From I Deal Healthcare To Ideal Healthcare - A Letter To Bhagavan
For over a millennium, healthcare in the world has taken a turn to balance the opposing forces of good patient care and financial gains. The World Health Organisation reports that the per-capita expenditure on healthcare in the OECD (Organisation for Economic Cooperation and Development) countries has been increasing over the last decade. In many places today, healthcare is about the art of making the perfect deal. In a 10-year study published in the British Medical Journal (Friebel, Hauck, Aylin, & Steventon, 2018), the rate of readmission of patients had increased in such an environment. A study in the U.S. reported by the Healthcare Utilisation Project showed similar results https://www.hcup-us.ahrq.gov/reports/statbriefs/sb199-Readmissions-Payer-Age.jsp. When we consider these results,we can notice the glaring lack of correlation between how much we spend on healthcare on one hand and our health status on the other. Where did we go wrong?
Beloved Swami! You showed us a path out of this “I Deal” type of commercialised healthcare. You taught us “Ideal Healthcare”. You have gifted humanity with a way of practising healthcare that radically changes our view of healthcare delivery and management. You have provided a Divine answer to the healthcare paradox: why is healthcare spending not correlated to health outcomes? You showed us a way to transform commercial “Healthcare to compassionate Healthcare”
The Sathya Sai International Organisation (SSIO) distilled Your teachings on Ideal Healthcare from 20 Discourses You gave from 1960-2005 and published them for the world in a single compendium. There are many more of Your teachings including personal experiences that have created and enshrined Your principles of Ideal Healthcare http://www.sathyasai.org/about-us/service/healthcare/sai-ideal-healthcare
Sathya Sai Ideal Healthcare is not just about free healthcare or compassionate healthcare or comprehensive healthcare but is also about preventive healthcare, state-of-the-art healthcare and timely healthcare. As a result, the regressive trends in healthcare metrics we see in the world are not seen in Your hospitals and wherever Your Ideal Healthcare is practised. What a beautiful gift You have given the world. You not only gave us life, but You also gave us the means to keep that life healthy.
I am ever grateful for Your grace to allow me to be part of this glorious mission. If I think about how it happened, I can now see how You orchestrated every step of this long journey. So, I sit today in front of Your altar and reminisce about what I have learnt along the way. Until a few years ago, I used to keep handing You letters and sometimes empty envelopes. Your Divine grace combined with my exhilaration when You took the envelopes created indelible moments that I have always cherished.
Today, Your physical presence in our lives is replaced by a deep understanding and experience of your Divine Presence in the home you have always had in each of our hearts. Never more do I seek Bhagavan outside of me as I cannot seem to stop relishing Bhagavan inside me.
You have taught that individual transformations do not have to be grand quantum leaps in life’s trajectory. Every little step in life is a transformation.
I often think about how from the podium of a scientist who was reluctant to come to You, I was smitten at the very first sight of You and could never stay away. How did this happen? To paraphrase Elizabeth Browning, let me count the ways.
I was wedded to the idea of becoming a physicist. My first research paper in physics was submitted to the National Science Talent Search Council in India and won an award when I was in high school. I was determined to be a physicist. Then suddenly, I was directed by my mother and father who were devotees of Devi and Siva respectively to pursue engineering instead. Their advice was based on a dream. To a scientist, a dream was the weakest excuse. I relented. I obeyed. I transformed. I became an engineer with physics in the back of my mind.
I spent five years as an undergraduate in electrical engineering in IIT Madras. During those years, I kept visiting the elderly Sankaracharya (Chandrasekharendra Saraswati) in Kanchipuram Kamakoti Peetham getting guidance and learning from him the beauty of solitude and silent meditation. Just as I was looking to launch a career in engineering, You presented me with poverty, sickness and suffering around me and by Your grace You showed me a path to alleviate this inequity and suffering through sound economic policies. I wrote several papers in economics and caught the attention of Professor J. N. Bhagwati who was in MIT at that time. I did not know at that time about his family’s connection to the Sathya Sai Seva Organisation in India. By Your grace and the personal guidance of Sankaracharaya, I began to consider a career in economics and eventually graduated from Caltech. I relented. I obeyed. I transformed. I became an economist with engineering and physics in the back of my mind.
When I first visited You, Dear Swami, I was a man of little faith in You. I went to accompany my mother and escort her during her trip from the US to Prasanthi Nilayam. Your first Darshan to me was simple: You made it irrefutably clear that You were Divine, that my true nature was Divine and that every step of my life was orchestrated by You. You even told me that my life was in your hands (and clenched Your fist). What a stunning beginning that was!
From that moment on, I drenched my mind with Your Discourses, Bhajans and immersed myself in You. I kept asking myself why I cannot experience Your divinity in me. What did I need to do to experience Your divine effulgence?
As a scientist, I was used to a clear hierarchy of inquiry: It starts with experience, then science tries to find an explanation using our senses and builds knowledge. Then we develop faith in the knowledge. So, the sequence I was used to was experience -> knowledge -> faith. You taught me in a personal conversation why faith should come first in my life. You told me to completely flip this sequence in my life: Start with faith in the Divine. Then comes knowledge of the Divine. Then comes experience of the Divine and finally comes being Divine. You taught me the sequence faith -> knowledge -> experience -> being.
Thus, began my quiet education. So far, I had studied, but was not educated. I obeyed. I transformed. I left behind all that I thought I knew.
I thought I had a comfortable life with tenured professorial ranks in business administration, economics and game theory. Then one day, You called me and asked me to study medicine and become a stethoscope doctor. From having summers off and enjoying sabbaticals, I went back to school and started to learn biology, biochemistry and wrote exams to enter medical school. I obeyed. I transformed. I left behind what I thought was valuable then. But I realise that what I know now is invaluable.
