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Hi, my name is George Abraham and welcome to Eyeway Conversations. My guest today is Dr. Sharad Philip, a practicing psychiatrist. Hi Sharad welcome!
Hi Sir!
Sharad, you know you are a Doctor professionally. And I just wanted to ask you, do you think blind and visually impaired people can take the liberty of aspiring to be doctors or medical professionals?
Well, sir, my straight up answer is yes. I believe that every person with disabilities should aspire to get into the healthcare professions, should get into the medical professions. There's lots of things that the entire medical community can learn from them. And most importantly, if service and quality and all the things that need to be improved, can be improved, it's only going to be with the disabled people and the disabled community entering into medicine. Now, there are challenges. Yes, it's not an easy road at all. And it's a little unheard of, it's difficult to put it mildly. But I don't think it's impossible. As for liberties to aspire, I think the sky's the limit for anybody, for anybody who wants to apply their mind, who has the right opportunities and the resources, there's no limit to what they can and what they should not do. Nothing like that, in my opinion, yes, they should.
You've qualified to be a doctor, you did your MBBS, and then your MD and you've got several diploma degrees also in your specialized area. So maybe you could share with us some of the challenges that you faced on your journey starting from the entrance.
I'm someone who has retinitis pigmentosa and the feeling I find didn't really help with trying to convince people that I can do medicine. So for starters, the first person that I had to try and convince was the ophthalmologist, the eye doctor announcing my diagnosis and telling me that you should not take science stream. Not just with him but then also with my father, who had been convinced that you know, it's going to be a quite an arduous uphill endeavor for me to do that. And just going to feel like, I had to face a lot of challenges with regard to trying to explain it to myself, my self doubt, the doubt of people around me. The next two years consecutively, I got into the Armed Forces Medical College, I was there for the interviews and all of that. And I was just trembling, trying to think of how am I going to clear the physical because I know that they are saying they will not take a person with an eyesight problem like mine. And by God's grace, I just got into Christian Medical College, Ludhiana at that point of time. And through that, through whatever tests that were done at that point of time, I was able to clear those tests with ease. Entrance exams were horrible. For me, I had given almost 20 entrance exams a year, that was the time when there was no NEET and everything you had to give separately. I would kind of try and ask each invigilator, can you please let me sit next to the window, can you please let me sit under tubelight. And there will be many times where I was not able to make out where I was marking. I lost out on a couple of entrance exams because the sequins on the optical mark reader sheet, you know you had to color those sheets with the ABCD. And then it will just you know, kind of spit out your score once it goes through a scanner. So if you get the sequence wrong, like for example, you're doing the second row and you're starting from 51. And suppose you start marking from 52. So after that whatever you're doing, every answer goes wrong if you miss just one, and there was so many things that I had learned on by doing, learned by experimenting over there. Because I felt there was no one really would understand, anybody I go and tell this problem to would just simply say why the hell are you getting into this? Why are you making it difficult for yourself. So that was that.
But didn't you look at getting a scribe to help you out at that point?
No, actually, there wasn't a provision for a scribe We're talking about 2000 to 2003. I wasn't aware of these things, either. I wasn't aware that my disability, if told and talked about would actually help me. I thought it would be something if I reveal to people, it would be a limiting factor, it would be something that would kill my dreams.
When you got into medical college. Obviously, people around you would have realized that you have an eye problem, your professors would have felt it. How did they respond and how did they kind of facilitate your journey through?
