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Showing posts from 2014

The article on 'cats can sleep anywhere'...

I saw this article on cats can sleep anywhere....and that brought back memories.I have also slept in strangest of places in my life and as I go back the memory lane it sure does make me nostalgic. I have slept on stone benches in Satbarwa awaiting another call on hot summer night enjoying the cool summer breeze.I have slept on the stone parapet on my way home from a call near the badminton court.What do you do when the temperature touches the forties and your fan moves at the speed of the wall clock? I have slept on my head on top of a cemetry at four in the morning,that was Sheba and me in one of our quiet times in Oddanchattram.I have slept on a bench with just the frames and the wiring all given away ,when friends were visiting and I just had a two room accomodation. I have slept on top of newspapers,on cold winter nights....and I am not homeless as yet. One memory I hold dear to my heart and often recollect was travelling from Vellore to Oddanchattram in the general compartment wi

Psalm 25 vs3

I had but come back from the village and was just about getting a wink ,my junior was at the door.A local lady who had visited us the last week and had decided to deliver in our hospital and the EDD was a week away, had come with a history of fall from a ladder and pain abdomen with fluctuating foetal heart sound in foetal distress. We immediately called the operation theatre team. There was no bleed in the abdomen but anaesthetizing her was a problem-nothing was working and if it was ,it was for a very short while.When we opened her uterus a gush of blood greeted us .She had bled into her placenta.It was a face presentation and the baby was huge.Somehow the baby and the placenta was out but we had a very restless lady on the table with an open abdomen. Wherever we put in sutures it was bleeding. The bystanders were insistant we do a tubectomy although we were not too keen. By the time we had finished suturing her uterus we had a very flabby uterus in our hands which was not respondin

meeting malti

Yesterday was a ripper. Celebrating the spiritual week ,it was my turn to go to the village. I visited one of the villages near Chapara. Eight of us went excluding the driver,we divided into groups of two to do a prayer walk. Scenically beautiful village in the interiors,most of the village apparently has bonded labourers. Both sides of the village are flanked by temples. Myself and Nisha walked into the first house on a hill-top. The family was around for lunch break.The men were mending their wooden yoke whereas the women were lounging around. They were overjoyed to see us and immediately sent the daughter-in-law to make some tea for us.We sat with them ,played with the little child ,took photographs,gave some consultation ,got invited to lunch which we politely refused. Each house we went to the folks wanted us to sit down for tea. We were walking the road which ran down the middle of the village when suddenly a man carrying a load of wood on the head greeted us and enquired if we h

Different strokes.

I was attending the diamond jubillee celebration of one of my alma-maters.As different people went forward and shared their unique experiences one genteel lady got up ,apologised for the absence of her husband who was actually one of the alumnis but was occupied otherwise and thus had asked her to attend instead. She gave a humorous account of incidences from her husband's time in the institution.Suddenly something clicked and my memory took me to a place long ago when as uncertain medical students in a government medical college the couple used to visit us and perhaps for the only time in my life I remember travelling on the rooftop of a bus singing our lungs off with worship song to make a trip between Bankura and Purulia and were received with such warmth into their home.There must have easily been a dozen of us. As I gathered she could not place me.Brought to memory Mathew 25,vs 36-37.....Lord when did we see you hungry and feed you ..... Stalwarts who in obedience to the Lor

Will India's contradictions ever meet?

Manikram came to us with a rotting leg.There were ulcers down the front of the shank to the dorsum of the foot.Maggots were having a field day feeding off his flesh. My junior did a good debridement along with the senior nurse. I saw Manik Ram in the ward accompanied by his wife they were simple village folks.They had come from a faraway place and there was no way they could have managed to come for dressings so they decided to stay back in the hospital. Anticipating a big bill, we decided to discharge the patient in our software but never the less keep him back in the hospital free of charge while we did his dressing. At the end of the second week his perky daughter-in law appeared out of nowhere. Maniklal seemed to have made up his mind to go home. I thought he might have been home-sick so I agreed to let him go and offered to teach the bystanders how to do the dressing at home They could come back to us for further management. Meena bai,our nurse assistant , matter of factly enlight

