Category Archives: A Doctor’s Diary

Women Who Inspire: Anandibai Joshi

The path for women physicians hasn’t been easy. For the longest time we were considered inferior to our male counterparts. But we have come a long way. According to a recent study it was found that patients cared for by women doctors  have a lower mortality rate. They tend to live longer and fare better.

Today on Women’s Day I’d like to narrate the story of a brave woman who led the way– Dr. Anandibai Joshi.

Dr. Anandibai Joshi (1865-1887)

Indian women pioneered many things not just in India but also in the west becoming a source of inspiration for women and women’s movement across the world. Early in my residency and sometimes even now, I’m made to perceive that I’m not good enough to be a doctor just because I’m a woman. Once an elderly lady told me to my face that she’d prefer a male doctor to do her gynecological exam. I was stunned to comprehend the degree of prejudice women have to face particularly those in the fields of science. So when I read about Anandibai Joshi and women like her, I’m dumbfounded by their bravery and the degree of resistance they had to overcome.

Anandibai Joshi was among the first Indian women qualified to practice western medicine.

Dr. Joshi belonged to an orthodox Brahmin family of rich landlords in Kalyan. At the tender age of nine she was pressured to marry a widower, a man twenty years her senior Gopalrao Joshi. The beginning of a typical Indian story? No. Anandibai was just thirteen when she had her first child.Unfortunately the child died when he was just ten days old. She was heartbroken and angered to realize that her son would have survived if he had received proper medical care. This sparked in her the desire to study medicine and her liberal husband stood fully behind her.

Why would an Indian woman go so far away for medical school?

Because it was the best way to serve her country was the gist of Anandibai’s answer. The reason Anandibai had to look to the west is because in India, Hindu women, particularly those belonging to higher castes were not welcome in the profession.They were pushed to become midwives instead. If they insisted they could enroll in Chennai, to be taught by reluctant male instructors, and receive an incomplete training. It was easier if they converted to Christianity as they could wear a dress and that wouldn’t cause a scandal. Since Anandibai and her husband had no desire to convert, she decided to turn to the America. She applied with the assistance of Presbyterian missionaries. She enrolled and subsequently received her degree in 1886, from the Women’s Medical College in Pennsylvania. Her achievement was lauded, to the extent the dean of her school wrote about it to Queen Victoria, Empress of India. Anandibai was invited to become the physician-in-charge of the women’s department at the Albert Edward Hospital in the princely state of Kolhapur, where she also had the opportunity to instruct women medical students. Unfortunately, before she could embark triumphantly in her career, it was destroyed by the diagnosis of tuberculosis and she breathed her last in the arms of her mother, a month before her 22nd birthday.

Dr. Anandibai Joshi lived a very short life but she achieved a lot. She broke barriers not just for women but also for the Hindu community. Even now we can look to her life and gain strength and inspiration. 

Happy Women’s Day!

 

simi blog imageDr. Simi K. Rao, creator and founder of The MedBag is a board certified internist and hospitalist currently practising in the Denver area. She has special interest in preventive medicine. She is also a published author of four novels. Her newest book of poems and short stories ‘Under the Shade of The Banyan Tree’ will be published in December ’18. You can learn more about her work at https://simikrao.com//

 

The White Room (A Poem About Dementia)

The White Room

I lie on the bed

in the white room

They sit around me

These strangers with familiar voices

I think we are waiting for something

or someone.

These strangers, they look at me

They mutter words I don’t understand

A man in a white coat walks in

He stands next to my bed.

He speaks not to me,

but to these strangers

They are talking about me, I know.

About what, I don’t understand.

Irritated, I kick off the covers.

Mother! They chide me and pull them back.

About the poem: This is a poem about dementia, the hallmark of the disease being loss of memory. I write about a scene I came across during my rounds in the hospital—an elderly woman in the advanced stages of dementia is lying on the bed surrounded by her caring relatives. It’s difficult to know what’s going on in the poor woman’s mind because she has lost the ability to speak, even comprehend. Yet it’s apparent she’s unaware of her ailment. She doesn’t even know where she is or who she is with.

Dementia is a syndrome that results in gradual and progressive decline of previously acquired mental abilities that results in a loss of social and occupational functioning and ultimately to loss of independence. It is imperative to distinguish this from normal aging- normal aging never results in loss of independence. For the diagnosis of dementia there should be impairment in at least 2 of the following– memory/learning new information, executive function (ability to perform usual tasks such as handle finances that one was able to do before), perception (recognize people, hallucinations) and motor abilities (ability to write, draw, walk, coordination), language, social cognition. Alzheimer disease is the most common type (60-80%) followed by vascular dementia (in those who have suffered strokes). Other types such as Lewy body, Parkinson’s dementia, frontotemporal dementia are less common. Aging is the major risk factor. For vascular dementia risk factors are diabetes, HTN, heart disease, smoking and obesity (same as for heart disease). Other risk factors include history of head injury, APOE e4 allele, mid-late life depression, alcohol abuse, HIV infection. On the other hand, higher education and occupational advancement can lead to reduced risk or delayed onset of dementia. Dementia also results in reduced life expectancy–an average of 4 yrs for vascular and 8 yrs for Alzheimer’s and Lewy body dementia.

Therefore, if you are aware of someone who is missing appointments and arriving at the wrong time/date all the time, is not able to follow instructions, is losing weight, is failing to thrive, has new or worsening depression and or anxiety, is exhibiting changes in behavior, poor judgment, loss of initiative, he or she could have dementia and it is important get an evaluation. Though at present there is no specific pharmacologic treatment that can halt or reverse neurodegeneration there are a few drugs that have been shown to slow down the symptoms of dementia. What is most important is understanding what a loved one with dementia is going through and providing them support and a loving and safe environment.

Here is an excellent website that provides guidance for caregivers.

simi blog imageDr. Simi K. Rao, is a board certified internist and hospitalist currently practising in the Denver area. She has special interest in preventive medicine. She is also a published author of four novels. Her newest book of poems and short stories ‘Under the Shade of The Banyan Tree’ will be published in December ’18. You can learn more about her work at https://simikrao.com//