The world would have been a much better place to live if violence were not there; if there were no cruelty and people were caring for each other.
I see violence every day, and it’s not easy to find a trace of humanity over here. What people want is destruction of each other. I always have hated low class violent movies with lots of fights and injustice and assaults… but never in my life had I imagined that they could be this true. There is no peace, there are no smiles, what their faces shower is anger and revenge flooding from their minds, and sometimes there are tears and fear. There is blood, broken bones, bumps, lost organs caused by people who are members of the same species, humans. There are rapes and rapists, lies, frauds, fake care and showiness… I crave for goodness, I search for hope and I see darkness; I don’t feel convinced about my role in casualty of treating their wounds and helping the Medical officer in medico legal procedures……..
But some goodness is there, I see it when I see people bringing complete stranger accident victims for treatment, when some nurses really care for the patients. And I want to exaggerate that goodness. I wish I could get that goodness out of their brains and amplify it by several folds and then spread it to every human brain in the world like some infection resistant to hatred. I wish I could bring this horrid situation to an end and make a world where humans would act as humans. And I want to do it, no matter how impossible and strange it may sound… just trying to figure out how.
Tuesday, May 3, 2011
Saturday, April 30, 2011
A Causality of humanity
How nice it would have been if I were a robot….! I would have done my duty as per the order and would be satisfied… but robots don’t feel anything, so I wouldn’t be satisfied. But at least I wouldn’t be dissatisfied like what I feel; at least I wouldn’t feel incapable, sad or lacking something or like living in a nightmare…
But I do live in a nightmare… I’m in Causality department of my hospital, and it’s not less than a nightmare. I’m not new to the wounds, the fatal accidents, deadly dehydrations, bleeding, burns, bites, poisoning cases… but here I see the medico legal side of these things… and it’s as horrid as the fatalities themselves. Though my job is to try to keep the victims alive, I do hear the conversations of accompanying people, the police, the medical officers and the victims if they are in a state of talking.
I hear a drunkard father with a stab wound on his arm he says caused by his own son expensing all his money as military pension on prostitutes and drinks and gambling, and speaking of throwing his wife and son out of their house… and filing a case against them, and the son saying that the wound is caused by that man himself…
I hear different stories about a young woman drinking linden from her different relatives, and I hear people misleading police about the burns caused to a middle aged woman.
I see brothers with broken bones and many injuries trying to kill each others in fighting, and filing cases against each other for attempts of killing. I try to be a machine and try to help both parties to survive…
And I do feel proud of my hands when I suture the wounds… when I insert the RTs, it almost never injures the patient… but I feel incapable that alas, I can’t suture their minds, can’t help their minds to get rid of the poison of hatred for their own kins… I can’t even understand what in the universe is making them to behave like this? How people get time to make stories when someone from their home is dying?
And I keep on working, treating one patient after another, like a machine programmed to suture, to insert the branulas, the catheters, RT tubes… and keep on feeling flaccid, paralyzed, something like a loser. I must be totally mad to dream a happy altruistic world when the reality is exactly opposite. There must be something wrong in me, so that I keep on thinking that the situation can be changed… and a violence free world can exist with every heart ejecting love with every beat it beats. Either my concept of a human being is wrong or we’re living in a world of subhuman…
I try to find a solution that’ll at least start changing the situation… then I find the chain of my thoughts broken… the branulas in causality department are damaged, they just gel folded up when attempted to be inserted in the vein, I use the scalp vein set for superficial veins as an urgent measure to reduce the dehydration… there are soooo many things those need improvement… and by now, I’m completely sure about my madness in dreaming my dream world. But alas, this can’t stop me trying for making my dream a reality.
But I do live in a nightmare… I’m in Causality department of my hospital, and it’s not less than a nightmare. I’m not new to the wounds, the fatal accidents, deadly dehydrations, bleeding, burns, bites, poisoning cases… but here I see the medico legal side of these things… and it’s as horrid as the fatalities themselves. Though my job is to try to keep the victims alive, I do hear the conversations of accompanying people, the police, the medical officers and the victims if they are in a state of talking.
I hear a drunkard father with a stab wound on his arm he says caused by his own son expensing all his money as military pension on prostitutes and drinks and gambling, and speaking of throwing his wife and son out of their house… and filing a case against them, and the son saying that the wound is caused by that man himself…
I hear different stories about a young woman drinking linden from her different relatives, and I hear people misleading police about the burns caused to a middle aged woman.
I see brothers with broken bones and many injuries trying to kill each others in fighting, and filing cases against each other for attempts of killing. I try to be a machine and try to help both parties to survive…
And I do feel proud of my hands when I suture the wounds… when I insert the RTs, it almost never injures the patient… but I feel incapable that alas, I can’t suture their minds, can’t help their minds to get rid of the poison of hatred for their own kins… I can’t even understand what in the universe is making them to behave like this? How people get time to make stories when someone from their home is dying?
