CMC is the pulsating heart of Vellore. Patients sometimes travel for days to get here, some from as far off as Assam and Bangladesh. With them, they bring the hope of relief from life's medical misfortunes that not many other places in this corner of the world can offer. And that hope is not misplaced....CMC offers the latest treatments available and haematology is no orphan area. As expected, cost is the main limiting factor and treatment here is tailored according to one's means. While we are sometimes oblivious of this in the UK, here every doctor has to know the precise cost of a treatment and a detailed income history is taken once diagnosis is confirmed. A profit is made on the treatment of 'rich' or private patients and this 'subsidises' the treatments of the poorer ones. Social justice you may call it, or just common sense that works. Charity organisations like the TATA Fund also sponsor quite a few patients, and the government pays a small contribution too. People here sometimes sell possessions, jewellery and house to fund treatment and there is no room for creating false hopes. Those are some of the most heart-wrenching moments that make up the lives of clinicians here. As a counterpoint to this harsh reality, most treatments here are at a fraction of the cost of that in the US or UK. India makes most of its own drugs and CMC having pioneered many of these protocols, it enjoys priviledged prices and stocks.
At the heart of all this, lie the stories of the doctors and nurses, whose lives revolve around the hospital. They get paid peanuts (120 pounds per month for a year 3 reg) and most finish work at around 9.30pm after an 8am start. Work continues on Saturdays and Sundays- patients don't miraculously get better on those days! The contextual perception of one's work and the satisfaction derived from it is what makes this possible. This all reminds me why I wanted to be a doctor 10 years ago- a faraway thought that for some, gets somewhat diluted as one gets through the western medical training system. I cannot generalise of course, but I feel this is a fundamental difference between the ethos of work here and in the UK, and what keeps CMC,and other hospitals like it, going.