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Sunday, February 18, 2018

The happy patient and the sad surgeon !

Well before I start writing the tales, let me put up the disclaimer first..

Disclaimer- not all is fiction , not all is a lie !( on)



There are a few surgeries in CVTS which re extensive, have long operating hours, may need a re exploration and lastly need a lot of funds. Eg- arch dissection, ischemic VSD, etc. And inspite of all of these the result may still be unfavourable.

I was sitting in my opd just after finishing my morning case. As a routine , I don't ve lunch till I ve completed seeing all the opd patients. These guy travel long distances, some more than a 100 kms and they ve fixed buses/trains to get back home. So my customary daily meal happens at 7.30pm and I dunno if i could call it lunch or dinner.. I prefer calling it 'Mom s anger' coz that is the best suited word to describe it. But it does make you lose a few kilos, so I call it the 'cvts diet'.

So as I completed my last opd case, I got a call from the heart command. I rush there to see a 69yr old lady with acute chest pain . The moment a stethoscope was put to her chest , and you hear the devil s murmur.. u know it's an ischemic VSD. The cardiologist s helpless face tells you that he can't offer his services. The fact that we had done an inferoposterior ischemic VSD last month made me think that we should be able to do this too. But then reality seeps in you realise how helpless you are, and how sad life can be!

So I meet the patient and her aged helpless hubby. They are from Rajasthan. I tell them the risks of the procedure and the expenses. Frankly they look poor and he tells me that he can't afford a surgery at any cost. He says that he had two sons. Both served the Indian army. And both were martyred at Kashmir. Now at the age of 70 he has to look after his wife and both the daughter in laws. The last piece of land will have to be sold off if they were to fund her surgery. And that would be a catastrophe.

This is not the first time that I ve come across aged parents who have to fend for themselves , with no money and no living children.
I just have immense respect for the guys who lay down their lives for the country. But I so wish that even in a private set up we could help them. Maybe the govt should come up with a VIP card for the families of the martyred soldiers, so that in emergency when they can't get to the army hospital, any hospital should serve them!

Sadly the aged kaka took a discharge and took his wife home... Knowing well, that the condition can be hundred percent fatal without surgical intervention:( :(



Sadly the new low in medical practice is some unethical GP practice. I ve seen them ask for hefty sums for reference. And as a rule of the thumb I would never do or associate with anyone doing it.

So the other day as I sat in my opd in my previous organisation this heavy weight GP arrives. He comes in dressed as a super star accompanied by his 65 yr old wife and 40yr old son. I think he expected a red carpet welcome and was disappointed on that front. On being asked about his symptoms ( He had come for a minimally invasive CABG) , he said what do you think looking at me will be my problem. I said well you look quite fit. This brought a smile of satisfaction on his face. He straightened his back , rocked his chair and adjusted his tie. He cleared his throat ( in the typical filmi ishtyle mein) and said- you re right doc, I can do all the usual stuff with ease. But when I do S#x and after 3 times (thus is a 70yr old guy speaking in front of his wife and son) I start getting heaviness in chest. But nothing happens when I do the f0£#play and other stuff. What do you say doc? Now I was frozen, as in I was not expecting this question. A look into his son s face and i could sense the embarrassment. He then started describing the way he performs , when I interrupted him and said that his angio shows critical TVD and we should plan an early bypass and that would cost him approx 5L. He said ,in a dominant voice that MICS chahiye and 3L mein Karna hoga. Well the mics tissue stabilisers cost 3L , so obviously it's not possible. On hearing this, this guy brags that hum Pune se Gujarat kitne pts bhejte hai. Mein 2L bolu toh woh do mein kar denge! I politely told him to go ahead and do it in Gujarat, why come to us in the first place. To this the guy replies dekh lo pts nahi bhejenge.i said sorry, I didn't know you were a VIP doc, coz for VIP s we ve a revised rate policy. So your surgery will cost you 6L plus . His eyes were red as he stood up and left in a jiffy, never to be seen again !



I sincerely feel that Apollo Chennai was one of the best things that happened to me. Being a part of this esteemed institution, and working with Dr Girinath and Dr S Vijayashankar and the rest was the happiest phase of my life, after my Alma mater KEMH!! If KEM taught me how poor people present, I was introduced to international patients at Apollo. We would operate on them very frequently, and I ll share 2 of my lite 'gelusil' moments with them..

Well I had just finished my second case for the day. I stepped out of the OT and got a call that there's an international patient in the emergency with chest pain. So I got down and I see this 60 yr old Saudi guy huffing and puffing and tossing over. He is accompanied by a 'Katrina-looking ivory white' relative /daughter. I asked him what happened and realised that he just understands Arabic. So I send for the translator. Meanwhile I ask his daughter to tell me what happened. She spoke clear and fluent English. So I asked her since when did he have this chest pain? Does he have shortness of breath? She gives me a blank stare.
Before getting mesmerised by the eyes, I repeat the question.
This time with a frown the lady speaks.. how the hell am I supposed to know what happened to him??
Now I was a little confused, coz in India we ask the children accompanying the elderly parent bout the history,in case the patient is not in a position to answer. So I was just gonna say that he s your dad, so I presume you would know. (Thankfully, I didn't say that)
She probably read my mind.
She answered- look doc, I'm his 6th wife s 4th daughter. He was staying with his first wife when I got a call from Thailand saying that he developed chest pain (during a special Thai massage) and I was asked to come immediately, and then we decided to get him here. So I have no idea! I didn't know why he went to Thailand unaccompanied. We thought he went for a business conference at Dubai!

Well that practically answered my question by not answering it. So I waited for translator to come and save the day! I guess 3 of his wives turned up for the surgery and then we didn't know whom to talk to, as none came in the presence of the other.. funny problem.. but eventually it went off well.

Another day we operated a 70yr old middle East guy and there was this pretty lookin 18 yr old gal always by his side. I thought that the daughter really cares a lot for the dad. Every day post rounds she would try to sneak in a word, but he would be awake and she would not talk!
Then one fine day , the guy was asleep and the pretty cherub seized the opportunity and ran to us talk!! She said.. doc I have a request( she had a very familiar Hyderabadi tone to her voice), I request you to help me. Just tell him that after surgery S#X is prohibited. I am his 15th wife and all he does all day is 'this'. That's the only job he knows. And I'm tired of this nuisance. I'm from India , Hyderabad. He married me last year(read as 'bought paying a handsome sum to her parents!') and I'm just bugged.
We were flummoxed as all this while we identified her as her daughter. Damn.. that was ironical, and I ll remember her and the conversation!

Well that brings me to the end of this Tale , shall revert back with more interesting reads! But now I ve my night CTICU rounds pending, so gotta go!

Auf wiedersehen!