A SARCASTIC Soul!

Its been a long time since I have penned something down. Confining myself to the walls that I have built around me, it needed a herculean effort to dig a tunnel and get on to the other side! And when I did get there, what do I see….
I see that a lot has changed.. in time..in place.. in person… in deeds.. in life!

So when Lucky and Shao dragged me to the pub after, almost eternity, and we did.. ,not drinks but, karaoke..it reminded me of the MBBS days ..the songs that we would sing aloud when we were happy.. and the songs which only your room mate would sing when he was sad, esp on that last day when he knew that he would never see her again! Reminded me of all the happiness, bliss..and the pain and angst and those tears behind..
‘ hum rahe ya na rahe kal… pal yaad aayenge yeh pal!’
That same bus stop outside gate no 4 where you would drop her off everyday to the empty road that now lay like a recluse…!!!!!!!! Life has taken us afar…
His story too shall feature on my blog.. but not today!

So then what do I write bout … well lets say ..going by my present mood...sarcasm!

Farewell MOTHERland!

We see a lot of people settled abroad, but their parents still reside in India. The other day a 80yr old lady gets wheeled in our ICU. I was checking a cardiac patient when I see her ..she doesn’t make any sound, gives a blank stare and makes no movement! I know this is Stroke, and I know it takes a while to recover. A day passed and I see her in the same state. And what surprises me is that she has no one around, esp when its this critical. On inquiring I find out that she was brought by the members of an old age home close to our hospital. I presume that she has no living kith or kin and so was a part of the old age home. What I learn the next day surprises me further! The lady has a son settled in USA and a daughter based in Australia. Both of them know that she s admitted but wont come down. Finally on the 4th day a grandson shows up[ dunno from where] . He pays the charges and disappears! The lady finally goes back to the old age home and that’s where we lose her!
Clearly this is not an exception these days. I have seen many parents sad … old age is when they act like toddlers and become dependent on their kids . when the kids do this to the parents, I don’t like it at all!

TRANSPLANT ing in time!

We see a lot of smart people coming for consultation these days! I saw a doctor couple outsmarting themselves the other day! They had a relative, a young 30yr old , with dilated cardiomyopathy with a very low pumping fraction of the heart. He was taken to a prestigious hospital in the western suburbs where the cardiologist treating him did not think at any point of time that a cardioverter-defibrillator implantation would help him, given the recent history of multiple syncopes. Moreover the fact that this guy is an ideal candidate for a transplant was never discussed! Rather he was managed in the ICU and shifted to the ward when he was a tad better! A common family friend gives me a call and says –boss don’t you think he needs a transplant! I say yes. He asks me if I can help him out. I say why not. I get in touch with my team and we tell them that we should move him straight to the transplant centre and register him! The doctor relative doesn’t call me for a week. I am busy in my work but still whatsapp him to ask –what s going on?
No answer! I get the answer!
Suddenly after 10 days the relative calls frantically! His patient has collapsed and is back in the ICU gasping with no urine output and completely altered in mentation! They want a transplant now.. stat! I like stat orders… seriously! I mean is transplant an injection that you give for fever? Abhi de do doctor saab! So I start arranging for the stuff when they say –doc can you come down and see him once. I say yes. I tell them to intubate him and preserve his higher functions to which the treating cardiologist says they don’t agree to it. So if a patient is gasping and you don’t intubate how will he make it till the transplant happens? I really don’t know what educated patient s relatives want these days! Im not surprised when I get a message in a while.. Mr ABC has peacefully passed away!
Im sad because this was a young guy who was eminently salvageable had the relatives made the decision in time! These guys had also called up another doc who probably didn’t know anything bout transplants but still gave his opinion that it wont work,blah blah. I have seen this time too many. Even if you don’t ve expertise in the subject you would still give an opinion. And because you ve gray hair , and as the indian mentality goes- gray hair/ bald guy + old age= good doctor! the people believe in your opinion and disregard the helpful ones! Chalo..koi baat nahi!

Sherlocked or SHELLSHOCKED!