Okay, yeah, that's an important thing. I mean, I found that responses to be quite like the rest of the community. It was not very welcoming, if you say on the overall, but there were these islands of really good people, supportive people who were there. It just takes one or two, maybe even just a small group of people to actually make a person with disabilities' live better. But you know, the entire thing hinges on what the majority opinion is. And, you know, one or two negative comments also tends to depress you. So I had one of my anatomy teachers tell me, you will know what you're doing is not right. There's going to be a problem. Tomorrow, there is a patient who comes to you, that patient is going to feel at a disadvantage, compared to other people, you may not be able to pick up and be a good diagnostician. And at that time, it was like, I really didn't understand why people were saying that it's, I mean, it almost felt like the eyes were studying medicine and not me. It almost felt, you know, if I didn't have the proper eyesight, I didn't belong there. But yes, there were times where I was able to do this. And this was just through a lot of prayer and support, and a lot of help I got. So one of the things was I actually came third in my entire batch for a dissection competition. I had to dissect the back of the knee and show some vessels and nerves, and all of that and I came third. And I didn't really get how I did it so well, but I just did it. And I really thought that, no, my dream of being a surgeon, and all of that would be something that I could do based on that. From there, I did see that a lot of other faculty would not be quite supportive. So I had to go out the extra mile to show that I belonged there. So for that, I would like to take on extra tasks, extra responsibilities, be it volunteering for presentations, for tutorials, for discussions, and try to show, you know, all throughout that I'm there understanding, I can understand what you're saying, and I'm good, as good as anybody else. And my whole achievement-oriented philosophy started from there that I had to show that I am the best, not just one amongst them. I had to show that I was the best. So I had very supportive classmates who were there with me, who would just revise the topics with me. And you know, I will just here and I was starting to learn by the year and I could go and reproduce I was told better than the people who told it to me. And that started getting me a reputation. That started separating me from whatever people had in their mind about a person with visual impairment doing medicine. Yes, there was some clinical postings, there were issues with things but then even those could be surmounted, you could always be tested on alternate things. It's actually the learning and the understanding that should be tested rather than you know, a person's eyesight or the strength of one's hand, or whether they can walk about or not, or stand in an operation theater. All of these things appear, you know, superfluous if you asked me. So what's important is that people with the right abilities and the right understanding and the right learning are there and we should do everything to retain them.
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Now when you're doing medicine, there are also clinics with ophthalmology, with various departments or various branches of medicine, where as a medical student, you are kind of put through the grind so that you learn. So there are these branches where the eye or being able to see is very critical. Do you have any experiences there to share?
Yes, I really have. I mean, one of the things was the microscope. The microscope and me, we are not friends because the moment I tried to look into it, it used to be so bad I just couldn't make out there was so much of blood, there were so many floaters, there would be so many things that I couldn't just make out. I mean, people would say there are these colors, identify cells, and for the life of me, I could not understand why this is a basophils. And this is not a neutrophil, and these are cell types, these are white blood cell types. But then I understood that just being able to identify this is kept as a basic competency. So if there's some way where I could, you know, look at a magnified picture or be able to tell them, these are the characteristics with which I would differentiate one from the other. It may not be that I have the eyesight to be able to differentiated myself, but if I could get another person by describing it to them, you know, in the simplest of terms, and be able to help them differentiate between that I think that should suffice. So, one thing was very clear for me, I am not going into medicine demanding that in spite of my eyesight, my eye problems, I be allowed to do everything that a person with superb eyesight needs to do. I'm not wanting to be an ophthalmologist, I'm not wanting to be an expert surgeon, or any of those things. My entire intention was to get the whole aspect of being trained in medicine, so that I can take the next step to try and understand what I should do towards helping people. Not every person who gets trained in MBBS remains in medicine, a lot of them move out into research, a lot of them move out into public health, policy, management. So I think this is something that should be kept in mind.
You opted to do psychiatry, Now, was this a decision that was made for you or you chose?
So sir, my initial dream when I got into MBBS was to be a good diagnostician in terms of wanting to, you know, be able to understand whatever problems that people came with. So my aim was that slowly I enjoyed doing a lot of orthopedics and my orthopedic teachers, professors and faculty really enjoyed working with me and I actually got a lot of chances in cutting so I scrubbed up and have assisted my HOD in some surgeries. And I did it with whatever sight that I had, and when I was doing something wrong, they were kind enough to tell me that see, this is where you're going wrong, just hold on, just don't do this more. So I have actually scrubbed up for as many surgeries as possible. And I don't think I have done any less than any of my peers or batchmates. But that said, yes. I had to choose psychiatry. Initially, I didn't really know that this was an option that I would like. But then I got into it because I had to do my service obligation for doing my medicine in CMC. And that was a time that two and a half years I work straight out in psychiatry and I enjoyed the work. I enjoyed dealing and working with people with substance abuse, working with families, a person with severe mental illnesses, really supporting families who had children with intellectual disability and autism and all of those things. And so much so that there were periods where I was the only person in that entire department, eight to five, eight to four things would work and then after four, it was just me so I was handling everything and I just wanted the full on experience and I never let go of psychiatry after that. So then from there, it was another journey to NIMHANS and learning that I could actually take help for my disability when I went to them.
