On the occasion of the Diamond Jubilee of the Cancer Institute, Adyar, R.V. Rajan, narrates in a two-part feature his personal experience with the hospital and the story of the hospital itself.

It was on June 4, 2012 that I got the shocking news; my wife was suffering from cancer and it was an inoperable case. Unfortunately we discovered the disease late. All the doctors who saw the test reports agreed that cure was not possible. But still, we felt we had to give her some treatment to see if we could contain the disease so that she could live longer than what was predicted.

The venue for treatment was a choice between a top five-star speciality hospital and the Cancer Institute. We were in a dilemma. My family had already had a bad experience with a starhospital for a simple tonsilitis procedure required for my granddaughter. Such hospitals boast of some of the finest doctors but because they are corporate institutions with high investment in the latest equipment, they have to ensure maximum utilisation of the equipment to achieve a profit for the hospital.

On the other hand, the Cancer Institute, Adyar, a centre of excellence in cancer treatment, is run by Women's India Association (WIA), and is a not-for-profit NGO with the image of a typical government hospital. It caters largely to poor patients from across the country, who are given the expensive treatment totally free of cost! So there was some hesitation on our part to go to the Cancer Institute.

A senior doctor from a five-star hospital whom we consulted informally helped us make up our mind. He said, "If you are prejudiced against the five-star hospital because of your bad experience, I would recommend you go to the Cancer Institute, Adyar, as they are one of the best in the country".

So the decision was made. My wife would be taken to the Cancer Institute for treatment not because it was less expensive but because we were assured that the hospital is totally dedicated to providing top rate diagnostic facilities and focussed treatment for all types of cancer, irrespective of whether the patient is poor or rich. Our experience with the Institute laid to rest all our early apprehensions.

The hospital has two wings. The main building is where thousands of poor patients are provided free consultation and treatment by a panel of highly qualified oncologists. There is another wing called the Maduram Narayanan (M&N) Block where patients paying for the services are given appointments to meet the consultant doctors. This wing has an airconditioned reception area where patients wait patiently for their appointments with the doctors. The same building also houses well-appointed and well-maintained non-AC and AC rooms for patients who come for treatment, be it for investigations, chemotherapy or for post-operative care. Rooms are reasonably priced, unlike the rates of rooms in five-star hospitals which are higher than even the rates in some of the five-star hotels today.

A team of top oncologists provides consultation to all the paying patients. If you are particular about meeting the same doctor for reassurance, you can do so by scheduling an appointment on the specific day of the week when that particular doctor is available. All the doctors are down-to-earth, practical and friendly. No patient or attendant is allowed to throw his weight around, using his/her position or power. At no stage do you get the feeling that you are being exploited. Besides that, as it is a speciality hospital totally devoted to cancer, only relevant tests are conducted. Thorough investigation is done to locate the root of the cancer before the doctors commence treatment. There is no question of your being admitted to the hospital for observation and having every single specialist in the hospital check you, recommending unnecessary tests, the costs of which get added to your bill.

The Cancer Institute has the best of diagnostic testing facilities in the country which are available for both paying and non-paying patients. Testing facilities are common for both.

This is the only place where paying patients have to rub shoulders with non-paying patients and where I saw some discrimination – paying patients getting a priority over non-paying patients, if there is a long queue for a particular test.

All the doctors at the testing centres are kind, sympathetic and try to make the patients feel comfortable though the patient is undergoing a painful procedure. The nurses and nursing aides are equally friendly and kind.

Two other areas where I found the hospital distinctly different from the exploitative five-star hospitals are in their methods of treatment and financial dealings. All the tests we had conducted conclusively proved that her disease was not curable. It was only a question of time. Three of the consultant doctors told us that though special and highly-priced injections were now available they would not recommend them because the effort would be futile. At best, her life span could be extended by a couple of months but would be accompanied by all the pain and misery related to the disease. So they decided to give her only palliative treatment which would keep her comfortable with much less side-effects than what there was likely to be with aggressive treatment.

In a similar situation involving a relative, the doctors at a five-star hospital started on the expensive injection from the word 'go'. The patient did not live long and the last few days of his life were spent in the ICU of the hospital, resulting in the family having to pay a huge bill before the body could be removed from the facility.

As for the payment system – this is where the five-star hospitals make you feel miserable. Not only do you have to pay a sizeable advance to such hospitals before any kind of tests are conducted, but you have to keep topping up the balance constantly to ensure that the tests and treatment are conducted without interruption. On the other hand, at the Cancer Institute, apart from paying the consultant's fee on the first occasion, there is no further consultant fees. If the patient has to be admitted to the hospital either for tests or for treatment, you get an order from the consulting doctor that you produce at the Cash Centre and pay the necessary fees in advance and in cash. If the amount is more than Rs.5000, you have to pay the amount at the Andhra Bank counter located within the campus and obtain a receipt. Credit cards or cheques are not accepted but there is an ATM machine in the premises for emergency cash withdrawals. If it is a continuous process running for a couple of days, then the Cash Department makes a note of the doctor's diagnostic prescriptions in your account and provides you a final bill at the time of discharge. There is no question of treatment and tests being stopped for want of a balance in your account.

Considering the large number of patients handled by the hospital and the apparent pressures on the administrative staff, I found that the established systems and procedures worked very well and every single patient was attended to every day. There was method in the madness. There was hope and a positive attitude among the hundreds of patients and their attendants waiting in the reception area.

In spite of the huge turn-out of poorer patients visiting the facilities, I found the hospital being maintained well. The entire sprawling campus was clean and even the Wards for free patients were neat and tidy. The typical overpowering disinfectant smell you get in any hospital was, surprisingly, missing.

My wife had to be admitted to the hospital seven times during the six-month period she was undergoing chemotherapy. Except for the first time, when there was a feeling of nervousness and trepidation, on every subsequent occasion it was like a picnic for two or three days. The atmosphere was so informal and nice that, in spite of the pain and suffering, her stay in the hospital was comfortable.

Though my wife passed away during the seventh month from the date of being diagnosed with terminal cancer, never, at any point during the course of her treatment, did we regret the decision to go with the Cancer Institute instead of a five-star hospital. Their care and commitment were exemplary. Despite all their efforts, the miracle that we were hoping for did not happen and my wife left this world, surrounded by her family. Her time had come.

(To be concluded)

Feedback welcome on rvrajan42@gmail.com.