Sunday, December 18, 2011

the Lion, the Old Man and the MAGIC BULLET



A 75 year partially deaf old man with COPD (a respiratory disease) kept on insisting  that I prescribe the particular dissoluble powder that when drunk (mixed with water) used to relieve his breathing problems. I scanned his documents...found nothing fruitful. To be frank I was ignorant of such a powder! So at last I asked him to bring the magic powder.


After an hour he reaches my room. He gave me a wrapped up sachet.
I haven't unwrapped Snickers with such haste...

The magic drug was nothing else but O.R.S.

It took five minutes explaining to him what O.R.S was. Felt bad, most of his older prescription had orders for O.R.S. The patient denied of suffering diarrhoea (yeah yeah Everybody Lies!).

He left. Sigh! I had shattered his belief, the placebo wouldn't work any more. The disappointment that shadowed his face when he learnt that the magic drug was only meant for dehydration...was...frankly (yeah yeah slap me)...funny!

(Now before I'm branded 'SADIST', I leave...)

update: Officially a Doctor (I prefer the Half Doc.status) at last. Currently doing the 'compelled' rural service at Primary Health Center at PERUMON, Kollam, Kerala.

Saturday, October 22, 2011

The Lancet Article: Erudite Conclave 2011


Erudite Conclave 2011: Featured in The Lancet


Check out The Lancet Student page featuring the mega event: Go to Lancet

Sunday, July 10, 2011

Dr.


Where exactly did you hear the heart sounds?

With a rather exuberant gush of confidence, my index finger pointed to somewhere a few centimeters away from the mother’s umbilicus.

Impressive, but I’m afraid the USG revealed a dead foetus hours ago.

I saw no point in blaming my Littman anymore. I walked out of the ward.

Beep beep…beep beep….

Wake up Joe. It’s your phone.

9:13pm. So I’d really dozed off. Again.

I had never performed a venous cut down before. Her burnt body evoked a terrible sense of sympathy in me. I hesitated to make the first incision.

Don’t worry Joe, with 60% burns she won’t survive anyway. You’ve got too many lives to save.

I normally respect the words of a Post Graduate. But I still wonder what forced me to remove the gloves and walk away.

Beep beep…beep beep…

Where I stood now was filled with a cacophony, and it did not smell too good, either.

Now that’s for her own good brother. If you don’t do it now she’ll lose her leg soon.

So that’s it. The lady’s wails didn’t deter me from cutting her flesh off. The barbarian in me carried on his work till he saw fresh blood. There was little slough left to be chopped off.

Beep beep…beep beep…

Am I supposed to wait till the flow stops?

The PG stared at me, nonplussed.

Now CSF is what is being siphoned out and you ask me this?

Oh! I’d gotten carried away.

Yeah, you should be. The nursing student is a charming view.

A violent tremor.

Slept off again Sir? It’ll take another fifteen minutes, I suppose.

This whole journey must have shed a few kilos of mine. This ambulance should be older than me. I glanced back. The young lady was comfortable with her head resting on her husband’s lap.

Poor thing, I hope it’s not an ectopic. I hardly attempted to console the couple. Not because I was iron hearted. The couple spoke the kind of Hindi that our driver, an experienced authority, couldn’t decipher.

Finally we reached a tertiary care setup. We rushed to the Department of Radiodiagnosis.

Dark room. Radiologist.Nurse. The Hindi patient. Young doctor.


Except for the physical presence, I knew little about the intricacies of ultrasound imaging.

Okay. Radiologist- "Where's the condom?"

Err...I return her nothing but a startled look. She extends her hands to the nurse. The nurse searches the table and hands her something.

Ahem.

She turns to me. My expression should have carried her to any of the viva voce sessions she passed through as an undergraduate.

"Well I need a trans vaginal ultrasound for her. Hmmm do you prefer to share this room or..."

I could hardly give her time to complete. I rushed out of the room; out of the scan center.

Crossed the road.

Bought a bottle of mineral water.

Finished it. Waited (along with the husband) for the scanning process to be over.
--------------------------------------------------------------------------------------------------
“At last, here we are”, driver broke the silence.

“Joe, wake up. Here, wear your specs and ehh wipe you face”

Yawns. Stretches.

The couple stepped out of the car. A huge banner welcomed them all.

‘DOS ENSEMBLE’

Now what does that mean any way?

The Alumni meet kick started in an hour.

(CSF: Cerebro Spinal Fluid. Often tapped for diagnostic studies)


(Contains part of a previous post

Dark room, Radiologist and Condom)


Tuesday, July 5, 2011

Dogs, Cats and Docs

video

One of the things that I hate about the Medical College wards is the uncontrolled feline invasion. I wouldn't like to spoil this post by adding an overdose of words.



These shots come from where you get 'anti-rabies' shots :) Now gah shoot me for the sarcasm.

Dogs in the title refer to the myriad of dogs found in the campus. Oof...now I should stop here, too much of irony.


Sunday, June 26, 2011

An Adjustment Hypersensitivity Disorder



'Skin Posting'

Day 1
I: Hey I've got this medicine unit treat today, can you cover for an hour or so?
She: No.