Where less is more…

In my three months of tenure in Lakhnadon I have but lost one patient truly .There were two young kids with aluminium phosphide poisoning and one lady who was brought in decerebrtating ,a case of hanging which I would not count because they were expected to die anyways,we do get extremely sick patients reffered to higher units by our colleagues from the government hospital and local nursing homes. I have been severely restricted in my patient management due to lack of equipments. In my earlier tenures I have seen aweful iatrogenic faux-pas in well-equiped places which have given me restless nights. Having talked to a physician colleague who works in a critical care unit in a research institute and her observation that patients actually do better in a peripheral set up because we are less invasive ,I wonder if she is right.She was talking about how elective intubations expose patients to nosocomial infections and the pneumonia resulting greatly increases the cost for the patient beca

Uncomfortably comfortable.

Today,I stand in a strange place. I do my rounds of the hospital ward and I wonder where I am . I have two ladies who have undergone total abdominal hysterectomies,one gentleman who has undergone resection anastomosis who has just started liquid diet,one gentleman who had his obstructed herniae released and underwent a herniorhaphy with a mesh insertion,two ladies who delivered by caeserian section,one lady with a breast abscess who underwent incision and drainage,one patient post-snake-bite who underwent skin grafting,one patient who has come for exploration of the sole of his feet for probable foreign body.One gentleman who has presented with a bad wound infection post-electrocution for wound debridement. I also happen to have a lady with unstable angina,a young kid on ambu ventilation for snake-bite ,a few patients with fevers and acute gastr-enterites. By the grace of God they all are doing well. These past few weeks I have seen a lady with a haemoglobin of 1.


Malti was brought in with snakebite. A tribal from a village in Seoni ,was not talking,drowsy and had labored breathing. We pumped in ten vials of anti-snake venom ,gave her neostigmine and atropine, intubated her and taught the relatives to ventilate her with an ambu-bag. She needed ten vials more but financial constraints on the part of the hospital and the relatives did not make it possible. At ten in the morning the nurse anaesthetic after consulting me decided to extubate her.However, on extubation, her breathing stopped.I was busy attending to another patient ,so the nurse anaesthetist intubated her and she was back on ambu bag.The whole village it seems were keeping a vigil in the vicinity of the hospital so there were no dearth of hands to bag her. We had given them some tips about watching the saturation et,al. At around ten–thirty at night I received a phone call from the nurse asking me to attend to the patient immediately as she was bloating everywhere.I rus


Today I got talking to Suresh our chowkidar.His only child had had fever so he had brought him for evaluation. I saw that the little kid had pierced one of the ears and had put a ring in it.I asked Suresh, ‘Is it a girl or a boy?’ He answered, ‘it is a boy’. Why have you pierced his ears? Sahab,if I don’t then they will take my child. I asked ,who and where? To use as a sacrifice for building dams,etc. Open mouthed by now I asked ,so if he pierces his ears they will not take him? Yes sahib ,it means that the ear is already cut so he will not serve as a sacrifice. This is India,in the 21st century. I guess nobody has told them that the sacrifice has already been made.

Where have we lost the plot!

I have been in Madhya pradesh for barely a little less than a month.Looking at the spectra of patients who enter my out-patient I must say I am impressed. Seoni district is supposed to be the poorest district in the state.The first thing that I had to face as soon as I started working was predictably in the field of tuberculosis. Anti-tuberculous drugs were just not available over the counter.This was a dream we had been dreaming of all those days when I was working with the tuberculosis programme earlier in Jharkhand and later in HCH and had thought would never happen in India.There have been forums which have waxed eloquent in this but practically I thought it would never happen in India,but this state has done it.Even though grudgingly,I had to give kudos to the government here. However the flipside was when a patient of miliary tb presented to us and would not give a sputum and so apart from the CXR we really did not have anything to fall back on.The bystander had to make the round

You turned my wailing into dancing…Psalm 30:11.

