Why I am starting to write — and what I hope it is useful for
Thirty years inside Odisha's public health system has given me a particular view of what works, what doesn't, and why. That view should be in the open.
For most of my career, my opinions stayed inside the system. They shaped what I said in OMSA meetings. They informed what I chose to fight for — and what I chose to let pass, because the time was not right or the argument was not yet strong enough. They stayed in hospital corridors and in conversations with colleagues who already knew what I knew.
I have been asked, with increasing frequency, why I am now writing publicly. This is the longer answer.
The short version: knowledge that is only useful inside an institution is, in the end, only useful to the institution. Thirty years inside Odisha’s public health system has given me a particular view of what works, what does not, and why. I am putting that view in the open, where it can be argued with, corrected, built upon.
The longer version requires admitting a few things.
I am a doctor, not a writer. My instinct, when I encounter a problem, is to diagnose it and treat it — not to describe it at length for a general audience. Writing is a different discipline. I am learning it slowly, and I am not naturally good at it.
I have a particular kind of credibility, and a particular kind of blind spot. Thirty years inside a system gives you detailed knowledge of its failures. It also gives you a vested interest in certain explanations over others. I will try to be honest about where I am likely to be wrong, and I welcome being corrected.
I am doing this near the end of my government service, not the beginning. Whatever I write will have to be worth writing with the time I have. This is a constraint, but it is also a clarifier. I am not building a platform. I am trying to be useful.
Some of what I write will be unpopular inside the institution that employed me for thirty years. I have tried, throughout my career, to be honest about what the public system does badly — in rooms where that honesty could be acted on. Writing it publicly is a different kind of honesty. I think it is time.
So that is the answer. I am writing because the questions I have been carrying for thirty years deserve to be in the open — where they can be tested, challenged, and, I hope, occasionally useful to someone making a decision that affects the people the system is supposed to serve.
Thank you for reading.