When ECHS sounds like ACHES

My buoyant pride and (psst) part surprise at the alacrity and efficacy of MH in handling an emergency case I was accompanying on Friday night, was soon to be deflated with my experience at the ECHS on Sat morning. It seems that all govt establishments feel they would be rendered redundant in terms of importance if they don’t make you run around in circles for signatures. I mean how can it be that you leave the place without getting your taste of babudom and moving from window to window, part seething, part pleading and questioning how they have perfected the art of making simple things most complicated. And it doesn’t matter even if it’s the medical specialist at the MH who’s sent you with the papers for the patient in ICU to be referred to a private hospital.

So we arrived straight at the OIC’s office, a retired officer, who was sharp and receptive and told us that the med specialist had put his signature but not the stamp. Thankfully he was reasonable enough to tell us to get all the signatures at ECHS first and then go back for this stamp. But this was our first and last stop where sharp and receptive and reason ended. He told us to go to A office, get a stamp, then go another counter for an online registration and get back to him for his signature. He even told us that we wouldn’t find him there but another officer would sign the papers. And here started our campaign to get those precious signatures on the referral papers. 

We stepped out looking for Cabin A, there were no signages or boards and every room that we saw had a forbidding board saying, do not enter. Much against that I got in and asked where ‘A’ was, and was pointed to the next room, where a harried old man was sitting at the desk. He asked us, “Kis doctor ko dikhana hai?”

“Doctor ko nahi dikhana hai, bass sign chahiye. We went to the OIC and he told us to get a sign from here.”

“How is that? Doctor ko toh dikhana hi padhega?”

“No, our patient is in ICU since last night, the med specialist has already signed asking for a referral.”

“Oh, ok. Ok”

Now it seems that he’s got the plot. He enters the ECHS no, patient’s name and even goes through the case sheet, even though he’s not a doc. He types A-24 on our paper and tells us our number is 24 and we can go, see the doctor. We tell him again that we do not need to see a doc at ECHS. We go through the whole explanation of patient admitted last night, ICU, med specialist referral, what OIC ECHS has told us and that’s when the penny drops.

“Ohhh, doctor ko nahi dikhana hai. Thheek hai, thheek hai, you go the online counter now.”

“Where is it?

“Well you will cross this aisle and there you have the medical labs and then you will take a left and enter a big hall where you will see patients waiting, cross that hall and you will reach that counter.”

Now this seemed like a distance of 150 metres if not more. And we have no clue where these labs are and what hall he is referring to. The patient’s wife, Mrs Murthy, who was with me said that we haven’t got any signature here and the OIC had specifically asked for some stamp/sign. We enter a small room within Cabin A, where another man with snow-white hair is sitting. We ask him what signature we needed from here. He doesn’t answer and starts going through the case sheet. Point to note, he ain’t a doctor. Now he asks us questions like, “Kya hua thha, kab hua thha, abhi patient kahan hai” and he also points out that med spl stamp is missing. Again we tell him that we will get that stamp once we get the signatures needed here. He puts one stamp of the OIC there and tells us to go to the online counter. We ask for directions again because we do not trust the first set of directions that we got and the man just points to the building that we can see from his window and says, “Yahan chale jaiye.” 

I persist and ask ‘uss counter ka koyi naam hai, kaise jaana hai wahan tak,” and he shouts saying, “YEH BUILDING HAI SAAMNE.” I am absolutely taken aback with his shouting and I tell him that I was told aisles and med labs and halls and so I asked. He realized his mistake and said “who toh kuchh bhi bahut lamba kar ke batayenge.” And now it is my turn, I ask him calmly, “aap chillaye kyun mujh pe,” and he says, “Main kab chillya.”

“Right now, you shouted, “YEH HAI”.

“Aap baar baar pooch rahe thhey kahan hai, kahan hai, isliye.” 

I realised the futility of taking it any further than this. So much for labs and halls and right turns.

We are at the online registration counter in no time, but much to our despair they are a dozen people at the counter waiting for their registration. After some time we request the bald, very serious looking man at the counter that our patient is in ICU and if he can take our papers next, and without even as much as raising a brow, he takes the papers and says in his flat trite voice, “ICU mein hain toh le jaiye hospital, baad mein paperwork karaana.”

