A Winter in India

Our Dean asked us to come for an interview with a film crew from one of the local TV stations. As it turned out, this station, like most stations, broadcasts primarily in Hindi. So most of the actual interview was in Hindi with the Dean. They then wanted some photos and an interview in English with us. So off we go to meet the Dean in the clinic for the photo op. We stopped dead upon realizing that what they meant was the Dean was treating a patient and the TV interviewer wanted us to pose as helping him work on the patient. Leaving aside all of our American HIPPA rules of patient privacy and confidentiality, none of which apply here, we were still horrified from an infection control point of view since we had no gloves, no masks, no protective eyewear. Reminded Pam of when she and Lee and 20 other microbiologists had been trooped into the Intensive Care Unit at Peking Union Medical Hospital in Beijing in 1996.

The interviewer got quite huffy when we told her that we would not pose for the photos she wanted. We explained that it made us feel very uncomfortable to be pretending to do something we had not done any of while we were here at Maulana Azad Dental College, and that Pam was not even a dentist. And that it was not healthy for the patient to have us in her face. (Of course it also wasn’t healthy to have a TV camera in the patient’s face, but we didn’t bother saying that.) The interviewer’s reply to our ethical dilemma was only to say, “Well, television is a visual medium. You must understand that I must have pictures to tell the story.” We tried to say that precisely because of that she shouldn’t be asking us to pose for pictures that were a lie. None of this had any effect on the interviewer, only made her more annoyed that we wouldn’t do what she wanted. Meanwhile the Dean was working away and the patient was trying to figure out what was going on, although a sudden increase of five people in a small room didn’t seem to upset her. People seem used to that sort of thing happening all the time.

The interviewer wanted to “negotiate” all of this in the treatment room, but we walked out to the hall. She demanded that we work out a solution to her problem. Which really made us want to walk away, but being the good Fulbright Cultural Ambassadors that we have been trying to be, we eventually arrived at a compromise where she did the interviews and got her footage in another clinic that wasn’t being used. Still a dental resident got roped into posing conversing with Dave about an X-ray. This was possibly a good thing because it was an interesting X-ray of extra third molars and got Dave’s mind off wanting to smack the interviewer. Dave had actually prepared a statement, on the off chance that any of this might be of substance, so he gave his three-sentence talk to the camera. Pam babbled something about science education. The interviewer then asked Dave to comment on the quality of the dental equipment. Dave said it’s the best equipment, brand new, and pointed out all the good features of the chairs, lights, trays, etc. To which the interviewer said, ”So in India we have good equipment but no one knows how to use it, correct?” Dave said, “No, the students are getting good training and everyone knows how to use it.” That trap was pretty much the last straw and we left.

Talked with the Dean about it later. He explained that these are free-lance TV crews who get contacted to get a story, but don’t get paid unless the station airs the footage. He also thought that the interviewer was so young that she thought anyone who spent four months at a dental school must have been working on patients, because that is what dentists do. Someone else told us that they had had an encounter with her before and that she does try to stir up controversy in front of the camera. Luckily the piece, if it aired at all, was going to be shown on some 6 AM news show, so hopefully no one saw it. We don’t have a TV, so we could pretend the whole thing never happened.

It’s a very tricky thing navigating what for us are ethical dilemmas in a culture where these particular things aren’t considered ethical dilemmas. And it’s even harder when the dilemma seems like its not just ethics but a biological “reality” so how could anyone not listen when we explained that we were being asked to endanger a patient? Of course our current laws on infection control in the U.S. only came about since the early1980s, so even though they are called “Universal Precautions”, they are far from being universal around the world. We have to accept that standards are different. They do have an infection control standard here in India but we have not been able to find out exactly what it is.

These conundrums are an almost daily occurrence, but it’s not easy and after four months we are no better at knowing how to act in such situations than we ever were.