And I keep on working, treating one patient after another, like a machine programmed to suture, to insert the branulas, the catheters, RT tubes… and keep on feeling flaccid, paralyzed, something like a loser. I must be totally mad to dream a happy altruistic world when the reality is exactly opposite. There must be something wrong in me, so that I keep on thinking that the situation can be changed… and a violence free world can exist with every heart ejecting love with every beat it beats. Either my concept of a human being is wrong or we’re living in a world of subhuman…
I try to find a solution that’ll at least start changing the situation… then I find the chain of my thoughts broken… the branulas in causality department are damaged, they just gel folded up when attempted to be inserted in the vein, I use the scalp vein set for superficial veins as an urgent measure to reduce the dehydration… there are soooo many things those need improvement… and by now, I’m completely sure about my madness in dreaming my dream world. But alas, this can’t stop me trying for making my dream a reality.
Sunday, April 10, 2011
a fossil of memories
I’m in UHC, and it’s not busy… only few patients arrive there, that too with stereotypic complaints, nothing to stimulate thinking. Other doctors are there and they talk to each other about some topics that never attract me. I sit there tying my hands with my best friend- my loneliness; trying to draw my feelings on pieces of rough paper… examining patients occasionally and then giving medicines to them (the pharmacologist over here is on leave for unknown time).
When I feel dull the sensations of my dream world in which I live become blurred… I keep on trying to keep control over what I think but I lose it often. And I look at the calendar hanging over the front wall telling me how time flies… I was an extremely sincere student once upon a time, a matter of pride for my parents and teachers and a stimulus evoking jealousy in my fellow students. I always and always occupied the first bench, always was the first to get into our college bus and into our class, always was first to examine the slides first to do the dissection first to reach the patient and examine her… and was of the rarest varieties that used to read and then attend the classes hence I always answered questions of teachers. I happened to be the strongest girl in my class and had overtaken all boys from my batch in the fitness test in physiology, and no one could attempt ragging on me when it was so common when I was in first year. And when other girls were requesting boys to break the skull during dissection, I myself was using the hammer and chisel eagerly to see my most favorite organ, and when the brain was out I glanced that I was encircled by more than forty mystified students of my class and they were staring at me as if they were looking at some ghost or something.
I hated mugging up and reading the small readymade answer books… all I read were the big weighty reference books. I was never a topper but was surely in top ten, teachers expected me to write answers like those short answer books and sometimes I had to take the reference books to the teachers to tell them that what I’ve written is correct… I had written an article for our magazine explaining this situation and had won the best article prize for it. I remember of it when some nursing students those I don’t know ask me today, “Are you Namrata Shinde from 2005 batch? We have seen your photo and read your article Maathaache Manogat… We liked it a lot…” and I had shocked all those people who used to think of me as a book insect by winning first prize for Love letter writing. I really had enjoyed the rumors saying that I couldn’t be delicate enough to write something as tender as a love letter, and the prize winning letter was written for me by someone else. Next year I tried to combine science fiction and romance in the competition and got a queue of girls with tearful eyes at my room to congratulate me for my writing… that was the birth of my novel ‘I know you love’. On a professor’s request I had written a drama to express problems faced by young people for representing my college in a competition… my roommate was the only girl who had read it, and boys from my class congratulated me for it. But a big competition started amongst senior students for the lead roles and politician boys of my class took it from me and instead of my drama they played something else; I had no copy of it with me. I lost it for good… and recalled about it after four years when unexpectedly my roommate showed me a bus driver and said, “Look, this man looks like the loafer Raghu in your drama…” I was left in tears.
I have attended some clinical postings alone in my second year sometimes with a batch one year senior to me… I used to literally wander in the college and canteen searching for my colleagues who used to bunk them and beg to them to come to the postings when teachers refused to teach only to one or two students … I never attended parties, never went to watch movies, never attended trips, I didn’t even attend the gathering of my college… I was immersed in my efforts of collecting more and more knowledge… I’ve read Harrison’s medicine and Belly and love for surgery in my second year only… and had read most of the Kaplan’s psychiatry and tried my eyes on big Nelson of pediatrics. All I wanted to do was to become a scientist working on brain.
But things started changing and getting worse and worse… in third year there were almost no lectures and in postings rather than sincerity something else became important. Scoring in exam became a dirty game of politics. It wasn’t transparent… and I hated sordid means. I did have quarreled with one of the lecturers for whatever was going on there… no lectures, declaration of exam just one day prior to it without any explanation about the syllabus, copying… everything was like living in a hell. As there were no lectures, I had no chance to communicate with the teachers in proper. Then I had got shocked to see one of my most respected teachers smoking the public canteen in my college. It was hardest thing my life to accept this realty which was far far away from what is ideal.
