I have to learn hacking. There is a lot to learn to use this awesome machine called PubMed. This doesnt have an interface like Google where even a tot can type Tchaichovsky and get results. Using Pub Med requires brains...and patience. And I am desperately in search of someone who knows how to use it, and abuse it. Not that I will pirate stuff out the way I am doing in other aspects of my learning ( enriching the Third World, one person at a time, spoken in third person..) but I want to know it so I can see my patients better, make better diagnosis and treat them with the best of the available diagnosis.
As an aside, was happy with the fact that my diagnosis of cutaneous tuberculosis/ papulonecrotic tuberculide was bang-on....They will just take the biopsy for the apple jelly nodules.
And oh boy!! I did find Dubin 6th edition and downed it...Gotta gotta gotta gotta get into this more. And I will be the biggest e-bandit queen of northern skies.....Invisigoth...I want to believe this.
Calls for celebration. Only those who know it can know what I am saying.
Yippeeee....
Friday, April 9, 2010
BADAM SINGH
I got bitten by a dog 3 days back, who is flexing his Pterygoids thanks to the kind hearted souls of PGIMS Girls Hostel who throw him scraps with unfailing regularity. Trouble is, this testosterone racked canine mostly has a field day in our hostel premises doing this with no one to stop him post Maneka Gandhi's campaign to sterilize animals and not kill them. Although for me, this happened as a consequence of trying to help a Pathology Co-PostGraduate's mother with her over weighted water jugs when I accidentally stepped on God knows what part of his body. At least as much as the others have told me, he bites unprovoked. But for me, I provoked him. He spun around with an injured ego tantamounting to anger and snipped my Gastrocnemius, and mildly abrading the other part of my calf as would befit a set of canines and set of incisors his size. I had 2 big sets of briuses and one canine that dug deep. Thank god my Olive 'war dress' saved me further injury.
It was not the pain, or the bite marks. It was the apprehension. The dog is semi rabid. I am almost as scared about it as one would normally expect to be post needle stick with a seropositive. More trouble is the set of ATS and the Anti Rabies Vaccine that came after it ( the immunization sister first gave the rabies shot on my left arm, the ATS shot in my right, and solemnly declared.."your arm is gonna hurt for 2 days doc..ATS hurts". I would have taken it in my butt if she could be a little early..). Plus my viral fever or whatever it was along with the snot came up to clog my sense of smell and balance badly. I was having a major headache and my Professor was the dearest person on earth to see beyond my silence that I was not feeling well ( my wellness quotient inversely proportional to my temper and my voice in the ward, as well as the purpose of my walk, if not necessarily the pace of it). I was given a off post afternoon round on Emergency day, post Post Emergency day and Post Emergency Night. I will be very grateful to Prof H for this. We may work endlessly but he knows. And he gives us the room. We don't work like dogs; literally, like some of my Co-Pgs are having to do. A good atmosphere can pummel or plummet the ergonomic quotient in an institute like a hospital, where efficiency and emotions are the key words for success. And I know this because unlike P, my co-PG who is either summarily dismissed or looked upon with sympathy, I am looked upon with either fun, or amusement, or appraisal. I want to insist that despite my sense of humor I am a very serious person. But seems no one is intrested to understand that I always appreciate that I should have a sense of gravity about me. Guess I cant have that. People just end up seeing me as angry and benign. I want to be snaky and diplomatic. But circumstances don't allow me. I laugh too much. And I still take them to my eyes. Kept me alive through everything. and I was granted 15 odd hours of full recovery, during which I saw Shutter Island, read Revolutionary Road and slept and slept and woke up not worrying about going to ward for once.
In any case, Prof H finally came to know of my Curious Encounter with the Dog and called up Badam Singh, the Chief Security Officer ( name preceding reputation or vice versa I do not know, as you will know later) and he readily agreed to take this dog to his destiny ( not revealing what it is...) I was happy, especially after my written complaint was met with the Matron deciding that the dog would not be found inside the hostel ( it has bitten me, my SR, Dr J, Dr P, and three or four others outside the hostel and in the hostel premises in every instance). I reiterated that fact. To no avail. The female sweepers were summoned and told to find the dog wherever it was and to drive it outside the hostel. They all went about in every directions. I went to the washroom beside the Matron's office and he lay there, in all his glory, casually inspecting me. I walked back and told the Matron the dog was right under her nose. To this she summoned the nearest sweepress who was running about nearby, handed her a bed post and asked her to drive the dog out of the hostel. And she did..the dog nimbled along out of one hostel into another of the five. My written request of a 'potential health hazard, subsequent to its repeated unprovoked attacks on the inmates of the hostel' had this fate.
