An ode to Tata Memorial Hospital.

I am now done with two chemo sessions and for everyone who’s enquiring about it, I have this to say - So far, so good. I will write about my experience in detail probably after 3 to 5 cycles are done. I expect that by then, the side effects would have manifested quite a bit, and I would have a better sense of how I feel.

Today I want to write about something that has touched me in so many ways. It's about the hospital where I’m undergoing my chemotherapy.

Tata Memorial Hospital (or Tata Memorial as it’s popularly called) is a love story cast in stone akin to the Taj Mahal. In 1932, when Lady Meherbhai Tata died of leukemia after treatment abroad, Sir Dorab Tata decided to establish a similar institution in India. However, he too died soon after, but the trustees carried his mission forward and Tata Memorial Hospital, the Taj Mahal of Medical Sciences was born in 1941. You can read more about it here.

It is rare to find someone in India who hasn’t heard of TMH. In fact, the moment you utter the word cancer, TMH will soon find its way into the conversation with anyone you speak with. My first choice of a hospital to get treated (although strongly recommended by many people) was actually not this one. It was the hospital in my vicinity where I had my lumpectomy.That’s where I stumbled upon my surgical oncologist. Incidentally he spent many years working at TMH before moving to this hospital. I had my surgery done by him and then wished to start my adjuvant treatment under his supervision. My surgery went extremely well and my plastic surgeon completed the reconstruction with the finesse of an artist (another doctor I highly recommend not just for his skills as a surgeon but also for his gentle ways).

Life however had different plans. My tumor was HER2 positive. This meant that aside from chemo, I’d have to take an additional drug (called Herceptin) for several months. This drug is bloody expensive, with each dose costing much more than all the other medication that I’d be consuming. So on one of my appointments, I had a tough and painful discussion with my oncologist to get an estimate on my medical expenses. That is the backstory to how my relationship with TMH began.

While I write this post, I realize how hard it is to summarize my impressions in one single post. There’s so much that happens in TMH on so many levels.

TMH is located in central Mumbai spread across a large area. It has two wings, a general and a private. The treatment and medicines there are very subsidized, much more so in the general ward compared to the private.The first thing I’d noticed when I’d been there the first time was how sprawling and well maintained it is. Also, they’ve really tried to streamline things as much as possible. When you register yourself as a patient there, you first need to get a patient card made. This sort of card is probably what the government of India was aiming at when they launched the Aadhar card scheme.

This card that you make is your debit card and repository of all information about you. Payments can only be made through this card and the card is linked with your patient page that has all your details on their portal. My personalized portal doesn’t just display my basic details. It also has all my reports, my treatment plans, my treatment updates, everything.So when I am shuttling from one department to another, all that the personnel needs to do is to key in my ID number or scan the card and she would get all the details on her screen.

There is no way TMH could have survived without such smart use of technology. It is thronged by people from not just all across the country but the rest of the Indian subcontinent too (Bangladesh, Nepal, etc.). It may as well be called a mini Indian subcontinent for the sheer number of people present here at any given time.

One may wonder how a hospital can maintain its quality when dealing with such large numbers. I did have similar questions and that’s probably why this wasn’t my first choice. Would my doctor give me a patient hearing when she/he has so many patients waiting in line? Would it be too overwhelming to be surrounded my so many cancer patients of all ages, etc?

Let me try and deconstruct the doctor-patient part of my experience here. TMH has different sections for different type of cancers that straight away makes both the patient and the doctors’ job easier. It takes hours for you to reach your doctor as is the case for most of the things that happen at TMH. There would be 2 or 3 oncologists of the type that you are seeking and you could be sent to any based on where your file is.

You will first be seen by the residents who will note your history/ progress/ concerns and then be seen by the senior doctor. The residents remind me of one's I see on House M.D. or Grey's Anatomy as they seem to be bright, concerned and forever mumbling some research study or the other under their breath. When you see the senior doctor for the first time, she will spend some time with you in explaining the current status and the approach they would be taking. I have seen 3-4 doctors at TMH and have barely felt rushed. When you are an old patient and the concern that you came for is not so significant, it is possible the doctors’ impression will be conveyed to you through the resident.

TMH is in no ways is an easy experience to have. The fact that it is one of the few affordable cancer specialty centres means the volume of people seeking its services is forever more than any establishment can handle. One has to wait for everything for hours, from billing to meeting doctor to buying medicines or getting tests done. The access to doctors is not easy. Unlike your doctors in other hospitals, you won't have their numbers. It’s futile to call reception in an attempt to connect with them. Still every patient you interact with has so much gratitude and respect for the hospital they are in.

Most medical professionals (doctors, nurses, technicians) in TMH appear competent. They may not be the most pleasant people you interact with, but one will rarely feel shortchanged. I believe when one is at ease with the quality of treatment, the other things start bothering you less. The other thing that helps puts things in perspective for every patient who visits TMH is the awareness that so many of us are going through a similar experience .When I see patients braving the long waits and even sleeping on the footpaths for accessing the general ward, I feel what those of us in the private wards experience are really first world cribs.

Cancer is a seriously expensive disease. TMH makes it possible for so many people to access high quality and reliable treatment at a very reasonable cost. If this is not philanthropy of the noblest kind, I don't know what is. 

The medical team that works there must be constantly overworked because of the kind of numbers they attend to.I will not make tall claims that I have not met staff who didn't yell at me or weren’t impatient. If I was anywhere else, I don't think I would tolerate it. But at TMH, you empathize with not just your fellow patients, but also your doctors and nurses. They are reaching out to so many people in need, we can surely cut them some slack.

I guess TMH is not just a place where I access my treatment, it is also where I learn to look beyond me. It is a place that has already taught me immense patience and to be grateful in the most imperfect location.

I want to wind up this long article with a heartfelt thank you to the group that has not just given us one of the finest medical institution in our country but made it accessible to so many.