Day 3
7.30 am
I: Hey, I can hardly breath, severe asthma...and to make it worse sinusitis has struck me like never before. I'll take my only permitted leave today.
She: Okay

1:15 pm
She: I've got this unit treat today. Can you cover the duty for me?
I (finding it hard to breath): Fine *nothing to say*

Day4
8.05 am
She: Now that I took your duty yesterday, you'll take mine today right?
I (poor health, wheezing): Okay

Noon
I: I can hardly breath. Need my inhalers. I think I'll cover your pending duty some other day?
She: Yeah okay

After fifteen minutes
I reach home. Phone rings

She: I need to go home. Can't take up duty today

I (frustrated, angry, desperate): FINE

Day 5 (Sunday)

I: Got some works today. Could we exchange duties today?
She: No. I plan to leave as soon as possible.

Day 6
Gets an sms: Won't be coming today. Fever, headache, vomiting



Saturday, June 25, 2011

Quietus


I just saw the catastrophe that would take away my life;
Was that here where I would lie gasping for breath?
The night was too dark for me to locate.
Now that I have seen it all,
Is that a wish or a fear,
That I wouldn't last to wake up at the crack of dawn?

Tuesday, April 19, 2011

Doctor's 'IN' :The Vithura Chapter (mal title: Ningalenney Doctor Aakki)


"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all," said Osler.

Patients are interesting books to read and in that sense I read a lot these days. What follows are some of the conversations that hit my ear drums during my stay at Primary Health Centre, Pangappara and Community Health Centre, Vithura.

1)"Pani ennalle paranjathu, athinu moothrama parishodhikendey?"
(I said Fever and you want my urine tested?)

2) A 24hr duty is usually awesome, but on this rather terrific day I received an emergency call from the duty nurse.
I rushed, but this is what the patient had for me:
"Marumole kaanan vendi vannatha. Ithinadutha avalde veedu. Ivide doctor undennu kettappo onnu kandittu povannu vachu."
(I was here to visit my daughter-in-law who stays near by. Someone said the doctor is available, thought of checking out)

3) Even the moon was yawning at 2.45am when my colleague who was sound asleep in his duty room heard his door being knocked. He rises, searches for the stethoscope, opens the door.

"Staff nursa Doctorjee, urakkam varanilla. Enthenkilum kazikkano?"
(I'm a staff nurse Doctorjee, I'm not feeling sleepy)

4) "Nalla gasinte shalyama Doctor. Njan purathottu oothy vare nokki, ennittum aaswasam kittanilla"
("Severe gas trouble Doctor. I even tried blowing out air, there's no relief.)

5) Patient:"Wheezing's there Doc, nebulisation will do.
Gas trouble, antacid will do.
A slight fever, paracetamol will do.
Tiredness, vitamin tablet will do."
I : Anything else sir? Coffee?

6) My colleague notices an empty 500ml Pepsi bottle with the patient, "Enthina amme ee kuppi?" (What is this bottle for?). The old lady replies, "Oh kazinja thavana thanna chumakkulla marunnu thikanjathe illla mone. Athondu ithavana immini balya kuppeel thanna mathy". (Translation won't work here!!!)

7) A pretty young female patient walks into my colleague's OP and complaints, "Severe headache after I talked over phone continuously for 12 hours. Is something wrong?"

8) Patients and patience are what a doctor needs. I was having my dinner and I get a call from the emergency room. I run to the casualty room and finds the patient.

I : Yes?
Patient: Cold and running nose.
I : Since?
Patient: Yesterday
I : Now that's supposed to be an emergency?
Patient: Err...isn't it?

I could do nothing else but blast her off.

Here's one of the commonest replies that you get while enquiring for drug history:
I: Enthu marunna amme blood pressurinu kazikunne? (What medication do you have for Hypertension?)
Patient: Oh. Athoru chuvanna vattathilulla cheriya gulikaya mone (Oh. It's a tiny red round tablet)

...

‎"The simultaneous occurrence of scabies in a doctor and a nurse may mean that they have shared nothing more exciting than a patient with Norwegian scabies."

Friday, February 11, 2011

Labour Room: by a BABYatrician ;)



Hero's having a wonderful time in the Labour Room these days.
The cartoon was made by our neonatologist Madhav chettan ;)
We just thought of changing the terminology of paediatrician to BABYATRICIAN by the way ;)

Thursday, January 13, 2011

Evincere is 3 years Young !




The beauty of life rests in very tiny things. To gift a smile is one divine deed. I am still amazed by the fact that the source of the very first smile for this day was a total stranger. I woke up to find this blogger 'Teena in Toronto' wishing my blog a happy anniversary.

"Wow...cool," I said to myself. 3 long years have not enriched my vocabulary to the extent of letting me aptly describe the essence of the very feel that drove in.

This blog, to be frank, is everything to me.

It would be a sin to fill this precious space on this precious day with what may be described as a mundane write up. Blogadda had already given me chance to spill out all the ethics of blogging that I cherished in my soul.

Let me not lengthen this write up further. Few official announcements, for those who have been out of touch for a while.

