Welcome to Docscopy section of MedBound Times.
Priya Bairagi (MedBound handle: @Priya Bairagi) and Himani Negi (MedBound handle: @Himani Negi) had an opportunity to have an exciting conversation with Dr. Jaison Philip. He shares insights on maintaining work-life balance, navigating politics in medical education, and advocating for healthcare reform in India while addressing common misconceptions and preventive measures for stone diseases and heart health.
Dr. Jaison Philip is currently a Senior Urologist at Government Kalaignar Centenary Hospital, Chennai, Tamil Nadu, India. Dr. Jason Philip completed MBBS from Govt. Stanley Medical College, Chennai, Tamil Nadu, India in 1997, MS General Surgery from Govt. Kilpauk Medical College, Chennai, Tamil Nadu, India in 2005 and MCh. Genito-Urinary Surgery from Govt Stanley Medical College, Chennai, Tamil Nadu, India in 2012.
Himani: Sir, so how do you maintain your work-life balance? As your workload must be very high, so are you able to spare some time for yourself for your family daily?
Dr. Jaison Philip: Not really. See I have been in this field for several years. They may be called tonight for a urological emergency at the hospital where I worked and I have to simply go there. Right now, I'm sitting here. But maybe my cell phone is by my side and I may get up a WhatsApp message or a phone anytime and I may have to go. Also, I'm too deep into surgery. There is no exit clause. It's like Abimanyu in a Chakravyu. There is an entry clause. There is no exit clause. Mean I can't exit, I'm fully into it so that's it.
Himani: But do you enjoy it?
Dr. Jaison Philip: I mean it's not always a soap story. You do enjoy a lot of things in general surgery. I have performed a great deal of surgeries. I cured a lot of people. I even cured cancers and was there for several transplants, saving the lives of patients from many other diseases. So some amount of job satisfaction is there and the money. I did a lot of private practice till I had my health problems that restricted me and I did earn money with private practice as well. So, money part I’m quite well off. That is something I enjoy and I do take vacations from time to time. Mean you can't be 24x7 available for a patient throughout your life. I do pick vacations, exotic vacations even abroad and I do have earned money, I take time off and then I take time off for my hobbies and I do enjoy my work. Also, I mean the surgery is an enjoyable field if you are. So, after many years of surgery. I do enjoy not just urological surgery, I perform general surgery and enjoy that as well. So, there is job satisfaction. There is some money. I mean there you can pursue extracurricular activities and it's not as gloomy as I might have portrayed in my emotional state. But yeah, there are positives and negatives.
Priya: My brother is pursuing MBBS from Government Medical College in West Bengal Kolkata and you mentioned that the doctors are controlled by IAS. You have an idea of the politics that are involved in it and it seems the same strategy is happening in his college too. Students are under pressure from politicians and many political things happen in college for example during his semester exams, many of the students are made to fail in their exams because they didn't support the political party. So, sir, what is your opinion on this? If a medical student should be related to politics, you should go into politics or you should focus on in studies?
Dr. Jaison Philip: You should be focusing on studies or not politics but your higher-ups have no business telling you about your political poking their nose into your political orientation or your ideological orientation or whatever. They’re here to make you a good doctor let them restricted to that. This is something that the politicians have to do. But the sorry state of affairs is that the bureaucrats and politicians have been administrators also not just a surgeon and sometimes people politicians, I mean, I don't want to give names, but politicians bring up and speak, "Release this, release this accident body without a postmortem.", and all that stuff that cannot be done legally. I can be held up in court if I do that. So, all this stuff is there. Political interference is always their caste interference. But the first thing there, one of the first things they ask you in the hospital is your caste, your religion, and sometimes your political affinities. I mean all the medical studies should be bereft of all these things, but these are evils that we have to do. What cannot be cured has to be ended, so I've been in this field for long enough to know this and imbibe this and internalize this, so what cannot be cured has to be impure. What else can we do?
Priya: Sir, you have been a doctor for so many years so what are the changes you observed during these years and what changes do you want to make in the healthcare system of India?
Dr. Jaison Philip: First increase the salary of doctors and first stop proliferating doctors. See Tamil Nadu has 7.6 crore citizens. Making everybody a doctor is not a solution to the medical needs of a common man. He must be a competent doctor. Just by liberalizing medical colleges, grants to medical colleges, and building Medical College on every street, every haveli, and every small road you're not going to improve the medical situation in India. So first increase the salary of doctors, restrict the number of colleges, improve the quality of education that's the most important thing. Improve the quality of education of medical students and don't mix politics, caste religion creed, or ideology in teaching and inside medical institutions and give incentives for well-performing students. Students who perform research, students who perform very highly, and all that stuff give them some monetary incentives and other incentives as well. Maybe an exchange program with colleges in the US or UK and all that stuff and stop this bond system and lower the fees of medical students. Make it a pleasant experience for being a doctor, being a house surgeon, and being a resident make it a pleasant experience and reduce the number of paths. But you cannot put a human being on 48 hours of continuous duty and expect him to make rational decisions. You are, you don't have sleep for two days continuously, your mind is going to make wrong decisions which may which may be harmful to the patient. So, reduce the working hours to a reasonable limit and respect the medical student, respect the CRRI, respect the intern meaning the PG intern, be the PG resident, and try to reduce toxicity. Just like you have Bishaka Commission for Sexual Abusers against Women also has regular meetings between the higher-ups and the students called grievance addresses. There have been grievances. Grievances need not be sexual, mean only sexual in nature. There may be other grievances, have regular teacher-student CRRI resident meetings, and hear them out. Try to find solutions for them. So, these are my thoughts on the subject.
Priya: Sir, you have been working in government hospitals for so many years. What kind of patient road do you commonly see in government hospitals? What kind of disease do you normally observe?
