While many in his profession prefer to work from behind their desks, this young doctor finds joy in treating ill travellers at their hotel bedside.
Monday, he works at Sukhumvit Hospital. Tuesday, Thursday, and Saturday, he is available on-call with Global Doctor Clinic. Wednesday and Saturday, he is the chief resident on-call at Rajavithi Hospital. This is the schedule for 29 year–old doctor Nivit Rajeev Kalra.
The only child born into a trader family, Nivit took up medicine 11 years ago knowing full well the personal sacrifices he would have to make. But he still gets support from his family and his patient wife Amanpreet, whom he barely sees during the week. Down-to-earth and talkative, Nivit is one of the few Indian doctors who still practise the tradition of house calls. And through the Global Doctor Clinic service, Nivit is able to fulfil his love for meeting patients and tending to the sick at their bedside. When he is not running around Bangkok treating sick hotel guests right in their rooms, the young doctor studies late into the night in preparation to become a cardiologist. Here, he tells us what it is like to be the only Indian in a class of 800 medical students and what he loves about being a doctor.
Did you always know you wanted to get into medicine?
When I was 12 years old, my parents gave me a choice [to either continue] at a Thai school or move to an international school. I thought that when it came to working in Thailand in a professional field, it would be best to continue studying in a Thai school. When you are in a Thai-medium school, and you excel in studies, they push you towards either medicine or engineering for your final year.When it came to the final year entrance exams, I took six months off to study. During those months, I decided to explore [all possible career] opportunities available. I met with a lot of industry professionals in stocks, marketing, politics, engineering, and medicine. Even though my dad had a business in textiles, he gave me the opportunity to venture on my own. Then my uncle gave me a piece of advice that I will always remember. He said, “A doctor can sell noodles, but a noodle salesman can never become a doctor.” So I started researching medicine seriously, looking into all aspects of it, from financial security to social life. That is when I decided to make this my career. I ended up with a good score in my exams and was accepted into [the medical school at] Siriraj Hospital.
How competitive was medical school?
I was the only Indian in a class of 180. In the span of six years, there were no other Indians, so I was the only Indian in a group of 800. Standing out has its pros and cons. If you are good at what you do, then you are very well-recognised for it. But of course, if there is a misstep, then you will always be remembered. So that is very tough, especially for an Indian in such a demanding line of work. There were times that I felt I was treated differently, but it was not a racial issue. But it was difficult to push myself, because we were with people who were in the math or physics Olympics.
What were some of the changes you had to make to your life?
The added responsibilities meant that I had to cut down time spent with my family and friends. It was difficult for me at first. I couldn’t be there for my own cousin’s wedding. Sometimes when my own family members are sick, I feel sad that I cannot be there for them. Luckily, my wife understands and gives me space to study or rest. She was my support system during my last year of medical school.
What is the hardest part of your job?
The most difficult part is to meet relatives of a patient who is chronically or fatally ill. I am a very sympathetic person, so I find it very disheartening to explain to them in layman’s term the things that are going to happen to their loved ones.
Has there been any one particular case that has truly affected you?
You always have one patient who reminds you of where you are and how you got there. Mine was when my first patient passed away while I was doing my training. It was due to his illness. I treated him for one and a half months. Since I was the attending extern, I got to sit with him every day for those six weeks. I got to know him and his entire family. So when he passed away, it took a toll on me. But I understood that it is a milestone that all doctors have to go through.
How have you changed your practice since then?
It was no longer about the books; it is about the minutes you spend with the patient. It is what you see or hear in their voice, the little symptoms and signs. So I started studying the body language, verbal communication, social status, language barriers, and nationality differences. I realised that dealing with patients requires that you give them tailor-made treatments. That was helpful when I started working with Global Doctor.
Tell us about Global Doctor Clinic.
Our clinic—run by a Thai-Indian doctor couple—is based in Silom, and we are tied up with many four and five-star hotels around Bangkok. The hotel usually calls our clinic when a guest falls sick. We travel with a nursing staff and a medication packet that is equipped for an examination. There are five other doctors working there, including me, who work different days of the week including night shifts. But even though I work three days a week, I still consider it a full-time job. We are not the first service of this kind here, but we are definitely the most well-equipped and connected.
Is it different from treating patients at the hospital?
When I see a patient in their hotel room, it is much worse than seeing a patient in a hospital because they are out of their comfort zone. The most common type of illness I am called to treat is gastroenteritis, which is traveller’s diarrhoea. The illness is straightforward and not very difficult to diagnose, but I have to adjust my treatment to suit their needs. I have had patients who were keynote speakers, so their treatment [had to yield quick results]. And then there are travellers. Sometimes we bring our phones or computer to translate for them, in case we don’t have a translator on hand. Recently, I had a Chinese patient, and he couldn’t speak a word of English, so I had to work very closely with him.
What are some of the benefits of working at Global Doctor Clinic?
Generally, when you stay on-call at a hospital, you have to be there at the hospital, meaning you have to be readily available for them. Whereas as a concierge doctor, the hours are a bit flexible, [so] I get to spend more time with her [Amanpreet]. I get to sleep in the comfort of my own bed. But if I get a call, I have to go. This allows me to enjoy my work and also my family life at the same time.
If you are sleeping at the hospital, for you to reach a patient takes five minutes. For a concierge doctor, it takes a minimum of 15 minutes, but in general, it takes about 45 minutes to reach a patient. So that is tiresome for me and for the patient waiting
Most doctors do not prefer visiting patients outside of hospitals. What do you think of that?
Some people do feel that it is demeaning to go see a patient, some people don’t. I see it as a service being provided in whichever way, whether you sit behind a desk or go see someone in a hotel. Some doctors find it difficult to travel from their desks to a hotel. But I see it as an opportunity to help. Sometimes after a call, I will sit [at the lobby] and enjoy a cup of coffee.
What would you like to change about the present medical industry?
The prescription system in Thailand is too vague and many over-the-counter medications are being misused. I like the structure of medicine in Thailand but I also see that there are a lot of things that can be improved. I don’t want to get ahead of myself, but I hope to see myself making a dent in the medical history in Thailand. I want to see how doctors and patients can interact in a way that can benefit both sides. As of now, it seems like a one way relationship that is more service-minded.
Freakonomics by Steven D. Levitt and Stephen J. Dubner, Billy Bat by Naoki Urasawa and Takashi Nagasaki
A habit you need to kick
Addiction to my iPad
Video gaming and graphic novels
Memorable medical moment
When I was in the operating theater seeing my father’s heart valve being repaired
Dr. Darvin Narula at Sukhumvit Hospital and Dr. Sumait Premmanisakul of Global Doctor
For the original PDF, please click In focus, A doctor’s calling
Featured in Masala Lite April, 2013