What gives

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...

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...

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...

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...

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...

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...