Dr. Jaison Philip: Disease. I'm a urologist, I find, I'm in the department of post in the Department of Urology. So, I find only urological. I treat only urological disease, disease. That's my competency. I treat urinary infections, urine stones, sometimes cancers in the urological system, and prosthetic diseases in the elderly. These are the diseases that I commonly see in my patients.
Himani: I want to ask one question about kidney stones, which are very common in rural areas. This is what I have observed. So, what do you think can be the reason and how one can prevent like a general awareness to, you know?
Dr. Jaison Philip: Drink a lot of water, means drink enough water, not a lot of water. Drink water regularly, restrict foods and restrict animal proteins, restrict salt intake. I mean the list of foods really long and prevents obesity. Exercise regularly. Maintain weight. Stay hydrated and avoid urinary infections. If there is an infection, the infection produces stones and stones produce infection, so these are interrelated. So, when you suspect that you have a urinary infection, go and get it treated by a doctor, not necessarily by a urologist, but at least go and get it treated. So, this is the general advice I would give to reduce the stone burden in society.
Himani: Sir, there's one more doubt I have, so I completed my bachelor's from Uttarakhand, which is a hilly region. There is one term they use for the water source and it is because the level of silt is high on water. It can be one of the reasons for stone. So, how much of is it true?
Dr. Jaison Philip: See some sources of water that can produce stones means that is for the government and the civic agencies to take it up, pure it, and give you safe water that is for the government and the civic agencies to do it. Yeah, some sources of water, and even in Tamil Nadu, a team from AIIMS Delhi came and took the random samples from several cities in Tamil Nadu and we were informed urologists were informed to tell the people that these places had mean water which could give rise to strong disease. So, whenever you find that the government and the civic agencies are how to go to work and try to give portable safe water to the public.
Himani: So, what can be done in that case on a personal level like we can use a water purifier, so what should be at this TDS level or exact correct TDS level or something?
Dr. Jaison Philip: You can't do anything at a personal level, it has to be done by the government and your local authorities’ civic authorities. I don't think you can do anything at a personal level for it.
Himani: So, sir, does the water purifier work?
Dr. Jaison Philip: I mean water purifiers in the context of stones? I don't think they work. So, the water purifier is in other aspects removing Bactria and all that stuff maybe the bug. But water purifiers in the context of kidney stone disease. I don't know their effectiveness. I read a lot of journals, I subscribe to a lot of international journals as well as local journals and I have not come across any evidence that water purifiers lead to a degree of stone burden in a society or a community a gated community, or a family or a person.
Himani: In the case of Gallbladder stones, the gallbladder is removed generally, so sir are there any side effects or cons that happen due to the removal of the gallbladder?
Dr. Jaison Philip: As a general surgeon I would say nothing of much significance.
Priya: Sir, my father had a gallbladder stone, he says he cannot digest fat.
Dr. Jaison Philip: That’s not a correct statement. A person who is under polypectomy that is, removal surgical removal of the gallbladder can digest fat. I mean there are mechanisms I have been there have been. I need to draw diagrams and all that to show you because yours is an incorrect statement. That is not a valid statement. Maybe it's, you who fear it, but that doesn't mean you won't be able to digest fat. You will still be able to digest. In fact, my close relative who has undergone polypectomy is here. She is very normal and she digests fat, she eats meat and all that stuff. Nothing has happened to her, that is on a personal level. I've seen a lot of patients also. I mean no patient has complained of indigestion or indigestion of fats particularly after the removal of the gallbladder. So, removal of the Gallbladder wherever indicated wherever it is chosen as the type of surgery by the doctor is quite safe and free of side effects usually.
Himani: Sir, are there any precautions that one should take after the surgery like for a lifetime, something like that, or is it like? One can lead a normal life completely?
Dr. Jaison Philip: One can lead a normal life.
Himani: Okay, good, thank you so much, sir. Priya over to you.
Priya: Sir, talking about stones I have seen in North India that most people separate from stones and heart disease. Is it the food habits that affect kidneys & gallbladders?
Dr. Jaison Philip: Of course. You know, the relationship between fatty foods, obesity, sedentary lifestyle, stress and the foods that we eat and heart disease that is something that you know and can disease been quite similar, similar with the diet that you take, the water that drink, in the amount of water that you drink, I'm not saying drink independence, amount of water, drink adequate water and at adequate intervals. Also, I mean, maintain weight, avoid obesity, and lessen salt intake if you want to avoid stone disease and certain foods need to be consumed less. Animal protein is strong and has a strong association with stone disease. If it is possible, lessen animal protein intake and there are several other foods so exercise regularly and treat urinary infection promptly by a urologist or by anyone else. That's all. These pre proportions will help you prevent, I mean, many cases of stroke disease and for the heart. I told you when you were aware that these factors for heart disease, and ischemic heart diseases are blood pressure diet in a high-fat diet, a sedentary lifestyle stress, sugar, the sugar intake. I mean, nobody understands that sugar is a new alcohol, so the higher the sugar intake, the higher your triglycerides rates, the greater the probability of your heart disease. So right lessen intake of sugar or processed sugar. Try to lessen the intake of fatty foods. Try to exercise regularly, maintain weight, and try to be stress-free. It's not proper. No human being can be entirely stress-free but try to reduce stress. That's you’re this thing. This is the advice that I would give to prevent heart disease, avoid smoking that's very important and limit alcohol. I mean the safest alcohol limits zero ml. Even if you drink limit alcohol to the very basic minimum and I would say don’t drink. But who's going to take my advice? The safest amount of alcohol is zero ml, so this will be general advice I would like to give people.
Stay tuned for the last part of the interview!