We show urgency by mentioning how it was a case of seizures and patient being in ICU and he again told us, absolutely unperturbed, “ICU mein hain na. Bed per toh hain. Baithiye, aapka number se karunga.”

I was livid on hearing his apathetic response and his attitude of “I know that without my help, you can’t get this job done. So either suck up to me or buzz off”. Sadly, we couldn't do anything and held our patience while he entered each detail on another form with such studied slothfulness that I wish there were some sort of current we could pass through him to spark him up. If he had to enter a 10 digit phone number, he would look at the form, mumble one number and then type the number. So the whole process was like turn right, see number on form, turn back to keyboard, type number with index finger. Imagine seeing him do that with all the details on the form. And then lo and behold the patient whose details he was typing in did not have the doctor she wanted on the panel. Then another senior guy is called from an inside room, a phone call is made to the doctor and asked if his empanelment was cancelled and this doc said that he will text on the number that he has got a call from but unfortunately his screen is damaged so the ph no should be dictated to him. And there we all are, a dozen minus one, waiting for this conversation to get over and the mahuratam for our form to be queued up for ‘online’ entry.

Mercifully Mr Sloth at the counter takes our form next and then comes the big roadblock, we don’t have the aadhaar card number of the patient. The patient’s wife, Mrs Murthy, who is with me has no one back home to tell us the number, we can’t go back and get the card, because the MH has told us to hurry back and shift the patient to the recommended hospital ASAP. Despite pleading, Sloth refuses and tells us to go to OIC and get his sign to say that he approves of entry without Aaadhhar. We beseech him saying we have already been to him, but Mr Principled Sloth refuses to budge. We go the OIC’s room but he is not there, we are told to go to G cabin, thankfully a lady peon goes with us and we enter the doc’s cabin. He does not even look up, runs his pen over the case sheet, taps on the Med spl’s sign and tells us the stamp is missing. Need I add here that we give the whole explanation again of getting the stamp once ECHS bestows its grace on us. He says something in Telugu to the lady and we leave not knowing what’s happening. She goes to Mr Sloth , tells him to enter our details without the Aaadhaar number.

By this time arguments have broken out between different patients who have been standing there. One retired officer is trying to be the voice of reason there, telling Sloth that we have an emergency and he should deal with us first, and another young guy is being belligerent saying his mum and he have been waiting for over an hour. Sloth meanwhile is absolutely unfazed and is busy doing his act - 'turn right, mumble number, click on keyboard, repeat'. I have by now taken a chair, lest I lose my cool at Sloth, while Mrs Murthy stands at the counter, waiting for her chance. And then our turn arrives but what a catastrophe, the computer refuses to take the entry in the absence of the Aaadhaar no. Someone suggests, “Koyi bhi Aadhaar no daal doh.” I give mine, but no luck. Finally Mr Senior, from the inside room comes in and voila, with his sorcery at the keyboard, we are registered online. Mr Senior was like God Almighty at that moment of time.

Now that we had crossed two of the three milestones - Cabin A and online entry, in this momentous journey of ours, we were more than halfway done. Again we go to OIC’s office, the OIC is still not there and we are told to go to G cabin again. We try to peek in but the lady peon there tells us curtly, “Baahar wait karo,” in her best condescending voice. We wait but after a minute or two, just walk in, and put our papers on the table. The female peon picks them up and puts them under the papers that she has in her hands. After Sloth, it is her vs us. The doctor still doesn’t think we deserve a glance and when our paper finally sees its moment under his eyes, he once again taps on the med spl’s signature, mentions the stamp again, and still has his head and eyes fixed to the paper as we give whole explanation for the nth time now. But glory be to the heavens that he signs and stamps the papers. 

What a miraculous happening! We did it! From OIC to Cabin A, then to Cabin A’s smaller room, then to online counter, then to OIC’s room, then to G Cabin, then back to online counter, then OIC’s office and then G Cabin, we finally had those precious signatures on the papers.

And believe me those people are lying when they say that they take the whole day to get those signatures at the ECHS, we just took over 2 hrs 45 mins. But of course, you see we were lucky, we didn’t have to queue up as A-24 to see the doc there. LUCKY US! God bless the systems that have been put in place to ease our lives, but just happen to make them more warped than ever. And ECHS will sound more like ACHES, everytime I hear of it next.