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By candlelight, a nation confronts its dark heart

It won’t be so easy to change the deeply entrenched patriarchal mindset that lead to the rape of a 23-year-old woman in Delhi.

On the evening of 16 December, a 23-year-old woman set off for home with her fiancé after watching a film at a south Delhi cinema. They hailed a chartered bus, a private vehicle used to ferry schoolchildren during the day and which prowls the city streets by night in search of passengers.

There were no other passengers on the bus. There were six men, all staff. The men assaulted, beat and raped the woman as the bus –which had large, tinted-glass windows so that no one could see in –was driven around the city.

A rusty iron rod was forced into her. A part of her intestines was pulled out. (Her injuries were so severe that the whole of her intestines later had to be surgically removed. But the infection could not be contained. It spread to several of her vital organs.) The men then stripped the woman and her fiancé and threw them out of the bus.

The woman, who has not been named to protect her identity, was a student of physiotherapy from a lower-middle-class family. Her father, a loader with a private airline at Delhi Airport, had sold his ancestral land to pay for her studies. She gave private tuition to help out. She lived with her parents and two younger brothers in a one-bedroomed flat on the edge of the city.

As doctors fought to save the woman’s life in a Delhi hospital, India erupted in a manner never seen before. People were overwhelmed by the horror of the incident, angry and ashamed that it could have happened.

Waves of protests engulfed the country. In a country familiar with political rallies and speeches, these demonstrations drew a very different crowd: young men and women, mostly ordinary citizens, gathered in their thousands at various venues, among them the homes of the president of India and the chief minister of Delhi.

As candlelit vigils and marches persisted through the days and nights, police arrested six suspects by 21 December. But that was barely enough to assuage the people’s anger. It could have been any of us, they said. They wanted action. They wanted change. One of many demands was the death penalty for those convicted of rape.


As the horrific incident and its aftermath continued to dominate public discussion on television channels, in the newspapers and on social networks, the Congressled United Progressive Alliance government misread the public mood. Its initial silence was interpreted as indifference. It was not seen to be acting; it was not seen to be empathising with the young woman and her family; it was not seen to be reflecting the convulsed conscience of a nation.

People’s fury was exacerbated as barriers went up at certain protest sites, several underground train stations were closed and the government tried to put Delhi under lockdown.

With her condition worsening, the woman was flown out of the country in a plane chartered by the government, which by now had begun to try to control the damage inflicted on its image. She was taken to a hospital in Singapore on 26 December. In the early hours of 29 December, she passed away.

New Year’s Eve celebrations were muted across the country. We were shamed and chastened, united in grief, and the notion of revelry was not something that figured in most people’s minds.

As 2012 slipped into 2013, the Congress proposed harsher laws against rape: a 30-year jail term, chemical castration, and setting up fast-track courts to try the accused and mete out justice within three months. There has been only one conviction from the 635 cases of rape reported in Delhi between January and November last year.

That is not all. One of the accused in the bus gang rape is 17 years old. He is said to have been the most brutal of the young woman’s torturers. There is talk of redefining the Juveniles Act, of treating young offenders as one would adults, depending on the severity of the crime.

In the first week of the new year, the mood is still sombre, grief-stricken, impatient for change, angry and ashamed. Harsher laws are likely to come as soon as February to address the punitive aspect of the matter. But the slew of measures suggested to act as deterrents – stepping up police patrols; sensitising the force to deal with complaints of harassment from women; a more nuanced portrayal of women in popular cinema and advertising – may not be enough to make India’s streets safe.

Not all men want to be violent towards women or rape them. For those who do, it is a question of a deeply entrenched patriarchal mindset, upbringing, education and awareness. It won’t be so easy to change those things. That is the heart of India’s darkness.

As the six accused await trial, an entire nation will continue to look deep into its soul.

Soumya Bhattacharya is the editor of the Hindustan Times, Mumbai, and the author most recently of the fatherhood memoir “Dad’s the Word” (Westland, Rs225)

This article first appeared in the 07 January 2013 issue of the New Statesman, 2013: the year the cuts finally bite

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide