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Somewhere over the rainbow: Love is love

2023; Medknow; Volume: 6; Issue: 2 Linguagem: Inglês

10.4103/crst.crst_188_23

2590-3233

Prasad Dandekar, Gargi Mhatre, Richa Das,

Empathy and Medical Education

Interview of Dr. Prasad Raj Dandekar (MD, DNB) by editorial assistants, Dr. Gargi Mhatre (PhD) and Richa Das (MA), from the CRST journal team BIOGRAPHY Dr. Prasad Raj Dandekar is a radiation oncologist based in Mumbai, India. He heads the Department of Radiation Oncology at Sir HN Reliance Foundation Hospital. Dr. Dandekar was selected for the prestigious Kamal Nayan Bajaj Fellowship of the Ananta Aspen Center for young leaders (2018). He is an International Coaching Federation Certified Professional Coach (CPC). One afternoon, the Cancer, Research, Statistics and Treatment (CRST) team had the opportunity to meet Dr. Dandekar and ask him a few questions about his journey as a queer oncologist in India. CRST Team: In your Technology, Entertainment, and Design (TED) talk, you mentioned that the experience of discovering your sexuality felt like getting diagnosed with a disease, "I have LGBT." How did you come to accept your identity? Dr. Dandekar: When I was young and discovering my sexuality, there was no Internet. I was around 15 years old—and I knew I was not interested in what other boys were interested in. I remember that I always felt that I was "odd," unlike the people around me. I did not have the vocabulary to understand what was happening to me. The overwhelming feeling at the time was, "Maybe I am abnormal." Gradually, I learned that there were more people like me. I remember my life from ages 15 to 25 as a period of severe anguish and confusion. I questioned what was happening, "Is this all a phase, or am I bisexual? Will my feelings change after some time?" When I was 24, I met my partner, and it started dawning on me that maybe I wasn't abnormal and that this was who I was meant to be all along. I really liked him and was starting to get more comfortable in my skin. Those ten years (1995–2005) were also the time I spent in medical school. It was tough when we studied forensic medicine in college, where I heard the term "homosexuality" for the first time. We were taught that homosexuality was a disease, an aberration, and a disorder. I was scared and questioned the world around me. However, when growing up in school, I had a friend I loved dearly. I had the urge to tell him the truth about myself, as I did not want to hide anything from him. He continues to be a very dear friend, a cardiologist in America. I told him, "I think I am gay." My confession was followed by a brief pause that felt like years. After the pause, all he said was, "Okay." I was shocked and asked him if he understood what I meant. He confirmed that he did indeed understand and repeated that it was perfectly alright. He accepted my reality unconditionally and gave me the confidence to figure out what was happening to me. Later, I came out to a few more friends, some embraced me for who I was, and many I have lost with time. I focused on my journey as a doctor and tried to go beyond the constraints of being a "criminal" because of my identity. CRST Team: During your college years, India was dealing with a wave of HIV infections. The disease was often colloquially called the "gay disease." How did this affect you, personally and professionally? Dr. Dandekar: Yes, although for the West, the human immunodeficiency virus (HIV) wave happened in the 80s, for us, HIV became a topic of conversation around the 90s. Moreover, HIV essentially meant AIDS back then—a scary disease that would lead to death in a short span of time. It was awful—we lost so many people to the disease and had to deal with the social stigma that came with it. Fortunately, by the time I was coming out, protected sex had been normalized. Queer people understood there would be, "no wildfire if you did not light it." However, today, with the arrival of pre-exposure prophylaxis (PrEP)—the number of people having unprotected sex has increased—causing a resurgence in the number of sexually transmitted infections. CRST Team: How has your experience been as an out and proud member of the queer community? Dr. Dandekar: All hell broke loose after my MD degree. My partner and I were starting to imagine a future together, whereas my family wanted me to marry a woman. I came out to my mother and despite being the rational woman that she was, she had a meltdown, As they say in Marathi, "" (All's well when it is your neighbor's kid—God forbid it ever happens to your own son.) We sought the help of a psychiatrist, and my mother underwent some treatment. She was supportive and never forced me to do anything against my will. However, I always felt responsible for her unhappiness. It took me 16 years to recover from that guilt. In medical school and during my time at the Tata Memorial Hospital (TMH, Mumbai, India), I did not know any successful doctor who was gay or an ally. Later in life, I met a senior doctor who encouraged me to explore the world outside and get a different perspective from queer people who were living freer lives in the West. Today, because I am out and proud, I do not fear being "discovered" or "caught." I know people who cannot afford to come out because of the impact it could have on their careers. There is gross discrimination, which can hamper your growth and development. I have been denied promotions because I am a "single man" and do not seem to have the same responsibilities as my heterosexual peers, but despite all these hardships, I am acutely aware that I am a privileged man; many queer people live with fear and doubt all their lives due to a lack of social acceptance. CRST Team: It was courageous, but surely there must have been severe consequences of coming out? Dr. Dandekar: I remember the time when the "Human Library" initiative was introduced in Mumbai. I was interested in the concept and wanted to attend as an audience member, but when I told the organizers my story, they asked me to join the event as a human "book." It was a cathartic exercise, an opportunity to tell my life's experience to a group of strangers. Little did I know that the event would be extensively covered by the press. The media posted a picture of my partner and me on the second page of the Times of India. It was difficult to deal with being out in the public eye—my mother felt uncomfortable for months. After that however, there was no looking back. Many people chose to keep quiet and did not reach out. Later, we were also featured in a 20-second video for the Times of India. This time, in the month of June, which is celebrated as "Pride month" globally—a photo of me with my partner was printed everyday for a week on the front page of the Times of India. A lot of gay doctors from all across the country got in touch, and we found solidarity. However, the truth is that I am a part of a very small minority of people who are out and living life on their own terms. CRST Team: What propelled you to speak up despite the consequences? Dr. Dandekar: It was a combination of different things. A lot of it has to do with personality—how can I make my life exciting? How can I do something more? I have tried to challenge the status quo in all aspects of my life—whether it be conversations around homosexuality or the integration of technology in healthcare. Questioning the status quo has helped me accept my sexuality, and it has helped me not to succumb to societal pressures. If I can't do this, who will? I am privileged, hence it is my responsibility. I am an oncologist who is financially independent and can access several platforms. If I don't talk, someone who is at a far greater disadvantage will not be able to speak up. CRST Team: Your initiative, "Health Professionals for Queer Indians" played an instrumental role in removing the stigma of mental disorders formerly associated with queerness. What inspired you to collaborate with the Indian Psychiatric Society? Dr. Dandekar: The motivation behind this collaboration was personal. One of my colleagues, whom I knew from my Bachelor of Medicine, Bachelor of Surgery (MBBS) days, posted something homophobic on Facebook. I made a polite comment questioning the post. He launched a scathing homophobic attack on me—he called homosexuality "abnormal," and vowed to keep his children away from gay people. I was very upset and held a grudge against him for a long time. However, he was a nice guy. He was the same person who had previously performed an important medical procedure on me. What would make an accomplished and educated person like that say such awful things about queer people? I realized this was because he did not know any better. I started the initiative called "Health Professionals for Queer Indians" with an aim to sensitize healthcare professionals regarding homosexuality. I met Dr. Kersi Chavda during one of our collaborations with the Indian Psychiatric Society. In 2018, when a case regarding Article 377 (which criminalized homosexuality) was being heard by the Supreme Court, we managed to get a letter from the Indian Psychiatric Society—clearly stating that homosexuality was not a mental illness and should be decriminalized. The letter was quoted by three Supreme Court judges. We were ecstatic when Section 377 was scrapped, but we knew there was more to be done. It felt a bit like, "Too little, too late." CRST Team: Queer activism is often associated with the young. How was your initiative "Seenagers GupShup Group" received by the community? Dr. Dandekar: My friend, Ashok, has been a queer activist all his life. He would complain that he was bored and did not know whom to speak to about his life and experiences. There are very few spaces for elderly queers to find community all over the world. There are a couple of such organizations