I like a branch of medicine! It deals with the higher functions! Every lesion has a characteristic presentation! But you ve to look for the clues! Its like setting up a jigsaw puzzle in place! As you understand a few findings, newer ones get revealed! The same presentation may have different differentials! And you ve to put the Sherlock s cap on and then narrow it down to the final clue and present your diagnosis! obviously there are investigations that can help you through all this!but the diagnosis should be clinical and it can be supplemented through the investigations!
I know of an academic guy who loves to talk.. he goes on and on.. with his metaphors and similies and synecdoche’s …what a lovely clinician he must be! I too thought the same… until I saw the patients coming out with every possible investigation done and nil clinical diagnosis! And if someone did ask why most of the investigations were negative the reply would be—oh! I knew that it would be negative. That was just to rule out this XYZ condition!
I think people have forgotten the clinical examination part these days! Sherlock holmes is indeed sad! Also in KEM we would be taught to examine the patient thoroughly and elicit the findings , but nowadays I just see guys stand near the bed and look at the numbers on the screen, make a comment and move on! Sad…

The BIG Show!

My friend was telling me this story. There s this senior guy with him. He s a very average surgeon. Knows only the basic surgeries. But talk to him and he ll showcase his aura.. ohh when I was in USA I did 500 such surgeries, in Australia I ve done 1000 such procedures, this is how they do it in Germany.. I ve done so many of these stuff.. the list goes on and on! And when this big guy washes up for the case and its his turn to do the same thing that he claims to ve done a thousand times before….psst.. he says.. this is the second time im doing it, tell me how did you do it in your centre in south india? So basically the truth unravels, he s not done it before! But then why boast in front of others that you ve seen or done it a million times! And then opine on stuff that you ve never done or seen but talk as if you have been doing it since childhood.. just amazing!

Goof up GOOFY!

A friend of mine married a couple of years back. A poor cardiac guy that he was, I was sceptical if the gal married him just to ve a trophy hubby! Having cleared the air before marriage that he was not rich and it takes time to settle down in this difficult profession with long working hours, it was a shock a month later when the gal confided in him that she wanted to marry her BF. And the reason being that she wanted to marry her rich bf but her parents wouldn’t let her! And so she wanted to try and she how it feels to marry a good cardiac guy! But now it was clear that an easy life should be the preferred choice! The gal further added that she couldn’t say no before because all the people she spoke to gave her good reviews of the guy and so she thought lets try it once!
Clearly tripadvisor.com reviews are taken more seriously these days and NEET pattern of taking up a seat and trying it for sometime before giving it up are being tried in real life too! To her good luck the goof up goofy was allowed by the trophy guy, to leave without any hassles only to be hassled by her, later, in the courtyard of the law !

SEAT Matrix!

There was a pleasant pretty dame working as a RMO in a hospital after internship! And obviously when you have no inclination to study but at the same time wanna earn fast bucks, this is the best bet! And so when you get your not so encouraging result in NEET , you decide why struggle and study? Lets get a seat in a private college! But you ve to pay a bomb for that! So when this dame comes up and asks me what should I take up? I ask her back what do u expect from your branch?
She said -I want a branch in a good college with no emergencies with a very good pay and good quality of life!
Sums up the expectations of the new no workaholic culture these days! I wont work hard and still want the best results! Makes me sad!

FREE SERVICE to mankind!

A very common occurrence these days is a large number of extremely poor patients that we see in the clinic these days! The patient’s Audi A5 screeches to a halt and he dethrones himself! Walks to the clinic. He gets his sutures removed and just wont pay the fee. He will argue and threaten the guests relation executive that this is clearly an act of overcharging! The guy will spend 5000 bucks on his cigarettes a month, 10k on liquor, 3k on a movie ticket and popcorn, 11k for dinner with the whole family at mime and dine … but..but ..but 200 bucks for a suture removal and dressing is indeed a big deal! In contrast to this, I have a rich auto driver s wife who comes in for a consultation for her daughter. I have offered her daughter a waiver for my opd charges but still after the consultation , on her way out..she goes and offers a sum as the opd fee and asks my secretary not to reveal bout it to me! So on her next visit I ensure that I get everything done for her 3 yr old kid free thereafter. I am sad that the sweet lil one has such a complicated cardiac lesion that most ve refused to operate on her! And obviously they ve no funds.. but still are rich and beautiful.. by heart and deeds!

well i guess thats enough of sarcasm for the day... life is indeed a lil different from what it used to be! i guess getting used to it is a better deal... esp when you know you cant change much! tsk...tsk...

till next time........ adios!