Welcome to another section of DocScopy, let us walk you through the Life experiences of Dr. Neelam Sachdeva.
Dr. Neelam Sachdeva is a Senior consultant microbiologist and infection preventionist at Rajiv Gandhi cancer hospital and research centre, Delhi, India.
Let us see what she has to say on superbugs, their association with cancer and the issues related to microbiology on infection control and its impact on health outcomes, through the candid conversation between Dr. Neelam Sachdeva and MedBoundTimes [Dr. Aarti Nehra and Parul Soni]
Dr. Aarti: Ma’am, Please tell us something about yourself and your professional journey
Dr. Neelam: So, initially problems were there, one is acceptance and other is budgeting issues. And this field was something new which has come up like a division from pathology. People were not very receptive, they were not able to give money. If they are giving some samples today and you give them a report after 48 hours. Then the doctors were also not used to having that report. They just got a sensitivity on it and then they will have to decide their line of treatment according to your report, which was not acceptable to clinicians. But then gradually NABL [National Accreditation Board for Testing & Calibration Laboratories], and NABH [National Accreditation Board for Hospitals & Healthcare Providers] came into picture and infection control responsibility was given to microbiologists.
Initially problems were there, one is acceptance and other is budgeting issues. And this field was something new which has come up like a division from pathology...
Dr. Neelam Sachdeva, MBBS, MD, Delhi
So that's how we (Microbiology) actually came into picture. So, this went on and I was working at General Hospital, that too in the private sector only, for around 17 and half years. And then finally I switched to an oncology hospital (Rajiv Gandhi Cancer Hospital and Research center) and infection control plays an important role over here...
Parul: Why did you choose this career path?
Dr. Neelam: When I was not married, I was Neelam Narang and we had a teacher named Prof. Pratibha Narang in the 2nd year of MBBS who used to come on time, all decked up, taught microbiology with ease, remained calm, and went back home on time. I was highly impressed by her! It was a 9 to 5 job. It was something new. So, I opted for Microbiology.
Parul: Please tell us about some clinical or career-related cases that have made an impression on you...
Dr. Neelam: Yes, I have had a few incidences, there was one patient who came to the doctor. She had surgery after being diagnosed with breast malignancy. This is cancer with a good prognosis because once we remove the cancerous tissue, the Patient usually survives around 20 years or sometimes even more than that. There's no reason to worry as the prospects were very good.
But well, what happened next shocked me. Since we gave chemotherapy to this patient, the immunity is low for these patients and they don’t have the power to fight and they are prone to infections now. And then finally the patient came back after a year, she had an infection because radiation and chemotherapy were being given and she was immunocompromised. So she came back with sepsis and ended up in a bad condition, had a multi-organ failure, and eventually died.
Parul: So,Why did you choose the Infection Control path?
Dr. Neelam: Now I got this thought that, OK.., we need to do something about it! Because When patients are coming to an oncology hospital, that is a state-of-the-art specialty hospital. But then what happened? He got radiation and the best therapy possible from the oncology doctors. But sadly, the patient died of infection. Now the issue was that I thought about what microbiology would do to prevent it. The patient died because of infections and not because of the radiation or chemo. So that was one changing point, If I am looking after infection control, I need to do something. I started asking people and the staff to wash their hands or hand rub them. They had the same excuse that they are busy. We swabbed the elevators, and fingerprint machines and did culture to show people what grows in them when we don’t wash our hands.
I got in touch with one of the other patients. He had prostate cancer Grade 1 or 2. He got operated on, the same thing happened to him as he too succumbed to infection. He did not have a fast-growing tumor; we were not expecting it. It turned my mind that I need to do something to focus on infection prevention. We had an encounter with many nurses also. we found that those nurses were not very well aware of infection prevention.
Dr. Aarti: Hearty congratulations to you for receiving the National Health Service Excellence Award! Tell us something about it, how did you feel after getting it?
Dr. Neelam (Smiles...): A microbiologist getting this award was a new for people. After getting nominated, people thought why was I even considered. It was a different feeling after being appreciated, while I never do things to get awarded, but yes, recognition matters.