in the USA, and a new one was started by Ian McKellen in the UK. The whole focus of the queer movement in India had been on scrapping article 377— our concern was, "What happens after?" There are so many people from the community who need aid and safe spaces. Hence, we started "Seenagers," a group for elderly gay people—a lot of whom are married and divorced as well—to find each other and share their experiences, essentially to find companionship. CRST Team: Have you had any memorable experiences with your patients? Dr. Dandekar: Oh it's been lovely! In my office, I have a rainbow-colored mug that says, "Love is love." Every time I place my pen in the mug, people notice the mug. Moreover, many people search for information about me online even before they come to see me. In the heterosexual world, these gestures are taken for granted. We, on the other hand, have to put out such markers to show our solidarity. I have had patients and relatives of patients come out to me. These acknowledgments can be reassuring. At my current organization, doctors from all over the world arrived to set up a new tertiary care center. The first question anyone would ask me would be, "What does your wife do?" This would be followed by pity and disdain, upon learning that I was single, despite my age. I had had enough of this and one day, I decided to take my partner along with me to a work party as my "plus one." I introduced Shripad as my partner without hesitation. Some people did not understand what I meant, some were surprised, and some were shocked. There was a sweet lady who did not get it—I had to patiently explain to her what I meant when I called Shripad my "partner." Toward the end, I was tiredly joking with my colleagues, saying to them that by now I had introduced my partner to everyone, and only the big boss was left. As if on cue, the big boss walked into the party. Without batting an eyelid, I introduced Shripad as my partner to her—that was a defining moment for me and changed the dynamics at the hospital for the better. Despite the sunny days, I have had successful gay doctors tell me that they did not want to be seen with me as it would suggest that there was something "wrong" with them. I have accepted that everyone has their own journey and I am a mere bystander. CRST Team: How has your sexuality affected your life? Dr. Dandekar: The LGBTQ community remains ostracized at large. We do not have the option to legally marry—which eliminates the possibility of owning a house together, living wills, and so much more. Adoption via surrogacy is an option that leads to several dead ends. It is difficult to imagine sending your child to a school where no one is ready to accept the possibility of two dads. We are at a disadvantage socially, as well as in policy. This can cause severe trauma to elderly queer individuals who do not have a support system. I have met religious queer individuals who suffer from serious mental health conundrums as the lack of religious acceptance affects their relationship with God— which is a primary relationship for so many people. Things seem to be changing now—there are several new organizations and initiatives that are working on different aspects of queer life. I continue to hope. CRST Team: Any word of advice for the medical community? Dr. Dandekar: We, as doctors, think that we know everything—but not having the skills and experience of dealing with queer people and still being confident can be limiting. I have spoken to parents of young doctors who had been referred to me for counseling and their first question would be, "This is not okay – how do we change them?" This is quite sad. I hope this stigma goes away with time. Previously, I was torn by so much conflict. Am I valid or invalid? Am I normal or abnormal? Am I a criminal or not? For religious people, the question is - am I going to hell? This confusion can cause severe mental health issues. Working on my resilience has helped me move past these fears. I believe that the medical community should try to stop presuming things. Not everyone who walks into your clinic is heterosexual or cisgendered. If you remember this—you will be curious to ask more and might provide a more holistic treatment to them. Nothing matters more than kindness—even if you disagree with someone, you must be kind to them. We must embrace the joy of giving—even one good conversation despite a long day at work can make us feel fulfilled. Financial support and sponsorship Nil. Conflicts of interest Gargi Mhatre and Richa Das are members of the editorial board of Cancer Research, Statistics and Treatment. As such, they may have had access to information and/or participated in decisions that could be perceived as influencing the publication of this manuscript. However, they had recused themselves from the peer review, editorial, and decision-making process for this manuscript, to ensure that the content is objective and unbiased.