And the jealousy I had evoked in some persons started affecting me. I was getting accused wrongly of using my power to bully other girls and of showing off my height and figure and what not by persons who never happened to interact with me and even those classmates to whom I used to always help didn’t stand by my side. I was alone and again got accused of having some kind of behavioral problems… and having some pitfalls in personality rendering me unable to what they called it “mix” with other girls.
It was a blow to my soul, it was improper. I was getting tensed because of it and then I developed some kind of inflammatory disease, was wrongly diagnosed with Rheumatoid arthritis, became a guinea pig for orthopedicians who fed me chloroquine, methotrexate, anti depressants and tons of pain killers as strong as opioids. I was surviving, trying to make as many efforts as I could to reach my dreams… but alas, no one here knew what a scientist is and what they did was either to ignore me, or to pity over me, to mock me or to try to explain to me, “you complete your MBBS then while preparing for your MD entrance examination do your PhD thing.” I contacted to some scientists who suggested me to have some experience with research and this was the hardest thing to do in my college. I still managed to do a project for which I had to contact a local gym, a local video recording company, and had to take lectures of first year students on neuroscience to make them ready to be volunteers for my research.
I became so weak that I fainted while standing to observe a surgery. My parents were shocked to see the changes in me and they attributed them to the toxic drugs I was consuming for that arthritis. I took the drugs for more than a year, developed some itching skin reaction and anemia after that when my mother took me to a big hospital for joints, I gave up the toxins as the doctors over there said that I had no arthritis… after some months I also became allergic to common pain killers like parecetamol. My score in exams dropped near to the boundary of passing in third year, and in final year exam I got that gynecology blow over my soul. The days after declaration of my final year results were the darkest days of my life; my parents who were used to boast for my achievements were terrified. “Your thoughts are nice, but they’re meaningless if you always become a loser because of them,” My mother said to me ten months later that incident.
I survived it though I was a bit depressed, and was unable to express myself in full, and was dumb, it was an extremely traumatizing experience… even the part of my novel I had written in those days is so negative that now I’ve to rewrite it. But I didn’t give up trying for my goal, and then tried to express myself by writing in nature network, and in my blog about my feelings. And I did meet an angel powerful enough to make smile even in that condition. He helped me a lot to get out of the situation. Then I got a chance to do a research project on learning and memory in another university, and I did pass the final year exam to become an intern…
Now I’m an intern in UHC, and its 12 o’clock in the afternoon… the OPD is going to get closed. The doctors surrounding me who were discussing amongst them have left. I’m still looking at that terrible time map called as the calendar. What you say- why have I written all this autobiographical matter? Remember what I’ve written in the second paragraph… “… I keep on trying to keep control over what I think but I lose it often.”
When I feel dull the sensations of my dream world in which I live become blurred… I keep on trying to keep control over what I think but I lose it often. And I look at the calendar hanging over the front wall telling me how time flies… I was an extremely sincere student once upon a time, a matter of pride for my parents and teachers and a stimulus evoking jealousy in my fellow students. I always and always occupied the first bench, always was the first to get into our college bus and into our class, always was first to examine the slides first to do the dissection first to reach the patient and examine her… and was of the rarest varieties that used to read and then attend the classes hence I always answered questions of teachers. I happened to be the strongest girl in my class and had overtaken all boys from my batch in the fitness test in physiology, and no one could attempt ragging on me when it was so common when I was in first year. And when other girls were requesting boys to break the skull during dissection, I myself was using the hammer and chisel eagerly to see my most favorite organ, and when the brain was out I glanced that I was encircled by more than forty mystified students of my class and they were staring at me as if they were looking at some ghost or something.
I hated mugging up and reading the small readymade answer books… all I read were the big weighty reference books. I was never a topper but was surely in top ten, teachers expected me to write answers like those short answer books and sometimes I had to take the reference books to the teachers to tell them that what I’ve written is correct… I had written an article for our magazine explaining this situation and had won the best article prize for it. I remember of it when some nursing students those I don’t know ask me today, “Are you Namrata Shinde from 2005 batch? We have seen your photo and read your article Maathaache Manogat… We liked it a lot…” and I had shocked all those people who used to think of me as a book insect by winning first prize for Love letter writing. I really had enjoyed the rumors saying that I couldn’t be delicate enough to write something as tender as a love letter, and the prize winning letter was written for me by someone else. Next year I tried to combine science fiction and romance in the competition and got a queue of girls with tearful eyes at my room to congratulate me for my writing… that was the birth of my novel ‘I know you love’. On a professor’s request I had written a drama to express problems faced by young people for representing my college in a competition… my roommate was the only girl who had read it, and boys from my class congratulated me for it. But a big competition started amongst senior students for the lead roles and politician boys of my class took it from me and instead of my drama they played something else; I had no copy of it with me. I lost it for good… and recalled about it after four years when unexpectedly my roommate showed me a bus driver and said, “Look, this man looks like the loafer Raghu in your drama…” I was left in tears.
