Getting Better takes us into the corridors, wards and operation theatres of the King Edward Memorial Hospital in central Mumbai, one of the best-known public hospitals in the region and therefore one of the most overstretched. The statistics recounted during the 79-minute documentary tell you why KEM matters, and why it will always resemble a war zone. Every day, it attends to 230 in-patients, 5,800 outpatients and performs 150 surgeries. That amounts to 1.7 million visitors a year,
Thus, when a doctor says, “What we do is somehow never enough,” it’s a statement of fact rather than an attempt at fake humility.
Never a dull moment
The briskly narrated documentary opens with the dahi handi celebrations, for which revellers form multi-storeyed human pyramids on the city's streets. Inside the hospital, a special squad of doctors, nurses and technicians is on standby to attend to bruised skulls and broken limbs. This sequence establishes the 88-year-old hospital as a round-the-clock health care provider to anyone who lands up at its doors.
KEM’s vital role in providing free or subsidised treatment to underprivileged people is underscored by the portrait of Suyesh, a boy with a hole in his heart who has been waiting for three years for a crucial operation. Suyesh’s case is illustrative of the frustrations of dealing with a public hospital of this scale. His father has nowhere else to go, but he is also worn out by the endless delays and the constant changes in the operation date because of a mile-long waiting list and a shortage of vital equipment.
Dastur also ventures into Gordhandas Sunderdas Medical College, attached to the KEM hospital and the alma mater of some of India's most eminent doctors. GS Medical professor Ravi Ramakanthan, who was also the head of KEM’s radiology department, exemplifies the kind of doctor that gives the hospital its reputation: long-serving, hard-working, unflappable and dedicated to public health. “He was the dinosaur of the institution – the one guy there who knows everybody and everything,” Dastur said.
Winding his way through the different strands is Sanjay Oak, who was KEM dean during the three years in which the film was being made. (The current dean is Shubhangi Parkar.)
One death, many lives
A strange set of circumstances led Dastur, who has worked in civil aviation most of her life, into making Getting Better. She had been attending to her ailing father at Mumbai’s Jaslok Hospital in 2008. As she spent time at the prestigious (and therefore expensive hospital), she began notice the presence of a whole set of patients from poorer families there. Some of them had sold their homes to pay for the treatment at Jaslok.
After her father's death, Dastur wanted to help such patients financially, and the advice she was given led to Getting Better: “If you want to help the poorest of the poor, go to KEM.”
Realising that it was easier to make a film about the KEM than donate money to the Brihanmumbai Municipal Corporation that finances the institution, Dastur embarked on the documentary in 2009. “We got permission to shoot anywhere and anytime within reason,” she said. “It was a point-and-shoot situation.” Dastur attributed the unusual trust imposed in her to Ramakanthan’s recommendation, Sanjay Oak’s ability to “know what was good for the hospital” and her eventual goal to use the film as a fundraising tool, especially among GS Medical alumni.
She considered various ways of telling the story – a book, and a non-fiction television series. “At KEM, you need to see things properly to believe them, and even when you have seen them, you don’t believe them,” Dastur said. “If you stand there for two minutes, five stories will pass you by.”
It's getting better and worse
Getting Better’s account will be familiar to anybody who has worked or dealt with government institutions in India, especially in the field of medicine. Demand far outstrips supply, and too much needs to be achieved with too little. Despite the growing clamour for increased privatisation of essential services, it's clear that India's underprivileged citizens need free or heavily subsidised medical care. Yet, KEM and its peers in Mumbai and other parts of India are constantly foraging for resources. Sanjay Oak spends a small part of the film persuading the municipal corporation to complete the construction of a much-needed student hostel.
Media reports regularly highlight malfunctioning equipment, poor sanitation, under-equipped wards and understaffed departments in public hospital. A Mumbai newspaper’s story on a recently inaugurated Emergency Medical Services that lacks basic facilities such as X-ray scanners, operating tables and surgical instruments might seem shocking, but it is par for the course at institutions like KEM, whose staffers seem fortunately blessed with immense patience and fortitude.
The documentary’s title is partly influenced by American doctor and writer Atul Gawande’s Better: A Surgeon’s Notes on Performance, which recommends that medical practice needs to resurrect the basic qualities of “ingenuity, doing right and diligence”. These qualities help in making it through the average day at KEM, and not only among the doughty doctors and staffers. Dastur is alive to the laments of the mostly needy and worn-out families of the patients. The film acknowledges their complaints, but also suggests possible explanations. “That is what I saw – it is not a perfect place, but it is doing its best,” she said.
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