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Sunday, March 30, 2014

End of the on-call week ... a small collection of memories for the last week.

Yes, the on-call week is coming to an end within the next 12 hours as I write this. Over the week, I hardly had any emergencies, so light was the work. Partly, this was due to the school holidays that are currently on, and which will get over today. Partly, it may be due to the spring season that seems to be prevailing all over the Kingdom. Winter ended a few weeks ago, and the terrible heat of summer is yet to arrive. As a result, respiratory illnesses are at a minimum, as are serious cases of diarrhoea, high fever or other problems. Lastly, partly, it may be due to the increasing efficiency of our resident doctors, who are now able to deal with most of the common ailments that the local children are brought to the E R with. 

On Saturday morning, I went out for breakfast: a delicious paya and roti affair in a local Pakistani restaurant. The roti was the huge Pashtu roti, and I was barely able to eat half of it. Even so, my stomach got bloated! I skipped lunch as a consequence. At tea-time, I had time to prepare a pizza from a ready-made pizza package; unfortunately, I did not know how much heat to give it through my micro-wave and it got burnt. At the same time, the taste of this ready-made pizza wasn't so bad!Never mind ... as they say, it can only get better from the next time. 

On Saturday, I also went to visit a new garden that the Al Muwayh municipality has been building since over six months on the highway on the side opposite to the side of the village. The access of this garden is not yet finalised, so that people who are travelling from Taif to Riyadh will have to wait for some time before they can drive off the highway and relax in the garden and in the many shelters that the workers are making over there. Part of the garden has been already prepared, and the grass, all natural, is verdant there, already inviting many feathered guests! The rest of the place is not yet ready, but will be, I was told by one of the workers, in the next few months. 

On Thursday night, I played tennis with Dr. Essam Gheith: he has purchased a complete set of two racquets and a ball; this was the second such instance, actually, as we had played for a short while a couple of weeks ago. This time, however, it was better for me, as I got into the swing of things. For the net, we used a hanging rope tied across two light poles. It was not as bad as it seems to be, and we volleyed for about half an hour or so, with a few breaks in between for others to play and for chai. 

On Saturday afternoon, I lost my satellite TV signals, and it was late on the same day that I could get hold of a mechanic who agreed to come and right the problem. It was not that I was missing much, but I am kind of restless when things I should be able to control don't seem to respond to my "orders". Hence, I rested only after the problem was corrected - the dish on the terrace needed some adjustment, that's all. 

Anything else? No, not really. Awaiting your comments and feedback on this rather inane entry ... but it does reveal some stuff that I care about or that I wish to share with my readers from all over the world.


Saturday, March 29, 2014

Journey into the past: the medical college years: Dr. Indira Shetty

One of my friends and colleague, Dr. Indira Shetty, who lives near Bengaluru, India, has recently posted a brief account of her journey through medical studies at the Seth G.S. Medical College and K.E.M. hospital. As I was all along with her in the same batch, and we are in touch, she was kind enough to forward her write-up to me and has given me permission to reproduce this in my blog. The article written by her is, in her own words, "straight from the heart" and I must say she has well described everything from the basics to the feelings we all had. Being also a paediatrician like me, her journey has quite a lot in common with mine, though there are some differences (of course).
Here goes:

My Journey in the Field of Medicine

-        Dr. Indira Shetty, M.D. Paed. (Mumbai)

It was a languid afternoon, as I sat discussing cases with my paediatric colleagues at Srinivas Medical College, when two 4th year MBBS students trooped in requesting us to contribute an article for the college magazine.

Writing was indeed my passion but sadly over the years I had been wielding my pen only to write prescriptions. But now seeing these two bright young faces I felt inspired all over again.

So on the job, I got busy thinking of a suitable topic and I decided to pen down my journey in the field of medicine. Very recently my daughter crossed a major hurdle i.e. the 12th Board exams and around that time, like all adolescents she was at career crossroads. Her basic instinct drew her to the field of medicine, but the fierce competition made us sit up, do a reality check and explore all possible career alternatives. More the choice worse the dilemma. It was during this soul searching exercise I realized what taking up a career in medicine meant, how important it was for a student to have real aptitude for it; because becoming a doctor is a lifelong commitment and not a one night stand. Sadly quite often some children get pushed into medical college by status conscious parents to up their market value and this can spell disaster both for the individual and the society at large. During my college days the choices were limited. The human body fascinated me and I found the world of commerce humdrum. I was lucky indeed to get into the prestigious G.S. Medical College Mumbai and this is from where my journey starts.

My earliest memories of 1st MBBS are of the heavy text books, Guyton’s Physiology and Grey’s anatomy which altered as dumbbells and helped develop our biceps. I can still smell the formalin which would assail our nostrils in the anatomy lab, but soon some of us got so comfortable that we literally ate our lunch box sitting next to the corpses, especially a day before the exams. So engrossed we would be in deciphering the deadly details that we hardly realized that lying before us were once flesh and blood humans, now lying stripped and ripped so that we could dig into their vitals and learn anatomy in all its gory details. Little did we then realize that if not for those unclaimed bodies we would not have such insight about body details. Today looking back I whisper a silent prayer to all these anonymous humans who died unsung but played a stellar role in educating us.