Sumitra was thirty five ,gave a history of being four month’s pregnant, came wailing into the casualty with a back pain.She was pointing to her spine ,was more than hundred kilograms in weight. Her husband ,a handicapped person was emphathetic enough while the rest of the family watched the drama from a distance.She had a whole lot of complaints ,a lot of which could be attributed to depression. I was asking her the history and the staff was taking the FHS which could be heard clear and loud through a Doppler.I was talking to the husband and when we asked her for a history of discharge PV she said she had had it for the past two days. We decided to do a PV examination.Much to our chagrin ,she was fully dilated and the membrane was bulging.She had no USG with her but she and her husband were absolutely confident about the dates although her uterus looked almost term. We shared all the possibilities with them. We decided to induce labour with all the necessary warnings that should the

Treating Malti

Malti is eighteen .She was reffered in by one of our community nurses as having headache and fever of one month duration.Her feisty uncle and her docile father had brought her in. When she was brought to the casualty,she gave me a blank look ,hardly spoke.She seemed terrified of being examined.She read abuse all over her. When I asked her for the history of fever as written in her referral sheet she shook her head definitely to indicate she had none. It was difficult to get history from her since she looked badly. I diagnosed her as having early schizophrenia but never the less screened her for organic problems. I put in a word to Dr.Rajah our clinical psychologist in Herbertpur.Rajah as helpful as ever was effusive in his response and gave me a detailed guideline as to how I could manage her. I remembered many a day when Dr.Rajah had futilely tried to hammer in psychiatry into our medicinified brains.I had sat through his talks taking in the lighter aspects and thought, had not taken

Getting to know Meenabai.

Meena Bai was nineteen years ,seven months in the family way.She worked as a daily labourer in the road and earned all of one rupee and twenty five paise. She became unwell so came to the mission hospital for treatment. The mission people had an unusual way of treating patients .They not only gave medicines and examined ,they also spent a long time talking to patients. Sister Barbara was one such lady who counselled her for a long time.She specifically remembers being told not to keep too many things in mind or worry too much. Life was difficult.Her husband had an erratic work.When there was work there was enough to eat. The hospital ,when she was about getting discharged ,conducted a camp for surgical patients.The doctor asked her to help out in the camp.She still remembers she was employed for fifteen days at a stretch . They gave her all of sixty-five rupees at the end of it. She had never seen so much of money in her life. That is how she started working in the mission. That was fo

These days....

I am yet to venture out from the four walls of the hospital.Being the lone doctor for the moment,I cannot really move out of the campus. While walking back from the hospital I unconciously walk past my quarters.I have no attatchment to the place whatsoever. Lakhnadon in many ways feels surreal to me. I look forward to an extra hand ,hopefully at the beginning of next month.I would like to move out into the villages more often. Late last night one of the bystanders of one of the patient walked up to my out-patient just to talk to me.She belonged to an Assembly of God background.She lives nearby.She was telling me how her family had single-handedly reached out to three hundred villages in town. This is a strange place where a lot of work has gone in ,people are surprisingly receptive but they still need to walk in through the gate. In the meantime we wait....and we pray.

Amazing Lord,you never fail to surprise me.

Although the out-patient opens at eight in the morning, patients do not trickle in until well past ten thirty.It is a little frightening sitting around waiting for them to come through the door. The last four days I have been here I have not seen too many medicine cases but for a few hypertensives and diabetics who have come to repeat medicines and a single young boy in sickle cell crisis whose pain was so severe that because of the need for narcotics to control the pain we had to send him to Nagpur because we do not have the license. I had just discharged my last IP patient that morning a lady with normal delivary who had had a tubectomy and was occupying the private room and had dragged her feet about going home. I was a little discouraged so I called a colleague and sat behind closed doors to pray. We had not finished praying when an old lady in her sixties and an old man ,simple village folks walked into my clinic with chest pain.She had a MI.Even as we attended to her I was filled

...and so it all begins.

It is exactly three days since I started working here. Being a lone doctor amongst a staff of 40 in the hospital and another 60 in the field is nerve-wrecking.Everybody is watching,everybody is waiting. In the forty who are in the hospital almost twenty are support staffs. I wonder if it is the 'Big' ministry the Lord has kept at our doorstep. They have been in the hospital for more than twenty years.My assistant tells me she has seen the ED come in as a youngster,do his post-grad,and then now he is incharge of the organisation. I share tea with Meena bai,she is just too shy to sit with me and sits behind the curtain watching me .She does not forget to say,'thank you Dr jee'. Yesterday she suggested I use a pessary for a lady who had a grade 2 cystocoele and had a certain amount of discomfort due to it.She even ran all the way to the OT to get it. They are there everywhere,sitting around,chatting but they immediately get into an alert mode as soon as they see me,I wonde

The last but one week.