I now call myself a 'Half Doc'. Job's half done. An year of internship is left.

I now earn by myself...! My dream of recharging my mobile balance all by myself is a reality.

As anyone close to me knows, 'a Song, a Stethoscope and a Book' defined my dreams.

My experiments with writing aided me in turning into a whole new page in life,


I started writing for Medindia, a leading online Medical Portal, months back,


and turned out to be lucky enough to be upgraded
to the post of a content editor.

Life has finally turned out to be hectic once again; responsibilities walked in.

The life within the white coat is just great...! Thanks to Amma for having made the right decision for me.

The magic that this blog weaved in me is beyond words...

I'm yet to decide the sex of this blog. At times it's a 'he', at other times it's a 'she'.


Whatever it is, he/she has played his/her part in making me what I am.

Another name worth a mention is Dollz, one of the greatest inspirations.

Billions of blasting B'day wishes to my lovely evincere... ;)

I don't remember a similar dedication before !!! This is the first it seems...
oops both of us have started to age :)


Keep in touch :)




















Wednesday, January 12, 2011

Dark room, Radiologist and Condom



Introduction:

Accompanying a patient for his/her imaging is a double edged sword. At times it gifts you a comfortable alibi when your 'co-interns' are drenched in sweat during an admission day in the emergency room (better known as the casualty), at other times you sweat yourselves out in the process of accompaniment.

If this sounded like a weird medical jargon. Here's the whole concept. It's been ages since one of the prime lifts in our prestigious hospital withered out. That means, any patient irrespective of the fatal potential of his medical ailment will have to wait for an ambulance (read that as minutes to hours), suffer whatever damage a busy traffic and 'typical Keralite roads' can offer and finally reach the imaging center.

A doctor (preferably loquacious)will have to accompany the patient during the process. Provided the patient is rather stable, the job works fine. Except for the miserable journey in the ambulance the whole trip is refreshing (from personal experience) since once the destination is reached, he can spend time in air-conditioned cabins provided by the Department of Radio diagnosis till the imaging process gets completed (However a collapsing patient is a source of palpitation for the doctor himself).

(Technically this introduction has little to do with the rest of this page. Don't ask me why I put it here)

What happened:

Internship or House surgeonsy is where a half-doctor begins his quest to completion. My pursuit (this has nothing to do with the EternalRemanan!) began months back. Two months with Surgeons gave me sufficient matter to fill my time line. I thought that was it, but no. The department of Obs & Gynec has started to add more fun.

Scene: A female patient suspected to have ectopic pregnancy (in plain English: pregnancy anywhere else but not in the uterus).
Condition of the patient: Stable
Requirement: Ultrasound scan-Abdomen
Complication: She speaks the kind of Hindi that even noted 'Hindi speaking Malayali PostGraduates' find hard to comprehend.
Environment: Rainy

The ambulance is unavailable. So young doctor stuffs himself in an auto-rickshaw, along with the lady, her 'Nepali' husband. Reaches the scan center. Meets the radiologist, a rather obese lady (doesn't mean that the young doctor was dead ringer for Dard-E-Disco lead).

Dark room. Radiologist. Sisterji. The Hindi patient. Young doctor.

Except for the physical presence, the young doctor knows little about the intricacies of ultrasound imaging.

Okay. Radiologist- "Where's the condom?"

Err...I return her nothing but a startled look. She extends her hands to the sisterji. Sisterji searches the table and hands her something.

Ahem.


She turns to me. My expression should have carried her to any of the viva voce sessions she passed through as an undergraduate. (Read that as 'blank look', Malayalis may read that as 'blinkasya')

"Well I need a trans vaginal ultrasound for her. Hmmm do you prefer to share this room or..."

I could hardly give her time to complete. I rushed out of the room. Walked out of the scan center. Crossed the road. Bought a bottle of mineral water. Finished it. Waited (along with the husband) for the scanning process to be over.

Journey back-uneventful.

Lessons to carry: Ignorance is bliss. A trans-vaginal ultrasound scan uses a probe covered with a condom and a gel.





Thursday, January 6, 2011

the Eternal Remanan



The very ecstasy that elevated me to pinnacles of happiness finally pulled me into a black hole that erased three long months from my time line.

My other self finally decided to bid bye. The fairy tale that I scripted preferred not to conclude with a ‘thus they lived happily ever after’. It was the best of times, in the beginning, and then walked in the worst of the times and I guess still better times have already set out to meet me in the midst of another fairy tale in some other world.

Some say this is it, some say this is just the beginning. Well, the truth is, it’s always like this. Life’s one big joke, laugh at it or someone else will. Now that I’ve filled the space with lots of perplexity mixed with the schizophrenic school of thoughts (now stop guessing what it is…I don’t know)

This is the beginning of the adorable aftermath. The most unexpected twists will be unleashed. A trillion neurons will begin to fire…as the Eternal Remanan begins his cruise.


"Every end, is a beginning"-Eternal Remanan


(Alternate titles: Tempest in a teapot or Storm in a teacup)

Courtesy: Pic-adapted fromDon Quixote by Denis Ziber