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On Being a Doctor |15 May 2012

A Certain Gift, and a Question of Ethics

Shilpa Bhardwaj, MD, MPH

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  • From Griffin Hospital and Yale University, Derby, CT 06418.

    Disclaimer: This is a fictionalized portrayal of a true event. The time and sequence of events mentioned in the article may not be exact.

    Requests for Single Reprints: Shilpa Bhardwaj, MD, MPH, Department of Medical Education, Griffin Hospital, 130 Division Street, Derby, CT 06418; e-mail, mailto:bhardwaj.shilpa@gmail.com.

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I studied undergraduate medicine at a university in Orissa, one of the eastern states of India. In this primarily rural, paddy-crop state, half of the population lives below the poverty line, with a yearly per capita income equal to about $100. This is one of the most impoverished states in India. Therefore, as an intern, I rotated in an extremely poorly funded state hospital. Unlike other state facilities in the country, the only thing that we could provide free to our patients was medical consultation. We had neither adequate supplies of medication in our pharmacy nor enough equipment in our inventory. Admitted patients had to purchase medications required for their treatment from expensive, privately owned stores outside the hospital. Sometimes we had to ask patients to buy such essentials as swabs, dressings, intravenous catheters, and disposable syringes as well. Not surprisingly, our hospital was a refuge for only the critically ill among the critically poor. People with better means preferred private nursing homes, and understandably so.
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Bhardwaj S. A Certain Gift, and a Question of Ethics. Ann Intern Med. ;156:750–751. doi: 10.7326/0003-4819-156-10-201205150-00017

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Published: Ann Intern Med. 2012;156(10):750-751.

DOI: 10.7326/0003-4819-156-10-201205150-00017

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