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Tuesday, August 9, 2016

Daaktuur

I am not very fond of you Surgery. But it's not your fault, I just like medicine more. I like eliciting a knee jerk more than I would like fixing a broken knee. But this post is not about surgery per se, it's about a patient that I have recently come across in the ESR. Actually, his relative is what I am going to write about.

Abusive, violent, short tempered, drunk..... he isn't any of those. It's Saturday evening. (I always end up in units which have Saturday emergencies. No Sundays for me!! But, I also have my entrance classes on Saturday and Sunday, which I end up either missing inevitably or reaching them so dead tired and sleep deprived, I wonder if I should just ask for a refund. Hmmmmm..... no digressing, back to the topic.)

So, it's Saturday evening. My engineering friends are probably out in bars and discotheques partying hard after having worked harder through the week, probably gulping down shots of tequila till they can no longer stand on their own two feet. Well, why shouldn't they, they can afford. I am a teetotaller, but I know that one shot costs 1700 and taxes extra. 1700, is what an intern's stipend was two years ago. Then it increased, courtesy my seniors who went on a strike. But, it hasn't increased that much either, one can now probably afford 3 shots. And, here I am inserting IV lines, Folley's catheters, Ryle's tubes, and suturing drunkards who've fallen by the roadside and cracked their skulls open. All work, no study. Sorry, I digress.

So, it's a Saturday evening. I've missed one more class. Today has a heavier than usual. Around 9.30 pm one more fellow wheels in. I ready my set of IV lines, one pink and one blue, to be chosen on the condition of his veins, the three way connector and saline flush and adhesive tape. 3 red vials for viral markers, two purples for blood grouping and cross matching and HbCBC. All is done at spinal level. 

His relative approached me. From his attire, he seems like a Koli (Fisherman). His eyes are red shot, not of liquor, but of exhaustion, a lot of which overflows on his face as well. I take a look at him. He is barefoot. After explaining to him where to take the blood samples and all other things that we require before admissions, he goes away and I get busy with other patients.

At about 1.30 am the flow of patients has ebbed. The lecturer has taken his rounds of the esr and has gone to operate. The houseman has fallen asleep on a stool (wooden), the exhaustion of 18 straight hours taking a toll. He won't sleep long, the next patient will come up in 10 min. His head fallen back weirdly, he'll surely have a sprain tomorrow morning. Somehow, he isn't falling off the table.

I too think of catching a 5 min power nap. I look around for any place where I can rest my head and where there isn't blood stain or some such infective secretion. My back has already started getting spasms. Or should I just solve a few mcqs? The 3 mcqs that I'll manage in 5 min, may be the decider between me getting a seat or spending one more year preparing. I do not enjoy reservations either, so maybe I should go for the mcqs.

"Sir, uuu bluuud banka se khun ka report aa gaya." My thoughts are broken by the fisherfolk. I look at his blood group and tell him to attach the report in his file.

He smiles back. Even though his smile is laboured, and his teeth stained, it is still full of warmth and friendliness.

"Array suno!" I call out to him.
"Aise hospital me bina chappal ke mat ghoomo. Khoon vagaira neeche gira hua rehta hai. Needle, kaanch bhi niche rehta hai. Pair me lag jaayega. Bimar pad jaaoge."

He just smiled back again.

"Kidhar se aaye ho?" I ask.

He smiles even brighter, the exhaustion suddenly disappearing.

"Virar ke aage Arnala aata hai." 
I remember Arnala. When I was a kid we had once gone to celebrate holi at the Arnala beach. Back in those days it wasn't so famous and a lot of families only used to come there. We would board a train to Virar from Dadar. Then take a shuttle to Arnala and then there would be rickshaws to take us to the beach. About 2 hours fun packed journey.

"Haan. Mallom hai." I reply.

"Udhar Shivaji ka killa hai!"

"Acchha! Ye nahi maloom tha mujhe. Mai to sirf beach pe hi aaya hu."

"Udhar se hi killa pe jaate hai. Wo beach se ferry karke jaate hai. Killa pe jaane ka hai bolo. Le ke jaate hai. Do ferry hota hai din me. Ek sakali jaata hai aur ek sandyakali wapas aata hai."

"Algi baar gaya Arnala tab jata hu kille pe."

"Aaap aao hamare ghar pe. Taja taja macchli pakadte hai hum. Dega aapko."

"Array mai non-veg nahi khata."

"Koi baat naahi. Hamara ghar k bahar choota bagicha bhi hai. Aao tum. Taja shabji deta hai tumko."

"Lekin aapka ghar kaise milega mujhe?"

"Wo kuch nahi. Aake kisko bhi poocho, 'DAAKTUUR' ka ghar kidhar hai. Koi bhi leke aayega. Hamara idhar daaktuur nahi hai. To fir koi bhi bimar padta to mai ich sab ko leke jaata illaz ko. Karke sab log mere ko ich daaktuur bulate."

He grinned again from ear to ear.

It's barely been 4 months since we've passed our final MBBS and taken the Hippocrates oath.

"Do no harm" is supposed to be our motto. But some of my colleagues have brushed it aside already! I too feel sometimes that I should take a few liberties and short cuts as well. Eventually, my future is going to be decided by my score in the exams and not by how well I have behaved with someone or how honestly and meticulously I have done my job.

"We are interns. Nobody's life depends on us." Says one of them as he sometimes (which is now becoming everytimeunderfills samples in vials so that he can quickly finish his set of blood collections and rush away to the library. "Even if the lab sends sample inadequate, the houseman will send another sample in the evening to the elab. Nobody's life depends on you."

Now I have an existential dilemma, who is a doctor?
One who's declared that nobody's life depends on him or one who is the only source of hope to sick man on a desolate islet?

Perhaps the latter isn't. He will only be a daaktuur at best.

"Wo mera godhali dekha tumne? Hara tha. Idhar rakh ke gaya tha tabhi. Mil nahi raha. Raat ko soneko laya tha.Leke gaya koi lagata hai. Aise hi sona padega abhi. Dekho tumko milega to. Idhar hi rakhke gaya tha mai. Pccccchhhhhhh......"