Badam Singh's goons ( read our ablest security officers) made a fatal mistake. Whereas they come with the unfailing regularity and timing of the Police in Bollywood movies when doctors call them in an hour of need, they rose to precrime levels in Rohtak's Minority Report and huddled up few of our own. Having beaten up the Class Three workers is like chugging a Lead ball up the sewage system of the Hospital and the stench was smelled almost immediately. To add to this, like a true captain of the sinking ship, Badam Singh did not back down from his co-worker's stance and went on insisting that the 3rd Class workers were at fault. And as a result of this all Class 3 and Class 4 workers of our hospital are on strike. Badam Singh's days are supposedly counted. We have no water, no reports, no ECGs and no support.
I met my old canine friend again as I walked back to the hostel and it was standing jaw pointing to air. His other cowardly-peppered-neither-here-nor-there female bitches stood flanking him. They smelled the air and casually turned their behinds to me to show what they had done to my written complaint, my Professor's request, the bedpost chase, and Badam Singh's cutting the ticket for them. Basically this time, they ignored me.I walked back to my room with my tail between my legs. I can only pray they find people like me so insignificant as to forget our existence and we will be ever willing to step on their shit and not complain to anyone, give them food before we take ours, and say amen every time we are bitten by them.
And tomorrow is time for the second shot of Equirab. ( 4 doses remaining)
It was not the pain, or the bite marks. It was the apprehension. The dog is semi rabid. I am almost as scared about it as one would normally expect to be post needle stick with a seropositive. More trouble is the set of ATS and the Anti Rabies Vaccine that came after it ( the immunization sister first gave the rabies shot on my left arm, the ATS shot in my right, and solemnly declared.."your arm is gonna hurt for 2 days doc..ATS hurts". I would have taken it in my butt if she could be a little early..). Plus my viral fever or whatever it was along with the snot came up to clog my sense of smell and balance badly. I was having a major headache and my Professor was the dearest person on earth to see beyond my silence that I was not feeling well ( my wellness quotient inversely proportional to my temper and my voice in the ward, as well as the purpose of my walk, if not necessarily the pace of it). I was given a off post afternoon round on Emergency day, post Post Emergency day and Post Emergency Night. I will be very grateful to Prof H for this. We may work endlessly but he knows. And he gives us the room. We don't work like dogs; literally, like some of my Co-Pgs are having to do. A good atmosphere can pummel or plummet the ergonomic quotient in an institute like a hospital, where efficiency and emotions are the key words for success. And I know this because unlike P, my co-PG who is either summarily dismissed or looked upon with sympathy, I am looked upon with either fun, or amusement, or appraisal. I want to insist that despite my sense of humor I am a very serious person. But seems no one is intrested to understand that I always appreciate that I should have a sense of gravity about me. Guess I cant have that. People just end up seeing me as angry and benign. I want to be snaky and diplomatic. But circumstances don't allow me. I laugh too much. And I still take them to my eyes. Kept me alive through everything. and I was granted 15 odd hours of full recovery, during which I saw Shutter Island, read Revolutionary Road and slept and slept and woke up not worrying about going to ward for once.
In any case, Prof H finally came to know of my Curious Encounter with the Dog and called up Badam Singh, the Chief Security Officer ( name preceding reputation or vice versa I do not know, as you will know later) and he readily agreed to take this dog to his destiny ( not revealing what it is...) I was happy, especially after my written complaint was met with the Matron deciding that the dog would not be found inside the hostel ( it has bitten me, my SR, Dr J, Dr P, and three or four others outside the hostel and in the hostel premises in every instance). I reiterated that fact. To no avail. The female sweepers were summoned and told to find the dog wherever it was and to drive it outside the hostel. They all went about in every directions. I went to the washroom beside the Matron's office and he lay there, in all his glory, casually inspecting me. I walked back and told the Matron the dog was right under her nose. To this she summoned the nearest sweepress who was running about nearby, handed her a bed post and asked her to drive the dog out of the hostel. And she did..the dog nimbled along out of one hostel into another of the five. My written request of a 'potential health hazard, subsequent to its repeated unprovoked attacks on the inmates of the hostel' had this fate.
Badam Singh's goons ( read our ablest security officers) made a fatal mistake. Whereas they come with the unfailing regularity and timing of the Police in Bollywood movies when doctors call them in an hour of need, they rose to precrime levels in Rohtak's Minority Report and huddled up few of our own. Having beaten up the Class Three workers is like chugging a Lead ball up the sewage system of the Hospital and the stench was smelled almost immediately. To add to this, like a true captain of the sinking ship, Badam Singh did not back down from his co-worker's stance and went on insisting that the 3rd Class workers were at fault. And as a result of this all Class 3 and Class 4 workers of our hospital are on strike. Badam Singh's days are supposedly counted. We have no water, no reports, no ECGs and no support.
