The Unanswered Questions.

             I was in the ward  at around 8.00 in the evening, taking a "case" to present the next day. Just a terminology, but surprisingly, how easily it takes away the feelings and emotions attached when you interact with a patient! And after that, around 9.00 went to collect a donation cheque. I was happy, cause the case was excellent with good findings and I had some money in the Bank, and walking happily in the corridor, when I heard something that felt like some one calling out to me from behind. I turned to see an old lady sobbing loudly, "Ae BABA ...... AE". No, she wasnt calling out for me. Neither to anyone else in that fairly crowded corridor. She was calling out to some one more powerful . After sparing her a second, I continued to walk on. For, two reasons, I di not know why she was sobbing, second, I did not know how I could be helpful to her.
            The next morning rounds were no better. As the rounds were going on in the female ward, two of our servants brought in a stretcher. Behaving very freely, the experienced one said to the novice, " मेरे साथ रहेगा तो सब सिखा दूंगा . दो दिन भी नहीं लगेगा.  ये अपना रोज का काम है ."

 At first I thought they were probably taking someone for an X-ray or something, but as my vision followed course, they nicely picked up the body, and wrapped it in the same bed sheet on which she was lying, covered up the face, and took it away as if it was a bundle of रद्धि. I was shocked at this lax attitude, but then again I was reminded that the previous night I was chatting with the sister-in-charge the previous evening and unknown to her an old man had come up behind her to ask for some cotton wool. She casually asked me, "कुठल्या गावातून आला तू?". And the old man, thinking that she had asked him, said "Kolhapur'. But she was so embarrassed that the old man thought she called him "TU". She kept on appologising to him and as far as I remember, told him about a dozen times,"आजोबा में तुम्हाला 'तू' कशी म्हणू?", even though he had no objections. Yet in the morning, a lifeless body, had no value. So, it is life only that garners respect. And as we will be celebrating our 65th Independence day today, we will be remembering and celebrating the martyrs and their contributions. No, then it means death garners respect. Complex!!!

            On the way out from the wards, we found a woman fallen unconscious in the corridors. In all probability she had an epileptic fit. The HOU directed us to take to casualty. On enquiry, the relations informed me that her husband had just expired. 

            Such is the beauty of medicine, it enriches you. There are innumerable such experiences that keep on happening every second. Every moment here you have to make a decision, are you supposed to be happy or be. Should I be happy for I have seen a patient with a rare disease and learnt some great things. Or am I supposed to be sad, that this individual is going to suffer a slow painful death, and in our setting not even perhaps afford the cost of his treatment, even after all possible donations and concessions.

               I strongly remember,  my HOU in surgery telling the houseman not to delay the discharge of a patient and in his own words, "For you this cost may be nothing, but for him, he may have to sell his farm and house." That dictum I want to remember and follow.

                But, as people fall sick, and sometimes the situations are such that despite wanting, you cant do anything, and then death becomes a daily affair, you try your best to preserve life, but death takes the upper hand. I think if you remain overtly sensitive, you will not be able to survive. You need to distance your self a bit. But, there are also complains now of doctors losing their personal touch. So, there is a fine line between attachment and detachment. Till where it extends, I do not know now.

              These are just thoughts in my mind, to which I think only time shall provide the answer . Perhaps tomorrow, perhaps after a decade, or perhaps even later. Whether I will comply with the dictum I now have set for me, or will I be forced to surrender to other forces and stresses, I do not know. I know some, but much I do not know.

             But, this is what medicine is: striving to find the answers. There will always be some questions unanswered. And on an personal note, that is precisely the reason, why I enjoy medicine- it gives you the opportunity to be a student for life.

            And that is why a doctor is always a practitioner, and never a perfectionist, because perfection marks the end of learning! These are some unanswered questions.

The Sthethoscope Poem

There was a young man in a boston town,

He bought him a stethoscope nice and new

All mounted and finished and polished down,

with an ivory cap and a stopper too.

It happened a spider within did crawl,

And spun him a web of ample size

Wherein there chanced one day to fall

A couple of very imprudent flies.

Now being from Paris but recently

This fine young man would show his skill.

And so they gave him his hand to try

A hospital patient extremely ill.

Then out his stethoscope he took

And on it placed his curious ear,

Mon Dieu! said he with a knowing look

Where here is a sound that's mighty queer

.

There is a empyema beyond a doubt,

We'll plunge a trocar in his side

The diagnosis was made out-

They tapped the patient ;so he died.

Then six young damsels,slight & frail,

Received this kind young doctor's care

They all were getting slim and pale,

And short of breath on mounting stairs.

They all made rhymes with ''sighs" and "skies"

And loathed their puddings and buttered rolls,

And dieted much to their friends surprise,

On pickles and pencils and chalks and coals.

So fast their hearts did bound,

That frightened insects buzzed more;

So over all their chest he found,

The rale siffilant and rale sonore

He shook his Head.

There's Grave's disease,-

I greatly fear you all must die;

A slight postmortem,and if you please,

Surving friend would gratify.

The six young damsels wept aloud.

which so prevailed on six young men.

That each his honest love avowed,

where they all got well again.

This poor young man was all aghast;

The price of stethoscope came down;

And so he was reduced at last,

To practice in a country town.

Now use your ears,all that you can,

But don't forget to mind your eyes.

Or you may be cheated, like this young man.

By a couple of silly,abnormal,flies.

By Oliver Wendell Holmes- An American physician & Poet Harvard Medical School.

BEFORE THE ALARM GOES OFF....

28th June, 2011- a date which will always remain etched in my mind, not because it is the day when I have proposed, but because it marks the day the “Final rotations” of our clinical postings have begun. As I see it, the CET results have been declared, and the grand joons will be arriving any day soon. It just seems yesterday, that my results were declared and I landed up in the college of my dreams! Drishti’09 and Aavishkaar’10 seem such a memorable past. Now, it will be someone else’s experience. And very soon GOSUMAG’11 will fall under the same category.

What makes me think more, more than that these are the final months for us to learn, practice, expertise and master our clinical skills, is that these are the final months indeed. “One and a half year more”, someone may point out to me, but don’t you realise how quickly these three years have gone past, these months will nothing but just fly away as well! And if my friend Einstein’s theory of relativity is to hold true, then these will run out even quicker, even before you and I realise it.

On a brief and quick flashback, I am amazed at the amount of experience this place has helped me amass. And I am sure, greater experiences are still in the pipe-line. It has indeed “metamorphosed” me, but in a good way and will still do some more.

What the future holds in store for us, only time can tell. Only time will prove whether 28th June marked “THE BEGINNING OF THE END” or just “THE END OF THE BEGINNING”! Till then I wish to extract more than a hundred percent of joy and memories out of the precious moments that I have left here at the Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial Hospital. A sound gongs in my head “TIC – TOC, TIC – TOC ............” can you hear it? Very soon, the alarm will go off and the dream shall be over!