HOLI continued

This is not an excuse to say what i was supposed to do in Holi and what I did not. No I did not clean up my room, and I did not see much movie either. The previous night was my worst as I did the night shift in the ward for a friend who flew to Pondicherry to be with his love for Holi. And so after I finally went to the Resident Room of ward 3 this is how the events unfolded.
12 30 am a patient of one unit with Diabetes Mellitus, with Diabetic nephropathy and an amlost hemi mediastinum full of fluid with ensuing dried up corneas and a death rattle was present. I cannot say if the presence of a Nephrologist Senior Resident makes me more attentive about fluid and my personal disgust for bad smells puts me off, but in any case, I ran him a fluid, for he was severely dehydrated, with a shot of Bicarbonate, and a BGA. Explained the prognosis, came back. He went 1 hour later.

At about 3 am, there was a 85 year old man with Tetanus, who must have gone a good amount of time by the time the attendants called me. Took off his tracheostomy tube, his Central line, and Foley's and declared him.

At about 4 30 a young girl I had seen passingly receive a blood transfusion lay dead with dilated corneas and cold extremities in the lap of her mother. She had SLE and was dialysed twice, the last time was 2 days before her dialysis. To me she appeared most okay, and if she had a disequlibrium, or went into altered sensorium, neither did the attendants inform me or the unit's doctor ask me to see her when he gave me the over for serious patients. The leukemia patient was quite fine, with a good pulse and some breathlessness. I fail to understand even now why the girl should have gone.

At 6 30 a case of Alcoholic Liver disease with Encephalopathy with Spontaneous Bacterial Peritonitis lay dead with no attendants by his side, with no medications given the previous night because he had no one who would buy it for him. I had seen him discharged days before from the unit my ward shares with and was mildly peeved when he came and sat in the Resident room right next to where we were having a short and much needed tea break. And I had noticed that despite being on his feet, he still had residual slurring of speech, mild icterus and some disorientation. Had told him the formula of low salt, less water and more sugar. Whats the use, he could have gone home and abused alcohol again.

This was a very sad night and a sad beginning for Holi. I have not had a night so far when I have seen 4 people succumb just like that. Finally I remarked to the sister about there being a big possibility of me having a cardiac arrest next. She remarked equally candidly that I cleaned up the ward right before the next Emergency.

I am not sad because I did not get to sleep a wink or that it was a terrible night to have. What I am sad about is that none of the patients were resuscitable, and a big extent why that happens is because of the situation we are put in. Neither was I in the best of health, and even if I could have done an intubation, none of those who went could have come back. The diabetic had to go. The Tetanus guy had gone, the Alcoholic Liver disease I frankly did not put much thought to going by his past 4 episodes of admissions and continual drinking. I am still confused about the Lupus girl. And this time there were no intravenous shots given by the sister through the Central Venous line. I don't know why she went. I saw her quite relieved with a blood transfusion going on when I was running for the tetanus guy and earlier for the Diabetic one. Her attendants mentioned that she merely stopped breathing.

It was the worst night in ward for me. Given that had there been anybody else it would still have been the same, but it brings up bigger questions of having a Leukemia, a tetanus, a Lupus with renal failure, an Alcoholic liver disease lying all together with 30 others and being looked upon by just one Doctor with only 8 months experience.

Its about the value of a life in India, which possibly being 1 divided by a Billion, doesnt amount to much.

As an aside I have been having some really thick Sputum production for myself for which I have suspended all my other activities and am waiting to get cured. The other side of the story is over, and I am gearing up for the Emergency, which with Holi being the event for upturning of two buses, is bound to be very hectic. Today is my PreEm, and I hope I will enjoy it somewhat.