Good morning. The first story today is hard to read. A third-year MBBS student in Bhagalpur is dead, five of his seniors are named in an FIR, and his classmates are asking the question any of us would. Then a discharge summary that cost ₹1 lakh, a state about to make every doctor on its rolls prove themselves again, and the air outside your OPD window.
— DR. ADITYA SETH, EDITOR-IN-CHIEF
01 · THE LEAD
DOCTORS
An e-rickshaw driver brought him to his own college’s emergency. Nobody there recognised him.
Rupesh Soni was riding his scooty home from the JLNMCH Foundation Day function, a little after midnight on Friday, when a speeding car hit him near Tilkamanjhi Chowk in Bhagalpur. He was a third-year student there. The car carried postgraduates from the same college. He landed on the road with head and chest injuries. Police say the resident driving tried to leave, a Dial 112 patrol stopped him, a medical examination confirmed alcohol, and he is now in jail.
What his classmates say happened in between is why the campus has not settled since. They say the doctors in the car moved him to the side of the road, put a jacket over his face, and left. An e-rickshaw driver took him in to JLNMCH, where nobody realised he was one of their own until someone cleaned his face. His pulse was hard to feel and he was defibrillated before he stabilised. He died in Patna the same day.
WHY IT MATTERS
A jacket over the face hides the one thing an untrained bystander can still watch in a head injury: whether he is breathing. It belongs over the body, for warmth.
Hypoxia and hypotension before arrival add a second insult to a brain that has already taken one, so an open airway and pressure on bleeding buy more than speed does.
The other occupants were released on personal bond. The principal gave all five two days to answer a show-cause notice over what the college calls inhuman behaviour, and that clock runs out today.
02 · MEDICOLEGAL
Two scans disagreed about her bile duct. Nobody produced the blood test that would have settled it.
She was 32, a few months past a caesarean and still breastfeeding, when an ultrasound found a 20 mm stone in the gall bladder and a 7 mm stone at the top of the common bile duct. Clearing one does nothing for the other. The MRCP next day described something else: stones impacted in the cystic duct, pressing on the bile duct from outside.
The surgeon operated. Dense adhesions, pus around the liver and a gangrenous gall bladder turned a laparoscopic cholecystectomy into an open one, which is a judgment call rather than a complication. Three weeks later she was still in pain, and an ERCP elsewhere pulled out the stone left behind.
The Tumakuru commission awarded ₹10,50,000 with 8% interest. ₹1,00,000 of that was for the discharge summary alone, which recorded almost nothing a discharge summary should. The patient filed eighteen exhibits. The hospital filed one sworn statement and no documents at all. What the order never engages with is whether that abdomen justified leaving the duct for another day.
03 · POLICY
Bengal says its own register of 1.1 lakh doctors is wrong, and will check every name by hand.
A sample survey turned up fake practitioners, and the department’s next question was what else the list had got wrong. By its own account the register still carries doctors who have died, doctors who emigrated and took other citizenships, and doctors who stopped practising years ago. On paper, each one is a registered doctor in West Bengal.
Health minister Sharadwat Mukherjee calls the fix Know Your Doctor: identity, qualification, registration certificate and the degree behind it, re-verified in person at the State Medical Council, or by video for anyone elderly, remote, or settled abroad. Doctors who first registered in Odisha, Bihar, Assam or Jharkhand get traced back to the issuing council, which in 2026 still means putting an official on a train.
No number has been released for how many fakes that sample found. There is no notification yet and no start date, and the state is still waiting to hear from the National Medical Commission whether any law restricts the exercise. Existing registrations stay valid meanwhile.
04 · PUBLIC HEALTH
Your patient’s app says 1,009. The government’s board says 483. Both numbers are real.
Delhi’s official index touched 483 this morning with more than fifteen stations past 400, and GRAP Stage III has held across Delhi and NCR since 6 November. The capital is still not the worst air in the country. Five towns in Punjab and Haryana sit above it.
|
WORST AIR IN INDIA · LIVE RANKING
Monday 9 November 2026
Why the apps and the board disagree: the CPCB index runs 0 to 500 and stops there, so Delhi’s 483 is the top of the Indian ruler. The live rankings use a different scale with no ceiling, which is how one Delhi locality showed 2,552 at 2 am. Different ruler, same air.
CPCB bands: 0–50 good, 51–100 satisfactory, 101–200 moderate, 201–300 poor, 301–400 very poor, 401–500 severe.
Delhi figure: CPCB, 8.10 am, 9 Nov 2026. Top five: AQI.IN, same morning.
|
None of it changes what you tell the patient in front of you, since the index is built on PM2.5 either way. N95 outdoors rather than a surgical mask. Reliever inhaler checked and carried before the commute. Exercise indoors while Stage III holds. Delhi schools have gone hybrid up to Class 5.
AAP’s Saurabh Bharadwaj said on Monday that stations had been shut, new ones placed far away and water sprinkled on the machines, and that parts of Delhi crossed 3,000 overnight. Delhi minister Kapil Mishra called it a campaign against Diwali.
What did you think of today's email?
Built by doctors. Read by doctors.
Know a colleague who should be reading this? Forward this email to them.
Forwarded this issue? Subscribe free →