Dil Chahta Hai!!!!!

 

Disclaimer- 

The author is playing the devil s advocate and using satire to pen down a few instances. Good people [ Doctors, Cardiologists and Patients ] do exist! This is a work of negative humour, to be taken with a pinch of salt!

Its been a while, writing on the wall.. so today ,quickly,  I pen down a few  stories and ….off I gooooooooooooooo!!!!!!!!!!!!

Cardiology conundrum

The other day, I was sitting in my OPD and admiring the lovely heart shaped wall clock made by my patient post CABG [ that’s heart bypass surgery, written in a medical way]… when suddenly I received the summons!

Naah, these weren’t the court summons, but being summoned to the Cath lab where a patient had collapsed during angioplasty [that’s putting in a stent and plumbing your way through the coronary, written in a medical way..wink wink!!]

Of late , such summons have become way more frequent!!! With more flamboyant machinery [aka lithotripsy, laser,rota, etc..just to name a few] and gizmos coming in, the operators [ who were overconfident anyways!] are now super [over] confident! They are now drilling holes inside a 2mm calcific vessel [ not one, but three!!do not smile in glee…hehehee heee!] , trying to pass a wire inside a 0.5mm lumen and in the enthusiasm [euphoria, the state before things go wrong] plumbing with full force, till the plaque, intima and vessel wall are forced open! A rapid sinister contrast leak outside the vessel after a spiral journey through the vessel wall.. and the euphoria has now subsided ! Frantic calls till the CVTS team reaches there.. its now or never! With the confidence that the back up has arrived, a covered stent is employed , IABP is shoved inside [ a device to decrease the work of a severely compromised heart post procedure], patient is shifted to the ICU on a ventilator!

Now, this patient would have safely undergone a bypass, but as the fashion trends change , the counselling of patients by the operators have changed!

In reality, CABG is a very safe surgery with minimal risks and is the Gold standard in three vessel disease with calcified coronaries, multiple skip lesions and bad targets! There is minimal risk of complications in the present era!

Yet the patient underwent a high risk plasty. This brings me to the hilarious part. This happens because of selective counselling…and not so true information passed down to the patient, selectively BYPASSING THE TRUTH!

A few examples –

Mukku- agar bypass karoge to sar se pav tak cheer denge . 4 -5 din tak uthoge hi nahi. Machine pe latka denge, khaa -pee nahi paoege. Chal nahi paoge. Plasty kar lo, shaam ko mere saath chai piyoge aur kal saath tahalne chalenge. Stroke ho jayega, zakham nahi bhar payegaaa! [ sing in the tune of naam gum jaayega, chehra yeh badal jayega by R D Burman saab]

{ the truth is that post bypass a chest incision heals in no time, wounds don’t get infected, stroke doesn’t happen in the way stated above, the patient is extubated 3 hrs post surgery and he is sipping tea 4 hrs post procedure and walking the next day.. all this and more.. the patient has no foreign material inside him, his own conduits flow and even if you miss a dose of medicine, you are safe! You resume office in a months time and life has never felt better!}

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Scooby dooby doo!

This interesting story made my day! I didn’t know how to react! A well to do RMO[ ward doctor babu, for non medicos] was getting  married in 2 weeks. On my rounds she rushed up to the table and exclaimed in glee that they have booked the entire beachside posh resort for the destination wedding at Goa. Her groom was based in Amsterdam and she would be flying with him post the wedding in a months time. I wished her the best!

Post wedding after 2 months I spotted her on duty and asked her bout it. She said she didn’t fly cz both her dogs didn’t get the visa and clearance. It costs 3 lakhs per dog , and it would be done by next week. She also showed me pics of her doggies wearing expensive clothing and specs! My  babies!, she exclaimed! To her bad luck her mom had a heart attack the next day , angiography was done and a bypass was suggested. She was admitted in the general ward and they were trying to move her to another smaller centre as they wanted to spend less! Clearly having a lavish wedding and buying tickets in lakhs for the furry four legged cuties were in fashion, but spending for her own mom- OUT OF FASHION! Sad, but true!

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Tee-totaller

I got a reference for a hip hop teenager for a decortication. She had an extensive amount of muck drowning her right lung! So that needed surgical evacuation. 

TB causes it , but not in her case. She had acute pancreatitis following which she developed this complication. Acute pancreatitis to this degree happens in chronic alcoholics. We had seen so many of them during our KEM days. But this was different, coz she denied any history of smoking or drinking. 

               Making a dolls face she proclaimed, I don’t do such things. Her parents were sitting next to her all this time. We asked her what does she do, where does she work? To which she replied , I work from Goa and im a freelance scripwriter! Now I was finding it difficult to connect the dots as she didn’t drink, yet had a bad pancreatitis! 

                That’s when our youngest team member came to our rescue.. Insta as we lovingly call him, showed us pics [ multiple] from goa, in which the lady in the hospital was clicking selfies consuming glasses of liquor underneath the cloud of smoke along the sea side perched on a shack.

Lying to your doc isn’t a good idea, but I see this trend.. with many patients. Fearing insurance policies, they deny history of vices, previous surgeries and procedures too, fake family history.. suppress pertinent facts! Not a good trend, but that’s what is TRENDING HOT THESE DAYS!

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A tale of two  nitty gritties!

A well groomed gentleman entered my OPD with his family. He had done an angiography and was said to have a very critical left main lesion with 90-95 percent blockages in all vessels of the heart and a low heart contractility. After telling him to do a myocardial viability, the results showed that the heart muscle was viable, and he was again told about surgery. He said I will think over it and left the opd. 

        After this instance, he visited our OPD  thrice just to say that he felt good on the medicines that we put him on. Then again, one fine day, he came back with a new angiography repeated. This angio showed that all blockages had worsened further. He was again suggested bypass, and this time he agreed.

But now comes the interesting part. He regularly travels by his new Brezza and comes to my opd. This time he put his iPhone on my table and folded his sleeves and exclaimed-

Surgery toh aap se hi karaunga. Lekin main bahut Gareeb hu, paise nahi hai. Free mein operation karna hoga.

 I said wow! If this is the definition of below poverty line[ he had got a free seva card too!], then acche din aa gaye hai!!!! A below poverty line dude with a Brezza, iPhone and a thick gold chains around the neck [ ekdum Thangabali style from Chennai express!] is the definition of a new India! I told him like God, the Govt is generous and we have good Govt hospitals to go to! But no!

                 Bhai says idharich mein apna operation karunga! I whisked him away and requested him to follow the hospital costing and let the real needy and poor use the Govt free scheme… if that fell in his scheme of things , I dunno! But I refused to operate on him!

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In sharp contrast , I met a poor 68 yr old lady in my opd. Her hubby was a rickshaw driver and had expired in covid. They didn’t have a child and now when she had a massive heart attack , she was forced to fend for herself. Her neighbours asked me if surgery was the only way out and what would be the expenses. 

            I gave them a fair idea and they returned after a week with 1,43,000 rupees that they had collected from their neighbours and community. The  ZAKAT trust arranged the rest! Her surgery went off smoothly and the iron lady went home in 7 days. 

           They came back, on the day of discharge, with another 50000 rupees . Now they could have easily opted for free surgery, but they did not. They contributed and got her operation done. We refused the amount and refunded back 50 percent of the previously deposited amount. We told them to buy her a proper bed and give her that amount to support herself and buy medicines  in the future. But never did they ask for FREE SERVICE! Aise bhi log hain 😊

 

Anyways its almost midnight, time to catch up with some sleep!

See you all soon, with better  experiences to narrate.. till next time!