The first thing i had to learn to do upon the start of my medicine posting during internship was practice getting up atleast at eight in the morning.for the day of a medical student starts not before ten and doesnt end before two at night.owls??
At vss medical college burla the medicine posting is taken very seriously.both by the management and by the students.I was very excited the first day as somehow i was getting the feeling of a great clinician!With the lifeline stetho around my neck, a pair of formals and with the decent BATA shoes i set out on my glamour.
Initially all you are asked to do is paperwork.well thats a polite way of saying it as it appearred to me nothing less than any clerical work.but then once the pg students have confidence in you you start getting to do things.i had fortyfive days with me to learn as much as i could and then we had the night emergencies.now those were a bit scary.but nothing is daring without being scaring!
Once it was my night emergency.i had a guy with me as my partner that day.he pretended that he was cool but he was anything but that.i had bought choco pie as usual,because i tend to feel hungry at weird times.by then i had already declared nineteen patients dead.hey calm down let me elaborate on that!what i meant was that i had written the death certificate for that many people as they had died during my shifts and mostly during night emergencies.and i was very proud of myself that i was successful enough to curb the emotional aspect while dealing with sick patients.a characteristic that is taught us to acquire from the very first day.it was two thirty at night then.me and my friend had just come back to the rp(resting physician) room after some ryles tube and catheterisation job. we got on our bed and my friend had this unique distinction of snoring away right after he touches the bed.and mind you he is damn noisy.i opened up my facebook on my phone.or rather was about to when somebody knocked on the door.leaving the snoring king at his kingdom i went to open the door expecting it would be a call yet again for vitals or to attend to a gasping patient.there were three small girls with their mother accompanied by our hospital attendant.the lady spoke sambalpuri in a bolangir accent and the girls didnt appear to speak anything.the attendant asked me to receive the patient,the lady’s husband,in unit two.giving a last look at the sleeping giant i hurried upstairs.
No bed were available so the patient was kept in floor.He was mincing in pain.I immediately asked the sister on duty for the ticket.he was admitted as a case of variceal bleeding with a query of portal hypertension.drunkard,i diagnosed in my crude way.
It was instructed on the ticket to give a bt(blood transfusion).the unit of blood was with one of her three daughters.after proper cross matching and allowing it to get to body temperature i decided to go on with the infusion.i asked the sister for the bt set and scalp vein.i pricked and i failed.i was very disgusted with myself.i was already fifteen days into duty and still had a problem with the scalp vein needle getting the right path inside the vein.tried again.this time the three girls were looking at me and so was their mother with a breath of despair and maybe disgust.i told myself “its your prestige at stake” and up went the needle right into the tensed blue vein.with an air of pride i said “its done,if the blood somehow stops trickling down call the nurse”.wrote the bt note and went back to our rp room.
Our system is lenient enough to spare us half of the next day of the night duty.so i went to the ward at two pm next day.Just after entering the ward i saw the same patient on a bed.yes he had got a
bed but he was not in our unit.i gave him a familiar smile and went ahead to my unit.it was a busy day that day.not that you expect to yawn your days out atleast during medicine posting.and being the cold month of december the number of cva(cardiovascular) patients gives you a real headache.after the round was over that day,i somehow decided to have a look at that patient i attended to that night.i went over to him.i asked his name.
“Parsuram” he said.and he was as i had guessed from bolangir.he was a carpenter.now that i knew it was a clear cut case of variceal bleeding due to liver cirrhosis(cirrhosis is caused by too much alcohol consumption), i frowned at him and said,”drink and drink more,you have done nothing but bought your death”.and the next moment i repented saying that as his three small kids cuddled up against each other in fright.to divert their fear i asked them about their schooling and all.and nobody was going to school.the eldest sister assisted her mother while she goes to wash utensils to different homes.their mother looked anything but healthy.shabbily dressed were all of them and were wearing an apprehensive future in their forehead.i left.as a pg was supposed to teach me lumbar puncture.
After that day i made it a routine to meet parsu after my duty.it seemed weird to my friends and pgs,maybe seemed weird to me too.but a human aspect inside the white apron was making the call.
One day his three daughters were not there.parsu was alone with his wife.i took this as an oppurtinity to give him some teachings for him to give away his drinking habits.