Now I feel that I did something right, something to serve people and the community. I made people aware of the proper disposal of biomedical waste and taught kids and moms to wash their hands while taking care of the sick, and on a daily basis. As we all know, Women don’t get appreciated at home often, children get what they want and they are on their way to study. Everyone is too busy with their life to recognize your efforts. So I felt elated after getting the award.
Parul: Share with us your perspective on resistant microbes, how do you relate them to cancer?
Dr. Neelam: It is of prime importance that we don’t burn our biomedical waste. Proper disposal is necessary as the superbugs or resistant microorganisms were getting into the underground water and contaminating everything. When we burn medical waste, poisonous gases are released containing Dioxins with other hazardous chemicals which mix with the air. These chemicals stay in our bodies for 6-7 years. When this is inhaled it causes abnormal multiplication of cells ultimately causing cancer. We actually carried out a study and found these superbugs were already present in patients’ bodies when they first come to the hospital with an infection. Even people who were not presenting with any symptoms also had it in the Gastrointestinal tract. We need to take care of housekeeping people and make them aware, as they dispose off the waste and spread the infections unknowingly
Parul: Dr. Neelam, you conduct 3 days workshop on Infection Control, can you please tell us about it? Who can enroll in it?
Dr. Neelam: First, we started a YouTube channel and started enacting some skits (called "nukkad natak" in India) to educate the staff and patients on the importance of hand washing and infection prevention. Gradually the staff started getting aware of the HIV infection and how to keep the IV lines clean and practice caution with needles.
It took me 11 years to achieve what I achieved. Then we started this course to be done every quarterly for the nursing staff and new doctors. The doctor course is more complex than others. Now we conduct this course for patients too. Enrollment is done on a ‘first come first served’ basis.
Dr. Aarti: Since you are telling us about skits ['Nukkad natak'], have you done anything like this in MGIMS during your college days?
Dr. Neelam: Maybe yes I did. Actually, it is in my genes, my father is a very good actor (smiling...)
Parul: Can you share an incident with a patient/caregiver or community that has left an impact on you?
Dr. Neelam: Once, when were enacting this skit to patients and their relatives in the waiting area of the hospital. one caretaker came to me and asked when is the next session/course. So that he could schedule the doctor's appointment accordingly, he wanted to learn it all. This deeply impacted me.
Parul: If I may, I want to ask something apart from the profession...
How do you handle pressure of having a neurosurgeon as a spouse with minimal time spent together, family, kids and your own career?
Dr. Neelam: My husband was always busy with work. So, I spent my initial days taking care of the family while working in a nearby hospital. When the kids grew up and went on their way to study, I switched and started working where I am now.
Parul: If you had to eat one food consecutively for 360 days a year…, what would it be?
Dr. Neelam: I prefer something healthy like salads everyday but even eating a salad is tedious as we soak the veggies in warm water to clean them properly as I have become finicky after studying so many microorganisms!
Parul: Please share some fond memories of your time at MGIMS.
Dr. Neelam: We were a group of five friends popularly known as "Panch Pandavas"
Parul: Do you like cooking?
Dr. Neelam: Yes, I love it and I do it all myself and my way
Parul: Any 3 qualities that you dislike in others?
Dr. Neelam:
Don’t like people who are not sympathetic toward patients / sick / oldies
Who try to be smart but they are not. They forget God has given the brain to everyone.
Those who don’t help others even when they can
Dr.Aarti: If your life was a movie what would you name it?
Dr. Neelam: "Zindagi Gulzar hai", we need to change our veiw point. Try to see good things arround, you will feel that.
Dr.Aarti: What would you be doing if you were not a Doctor?
Dr. Neelam: Artist 👩🎨
Dr.Aarti: If you had to describe yourself in 3 words, what would they be?
Dr. Neelam: Loving ,caring and thoughtful
Dr.Aarti: Finally, a message you would like to convey to the society?
Dr. Neelam: Like plants bloom anywhere you can also do anything provided you want to. The branch of medicine you choose is not a concern..
MedBoundTimes is extremely grateful to Dr. Neelam Sachdeva for sparing her time and talking to us.