I met my old canine friend again as I walked back to the hostel and it was standing jaw pointing to air. His other cowardly-peppered-neither-here-nor-there female bitches stood flanking him. They smelled the air and casually turned their behinds to me to show what they had done to my written complaint, my Professor's request, the bedpost chase, and Badam Singh's cutting the ticket for them. Basically this time, they ignored me.I walked back to my room with my tail between my legs. I can only pray they find people like me so insignificant as to forget our existence and we will be ever willing to step on their shit and not complain to anyone, give them food before we take ours, and say amen every time we are bitten by them.
And tomorrow is time for the second shot of Equirab. ( 4 doses remaining)
Monday, April 5, 2010
UNLOADING
Did away with half my clothes gathered from my Delhi days. Feels like undergraduate days when I would get a whole new wardrobe all at once, and splurge on these excesses, and give away all the clothes I used to discard all at once. And I have decided the only way I can keep my room clean is to get rid of the excesses is to throw away everything that is not needed. I have already taken about the dozen micropore that were present in my room and the equal number of heparin vials. The heparin I have kept to give to CKD patients who cannot afford. The micropore I have given to the junior sister, I do not know how so many needles came into my room but probably filling my pockets with syringes and heparin and needles got them there permanently and they finally came to my room. Anyways, tomorrow they will go to Ram Phal..
Been keeping terribly busy even though ward has been kinda light. All at once, we are writing papers, studying cases ( leave me out...I am not doing that..) and doing OPDs and Casualties and started with Rheumatology Clinics too. I have been appointed the official typist which means that everytime I dont have some work in the ward I am supposed to be free. Well sometimes its okay, but at times its too much, because I cannot complete my movies nor finish my Revolutionary Road...
And most importantly, the fan of my laptop has perhaps stopped working which means that bittorrent will stop working. S is coming to India in June and I have implored him to get a good one for me from US. But knowing my impulses I might just as well take off to a shop in Delhi and get a new one just like that. People crib about about their favorite things to be this and that but for me I am dead if my Bittorrent stops working....And right now I am downing a lot of good books and novels. Just did in the Britannica's Encyclopedia of Literature....
Rest of life is as usual..limited in scope and presence. And I am keeping busy which helps a lot. Just hope I learn ECGs well and learn to intubate fast. And read something about Computer Security and the like.
Been keeping terribly busy even though ward has been kinda light. All at once, we are writing papers, studying cases ( leave me out...I am not doing that..) and doing OPDs and Casualties and started with Rheumatology Clinics too. I have been appointed the official typist which means that everytime I dont have some work in the ward I am supposed to be free. Well sometimes its okay, but at times its too much, because I cannot complete my movies nor finish my Revolutionary Road...
And most importantly, the fan of my laptop has perhaps stopped working which means that bittorrent will stop working. S is coming to India in June and I have implored him to get a good one for me from US. But knowing my impulses I might just as well take off to a shop in Delhi and get a new one just like that. People crib about about their favorite things to be this and that but for me I am dead if my Bittorrent stops working....And right now I am downing a lot of good books and novels. Just did in the Britannica's Encyclopedia of Literature....
Rest of life is as usual..limited in scope and presence. And I am keeping busy which helps a lot. Just hope I learn ECGs well and learn to intubate fast. And read something about Computer Security and the like.
Thursday, April 1, 2010
2nd April 2 15 am...
Since I promise to write about nice things in this blog I will not mention how things have been going for me after one accidental discovery on the internet...and weirdly too this was yet again a consequence of following my gut feeling after a dream. Since then, I have been thankful of how the perspective really shaped itself out. Sometimes I think I have a notoriety for overestimating people and having more faith in them than they really deserve. And doing just the opposite for me. In any case, I am grateful the consequence of it all is that it has made it easier on my part not to repose anymore faith on any person to the extent that your vulnerability is taken advantage of. Now since a lot of the soul is a wasteland, I am trying to make my job bloom some flowers in it...and mercifully, thanks to some people, it has....Besides, I have become so independent over the last 3 odd years that things don't affect me anymore, ( or so I thought...but a recent discovery made me physically puke before I regained composure...so I don't know if I am any more mature than what I claim to be and know I am not) and thankfully I have a lot more important people in my life who bestow their living seconds in my hands. To these at least, if not the others who have done the splendid job of taking the word 'faith' out of my life and turning a caricature of it, I have more important things to do. The rest is upto God.
