without food, money, or a phone. Food would be earned in exchange for work. When we started, we were a feisty group, but by noon, spirits were running low. We looked ridiculously out of place as we approached a line of mud huts. “Doctor Saheb! Welcome! What an honor! Do come in. You must have a meal with us! The excitement was dizzying. We hesitantly told them that we would work for food. “Nonsense. Do you want to shame us?” Their generosity was humbling. We were eventually led us to a feast that had been specially prepared. We slept under the stars that night. The village sky was black velvet, resplendent with stars. The next day, we received a tearful farewell. A stray thought kept nagging me on the journey home. “What would I do if ten scruffy villagers landed unannounced on my doorstep?” It was a hypothetical question. However, I feared I would find the city had shrunk my heart.

Among my patients, the most striking are the gypsies. In their brilliant flared clothes, flashing with mirrors, they stand out in the mundane hospital environment. They settle down on the floor spreading their skirts. Their confidence is unshakable. Their eyes sparkle like the chunky silver bangles on their arms. A beautiful baby dressed in all its finery is presented to me. I remembered resuscitating him at birth. “Oh! the little darling,” I coo. “What have you named him?” The grandfather smirks. “Ambu Prasad. We call him that because when he was born, you kept on yelling, “Ambu, Ambu.”

Sometimes, I have nothing concrete to offer. A patient with cerebral palsy comes from a remote village with no rehabilitative services. What do you do when you are up against a wall, I wonder? Make a hole? I remember the story of an educationist from Delhi who made a hole in the wall between his office and a slum so that the children had free access to his computer. Nobody taught them, but nevertheless, they learned. The hole-in-the-wall was a resounding success. All it needed was somebody standing by and encouraging them. I struggle for simple solutions to offer the family. I try my best. Today, I am still in awe of how much the mother achieved on her own after 5 years of grit and sweat. The child can walk, goes to school, and holds a pencil. All I did was shower the mother with praise whenever she came. She found her own solutions and made her way.

I have a friend who runs a hospital for tribal people with four other friends. They all left the easy comfort of being ivory tower academicians in Delhi to muddy their hands in an incredibly poor district of Chhattisgarh. It has been more than 20 years. The poorest of the poor receive treatment there that you may not even dream of. They have developed innovations that amaze and uplift me- solar powered refrigerators for storing snake venom antidote, blood culture bottles that are incubated on the health workers thighs, school children who help carry malaria slides. People stream in from everywhere. They come with mosquito nets, goats, and cooking pots, marking their places unchallenged with a stone in the queue outside buildings overgrown with orange bougainvillea. They sit in such peace. It is a lost art in the city. To be still and wait with composure and grace.

Some time ago, I was in Hyderabad. A friend took me to show me the swanky interiors of an office on the Microsoft campus. Techies in their twenties were swarming everywhere. There were unbelievable luxury cafeterias with eye-popping menus, sleeping pods, open-air amphitheaters, even an indoor golf course. “They are paid very well, work for just 4 h a day, but it is still a challenge to retain them,” my host says. I could not believe him. “Why? Which young doctor in his twenties earns that much and lives in such comfort? I think of the 36-h duties that my resident doctors do! “They quit because they find no purpose in their work.” I am dumbstruck by my sudden epiphany. “True, in medicine, the hours may be long. But, every moment has meaning.”


To all my patients whom I have interacted with.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article

 Article Access Statistics
    PDF Downloaded43    
    Comments [Add]    

Recommend this journal