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So Sharad, on this note, I just wanted to also ask you, you know, there are a number of visually impaired people, blind people who have taken up medicine when their eyesight is perfectly normal. But along the way, they for whatever reason have lost a sight, or are losing their sight. Maybe during the period of studying medicine, or when they are qualified, and they are already in the profession, and you had dealings with them, you've been supporting them, you've been engaging with them. What has your experience been?
Well, sir, if you ask me, I think they are the best experts that we need in medicine. So someone who's been fully trained, someone who's had sight and you know, had the experience of losing vision as well. They will be problem solving so much, they would be coping through all of the things at such a high level, that there's a lot that we can all learn from them. I think their lives are like books that we can use, that we can read, that we can learn from, in understanding how things can be done better. I would like to tell you a story about someone called Jacob Bolotin is someone who was working in the late 19th and early 20th century. He was someone who was completely blind, he was born blind. And he is known and understood to be the one of the first doctors with visual impairment. And there's a foundation named after him. There's an award named after him in the US. Now, he was someone who people kept going to because he was someone who was not using the stethoscope, he would actually put his ear to the chest of the patient, and then make out stuff. And there are times he's actually saved people's lives. He's found out things that other people were not able to find, the ways that people are able to, you know, find alternate means of doing something is important. It's not just one way that, you know, you don't need to be someone who has complete vision to be a very good dermatologist. Now I am mentioning the story of someone called David Hartman. He is someone who completed medicine in the US 1976 to 1980. He was someone who had become completely blind by the age of eight, and entered training with blindness, he would be able to touch with his hand and with his fingers, he'd be able to realize what sort of dermatologic lesion it was, and he would be able to prescribe them. Of course, you know, when you're looking at that there's so many changes that that hospital allowed him to do, he would have his guide dog allowed inside the hospital, there will be a nurse practitioner or a physician assistant who would be there with him, to work with him and complete things. But then what I'm trying to say here is he is no less a doctor. In fact, he came out, he outrank everybody in his back, he graduated magna cum laude, and did supebly well.
In a place like India where there's so much of mindset, opposition, and biases. How have people actually responded? Are there any of these people you've met in India who have completed their course? Or who are continuing to practice as professionals?
Yes, sir, there are quite a few. Well, the first way that people I have seen have responded is they actually internalize a lot of the things that are going around them. The mindset that you're talking of ableism. So very simply put, everybody around you thinks that the opposite of ability is disability, the opposite of abilities in the ability, disability and inability are two different things, they need to be differentiated. And I think these people with disability are the ones who will be able to show that and showcase the best. Now, as they internalize it, they themselves go through an entire mental health crisis there you know, shattered dreams, aspirations, or feelings, then what will I do? So a particular person I know, had completed all of his studies in just towards the end of his course, the end where he had actually started doing an internship, he started experiencing rapid vision loss within one year, he completely lost his sight. And now what is he supposed to do, is he a worthless doctor? No, actually, he's learned, he's understood things, he's capable in many ways. So people should be encouraged in that aspect that there are people who respond with defiance as well, there are people who try to work things out, try to problem solve by showing that they are just as good as the others because they are masking whatever their problems are, that itself doesn't work. So trying to say that, you know, no, no, you don't have a problem, you can work without the assistance, you don't need a scribe or you don't need the extra help, you don't need the extra time. All of these things don't work. Till I told my professors that, with my current eyesight, I'm not able to make out on the X ray that you're making a red mark, or you're asking for a point I'm not able to make out. And I wasn't able to discuss a solution with them. So they said, okay, what we'll do is we'll just take a white doctors tape, make a point out of that, and put it there. And you identify that particular point based on your understanding of anatomy. And I was able to do that. So we need to be able to discuss this, we need to be able to overcome that initial mindset which is internalized in inside of us.
You've written a lot of papers, you've also traveled across the world, you've been to Israel, you've been to Romania, you've been to Nepal, what has been your general experience in terms of travel in terms of networking?