I have turned strangely irreligious here. Its a sharp contrast from those days in Cuttack when I used to bow down before God at every turning, carry conversations presumably in lieu of soul searching during some of my most trying periods of life; here, strangely I do not feel like bowing my head in front of any temple, except when I am thinking of some patient I desperately want to survive ( who usually doesn't survive...its usually too late before my enthusiasm matches my capacity to do that running around....) I feel irreligious because of a personal void that I cannot fill in because life is all about work, work and work, and there is hardly any conversation, any education, and any soul searching...even with myself if not with company...There is just no time...I haven't touched books for quite some time now, with the promise that I wont be doing so till my First Year gets over in June...because all my life I have done nothing else except live with them....Thanks to Dr S and Dr P, two wonderful women and fantastic doctors, I have managed to gain back some perspective, especially from the former, on how to go on with nothing in hand. So the result is that some work is to be done, in order for some dreams to be fulfilled, and I need to say a few goodbyes to some people who have stayed as very important portions of my life and thoughts for some time now. And that will be done soon. And after that, I begin my life...a trip to Ladakh, or any place up here...And I go alone if no one else comes along. And then my life and how I want to be as a doctor once I am done with these ward duties, and how I choose to be with whatever time is left over.
First year came and went like a jiffy...Now I know the way the Health Machinery of this state works, including the tweaks and fixes. I have given my best, in terms of sincerity and that old bad habit of not going back on my word...Someone asked me the other day if my Professor was happy with me. I have pondered over it. You know, at no point in time have I ever thought of doing something because I want to please some faculty member. My urges have been purely patient driven and clinically oriented. I love typing PowerPoint slides for my boss because I enjoy working with computers... I have opposed vehemently to some developments here, and then it was not because an ego was involved, but rather, because I did not think there was anything clinically to be done. Nor have I the capacity or charm or sweetness to sweet talk the VVIPs that get admitted here. I talk tough. The other day, I sounded off the CM's PSO whose mother ( who looked fit enough to be the PSO of Sonia Gandhi...in terms of attitude at least) was admitted for Chronic UTI; I made it amply clear that neither did I appreciate nor did the disease of the person appreciate that ceaseless smoking of cigarettes should occur in a 10 by 10 room. And contrary to what I thought about the 6 feet 4 guy throwing me off, the room had a freshener on the next morning I went to visit her. Here, as a hospital, and the only one in the entire state, with vigilance, uninterrupted attention, moolah and Paybacks in terms of references ranging from Hooda to Gandhi, we delegate tertiary care to a few, secondary care to most, and primary care to a considerable chunk of our inflow. Thing is, even with the circumstances existing, even minor attention to details, despite the daggerended cooperation between various units, a little work can dramatically improve the morbidity and mortality indices of this hospital, and the state. We just need some people who have the spine to push through the idea that nothing is more important to know than the illness, and nothing is more important to achieve than the cure of this illness.
On a personal level, I finally got an independent cupboard of my own so that I don't have to run with toothpaste, bed sheet, mosquito coils every alternate day to the ward, the providence will make me much more comfortable in the ward....Though the lack of a proper loo makes it very difficult for my precision timed bowel and bladder habits...And I hate to check BP of patients with a full bladder and anguishing bowel in the morning with a smile on my face. God forbid if anyone does the cardinal scene of calling me 'sister' then....And with morning covering casualties beginning this week, the real day has arrived. We will be all out..in the open...and alone, and we have to prove it. Thanks to my SR, I have made some headway in distinguishing ICMP with LVF/CHF from COPD with CHF and the different management in both...What scares me is ECG...I am pathetic in it...except gross changes that can be interpreted by an ant...And I hate myself for being so bad in this. My unit is hectic with work that goes on 24/7...With file work and countless other things and with my room that looks like the pit of a pig any day with all the books and stuff I have got piled in one room, life is a mess from sanitation point of view. Even if I am reading Revolutionary Road, I find it irritating and want to slap April Wheeler sometimes for being such a cold, heartless bitch. Some women never understand the meaning of love. (As an afterthought, what about the men who are made like that? I have no words for them)
Rohtak is on its way to the oven. Life is good. My left leg is markedly swollen both perhaps as a result of obesity and also postural...I haven't been able to start a lot of things I promised to, but I am glad I have taken some good decisions and have stuck to them.