“You know parsu,why do you drink so much?i am giving you the answer.because you think its the only way for you to feel good,feel relieved,feel happy and kill stress.but is it so?today you are here because of that.your children are denied basic education.your wife runs here and there to work to make both ends meet,while all you do is squander away all your money earned in carpentry and i am sure a sizeable amount of your wife’s earnings drinking a slow poison.if you wouldnt have picked up this bad habit today evening you would have been to a meena bazar with your family.is it worth it?the momentary satisfaction of craveness jeopardizing the very existence of five people.even i have friends who drink.we go to dhabas together.but they drink and i dont,because i know it starts with an experiment.an ecstacy followed by a weakness.and a dependence.theres not a single disease that we have read till now that that doesnt implicate smoking or drinking as its etiology.rest is upto you.if you cant live for yourself atleast live for your family”..i stopped realizing maybe i gave too long a speech,not my fault as it has been my copy paste dialogue to my friends since half a decade.but i turned back to see parsu’s wife in tears.she hold his hand and parsu spoke out “somebody needed to tell me this long before”.but i assured him that its not too late and that he can give up his bad habit and start a new life afresh after getting discharged.his smile had the nectar of hope and i felt immensely satisfied in doing a perfect ‘counseling’...
It was time for my night emergency again.it was comparitively a less busy night.i had already slept for an hour.but then there was a knock on the door.the knock that all interns would unanimously agree that they loath it like anything..
Anyways i went to attend.it was parsu’s wife!
Without even asking anything i ran to bed twenty,where he was supposed to be there.parsu was literally vomitting blood.checked his pulse it was feeble.his blood pressure on the lower side.yes he
was having a bout of internal bleeding.her family were not able to arrange blood that regularly and what was more surprising was when i looked at the ticket.he was not given otide(octreotide),a drug to prevent bleeding and the drug of choice in these conditions.i asked the sister the reason and she immediately replied “they are not able to afford the cost ”
I immediately asked to give tranexa(another bleeding preventing drug but with low efficacy and so also low cost).in a haste i snatched tranexa from a patient in the next bed and gave it to the sister.morales have priorities too i mumbled to myself.after an hour after he had had received three pints rl,his pulse returned to normal and his bp too.i was relieved.the smile of his kids was my trophy.i asked them to arrange blood and call me if anything goes wrong again.
Nothing went wrong that night.i took the first half off the next day and after having my lunch reached ward at 2pm.after having taken the vitals of all the patients i was about to sit down when somebody called me from behind.
It was parsu’s youngest daughter.she looked pale.the second year pg ran along with me to his bed.
He was gasping.
Oxygen was immediately given.so was dexona followed by atropine and adrenaline and the pg bhai started doing cpr.i looked at his wife.she was expressionless.her eyes spoke of many untold miseries that she was going through in those few minutes.the three kids were scared and trembling in fear.was it the end of their father?
The pg left.i didnt know why or maybe i didnt want to know.his pulse was not present.his bp was not recordable.his heart beat was muffled or maybe i wanted to convince myself that it was muffled atleast.but it was absent.
The pupils were dilated.dilated maybe to meander through the new path in a new journey.a journey that traversed many miles in a glimpse.took out the piece of cotton to check the corneal reflex.it was not there.tried to rub it hard to elicit a response.maybe his eyes were too strong to even resist a corneal reflex.hope that would have been the case.
I was lost.his family had deciphered what had happened.the mother of three had started wailing like hell.the children were still mute and were looking upto me as if still i had a trick up my sleeves to save his already dead father.i was a doctor after all,the innocent kids might have thought.that very expectation throttled me a thousand times.the stench of betadine that was emanating when i entered the ward was now odourless for me.people were making a lot of noise in the ward like they do,but i heard none.somebody called me from behind.maybe it was the SR or maybe it was the professor himself.but i didnt turn back.didnt have the strength to.the kids were still looking upto me thinking why i stopped in my endeavours.the next moment they clinged unto their mother but they were not crying.maybe sometimes tears are insufficient to express feelings.it had now dawned unto the children what had happened.i still stood there,paralysed by the poison of human grief.my heart skipped a beat just to tell me.....
.......”the show has to go on...”