I have attended some clinical postings alone in my second year sometimes with a batch one year senior to me… I used to literally wander in the college and canteen searching for my colleagues who used to bunk them and beg to them to come to the postings when teachers refused to teach only to one or two students … I never attended parties, never went to watch movies, never attended trips, I didn’t even attend the gathering of my college… I was immersed in my efforts of collecting more and more knowledge… I’ve read Harrison’s medicine and Belly and love for surgery in my second year only… and had read most of the Kaplan’s psychiatry and tried my eyes on big Nelson of pediatrics. All I wanted to do was to become a scientist working on brain.
But things started changing and getting worse and worse… in third year there were almost no lectures and in postings rather than sincerity something else became important. Scoring in exam became a dirty game of politics. It wasn’t transparent… and I hated sordid means. I did have quarreled with one of the lecturers for whatever was going on there… no lectures, declaration of exam just one day prior to it without any explanation about the syllabus, copying… everything was like living in a hell. As there were no lectures, I had no chance to communicate with the teachers in proper. Then I had got shocked to see one of my most respected teachers smoking the public canteen in my college. It was hardest thing my life to accept this realty which was far far away from what is ideal.
And the jealousy I had evoked in some persons started affecting me. I was getting accused wrongly of using my power to bully other girls and of showing off my height and figure and what not by persons who never happened to interact with me and even those classmates to whom I used to always help didn’t stand by my side. I was alone and again got accused of having some kind of behavioral problems… and having some pitfalls in personality rendering me unable to what they called it “mix” with other girls.
It was a blow to my soul, it was improper. I was getting tensed because of it and then I developed some kind of inflammatory disease, was wrongly diagnosed with Rheumatoid arthritis, became a guinea pig for orthopedicians who fed me chloroquine, methotrexate, anti depressants and tons of pain killers as strong as opioids. I was surviving, trying to make as many efforts as I could to reach my dreams… but alas, no one here knew what a scientist is and what they did was either to ignore me, or to pity over me, to mock me or to try to explain to me, “you complete your MBBS then while preparing for your MD entrance examination do your PhD thing.” I contacted to some scientists who suggested me to have some experience with research and this was the hardest thing to do in my college. I still managed to do a project for which I had to contact a local gym, a local video recording company, and had to take lectures of first year students on neuroscience to make them ready to be volunteers for my research.
I became so weak that I fainted while standing to observe a surgery. My parents were shocked to see the changes in me and they attributed them to the toxic drugs I was consuming for that arthritis. I took the drugs for more than a year, developed some itching skin reaction and anemia after that when my mother took me to a big hospital for joints, I gave up the toxins as the doctors over there said that I had no arthritis… after some months I also became allergic to common pain killers like parecetamol. My score in exams dropped near to the boundary of passing in third year, and in final year exam I got that gynecology blow over my soul. The days after declaration of my final year results were the darkest days of my life; my parents who were used to boast for my achievements were terrified. “Your thoughts are nice, but they’re meaningless if you always become a loser because of them,” My mother said to me ten months later that incident.
I survived it though I was a bit depressed, and was unable to express myself in full, and was dumb, it was an extremely traumatizing experience… even the part of my novel I had written in those days is so negative that now I’ve to rewrite it. But I didn’t give up trying for my goal, and then tried to express myself by writing in nature network, and in my blog about my feelings. And I did meet an angel powerful enough to make smile even in that condition. He helped me a lot to get out of the situation. Then I got a chance to do a research project on learning and memory in another university, and I did pass the final year exam to become an intern…
Now I’m an intern in UHC, and its 12 o’clock in the afternoon… the OPD is going to get closed. The doctors surrounding me who were discussing amongst them have left. I’m still looking at that terrible time map called as the calendar. What you say- why have I written all this autobiographical matter? Remember what I’ve written in the second paragraph… “… I keep on trying to keep control over what I think but I lose it often.”