When I was finishing medical school, I was also guiding some of my Ph.D. students in economics and game theory. I thought I would do a short residency and be done with medical studies. But You pulled me out one day in Darshan and in our private conversation, asked me to become a neurosurgeon. My first thought was that that was another six years! You asked me to come to see You two times every year. I did that during my residency. I became a neurosurgeon and thought that was it. I obeyed. I transformed.
During my last year of residency, You asked me to specialise in brain tumours, paediatric neurosurgery and fits. I obeyed. I transformed. I took two years to subspecialise in paediatric neurosurgery, epilepsy surgery and research in brain tumours.
Every visit to see You during this long trek, You talked to me in private or occasionally in public. In 1998, you told me that I should not deal in medicine but should provide Ideal medicine. That is where I got the title of this article – Your words. From commercial medicine, my attention was redirected to compassionate medicine. I obeyed. I transformed.
I remember once how when I needed Your command to deliver a certain treatment for a patient, You called me in and directly told me to start Heparin on the patient. What was in my thought came out from your words. You have talked to me about cancer, cardiopulmonary resuscitation, dementia, marriage, Dharma, computer and food. You were a doctor when I thought of You as a doctor. You were a mother when I thought of You as a mother. You were a friend when I thought of You as a friend.
Most neurosurgeons know that our profession is so physically and emotionally taxing that it takes away our very breath. But for me, it was a breathtaking experience when I worked at the SSSIHMS in Whitefield by Your grace. From the external beauty of the hospital architecture and infrastructure, I could only gasp at the internal architecture and infrastructure of the human brain and spinal cord that You have created. Your grace allowed me the Satsang of the patients of mine and their families. Bhagavan, Your patients were my teachers. Your faculty were my teachers. Your staff members were my teachers and every administrator in the hospital was my teacher. The Department of Neurosurgery at SSSIHMS is without doubt one of the topmost neurosurgical facilities in the world. And the only neurosurgical facility in the world that does not charge the patient any fees. One can feel the love that flows between the surgeon and the patients. It is that experience alone that makes Your hospitals and Your doctors all over the world stand out by living Your Message. Several years ago, we performed the first epilepsy surgery at Your hospital in a difficult case. By the never-ending beauty of Your grace, the patient is doing well till today without a single seizure, is an athlete and excelling in studies. My experience in Your hospital was an exemplary educational gift to me.
For the last 13 years, You have given me the blessing of Satsang, inspiration and education from association with one of Your own staunch and loving devotees who lives Your teachings. This led to Your blessing to direct the international medical camps in Prasanthi Nilayam. In the early years, our team of extremely dedicated professionals and volunteers would work for 12 hours with a brief lunch break. Every one of them was so dedicated to serving the patients and viewed every patient encounter as Your blessing, that they would not go for Darshans so that they could avail of Your Darshans embedded in patient encounters. At the end of the medical camp period of usually 5-7 days, the entire team would go for Darshan and every such time, You would talk to us about the medical camp, the patients seen and bless us all.
The most memorable blessing of the medical camp team was on 25th November 2010. This was the most precious gift for the group as this day was Your Thithi Birthday as per the Hindu calendar. The entire team was summoned to the Mandir where You paid individual attention and blessed each of us. You physically met every healthcare professional and volunteer and then to our heartfelt joy, You returned for another round of interactions, blessing us all with Vibhuti, Sparshan and Sambhashan.
You taught me about the impermanence of knowledge and the permanence of education. Through several patients I looked after and who You subsequently referenced in our conversations, You taught me the impotence of medical healthcare and the efficacy of Divine healthcare.
In the end, I realise that healthcare must evolve as does human life. But the evolution of healthcare cannot come through monetary incentives. Good healthcare arises from the goodness of humanity. It is a service from heart to heart. When you provide healthcare as a deal, you provide a set of services that is profit maximising for all stakeholders and the patient is one among many stakeholders. But when you provide ideal healthcare, the patient’s welfare surpasses that of the bottom line.
Dearest Bhagavan, I specifically remember an eye-opening moment: You once asked me the question that many have been asked: “What do you want”? I first told You, “Nothing, Swami”. You then said, “Not even Me?” to which I replied, “I already have You, Swami”. Then, Your Divine words that followed are still etched in my mind. You said, “You already have Me, but you have not already realised Me.” I then asked You if I could change my mind. You lovingly smiled and said “Yes”. So, I said, “I want to experience and be aware of experiencing Your Divinity in me.” You smiled, hugged me, lovingly slapped my cheek and materialised some Vibhuti.
You have taught me that everything I have (including life, health and peace) and everything I am is truly Your gift and each one of them is temporary. Whatever endowment this body enjoys is Your gift that will one day go away. My duty is to enjoy Your grace while I am able to.
In 2005, during the First International Medical Conference in Prasanthi Nilayam, I said to You “I place everything that I have and everything that I am at Your Divine Lotus Feet so that I can have a glimpse of everything that You are”. When I said this, You immediately materialised a Sphatika Lingam and a chain and pointing at the Lingam, You asked me, “Do you know what this is?” I said I did not know. Then You said, “This is a Siva Lingam”. Then you asked me, “Do you know who I am”? and I once again said I did not know. You replied, “I am Siva” and then proceeded to tell me how to use the Lingam and tied the chain with Lingam around my neck. I realise now that everything I have is from You and only by Your grace. Everything that I am is from You and only by Your grace. Who am I to offer and what can I offer You? But I continue to pray for a glimpse of everything that You are. I pray that before this body’s life ends, it experiences and is aware of the experience of its Divine nature.
– The author, a Paediatric Neurosurgeon by profession, is a Member, Sathya Sai International Medical Committee.