Passing 1st MBBS was a hurdle indeed, our college set us very high standards. Despite the tough exams most of us secured the necessary grades and we marched into the 2nd MBBS. At last we got to see some real patients and we felt like doctors in the making.

Our O.P.Ds at K.E.M. Hospital, Mumbai were always teeming with patients and our wards were chocoblock with inpatients, some lying under the cots and some admitted in the corridors. And amidst all this chaos we had our grand rounds. Those rounds were grand indeed because back then we had some real stalwarts in the field of medicine who were our knowledge banks. Their rich clinical experience and acumen gathered over years of seeing patients was what no textbook could ever offer us. On the rounds we students were at the bottom of the hierarchy and above us were the interns, postgraduate resident, assistant, associate and the H.O.D. The resident doctor presenting the case would literally get vivisected by his seniors, and we students would be all ears, trying to understand the nuances of the art of medicine, how from history taking and signs and symptoms you zero down to possible differential diagnosis. A few doctors did have the virtues of Sherlock Homes, but majority were like Dr. Watson. Thanks to our teachers who made the art of medicine so fascinating. Today looking back I pay a silent tribute to those Guruji’s who felt duty bound to part with their knowledge (sad to say their tribe is fast disappearing now) and those crowded wards were our temples of learning. 

But having said that, teachers were responsible for only half our education, and the other half was contributed by the helpless under privileged patient lying on the free municipal hospital bed, who got poked, probed and palpated by numerous trainee doctors. I still remember how some patients with interesting signs and symptoms were simply not discharged on some pretext or other. Little did we realize that they too had a life back home. Tell me readers who amongst us would submit oneself to such humiliation of being exposed and palpated. I hope today’s students realize this and treat these patients with all dignity due to them. Very recently I had the sordid experience of interacting with a poor patient admitted in a well-known medical college in our city. Despite her poverty she was charged a hefty bill due to failure on her part to produce certain documents at the right time. I was wondering at the lackadaisical attitude of the social work department which is supposed to guide patients in such cases. Also the high handed manner of the doctors treating the poor patient was appalling! Wake up, dear colleagues after all it is these very patient who fill up our medical college hospital beds, so that we get the M.C.I. recognition.

Today of course the education scenario is fast changing. Especially abroad, dummy patients and virtual bodies have replaced real patients for teaching purpose. Very recently I read about a virtual liver which will replace real patient drug trials. But looking back I am eternally grateful to all those underprivileged patients who contributed to my medical skills.

Before we realized, we were out of 3rd MBBS. I was lucky to get my choice P.G. seat in pediatrics and a whole new world opened up before me. Babies you know are known to gurgle, giggle and throw a tantrum. To diagnose their ailment was a guessing game. Even to this day an infant with excessive cry baffles me. But tell you guys I have never repented taking up pediatrics. It sets your age at eighteen and you live evergreen.

Despite my years of training and M.D. degree, when I started my private practice I realized how inadequate my knowledge was. I soon realized that what makes a proper doctor is not textbook knowledge, but experience gained over years of practice. The smile on the face of the babies and the relief on the face of their parents was my report card, I passed some, I failed some and to my joy I excelled some.

Education never ceases and each day you learn something new. And then comes a phase in your life when you graduate from, being a mere physician to becoming a true healer. This is the defining moment in a doctor’s life and the experience can be very humbling. Something lights up inside you and you find that God Spark within you which connects you with your patient . I have landed myself in situations wherein a distraught mother hands over her ailing child in my arms. Her pleading eyes say that she has faith in me. I may not be adequately equipped to handle her baby, but this is where the God Spark comes to my rescue, it gives me immense courage and unknown strength, and when things turnout good, and the child heals, the joy is priceless. The smile on the baby’s face, gratitude written all over the mother’s face and the happiness you experience no Master Card can ever buy. You feel blessed. 

No doubt, medical profession comes with its share of professional hazards; the odd hour calls, the nightmarish medico-legal pitfalls; but bouquets like these that life throws your way make the brickbats seem like a small price to pay. 
Learning never ends, it’s a lifelong process and so my journey too will go on; but this article has to end. Before I pen off I would like to thank the two students who made me write this article. It helped me rediscover myself.

Thursday, March 27, 2014

An on-call week: The usual grind

The week that is ongoing is an on-call week for me; this means that while I do not have to see routine O.P.D. patients, I am to respond to all emergency calls, and look after all the new admissions, whether from the O.P.D. or the Emergency room, PLUS I have to manage any and every baby that is born this week in the hospital.
The week runs from Sunday morning until the evening of the following Saturday. As I write this on the night of Wednesday, I have three whole days of on-call still in balance.
On Monday, I was alone, since my partner was on a day's leave to visit the Muderiya in Taif. It seems that he has paper work to finish before his scheduled exit in the next couple of months.
I am currently watching a new TV series by the name "ATLANTIS". It is mythological, but I have watched the first few episodes, and they were world-class! At the same time, my romance with "Breaking BAd" (Season 5) continues. It is perhaps one of the best-made TV serials I have ever watched anywhere.
I made a few new food items in the last four days. They include upma for breakfast and full-masoor ki black dal. Hoping to enjoy the dal. The upma was excellent.
That's it for now ... keep returning to read more blog entries.