Here starts my last but one week in Herbertpur. The last of my packing handed over to the movers and packers I look forward to seeing the back of it on tuesday. I wanted to meet up with Alem but that does not look like it is going to happen.She has gone off to Nagaland on a family commitment. In the mean time I look forward to my new responsibility as formidable as it seems from a distance.It does not seem formidable at all when I look up to Jesus. I remember attending a meeting in Ranchi of the RNTCP .The secretary then of the state who incidentally was a friend of my late cousin and had visited my home, turned to me and asked 'what is your strategy?'.I remember replying -'We have no strategy but we will do what has been alloted to us sincerely'. For me looking at what is ahead of me at a distance my constant query to the Lord is ,'Why do you want me there?' ..and yet there is a certainity that 'He wants me there.' I rest deep in that assurance. May yo

Book reading.

Molly suggested we start a reading club together towards the lattter part of the OPD since most of us are free just hanging around. We chose a book that encourages self introspection.Over the weeks Molly,Anu,I and Silus were the regular attenders.Reading the book around in circles has been a time of learning,bonding,letting down our gaurds and honest self introspection.I,for one am enjoying the experience throughly. We have been reading about the concept of being in the box, and self betrayal resulting in a whole lot of harmful wrong conclusions about situations and individuals. I, for one, suggest everyone try it. When we are willing to let our gaurds down and be willing to be vulnerable with each other, we edify and help each other grow as individuals.Isn't it what community is supposed to be all about?

'There is time for everything under the sun..'

These past few days have been strangely hectic. I have been trying to catch my breath in between cooking with the youngsters . I move to Lakhnadown next month.The Lord has been good ,helping me along the way with my umpteen questions. Was talking to a youngster even as I stirred my pot about life in general.Answering queries about my life and trying to understand hers and she came up with this statement..'Mam ,you are an institution in yourself.' Strange ,I thought.This was the second one this day. One of my colleagues way-laid me today and asked me about the move.Out of the blue he suddenly said,'I told my wife that your going to Lakhnadown was like an army going there.'I just smiled and laughed away what he said. It left me thoughtful about a lot of things. What do I anticipate in the move ?Another colleague way-laid me and asked me ,'Are you sure you want to go?'Why what's wrong with Herbertpur? I guess my anticipation is summarised in the answer

Reading Tozer.

Reading Tozer inspires me a lot.I picked up this book in CMC the last time I was there.Tozer writes about the mystery of the Holy Spirit. I was absolutely touched by the illustration he makes from the Noah's ark about the raven and the dove being let out to test for the receding of waters. The water was the judgement of God on the earth.The raven when released ,thrives on the floating corpses,desolation and the civilisation that was built on the floating dead. Noah releases the Dove ,she could not stand the judgement of God which was everywhere,she came back,so Noah pulled her back in. When the water receded,Noah releases the dove and when she finds a dry land where she can light upon she does not come back . What is the judgement of God? Judgement of God is everything that the Holy spirit would find distasteful in our lives. Just how important is the role of repentance in our lives if we want a clean slate. Tozer distinguishes between the Holy spirit 'residing in a be

The last few days.

A lot of things have happened in the past few days. I have been anticipating a move and now I understand I go to Lakhnadown.I don't know too much about the place apart from the few gossips that come in now and then. I am surprised at myself at the way I am not all curious about the place.I need to pick up my phone and dial a few numbers which I am too lazy to do.I am curiously neutral ,neither nervous nor excited just perturbed,praying and wondering why the Lord wants me there,for how long and why! I make it a point when I am in HCH to walk up to the map of India outside the HCH OPD put my hands over the land marked Lakhnadown and pray over it. In the mean time my cousin dear has contracted this deadly cancer. Squamous cell ca of the gullet.Fit as can be,keeping himself in the straight and narrow he thought he had everything under control ,he was exercising everyday for two hours till the radio and the chemotherapy started simultanaeously last week.God had other plans. We al

The first cut is the deepest...remembering NJH.