That was a whole different experience. So when I finished my MD and my training, I just had this inquisitiveness inside me. I want to find out if there's someone else, who's you know, had some similar journeys, either the best way would be to go for international conferences, I thought everybody would come for that. So I tried to get into as many international conferences as I could. I started presenting papers, research, I got a lot of awards. The trip that you were mentioning to Israel was something which was supported by the Department of Science and Technology from India. And I got a scholarship to go there and present in the bioethics conference over there. I also had the opportunity that you're mentioning for Romania was an award from the World Association, and they recognized me as early career fellow. So then the whole thing is, I mean, everybody expects that a person with normal and full abilities is going to come. But the moment they see that there's a white cane in your hand, it's a totally different expression. I mean, I have had people staring at me incredulously. At least I kind of feel them staring what I imagine that they will be looking at me thinking what's going on? Why I'm there like that? Yes, networking has been tough in terms of I may not be able to recognize people, where they are, when they are, okay, did I meet this person, I have to recognize them by their voice or I wait for them. A lot of people have been sensitive to this. And then they come and tell me hi Sharad, this is Mandes, or this is Victor. And those kinds of things are also there to be celebrated and noticed. Of course, I do network a little bit, try to find out who else is going and then I get to know and I pick them and plan things to do. So we've gone on visits and tours and all of those things. I believe I've not let myself down by saying that I can't experience this because I don't have the vision, or I don't have my full eyesight.
You call yourself an activist. So tell us something about your activism.
Any person who's going through a problem is actually the best activists. So I try to support people through whatever they're going through, and then work out in that. But there are times where, you know, you really see that can't really work out, they really are not able to do that themselves, or they're not able to come to that place to do that. So I've been trying to write letters along, we have an entire network across India called Doctors with Disabilities. I lead the section on people with sensory disabilities and visual disabilities. So we've been trying to like write letters and important Supreme Court cases and talk about that. I've been also working on job identification notifications and trying to analyze that and respond to the need, which is that the unemployment figures for persons with disabilities are so stark and so different from the general population, something needs to be done. So those are some of the efforts that I've taken up. I've written to the papers. I have had some statements and some details and all also provided. I've also tried to advocate about the medical system of admissions of selection of teaching, also the more distribution lists and now that's a work in progress. That feels like you know, you have to go against the tide. But I think people are more responsive, they're becoming more and more aware and this is the best time. I mean, there's never been a better time than this. Because all the legislations, all the frameworks are quite supported now. And it's a matter now of how we increase awareness and improve our advocacy efforts.
Sharad, you and your two siblings, all three of you are blind, very traumatic experience for your parents to start with, how did they deal with it and what are your childhood memories?
The initial response, like you said is like beyond trauma, it was like shock. It was disbelief. It was like, you know, everything's alright, with these steps ago. What is the issue? Why? How can someone's eyesight go and deteriorate? I mean, they have better eyesight and how can it go and deteriorate there? And he's able to play table tennis now? How can you not even see a whole car coming and hitting him? How can you miss a platform on the railway station and fall on the other side? So those are kinds of things that, you know, my parents have to deal with. A lot more than parents is, you know, no one's really trained for parenting. So a lot of people ask, I mean, a lot of parents look to their primary, secondary supports, they look to the elders, peers to you know, kind of support them through this to help them understand what is going on. And that's also important that, you know, there'd be a better a better way people respond. You know, you can't have people responding with superstition and all of those kinds of things. So, the immediate thing which happened for us as a family was, there was an entire faultfinding on Oh, this is because of bad deeds from your family or bad deeds from this side of the family and those kinds of things. So, it was initially quite, you know, disheartening, but I did see that my father, never really let the standards be lowered. He never stopped expecting us to perform well. He was himself a very high achiever and he himself would always have us you know, look at the best, want to be the best and you know, how do whatever our previous performances were. So in that regard, that's something that I got from my dad. My mom was someone who said that you know, you shouldn't give up on any of your dreams, you should just look to God. She is someone who really supported me in my faith and my journey through this is something that I have learned so much from her. That sense of, you know, God's got the best for you. I mean, this is not some sort of a punishment from God, this is not some sort of problem that he reached that only you carry or any of those things, it's something that even through this, he is going to do something good, he's going to do something great through you and I think that really happened. I don't think that given a chance I would want to go back and change something about my journey because I feel it's made me rich with a lot of learning experience and maturity. Those kinds of things are there.
Well, thank you very much Sharad. You've shared your part of your professional journey, your personal journey. It's been wonderful speaking with you. Wish you very best as we go forward.
Yes sir. Thank you sir
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