Going home last week of June. And coming back after the final goodbye to start the justification process thereof. Enough has been spent from life so that now the wastelands are on the verge of frutification for all times to come
I have turned strangely irreligious here. Its a sharp contrast from those days in Cuttack when I used to bow down before God at every turning, carry conversations presumably in lieu of soul searching during some of my most trying periods of life; here, strangely I do not feel like bowing my head in front of any temple, except when I am thinking of some patient I desperately want to survive ( who usually doesn't survive...its usually too late before my enthusiasm matches my capacity to do that running around....) I feel irreligious because of a personal void that I cannot fill in because life is all about work, work and work, and there is hardly any conversation, any education, and any soul searching...even with myself if not with company...There is just no time...I haven't touched books for quite some time now, with the promise that I wont be doing so till my First Year gets over in June...because all my life I have done nothing else except live with them....Thanks to Dr S and Dr P, two wonderful women and fantastic doctors, I have managed to gain back some perspective, especially from the former, on how to go on with nothing in hand. So the result is that some work is to be done, in order for some dreams to be fulfilled, and I need to say a few goodbyes to some people who have stayed as very important portions of my life and thoughts for some time now. And that will be done soon. And after that, I begin my life...a trip to Ladakh, or any place up here...And I go alone if no one else comes along. And then my life and how I want to be as a doctor once I am done with these ward duties, and how I choose to be with whatever time is left over.
First year came and went like a jiffy...Now I know the way the Health Machinery of this state works, including the tweaks and fixes. I have given my best, in terms of sincerity and that old bad habit of not going back on my word...Someone asked me the other day if my Professor was happy with me. I have pondered over it. You know, at no point in time have I ever thought of doing something because I want to please some faculty member. My urges have been purely patient driven and clinically oriented. I love typing PowerPoint slides for my boss because I enjoy working with computers... I have opposed vehemently to some developments here, and then it was not because an ego was involved, but rather, because I did not think there was anything clinically to be done. Nor have I the capacity or charm or sweetness to sweet talk the VVIPs that get admitted here. I talk tough. The other day, I sounded off the CM's PSO whose mother ( who looked fit enough to be the PSO of Sonia Gandhi...in terms of attitude at least) was admitted for Chronic UTI; I made it amply clear that neither did I appreciate nor did the disease of the person appreciate that ceaseless smoking of cigarettes should occur in a 10 by 10 room. And contrary to what I thought about the 6 feet 4 guy throwing me off, the room had a freshener on the next morning I went to visit her. Here, as a hospital, and the only one in the entire state, with vigilance, uninterrupted attention, moolah and Paybacks in terms of references ranging from Hooda to Gandhi, we delegate tertiary care to a few, secondary care to most, and primary care to a considerable chunk of our inflow. Thing is, even with the circumstances existing, even minor attention to details, despite the daggerended cooperation between various units, a little work can dramatically improve the morbidity and mortality indices of this hospital, and the state. We just need some people who have the spine to push through the idea that nothing is more important to know than the illness, and nothing is more important to achieve than the cure of this illness.
On a personal level, I finally got an independent cupboard of my own so that I don't have to run with toothpaste, bed sheet, mosquito coils every alternate day to the ward, the providence will make me much more comfortable in the ward....Though the lack of a proper loo makes it very difficult for my precision timed bowel and bladder habits...And I hate to check BP of patients with a full bladder and anguishing bowel in the morning with a smile on my face. God forbid if anyone does the cardinal scene of calling me 'sister' then....And with morning covering casualties beginning this week, the real day has arrived. We will be all out..in the open...and alone, and we have to prove it. Thanks to my SR, I have made some headway in distinguishing ICMP with LVF/CHF from COPD with CHF and the different management in both...What scares me is ECG...I am pathetic in it...except gross changes that can be interpreted by an ant...And I hate myself for being so bad in this. My unit is hectic with work that goes on 24/7...With file work and countless other things and with my room that looks like the pit of a pig any day with all the books and stuff I have got piled in one room, life is a mess from sanitation point of view. Even if I am reading Revolutionary Road, I find it irritating and want to slap April Wheeler sometimes for being such a cold, heartless bitch. Some women never understand the meaning of love. (As an afterthought, what about the men who are made like that? I have no words for them)
Rohtak is on its way to the oven. Life is good. My left leg is markedly swollen both perhaps as a result of obesity and also postural...I haven't been able to start a lot of things I promised to, but I am glad I have taken some good decisions and have stuck to them.
Going home last week of June. And coming back after the final goodbye to start the justification process thereof. Enough has been spent from life so that now the wastelands are on the verge of frutification for all times to come
:(
Tired of listening to Beautiful World by Coldplay...Cannot wait to change my ringtone...Trouble and The Scientist lasted longer...
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