It is A THANKLESS JOB sometimes

A certain experience has made me go off my normal track. Bear with me. Its been10 days since I joined my hospital in Bangalore. Surgery is the dept where you will get the most disgusting aspect off medical life, none more so than a diabetic ulcer. Gangrenous dead tissue, bad smelling pus that causes you to gag, rotting tissue, which are infested with maggots and make even the toughest of people throw up. Along with other wards this ward was part of my duty roster. I made it a point to talk with the attenders of the patients as the have the toughest time there. One particular boy is making me write this. 12 years old and taken the adult responsibility of looking after his grandfather who has one leg already cut off because of the disease.

It seems cruel but the fact is many people hide or escape taking care of diabetic patients even if they are family. This little chap though does not shirk his duty. The tenderness with which he takes care of dada is absolutely heart-warming. He does not hesitate to help change the dressing, he cleans the old mans urine if his bladder fails, he gives him a sponge bath daily and does not for a single moment tell that he rather have fun in his holidays (its summer holidays in school people). And to this gem off a boy I have to explain that we have to cut of the other foot.

Sometimes it is a thankless job being a doctor. I could feel my stomach turning when he tries to hide his tears, keep a brave and asks, “ pair katne ke badh acha honge kya”. patting his was all I could do as I thought of all the complications of the procedure flooded my head. It is not easy to tell a 12 year old the chances are too slim. It was the worse when I spoke the truth and saw the tears he tried to hide so bravely materialise. IT IS A THANKLESS JOB SOMETIMES

Mondays injection disaster

Ok so I said it would be Monday’s injection disaster but I waited till Thursday to put it up. Well I am a junior doc and busy is my schedule. Anyways another lovely day it was in the rural posting. A heavy breakfast (yeah we did get good breakfast in the village posting) got us started off for the week. Monday mornings are usually silent owing to most people getting cured on Sunday their free day. Some of our regulars, owing to the fact that they were jobless, preferred the quiet of Monday mornings to the rush of our Sundays.

So in walks our RHD patient. Nice 50-year-old man who is of the strong opinion that none of us new people know how to give injections. He voices that opinion pretty loudly too. And for our luck he needed fortnightly injections of penicillin. Looking forward to another sound scolding I load up the penicillin when one of my colleagues lets call him Dr.Do Little (he was the laziest guy I have seen) offers to give the injection. Never look a gift horse in the mouth I say and happily hand over the injection to him and walk away.

Dr Do puts attaches a new needle to the syringe. With grace swabs the patient, pokes the needle and is all ready to administer the drug. What Dr Do failed to do was attach the syringe to the needle tightly with the result that the not a drop of the drug enters the patient but instead serves to wet the bed he is sleeping on as the drug splashes out.

I snigger and wait for the patient to run of his mouth about these people who come to learn. “ Novu elle. Neva chanage koduthira.” (There was no pain. You give it well) was what the patient uttered. “Bull shit” was what I uttered. Now doctor Do little quickly balances the advantages of re giving the injection against just allowing things to be (meaning patient has missed one dose) and with typical doctors efficiency pulls the needle out and asks the patient to come after 15 days.

Like a dumb duck all I could say was QUACK QUACK. (Pun intended)…

Super sunday

Another Sunday. Day to laze, relax, clean up and all those stuff. Basically a day of no work. But common sense will tell you that its not the case for doctors. I mean patients can’t tell their hernias to just stay put cause it’s a Sunday. Its worse in the PHC (primary health care centre for those who still dint figure it out) cause the people who come are daily wage earners and cant afford to get their illness cured till it’s a holiday.

Sad state of health in this country aside this situation means we guys were kept pretty busy on Sundays. So in a cranky mood I enter the opd(you would be cranky too if u had to get up early Sunday morning). The patient was a worker from the building adjacent to my dorm. He complained of feeling too much HEAT in his body.????

Now this is a concept familiar to everyone except allopathic doctors. There is no literature anywhere about heat in body (its not fever so don’t confuse it). But every layman knows mango, curds chapattis cause your body to heat up (their in-depth knowledge bout heat and foods leave professors of thermodynamics and dieticians flummoxed). All is fine except the problem is there is not bloody treatment for it in our texts.

I mean no text reads chapter 420. “Heat due to foods is treated by miracle drug XYZ”. Hesitating to tell the patient that I don’t know the treatment for this (I remembered my first day and I swear to god id kill myself if he had suggested fair and lovely) I opened my mouth to talk when he did the thing patients here are such an expert at doing. He suggested the treatment. (These patients diagnose the disease and suggest the treatment, we are just there cause we can write the prescription. MBBS: Mr Big Bodied Stenographer is what we are).

Jokes aside his treatment for heat was TT injection. And he used logic for it. He said if you get Tetanus you become weak.. Heat makes us weak. TT can cure tetanus so he wanted TT for heat…. (my brain is still trying to process that logic but am pretty sure thats what he said). Gave him the TT (don’t look down on me for giving unnecessary injection, cause if had not he would have done something more unsafe like pushing ice up his behind to cool himself.). And continued my awesome Sunday. the joy of being a doc is unparalleled.

Ciao next to talk about Mondays injection disaster……..

The first day

We were posted in rural centre. Now the word rural is absolute, twelve hour power cuts, water directly from the bore well, supplies to be got from the city in bulk etc etc. I though, did not mind it, for I was one of those noble souls who gets satisfaction from serving the community. Well that was right up to the time social service blew up like a balloon in my face. It was my first day, neat apron, shoes polished, hair combed, dignity and professionalism oozing out of my every pore. My first patient was a lady who had spilt hot water on herself. Burns patients we classify them as. Skin assessed. My amazing experience (practically my first patient, but in theory I had a ton of experience having copied the answer on burns for three different exams.) tells me its no big thing. No treatment required. In the most serious voice I could acquire I inform the patient nothing was required. But rural mindset has it that if anything hot falls on the body a cream is a must (and for you city jackasses laughing I know most of you feel the same). Well I told them clearly (as clear as I can in local dialect of kannada) that its unnecessary at which point the husband of my patient remarks “avuru kaliavuru. Yenu gothiralla. Manege hogi fair and lovely hachana”(he is a person who is learning he does not know anything. Lets go home and put fair and lovely). Four and half years of medical training, hard work, millions of drugs learnt and all the clinical judgement replaced by fair and lovely. Boy did my ego get hurt… well that’s the start, to hear more about piles cured with tablets, a little TT injection for strength and rice reducing suture requirement keep logging in… ciao