Felt a little less of myself today. Did get another opportunity to bend the situation. Am beginning to realize that there are indeed streaks of a dictator in me. And while always, almost always the intention is for somebody's benefit, the method of execution of this intention is not always desirable. I am lucky to get a very kind hearted man as my teacher who gives me full brreadth and space to carry things out the way I choose. And while my strictness and concern for hygiene may prevent bedsores, stops pyorrhoea, and maybe causes people to recover, it doesn't necessarily apply to all. Especially people who bend the "Rules".

He did bend the Rules. And to some extent I was trying to put him back in place. But guess the result was undesirable. If he continued to act on my advise he would have still been in the ward. I hope he has the good sense to return a second time. I was almost asking him to stay in the ward. But two minds acted together and on second thoughts I asked him to go to the emergency. Predictably he did not.

For all his act of absconding with the file for twelve hours and returning minus the Ryle's tube and Negative Suction eighteen hours later, its true, as my colleague said, 'He could have done a murder and come walking back', which he did. But this was not the regular alcoholic Pancreatitis or the alcoholic liver disease you meet in wards frequently, whose chief intention is to get well to be able to go home to resume drinking. This was a scared, almost semi-apologetic alcoholic who I once had to virtually bully to believe that he would survive and that his love for his kids did not mean that he must spend his 'last moments' with them but to fight back, take medications and get cured.

They left for some place without ever telling me, breaching all the trust I thought they had in me which they had made amply evident in the 4 days that I had been treating them. we knew almost 6 hours later he was not in the ICU he was supposed to have been sent to. He returned at 5 the next morning, walked into the ward and requested admission. I gave them one of the biggest scolds that comes out of my pits once every two or three weeks, but still had asked him to lie in one of the beds till my Professor came. But a discussion with the Co-PG who was on duty the same time and I asked him to go to the Emergency, get another card and get admitted. Almost contacted the Doctor on duty, but he wasn't in the Emergency, or the concerned ward today morning.

he was not well. Did I deny Health? Possibly my action sounds politically and officially correct and in th event he was upto any mischief it may even have been astute of me to have sent him to the Emergency. But still a sense of foreboding persists. The possibility that the ignorance of the intervening twelve hours can so drastically change a treatment decision. He was an alcoholic, possibly a wife beater or a rogue. But he was sick. And minutes before he absconded he was talking about seeing his kids, and I am quite sure had he mentioned that he had gone to see his kids I would have allowed him to come back to the ward. But fear of the act becoming a precedence to others to repeat it for their own means, no communication with my seniors who would have been in a better position to decide, and somewhere the fear that my Professor would ask me the logical question my Co-PG had asked, about using his hospital stay to act as an alibi for possible wrong or criminal act prevented me from doing that. And I sent him away.

He has not been sighted ever since. I hope he has the good sense to come back again. He wont make it otherwise.