windsofchange’s blog

I am in Fursatganj again today. With nothing better to do I decided to continue a few more of the medical stories.

This time I decided to include my dear mom, some patients and Dubey Sir in my series…I will say these were lessons rather than humour accounts that I learnt as part of my medical life.
 
La Innocence

I am the only odd peg in my whole family which comprises of mostly engineers of all shapes and sizes. My poor mother was innocence personified and I, the devil reincarnate!!
For my parents and cousins it was a matter of curiosity about how we were taught medicine, how we were ragged and so on and so forth.They would listen in awe to even the silliest of the stuff that I had to tell.
That, I love rambling and making up stories was something only dad knew. He would always reprimand me saying, "Don't tell cock and bull stories” Nevertheless, he would chuckle at the flight that my fantasy took.
Let me not become a fantasia and come back to the land where mom and cousins were sitting. I was telling them how unclaimed dead bodies were sent our way for learning dissection and that there would be 100 medical students and we were divided into batches of ten, and each batch was given one body for the whole year to practice dissection skills in anatomy.

Out of ten bodies, there would only be one or two female bodies and the rest would be male.
Obviously, female bodies were equally important due to anatomical reasons and we would swap places just to learn and those who posessed the female bodies always acted pricey!!
I began describing the gory details to my mom about how we would dissect the groin region, one student would read, the other would dissect and the rest would either watch or chat away to glory.
So she said, ” aise hi, sabke saamne….so when do you guys remove their clothes?? ”

” Mom, it’s a dead body they don’t wear clothes. They are frozen in formalin. “
 
” My goodness, so many of you just jump on the bodies, poor souls!”

I was taken aback by her innocence but it set me thinking. So, many things that people of my profession assume as matter of fact must be quite chilling and daunting for others. But I somehow had to pacify my poor mother, so I said to her, "Ma, what these dead people do is a far greater service to humanity than can be comprehended. If it weren’t for people like them, how would we know what to do, and how to treat you living people. ”

“Better to practice on them than you!!”
 
That answer pretty much shut my poor mother’s questions or chastising exclamations for good!!

Here's to Atmaram, never knew him in life but my companion after his death for 18 long months.
 

My work is such that I meet new people everyday. The number varies from anywhere between ten to thirty in a day depending on how busy it gets. Interaction with these people, each one different, each with an interesting story to tell has certainly been the highpoint point of my career. Some of these incidents although are from aeons ago are etched in my memory as if it took place only yesterday. I want to share with you all stories of two such individuals, poles apart in their differences yet it was their ailments that held a certain similarity.

INDIA
 
Many moons ago, I was an intern at a tertiary hospital, where, patients came for treatment from far and near. One sunny sunday afternoon while I was posted in medicine I met this gentleman from one of the nearby villages. A dusty dhoti clad man in his sixties with a plain white kurta equally muddy from sweat and travel and a small turban and a “potli” clutched in his hand which probably contained a change of clothes and some food to eat. It was the peak of summer and trust me, the temperatures were soaring around 40 degrees. He had registered at the reception and was sent by the receptionist to the male medical ward where I was browsing through some patient files. He walked into the ward with a newly made folder of his. Once he sat himself on the stool next to my chair I began my interrogation.

” Babaji…kya traas hai ??” ( What is the problem ?)
 
” Dactarin bai..chaati dhad dhad hote aahe !!”  ( My heart is beating faster, for the uninitiated that’s Marathi!! )
 
” Kehva paasna ( Since when? )” I questioned.

By then he began to sweat profusely, I took his wrist and checked for his pulse. He continued to talk informing me this had been the case on and off since last couple of days but the palpitations had worsened in the last few hours. A quick check of his pulse showed his heart to be racing well above 160 beats per minute.
I was certainly concerned. In those days we had to bring the ECG ( heart tracing machine) from ICU if any of the ward patients needed a heart trace, which meant a whole 15 -20 minute wait depending on how busy the ICU was. We had three ECG machines for the whole hospital, something I worry about when I think of it even now.

I told the nurse in the ward that I will be back soon and took the man to ICU. In about 10 minutes we reached ICU, I took his trace and he showed VT. (Ventricular Tachycardia)

Not our very own vixx.rediffiland.com Hoi Polloi and Riff raff VT, but a VT that cardiologists love. 
 
In simple layman’s terms let me explain. A, B C and D are four points in the heart and it is A which has been given the responsibilty of all the elcetrical activity needed for the normal functioning of heart. Due to various reasons, many a times A goes slow or lazy or just point blank on strike and then B takes over. But in VT -  C or D takes over when it shouldn’t and creates a complete chaos in the heart and body causing all the electrical activity to go haywire. VT is one of the major life threatening medical emergencies, as an instant short circuit can cause “sudden death”.

And here was this man, with not much to go for as symptoms, chatting away happily complaining of only ” dhad dhad”.
 
The nurses and me included pinned him to the bed got all the vascular access arranged and started him on immediate treatment. Over the next few days we did a few more investigations, started him on required medicines and he was discharged.
 
 LONDON
 
The second incident was a few years later when I was working in one of the most advanced units of accident and emergency in a London hospital.
 
I was on  night duty when at 0300 in the morning the ambulance crew rang to say they were bringing a man in his sixties with palpitations. I was waiting for him in the resuscitation area along with a nurse.

The crew had already acquired vascular access and put him on oxygen. I began my interrogation again.

” Hello Mr X, how long have you been having these palpitations for?” While I was questioning him the nurse was simultaneously getting things ready for a complete ECG.
” Doc, I have been getting these palpitations on and off since last few days and it just got worse in the last couple of hours, hence I thought I’ll get myself checked out!”
 
“Sure thing Mr X, let me have a look at your ECG and start the treatment.”

As I glanced at the ECG, I knew I didn’t have to go through it intensely. Here was another man sitting with a time bomb ECG showing VT.
I told the nurse to start the infusion immediately and went back to examine him. The instant I looked at the man again I knew he was sinking, no infusion was going to help.
I asked the nurse to put a “crash call”. He was still conscious but going downhill pretty fast. Within seconds I had to give him the necessary shocks through the defibrillator but to no avail.
By then the crash team had arrived and we all tried our best to resuscitate him for a good 25 minutes and then, we had to say that it was “the end”.
 
Inspite of witnessing deaths so often, it still has a profound effect on me and that particular day I couldn’t help but think of the babaji and this englishman, so similar in their presentations yet so different in their outcomes. It unnerves me. The best of treatments may not bear fruition and to some, fruits come out of nothing.
 
Surely, there is a force beyond us.