Please make me sick

In the beginning years of my practice I have had a lot of trouble with certificate seekers. It is one thing to give a sickness or fitness certificate if the seeker has been my patient but it is altogether a different matter if one seeks such a certificate with out ever being my patient. Most of the certificate seekers who bugged me to no end in those days belonged to this class who wanted these certificates with out having suffered any illness.

Those of you who are not well informed as to how our people live and work the caption I have chosen for this piece may appear strange. But to those of you who are either government servants or working for public sector units or one of those who at one time or other tried to dodge an appearance before an income tax officer or a magistrate or any other such law enforcement agency will readily understand.

Why this class of people? In my country the state runs the show and there fore interferes with all aspects of our living. Except the air we breathe everything else is controlled to a more or less extent by the state. To man these various arms of the myriad departments the government has appointed a large number of people who go by the eponym ‘government servant.’ In today’s India if there is one group of people most disliked, it is this group. This is because the philosophy of governance in this country and the rules of selection are such that the best quality of human resources that is available isn’t used in administering the services. Persons who are thus employed are the ones who make the rules and regulations that govern their service and over years they have seen to it that they have the best of every thing with accountability spread so thin and wide that it is impossible to hold any particular individual accountable for any lapse.

Therefore it should not come as a surprise that they enjoy plenty of leave. If one adds up the various leaves and the government declared holidays it will come to nearly six months! This means 50% of the time they are not working! One would imagine this would be the most satisfied group. Far from it. They are in constant need of more leave. The only option left after they finish the allowed leave is to avail of medical leave. Going by the available records it appears that employees of socialist governments have a higher incidence of sickness. And these governments provide their employees additional leave to take care of when they fall ill. But there is one hitch. The employee who falls sick has to produce a medical certificate from the attending doctor. So the employee in need of additional leave will go to a doctor and entice him to give a medical certificate. It is generally fairly easy to get such certificates. Occasionally however they go to doctors who are unwilling to issue such certificates.

I am one of these and let us see what happens when such a certificate seeker comes to me. He is usually a stranger because my regular patients know they will not get these false certificates and therefore they don’t bug me.

Here comes the certificate seeker. It is 3 P.M. in the afternoon and I am pottering around in the garden at least that is what I call the small patch of land in front of the house. To catch my attention he knocks violently on the gates and forces me to turn around and look at him, ‘Is the doctor home'? he asks, obviously he takes me to be an inefficient gardener. I don’t blame him for this. In my half pants and the faded T-shirt I must have looked anyone but a doctor. Seeing in front of me a fairly fit looking man who obviously is not in need of any urgent medical attention, I tell him.’ Doctor will start working from 5 p.m. and will not see any patients till then.’ He gives me a dirty look and says, ` go and tell him that I want a certificate and it is urgent’. ‘He will not give sickness certificates to fit persons’ I reply. `How do you know with out asking him’? He persists. Now I am forced reveal my identity. I tell him, ` I know because I am the doctor’. He stands there for a while staring at me obviously not believing what he is seeing, then he goes. He must have thought it better any way not to take a certificate from this kind of doctor who does not look and sound sane!

Another man enters my consulting room and sits. I ask him what the problem is. ‘No problem’ he says and is again quiet. Then why have you come? I ask. He gives me a conspirational grin and says, ‘I want a medical certificate’ and specifies 15 days as the time I must make him sick. I am now curious to know why he has come to me, does not he know that I don’t give these certificates? I ask him. Yes sir, I know but I come because factory personnel officer told me to get one from you, then he [the personnel officer] says the management will sanction leave, I refuse to oblige. He goes out in a huff.

Another example. This man enters with a swagger, chest out, top button of the shirt undone with a scarf around the neck in true filmy villain style and demands. ‘Give certificate for one month’. I ask him why? ‘Why, I asked you that is why’ he replies and I refuse, but to make matters clear to this man I take the trouble to explain, ‘ I give sickness or fitness certificates to those who have taken treatment from me but not to others’. His look now became menacing and he shouts at me, ` what do you mean? Are you not a doctor? Do you know who I am; I am the secretary of workers union ’. This was clearly a threat to coerce me to give him a certificate. I pick up the phone and dial the police. He doesn’t expect this. He says` why call the police, what can they do? You think you are the only doctor around? There are any number who will give me what ever certificate I want, you stuff your certificate up your --, he says with a loud shout and goes.

Another certificate seeker enters and requests timidly for a sickness certificate. He appears really in need of this. I told him why I couldn't oblige him. He politely listens and asks,' are not you qualified?' I saw the board in front that says you have MBBS and other degrees in front of your name? Now this man is clearly under the impression that any man who has medical degree must give a certificate false or otherwise and a degree is a passport to commit this offence which he doesn't even know is an offence. I tried to explain my point of view and that doesn't impress him, he had come with fond hopes of easy success. He asks me who else does this, I give several names. He appears happy and gives me a parting shot, 'don’t worry doctor I will not tell the police about your degrees! He obviously is under the impression that as I am reluctant to give this certificate which is the right of a qualified graduate, my refusal means only one thing, my degrees are false and police can take action if he lodges a complaint! And by the magnanimity of his heart he is not doing it and is allowing me to carry on my nefarious unlawful activities!

Another guy comes and puts his demand. I tell him the same story of my not giving false certificates. 'That I know saaar, but my company's personnel officer has asked me to bring it only from you', he said. This was interesting. Why would the company's personnel chief would ask a certificate to be brought specifically from me? Curious I called the guy in question and asked him the reason. Doc, he said,' our managing director knows you don’t give false certificates and one from you will make him believe and I am interested in getting this employee this leave which he deserves though he has used the leave for some other purpose'. This left me speech less and it took me some persuasion to convince him to send the unfortunate leave seeker to another doctor!

In a scenario where doctors keep printed forms where in they only will have to fill the name, illness and the duration of leave required and liberally give these to all and the sundry, if one considers me crazy in the head and not qualified will you really blame him?

This was written before the days of economic liberalization when the hold of government on our lives was worse that it is now