Saturday, March 5, 2011
being a doc
Few days ago people in Walsang had seen a caricature wandering in their village for the first time. Now they know me as a doctor who works in PHC, and I get many smiles and salutes right from the moment I get down from the bus. The kids say, “Look a doctor is walking!” some brave ones come to me and ask, “are you a doctor,” and when I say yes, I see their eyes shining with pride. This’ the glory of this occupation, people learn to put their faith in your hands and they look to you as something special…
It might make you slightly grandiose when you find people waiting for you making queues and depending on you for their health and well being… it would be appropriate if I were some superhuman… but I’m not. I too am a human, and I too fall ill. Yesterday I was on the bus stop for more than two hours but couldn’t catch a bus thanks to my ill health and the crowd and Darwin’s ‘survival of the fittest’ ruling the already crowded buses. I couldn’t attend the morning OPD and I got a permission to come in the afternoon from the MO via my cell phone. And when I arrived here at around four pm I saw kids running into their homes after seeing me and then their mothers coming out and then they asked me, “Doctor where were you in the morning, we waited for you…”
I know being a doctor is not an easy thing to do… it’s a big responsibility. And it’s a thrill to make those people happy and satisfied with whatever resources you have with you. And it’s a big challenge to work in areas with scant facilities like these PHCs (and also something like my big hospital)! And it’s a lot of fun to play angel when you’re just a tiny human… and you get thousands of blessings every time the patients feel better after visiting you……
But to me, something is missing here…. I feel sorry, but this’ not the work that’ll give me complete satisfaction… I want more. I want to make each and every health center to have good health facilities like good medicines in sufficient quantity, good diagnostic tools, good surgical equipments, good transport facilities, and good care. I want every doctor to play angel and not robot. I don’t want this difference like rural and urban health facilities, and rural lying far behind the urban ones. I want every doctor to practice logically if not ideally. And I crave to make the treatments safer, I want every disorder to have cure. I want to make people really happy, even when I’m not there to treat each and every one of them. I want to become a scientist and want to work on brains of us… and also want to make improvement in the health condition of people in the world. Just figuring out what I shall do, and where I shall make a start to achieve it…
It might make you slightly grandiose when you find people waiting for you making queues and depending on you for their health and well being… it would be appropriate if I were some superhuman… but I’m not. I too am a human, and I too fall ill. Yesterday I was on the bus stop for more than two hours but couldn’t catch a bus thanks to my ill health and the crowd and Darwin’s ‘survival of the fittest’ ruling the already crowded buses. I couldn’t attend the morning OPD and I got a permission to come in the afternoon from the MO via my cell phone. And when I arrived here at around four pm I saw kids running into their homes after seeing me and then their mothers coming out and then they asked me, “Doctor where were you in the morning, we waited for you…”
I know being a doctor is not an easy thing to do… it’s a big responsibility. And it’s a thrill to make those people happy and satisfied with whatever resources you have with you. And it’s a big challenge to work in areas with scant facilities like these PHCs (and also something like my big hospital)! And it’s a lot of fun to play angel when you’re just a tiny human… and you get thousands of blessings every time the patients feel better after visiting you……
But to me, something is missing here…. I feel sorry, but this’ not the work that’ll give me complete satisfaction… I want more. I want to make each and every health center to have good health facilities like good medicines in sufficient quantity, good diagnostic tools, good surgical equipments, good transport facilities, and good care. I want every doctor to play angel and not robot. I don’t want this difference like rural and urban health facilities, and rural lying far behind the urban ones. I want every doctor to practice logically if not ideally. And I crave to make the treatments safer, I want every disorder to have cure. I want to make people really happy, even when I’m not there to treat each and every one of them. I want to become a scientist and want to work on brains of us… and also want to make improvement in the health condition of people in the world. Just figuring out what I shall do, and where I shall make a start to achieve it…
Friday, February 25, 2011
diary of ntern....
Humans are weak animals, with a small life and a big mind and huge desires… I feel myself as fragile, a miniscule creature hoping to bring happiness in human life. I love to go this PHC and see people every day and do something that I can, to help them with their health problems… and I face obstacles every day in one form or other those in fact should not arise. This PHC affords being constantly online, it affords the webcams, it affords the decoration it has… and the new decoration that is taking place; can’t it afford a one thousand rupees sphygmomanometer? And there are round needles, no matter what kind of wound it is, and where and for whom you have to use that big bored round needle for applying sutures… why should the people tolerate that extra trauma, only for the cause that they live in a village?
And I see poverty ruling lives… almost every woman and many men I see are anemic. I heard a doctor saying that complaint of weakness the women over here do is nothing but a psychological problem… I thought what’ll happen if he bleeds and his hemoglobin level falls near to five; won’t he complain of constant weakness and fatigue? The iron and folic acid syrup over here is out of stock, now I give the tablets… and they’re going to end soon the pharmacist insists. And I encounter women with backache and weakness in limbs due to compression fractures in vertebrae… with extreme tenderness over spinal cord… they are osteoporotic… leave apart the cementing of vertebrae and other surgical treatments I couldn’t even give them calcium tablets. They refused to attend a higher center- my hospital… and I’m sure they wouldn’t have got the treatment over there also. They can’t afford CT in government hospital and MRI from private hospital is a big thing for them. At least to increase their bone strength to some extent, I advised them to take milk everyday… then they smile at me sarcastically… “If I were a queen I would have got milk,” I remember one of them saying. My knowledge is helpless here… so is me.
