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 because of need for higher antibiotics ,etc.Often the bystanders choose to take the patient home.
Most of our centres do not have a good microbiology back up so less might actually be more in our set-ups.
Thank you Lord for the small mercies.
Monda suggested we go hunting. Dressed up to beat the rains and the unpredictable weather we ventured out at night with the two Dawas. Annie had baked a cake for Rumpanol.It started pouring in spurts but nothing could beat the enthusiasm.The junior Dawa was to drive us to a place around fifteen kilometres up the north Sikkim highway.We would come across three rivulets of sort where we could possibly find the edible frog.The senior Dawa was already at the spot making a pathway in the jungle for us to proceed. We reached the spot at around eight at night.in the pitch dark one could hear the sound of frogs of all variety and we started seeing quite a few but none of edible variety.We shuffled around in the rain with an umbrella,raincoat and torches like Nancy drew exploring the grasses and having eye contacts with stunned frogs which seemed to have lost the ability to run .The two boys did a Tarzen and was lost in the jungle with a sling bag ,a torch sans any cover from the rain.While
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