I spent the evening with folks from Satbarwa. Senior nurses come away for six months ,difficult times to be away from the family. The eyes whelled up even as they saw me. I remembered so many times in my younger days I had been impatient with some of them hoping against hope that they could be more efficient.Now I see them almost after three years- older, tired ,lost,in a new situation and they look beautiful to me,every line in their face telling me stories. I drank tea and made some pan-cakes for them even as they up-dated me on the news of their family and old friends from Satbarwa. Jeevan had sent me NJH calenders and I was deeply touched to see the format,the verses,the pictures. All the saints engraving their signatures in the Book of life,some getting justification on earth and some faithfully giving their best in difficult circumstances for the Lord because human beings sell us short. Thank you Lord for the testimony of Navjivan,I take heart from it every now and then.

I do,my Lord and my God

I travelled around the central India.I spent two full days behind my friend Grace's pallu in Champa. Years just fade away when one is with friends.We chatted and chatted and chatted .....reminiscing,remembering,laughing. These are friends who have seen me through literal rain and sun-shine. Met Mr Jone Wills who was our Christmas father in Satbarwa. Again laughed through the memories of  those learning days ... I travelled through the heat and dust to Jagdeeshpur..met some old friends there too. I did not travel to Lakhnadown although I wanted to meet Muani and was wondering what she was up to. I have been praying on this movement thing. Everytime I plan a move I get a clear leading from the Lord. This time my call is to 'faithfulness' and whenever I close my eyes I see the Lord asking me 'Do you trust me?'  

Pondi notes.

Pondicherry it is.I reach at six o'clock to a guest house owned by a French couple at six in the evening and am reassured to be greeted by a family with a little daughter. I have a splitting headache so I decide I want to eat a quick bite before I hit the sack. Little down the street I walk into a tibetain shop and gulp down a plate of badly made momos. The girl serves me in a traditionally sikkimese way,with that sign of respect which touches a chord. I do manage a quick walk to the beach after the lady behind the counter assures me that Pondi is safe.I understand why when I run into police cars,police bikes and personals every ten steps.The beach looks ferocious,and beautiful at night but is overcrowded to say the least.I see a few works of different handwork potraits of Rajnikant,MGR,and I don't know who.One of them is even made of paper roses. I walk briskly back to the hotel and hit  the sack. Next morning I get up early and walk to the ashram.The streets around the

Coming South.

Strange to be back in the south after quite a long gap.My friend asks me ,'are you back from Dehradun?'We were together in Tamil Nadu more than a decade ago.Slightly confused I say ,'back to where?' I was born in Mangan,educated in Gangtok,graduated in Bengal,post-graduated in Tamil Nadu,worked in Satbarwa,Herbertpur,England,Herbertpur and now am ready for the next bout of adventure . Even as I reach Chennai I meet Sheba after a little over a year,her parents after a decade.Uncle says I have grown fatter. I hear Dr Manoj's familiar voice over the phone.....into CMC there is Dolly,Deepak,Beulah ,Alex,Emmanuel,Jayanti,Susheel,Shalom,Ashita,Deepak,Dr Hansdak,Judy,..then there are the Satbarwa folks...Sishir,Suman....and then more Oddanchattram...Abraham.,Meghala....and then even as Abraham dials the phone and hands the set to me I am greeted by intermittant stunned silence and giggle on the other side of the phone....seriously I,think Anand has forgotten

Notes to myself.

It's been a little over two months since I last scribbled a post. In the comfort of having the parent's around one's mind stops functioning and you give in to the pampering . However ,over the last few months,I have watched it all through close quarters and the technical eye ,the saga of Tehelka....and now Shashi Tharoor being beaten to the pulp ,two human institutions I had looked up to .........for their transient glimpses of brilliance.I don't denounce them ,I understand them perfectly well, as I do myself and every human being on earth,fragile ,frial, and sinful. I hold on to what is good and accept the failings. In the meantime I take great joy in small surprises that the Lord blesses us with. I had the pleasure of having dinner with a young kid yesterday. She could not be more than twenty three. I called her over with a certain sense of responsibility. The thought crossed my mind but I wasn't sure I would meet her before she left the campus. I would