And the men are addicted to one or more drugs… especially to the alcohol and the smocking. If not anything else their families will definitely get good nutrition if they stop spending money on their addictions… but who’s going to stop them? Why the government doesn’t ban such things in total, when it’s known that smoking is hazardous to health, it harms even to the non smokers… why the cigarettes and beedies are still being produced? If they start getting profit from selling and producing something like cynide, will they do it? Will they promote suicide by cynide? Then why do they do it with nicotine and with alcohol? Who has given the manufacturers the right to ruin the lives of the consumers? I’m totally clueless… I’m nothing but just an intern physician.
And I see violence. I see adults coming with police cases with heads broken due to fights in families and in rival families… I see women with tender infected injuries they’ve got because of beating by their drunken husbands… and I also see kids with head injuries due to getting hit by a stone by a small sibling or a playmate….. And the cases of dog bites in children are also on rise as the kids go and kick the dogs on face!!! They also hit the pigs, but the pigs don’t bite. What is this? Why? Why this violence… why everyone likes to pick up the stone and target the head of other? Is this a learned behavior from the parents… or is it something deep in genes? I know, I can’t do anything at this level of mine. I want to study neuroscience and want to stop this violence… but I also want to stop this under nutrition and addictions… and these scant facilities… I want to see them happy. I don’t know what I should do to make it a happening… Leave it; I’ve started daydreaming……………………………………….
And I see poverty ruling lives… almost every woman and many men I see are anemic. I heard a doctor saying that complaint of weakness the women over here do is nothing but a psychological problem… I thought what’ll happen if he bleeds and his hemoglobin level falls near to five; won’t he complain of constant weakness and fatigue? The iron and folic acid syrup over here is out of stock, now I give the tablets… and they’re going to end soon the pharmacist insists. And I encounter women with backache and weakness in limbs due to compression fractures in vertebrae… with extreme tenderness over spinal cord… they are osteoporotic… leave apart the cementing of vertebrae and other surgical treatments I couldn’t even give them calcium tablets. They refused to attend a higher center- my hospital… and I’m sure they wouldn’t have got the treatment over there also. They can’t afford CT in government hospital and MRI from private hospital is a big thing for them. At least to increase their bone strength to some extent, I advised them to take milk everyday… then they smile at me sarcastically… “If I were a queen I would have got milk,” I remember one of them saying. My knowledge is helpless here… so is me.
And the men are addicted to one or more drugs… especially to the alcohol and the smocking. If not anything else their families will definitely get good nutrition if they stop spending money on their addictions… but who’s going to stop them? Why the government doesn’t ban such things in total, when it’s known that smoking is hazardous to health, it harms even to the non smokers… why the cigarettes and beedies are still being produced? If they start getting profit from selling and producing something like cynide, will they do it? Will they promote suicide by cynide? Then why do they do it with nicotine and with alcohol? Who has given the manufacturers the right to ruin the lives of the consumers? I’m totally clueless… I’m nothing but just an intern physician.
And I see violence. I see adults coming with police cases with heads broken due to fights in families and in rival families… I see women with tender infected injuries they’ve got because of beating by their drunken husbands… and I also see kids with head injuries due to getting hit by a stone by a small sibling or a playmate….. And the cases of dog bites in children are also on rise as the kids go and kick the dogs on face!!! They also hit the pigs, but the pigs don’t bite. What is this? Why? Why this violence… why everyone likes to pick up the stone and target the head of other? Is this a learned behavior from the parents… or is it something deep in genes? I know, I can’t do anything at this level of mine. I want to study neuroscience and want to stop this violence… but I also want to stop this under nutrition and addictions… and these scant facilities… I want to see them happy. I don’t know what I should do to make it a happening… Leave it; I’ve started daydreaming……………………………………….
Tuesday, February 22, 2011
diary as an intern
I’m an intern physician… I’m at PHC Valsang… and it happens to be one of the topmost PHCs in Solapur district. And here are many drugs, I never see in my hospital… though it lacks some fundamental investigation techniques, it seemed to be near perfect to me as a primary health service center… provided that you refer the patients to the necessary higher center when the need is apparent… and this doesn’t sound bad. But…
I hate that ‘but’… but it is there. I don’t want it, but it is there. This polished structure, this cleanliness this cool behavior is now I feel is sheep’s skin worn by bad nasty careless educated wolves…. Enemies of health working as health care workers. I feel it, that these webcams are foolish, morons or idiots… machine things having no IQs….. or maybe I’m an idiot.
As usual today there were many patients, with their usual complaints, and with their own usual theories about their complaints, and with their usual wrong beliefs and wrong health habits. And as usual I try to explain them the things, the importance of minor activities and good health habits and their effect on health… that ‘saline’ (their term for iv fluids) are not energy doses and that (pain killer) injections are not the solutions for every health complaint. And I usually succeed in convincing the patients and making them to understand their health problem at least an outline of it f not in complete… but then I face the complaint of the MO and even of the attending staff and class four servants that I ‘spend’ or ‘waste’ too much time on patients… and the crowd is very big and I’ve to check the patients in fast………..
