They say, “You have to be crazy to be a goalkeeper.” I say, “You have to be crazier to be an emergency physician!” 

My interest in emergency medicine started very early, in the 2nd year of MBBS itself, to be precise. The EMS and Trauma Centre at Sion Hospital in Mumbai, where it all began, is one of the top facilities in the country, handling the full range of medical and surgical emergencies.

I still distinctly remember and smile, thinking about the time spent as a medical student or intern putting hundreds of IV lines, collecting blood samples, inserting Ryle’s tubes and Foley’s catheters, collecting ABGs, taking ECGs, accompanying trauma patients to CT scans, counselling patients, etc. 

Whenever I was free after daily lectures or while taking a break from the library, I would hang around in the EMS. I would look forward to the ‘Emerg-Double and Emerg-Triple’ where the unit in which you were posted had the call day for the weekend and the following weekday(s), and you would end up continuously working 56–60 hours at a stretch in the EMS. 

No matter how busy it got, the doctors, nurses, mamas and maushis, and security continued to do their best, day after day. 

Over time, I realised that being a government hospital with limited resources and many patients facing financial constraints, the EMS was unable to offer the best treatment modalities or follow established treatment protocols. For example, there was no PAMI for acute STEMI, no thrombolysis for acute stroke, and no ATLS protocol management for trauma patients. Additionally, procedural sedation and drug-assisted intubation were not practised.

At the same time, there was a lack of communication skills, compassion, empathy, and sympathy towards patients and their relatives by the resident doctors. 

There were many instances during treatment by my peers that shook me and had a huge subconscious impact: seeing amputation of the hand being done under local anaesthesia with the patient howling in pain, pneumothorax while doing blind central lines, breaking multiple teeth while intubation, intubating awake patients with just a shot of Midazolam, patients requiring emergency surgery spending hours for an OT slot, etc., to name a few. 

I had kind of made up my mind then and there: the people deserve good emergency care, which includes not only the medical aspect but also the overall patient experience, satisfaction, and quality in terms of ethical and affordable treatment that is protocol-based and supported by the latest equipment and cutting-edge technology. 

I had vowed to practise ethically, not being money-oriented, for the best interest of the people and provide them with the highest level of care. 

Not even once did I ever think of working abroad, where it is possible to earn 4-5 times more money than in India, just because people here too deserve good emergency care. Over the last 15 years, I have worked exclusively in the emergency departments of the top hospitals in the country, setting up four emergency departments so far and being actively involved in the teaching and training of young doctors, nurses, and healthcare professionals. 

And the journey has been satisfying. More so because I have seen myself grow and learn every day. Even to this day, I remain excited and enthusiastic about going to work. I look forward to the patients I will be seeing in my department. A well-managed resuscitation, a smooth intubation, emergency procedures, STEMI, strokes, and everything in the emergency—the drama, the tragedy, the work pressure, the stress, and the urgency—still excites me like they did 15 years ago and keeps me going. 

If ever I feel low, there are two feedbacks that reverberate in my ears. One was by my security guard, who, after seeing the many post CPR ROSCs, said, “Sir, aap toh murda ko bhi zinda kar dete ho,” and the other by another hospital staff, “Sir, God forbid, kabhi mujhe ya mere kisi family wale ko kuch ho gaya, I wish you were present on duty in the emergency."

My current focus is on developing emergency medicine as a specialisation, providing world-class-quality care to my patients, and training healthcare professionals of tomorrow with integrity, passion, honesty, and discipline to improve patient care to a level where I can proudly tell my patients, "In a life-and-death situation, if we can’t save a life, nobody else can.”