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 !(hehe..read on)

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THE MARTYR S MOTHER

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:( :(

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THE DOCTOR GP AS A PATIENT!!

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 !

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BINTE DIL , THE #SAUDI CASE FILES# !!

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 ..to 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!

Traveller diaries!!!

Ever since I stepped into this new place, it's been a pleasant experience of sorts. From the coziness of 20 degrees of Mumbai to 3 degrees of Hisar, I ve indeed come a long way (1500kms to be exact). A long way, away from the comfort zone .. along the untravelled and unexplored path!



On the way , I passed through the land which has produced the most astute businessmen of the country, the iron man of India and has contributed the present PM of the country. I found this place inhabited by people who love to talk, and eat ('khaman' mistaken as the dhokla of Mumbai), and enjoy every festivity with much pomp and grandeur!
once the cab driver realised that this was my first time in Gujarat , he happily narrated me the local history and geography of the place! Also told me the reason why he migrated back from borivali post retirement. (You just can't leave out borivali and ghatkopar if Ur talking about gujjus..can you??!!:) in the same breath he told me about the best cardiac centres to get a bypass done, when I had just asked him that which is the best place to go if you need a heart ka operation ?

In the usual gujju accent.. Chamanbhai Patel spoke..

Agar tumko kam paisa ma operation karaucho toh apna civil hospital ma jau.. shaath hazar(60k) mein ho jayega. Agar Rajasthan se aaye ho toh Rajasthan hospital mein jao . Nahi to CIMS hospital bhi hai. Aur agar private mein karana hai toh Anil jain Saab bhi hai, but thoda jyaada hoga. Baaki Apollo hai par woh dur padega.

I felt that I wasted 100 clock hours researching on the net while this guy gave me all the information in less than a minute.damn..

Then he said that idhar aaye ho toh Gandhi ashram aur adalaj vav bhi ghoom k jaana . Humara no likh lo , kam charge Karunga.

Well inspite of what we think about the modern day India, I could still feel the basic vintage culture still hold forte.. . Patels, Shahs, mehtas,patidars,etc still ve differences. Not all can sport a moustache. And divorcees re still taboos ! And there s still a thin line that separates 2 religions out there.

But thanks to Pranjal I had a nice time at his hostel room at bjmc Ahmadabad. Had fun esp during the 'lounge bar' episode.

See, we guys at Mumbai re used to loud music and bar= drinks. But in Gujarat, bar=×drinks..only music , plus fruit juices and shakes to go with it. That was fun as the bar had a lot of people enjoying a live performance but sans a glass of liquor in hand! I also cherish my fight with a restaurant manager when he charged us 30 bucks for mineral water but 100 bucks for 300ml coke.. finally after 30min , he realised that it's never a wise call to argue with a CVTS guy!



In the second league of my journey, I crossed the state of Rajasthan. The brave Rajputs ,always intrigued me. Our history books way back in school always made me appreciate the bravery of the Rajputs, the valiant Chetak and the lovely Padmavati ( sanjay leela bhansali too was rendered sleepless by her for many nights in continuum ). After Shivaji s warfare tactics and intelligence, Rajputs were my next favourite!

The beautiful PINK city of Jaipur, the lovely carved windows at hawa mahal and the astonishing forts and the hidden passages interconnecting them , were simply awesome. Again Rajasthan showed me two faces of modern India.. the rich re exuberantly rich travelling in jaguars while the poor re extremely poor travelling stuffed in a small bus (about a hundred of them..just as they show in the movies !!) The roads reminded me of 'jab we met' and that lovely song in which aditya and geet traverse through Rajasthan.. tourism is redefined here, probably after Kerala..this is another success model. But sadly after all these years , this place still has no thriving MNC s, no IT, no medical centres of excellence (barring Jaipur and Udaipur), and no improvement in the social strata after all these years.

But it has some awesome clothes and embroidery and amazing good food...yummy!



Next as I crossed over to the final leg of my journey, Haryana , I realised how important farming is to the nation. We happily munch on to our food, but growing it and getting it to us is a long process. Something that I now understand better. Also how canal irrigation has transformed the non agricultural land into a profitable venture is worthy of praise.

Here I improved my GK with respect to the following, eg-
How many of us know that a cow costs 1 lakh. Gives 12 litres of milk daily. They sell it for 50 rupees a litre and earn 600 bucks ..and spend 200 bucks on fodder per day. The animal is treated as a family member and has a single room shed with sloping roof and lots of hay with 2 blankets for each cow! Wow..plus as we talk of our children, here they talk about their cows and buffalos too!

This next example will give you guys some insight into the status of females in the villages of modern day.

I got a call from the emergency Dept of my hospital . The case was a 25 yr old gal pregnant for the 7th time (she has 3 kids already) with an ostium secundum atrial septal defect with severe pulmonary hypertension. Her cardiac ailment was known since her 1st pregnancy, but her in laws and the big men of her village decided that nothing should be done for it. Money should not be spent in treating a female child. So inspite of the doctors advise to get operated ,she wouldn't. And now she was at an imminent risk of losing her life in the next few hours. I got my gynaecology consultant on board and we explained that this pregnancy should be terminated, the guy should use protection and she HAS to get operated. I'm still awaiting to see her back in my opd in 6 weeks time for the surgery. Lets see...

I also heard the deplorable incident of a lady losing her life due to uterine rupture during normal labour when it was clearly told to them that a ceaserean section is indicated. But the head of the house didn't give consent and so the lady lost her life in the bargain.damn..not done..sshhhh!

Plus I ve seen people not understanding the docs advise and ruining 'theirs' in the bargain. I had a patient with left main with critical disease who wanted a discharge despite ongoing chest pain because he had a marriage to attend.

Sir, I ll be back after 15 days said he, with a sheepish grin. I pray that he does come back , and we then do the needful.

Another patient with a valve replacement done came with deranged clotting parameters with coagulopathy. On being told that she ll need admission and correction with plasma , she bluntly refused saying there s a marriage at home. And went away !!! I was shocked at the indifference. But after 2 days itself I got another call from my emergency for a pt with intracranial bleed with a history of cardiac procedure in the past. And hey lo!what do I see.. the same lady now comatose, with her family members around her. The same ones that had refused admission. And now she lay gasping , struggling with the last few drops of life left!!!:( :(

Well as a country we have to educate and respect women if we wanna call ourselves a 'developing' nation.. instead of giving loans to mallya , SBI could ve helped these people instead. And I hope that state insurance becomes a reality, in the true sense, so that we can offer everyone the best treatment without having to cut corners !

Also I had the lovely experience of guzzling on Punjabi lassi and Bajre ki roti and sarson da saag , mast mast pakodes, huge Jalebis, yummy aloo parathas ...the list goes on and on..

Well I guess it's time to sleep.. it's sooooooooo cold in this part of India and I'm getting used to 4 woolens and 4 degrees.. gotta go , for a case tomorrow..

So till next time, it's adios..

Happy Valentine's day (belated)🙂 everyone.. hope you all get Ur Valentine and the Valentine gets you too..haha..

Auf Wiedersehen..!!!