Today I encountered a cheerful forty year old obese woman, a butcher’s wife (her weight was apparent by her size, though I didn’t actually weigh her). And she was there to tell about the ‘weakness’ of the right side of her body… there was no obvious loss of functions… and when asked about the onset of her weakness, she described an episode of profuse sweating with transient confusion which was followed by the weakness and the weakness had reduced then… she had not consulted any doctor. This was a mini stroke a herald of a catastrophe. I asked her about her blood pressure, and she told me that she was taking one blood pressure tablet for high blood pressure once upon a time which she stopped as someone told her that her BP was normal… I wanted to measure it, and I took her to the MO’s chair. He wasn’t there and I got a chance to examine the only BP apparatus in this PHC… it is fixed to a stand near the MO”s chair. And to my horror, its release valve is malfunctioning! And I got the reason why the MO tells that the BP of every patient I send to him as normal… even that of those having symptoms of angina. I somehow stopped the airflow and her BP was 210/ 150 mm Hg……………… stage two, very high.
I reached the drug store to find some suitable drug for her… only to find out that the ramipril and hydrochorothiazide tablets over here are the dolls decorating the showroom… the pharmacist refused to give those drugs to her. And I asked sir about what to do with that patient, and guess what that lady got- atenolol that too just 50 mg…….. aten 50 for bp 210/ 150??? He said after looking at my shocked face that what’ll happen if our stock of ramipril ends… the patient can’t afford it, so we give this one affordable- atenelol 50 mg! Then why the hell are you keeping that drug in your drugstore… I can’t guess, and can’t understand the logic behind this… the logic behind having the drug and not giving it to the patients who require it. Atenolol blunts the CNS… makes people dull as an adverse effect… and we must give any drug after evaluating its need or benefits and the potential harms it can cause. And if a better drug is available, we must give it instead of some crude one… I really can’t understand the logic behind giving her atenolol when ramipril was available.
And I see them telling a patient to get his forearm massaged at home with a gel after a trauma and when by examination fracture was apparent with no x ray advised and no immobilization was done. And I see infants getting prescription of nimesulide syrups… and I feel what if this’ just a bad dream and I’ll get up and I’ll see that this isn’t true… but it’s not… it is the truth. And I face it, everywhere… everyday and continue to hope that at least at some point of time this’ll change and we’ll live in a healthy happy world.
Am I really mad to dream what I dream? Is it possible to make some improvement? Is it possible to make the health service perfect… to make everyone healthy and happy? Can the world in my dreams exist? I don’t know… but I can’t stop thinking of it and trying for it… as if I don’t think of my dreams, I think nothing! And someone has beautifully told me that dreams can come true, without that possibility nature would not have incited us to have them… and I believe in him.
I hate that ‘but’… but it is there. I don’t want it, but it is there. This polished structure, this cleanliness this cool behavior is now I feel is sheep’s skin worn by bad nasty careless educated wolves…. Enemies of health working as health care workers. I feel it, that these webcams are foolish, morons or idiots… machine things having no IQs….. or maybe I’m an idiot.
As usual today there were many patients, with their usual complaints, and with their own usual theories about their complaints, and with their usual wrong beliefs and wrong health habits. And as usual I try to explain them the things, the importance of minor activities and good health habits and their effect on health… that ‘saline’ (their term for iv fluids) are not energy doses and that (pain killer) injections are not the solutions for every health complaint. And I usually succeed in convincing the patients and making them to understand their health problem at least an outline of it f not in complete… but then I face the complaint of the MO and even of the attending staff and class four servants that I ‘spend’ or ‘waste’ too much time on patients… and the crowd is very big and I’ve to check the patients in fast………..
Today I encountered a cheerful forty year old obese woman, a butcher’s wife (her weight was apparent by her size, though I didn’t actually weigh her). And she was there to tell about the ‘weakness’ of the right side of her body… there was no obvious loss of functions… and when asked about the onset of her weakness, she described an episode of profuse sweating with transient confusion which was followed by the weakness and the weakness had reduced then… she had not consulted any doctor. This was a mini stroke a herald of a catastrophe. I asked her about her blood pressure, and she told me that she was taking one blood pressure tablet for high blood pressure once upon a time which she stopped as someone told her that her BP was normal… I wanted to measure it, and I took her to the MO’s chair. He wasn’t there and I got a chance to examine the only BP apparatus in this PHC… it is fixed to a stand near the MO”s chair. And to my horror, its release valve is malfunctioning! And I got the reason why the MO tells that the BP of every patient I send to him as normal… even that of those having symptoms of angina. I somehow stopped the airflow and her BP was 210/ 150 mm Hg……………… stage two, very high.
