What gives

The last few days have been hectic.The last but one day to my off week I was hit by an onslaught of cardiac patients.If you were to ask me I love cardiology.It is my favourite subject.I have managed so many cardiac patient's in my life and yet when it comes to managing patients here one likes to follow the local protocol.So fondiparanex comes into the picture.I remember ,during the herbertpur days ,there was a medical representative who used to drive us up the wall trying to promote fondiparanex.The moment we used to see him we used to run off . So our patients rarely got fondiparenex,thanks to the MR. I am hand writing each and every protocol into a notebook even as I come to it.I think it is basically following everything to the book since every type of investigation is available. Today I wrote minutest details about paracetamol poisoning. I got a local mobile sim for myself.Washed a whole pile of clothes,went downtown and watched basildon enjoying a saturday in the town cen...

Am I a wee bit sentimental or what ! I have moved houses ,lost my purse ,have been through various phases in my life, taken most things under my stride by God's grace ,but somethings have gone along with me.I keep chucking old papers,spending old money,wearing out old clothes,even walked past a lot of people in my life but somethings I hold on to and it keeps passing the chucking test. One such precious item is a 10 pound scottish note which has been in my purse for the better part of the decade.It was the winter of 2006,November to be exact and I was visiting England for my ERS fellowship .Christmas was around the bend and I was at the Bink's in Cheltenham. I received my first post in England that year and it was a christmas card from Scotland fromDr Anne Urquat.This ten pound note was neatly folded within the card . I had met Dr Anne Urquat briefly when she visited Satbarwa years after she left India.I was deeply touched by the though...

Gotta get used to the way things are done here.Predictability factor is missing.Every day you are on to something new.I have never been in a situation where you actually get a week off after five days of ten hours week.It is like as though someone is saying ,'have a life!'So it is a lazy saturday morning.I put in my clothes for laundry.Recieved a note from Anu asking me whether she should come by to pick me up for the week-end. Got to get a few things in order. I am shifting room this week-end for one.I am trying to get my debit card working.Have not decided whether I want to go to South-end on sea for a day or two just to be away. One good news was after one and half weeks of sharing a flat ,yesterday I came to know that two of my flatmates are good believers.Got talking to one of them but the other one I must have seen and said hello to her once.She was on night call the first week I came and has been on a holiday eversince. All believers who live in the campus visit the...

C has alzheimers.She must be atleast eighty five.She accidentally consumed her husband's medicine and was brought to the A&E.Her husband looked more frail than her, was stone deaf and had to be wheel chaired around but he would never fail to chuckle aloud whenever he guessed that C wasn't talking sense.Sixtyfive years of marriage ,onslaught of debility and the alzheimers to boot had not diminished their deep love for each other.I asked her my usual bout of memory questions.Did she know who the monarch was?She did.She further added 'and here ,next to me is Prince Philip'.Her husband gave another chuckle.In between,I helped her with her tea cup as she was struggling to drink from it.They immediately warmed up and the next thing I knew, her husband wanted me to help her put back her crucifix chain that the doctor had asked her to remove during a procedure. I was extremely touched by the sense of trust and camaderie and suddenly C started telling me about how much her...

The quality of lab services we provide has to go beyond the rhetorics.The backbone of every hospital and clinical pratice is the laboratory .We have to admit that lab services remain one of our weakest points.When it remains weak,slowly the quality of medical services provided become more provisional and we remain limited in the range of medical services we can provide well. We can never think of improving our lab service till by some miracle some specialist pops into our hospital,decides to stay back and the hospital gives it the necessary backing. It is extremely mandatory that each lab personal undergo one to one evaluation at a regular interval.That keeps one on their toes. Apart form the quality control measures which apparently has been introduced in all the hospitals ,the lab continues to be a problem area.One time generalised training and workshop for the personals DO NOT HELP.After attending umpteen number of seminars and workshops they go back to the same way of wor...

Today has been a challenging day.Saw a patient with a florid ulcerative colites flare,a man apart from the steroids the doctor had put him on, was on steroids for body buiding.His bowels were giving him a hard time and he was having rectal bleed with serious discomfort in the abdomen.His CRP was normal and his X-ray abdomen did not show features of toxic megacolon ,stools were sent for routine and Cl.difficile toxins.We referred the patient to gastro on VTE prophylaxis. The second patient I saw through was a patient on CAPD with CKD grade 5. She told me that she had been anuric for the better part of one and half years and was on dialysis every night for nine hours.She had come to the regular clinic but had been sent to the A and E because she looked unwell.Her blood gasses and the electrolytes were fine.Her renal parameters looked unbelievable.She had bilateral wheezes with no evidence of fluid over-load.She did have a short history of cough with yellow phlegm for which she had bee...

Today is sunday.The weather forecast says that it is going to rain and it did.I have run out of groceries so I had to pop down to the market to get some supplies.Tescoes-I never fail to get what I want.Even managed a chilli paste. A senior has offered to take me to a church today at six in the evening.My first in the UK.The weekends seem quite deserted in the hospital corridors.I had my breakfast in the canteen.Five items of hot cooked meal,I chose sausages,tomatoes,a fry made of potatoes and onions,I thought it looked a little over the top but I managed to eat it without getting sick. Met an old lady on a walker,who swore like a fisherman but was dressed to the hilt,quite spirited I must say. It did rain as was forecasted.Was waiting for my transport so I sat down at the Wimpy's to catch a hot chocolate with cream and the napkin caught my fancy.