I reached the drug store to find some suitable drug for her… only to find out that the ramipril and hydrochorothiazide tablets over here are the dolls decorating the showroom… the pharmacist refused to give those drugs to her. And I asked sir about what to do with that patient, and guess what that lady got- atenolol that too just 50 mg…….. aten 50 for bp 210/ 150??? He said after looking at my shocked face that what’ll happen if our stock of ramipril ends… the patient can’t afford it, so we give this one affordable- atenelol 50 mg! Then why the hell are you keeping that drug in your drugstore… I can’t guess, and can’t understand the logic behind this… the logic behind having the drug and not giving it to the patients who require it. Atenolol blunts the CNS… makes people dull as an adverse effect… and we must give any drug after evaluating its need or benefits and the potential harms it can cause. And if a better drug is available, we must give it instead of some crude one… I really can’t understand the logic behind giving her atenolol when ramipril was available.
And I see them telling a patient to get his forearm massaged at home with a gel after a trauma and when by examination fracture was apparent with no x ray advised and no immobilization was done. And I see infants getting prescription of nimesulide syrups… and I feel what if this’ just a bad dream and I’ll get up and I’ll see that this isn’t true… but it’s not… it is the truth. And I face it, everywhere… everyday and continue to hope that at least at some point of time this’ll change and we’ll live in a healthy happy world.
Am I really mad to dream what I dream? Is it possible to make some improvement? Is it possible to make the health service perfect… to make everyone healthy and happy? Can the world in my dreams exist? I don’t know… but I can’t stop thinking of it and trying for it… as if I don’t think of my dreams, I think nothing! And someone has beautifully told me that dreams can come true, without that possibility nature would not have incited us to have them… and I believe in him.
Saturday, February 19, 2011
ideal Vs Real................ ..........!!
It’s not an easy task to be a good doctor, especially when nothing is known about many things, no specific treatments are available for many diseases, and many treatments those are available are not reachable to your setting… no diagnostic tools are available, and when patients have bad habits like addictions and false beliefs… I encountered today a patient with fully developed rheumatoid arthritis… with Z thumb, and bent fingers, and lungs shouting fibrosis and COPD, coughing and moaning with pain and with a packet of beedies peeping out of his pocket… and was asking me about the cause of nodules over the back of his elbows, and was requesting me to give some “high quality” drug that would cure him. He was emaciated… I wanted to refer him to higher center (the heck, to my hospital!) but the MO stopped me. Anyway it was a question what they could do for this patient… (I guess nothing other than prescribing a RA factor test and ESR and CRP- what if they were positive… and high) He was a regular patient over there, and was an alcoholic along with being a smoker. I had to give him some analgesics and after him I faced another patient brought by his wife, who was looking like his daughter… he was with full stretched abdomen with ascites of high grade and pitting edema over his feet… and she said that he had vomiting of blood in the morning. And he had same kind of vomiting few months ago… but no swelling. He was having liver cirrhosis (alcoholic) and he was drunk at that time also. And I found that ascitis tapping is not being done here. I searched for diuretics… alas, they were also not available. I ran to MO to ask for what to do, and he told me to send him back with some Tonic capsules (Tonic!!!??? He was as if closer to last stage… I would definitely have admitted him if I were in my hospital). I told her to take him to the causality (the emergency sector) of my hospital in case if some emergency arises… and then I caught the assistant of the pharmacist giving gamma benzene hexachloride ointment to a patient whom I had prescribed betamethasone ointment for atopic dermatitis.
What is going on here…? When are we going to get up and start practicing logically if not ideally? I see steroid tablets being given abundantly because the stock is in abundance, and the nimesulide… and tramadol injections for people with chronic trivial low back ache. I accept opioid analgesics if given after trauma or for severe pain. It’s not something that should be given to each and every patient complaining of pain. And nimesulide is totally unacceptable. And health advices like how to protect lower spine from injuries, and how to take care of spine, and to do exercise are not being given at all. And even if they’re told to do so, the smokers and alcoholics are not going to seize it.
How to change this? Where to make a start? Am I too small to think of that? I don’t know… maybe I’m… or maybe I’m confused. Is my dream of healthy happy world a daydream of a fool? Maybe it is; I never say that I’m a sane person. And I’m going to keep on trying, let me see what the future is going to show me…
What is going on here…? When are we going to get up and start practicing logically if not ideally? I see steroid tablets being given abundantly because the stock is in abundance, and the nimesulide… and tramadol injections for people with chronic trivial low back ache. I accept opioid analgesics if given after trauma or for severe pain. It’s not something that should be given to each and every patient complaining of pain. And nimesulide is totally unacceptable. And health advices like how to protect lower spine from injuries, and how to take care of spine, and to do exercise are not being given at all. And even if they’re told to do so, the smokers and alcoholics are not going to seize it.
How to change this? Where to make a start? Am I too small to think of that? I don’t know… maybe I’m… or maybe I’m confused. Is my dream of healthy happy world a daydream of a fool? Maybe it is; I never say that I’m a sane person. And I’m going to keep on trying, let me see what the future is going to show me…
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