Santhosh's ramblings

65 year old male who came to OPD couple of days back was found to anemic and hypertensive and an evaluation revealed that he had an ESRD – (End Stage Renal Disease – Chronic Renal Failure.) He had just recovered from a Cerebro-vascular accident couple of months back. He was from a lower middle class socio-economic back ground. As we started preparing the family for Renal replacement therapy (Dialysis/Transplantation) Vs Palliative care, to our surprise the relatives seemed to be - too keen and proactive for a transplant! Within 24 hours they had found a donor and was asking to be referred for further management. Such a response seemed too good to be true and so I called the younger brother over to talk. And the story came out. The patient has been married for more than 30 to 40 years but had no children. 2 years back, with the aim of having a child he (? with consent of the first wife) took a second wife. This wife is only 14 years old! (One is never sure about age in these co

Rounds at ICU. 4 patients being cared for following suicidal attempt with organophos ingestion. 2 young men, one girl and another woman. All impulsive decisions reacting to petty issues at home. One wonders - are these petty issues enough to push one into choices and decisions to take their own life. Or are there underlying deeper issues which has been simmering and the current event was an oil poured into the smouldering fire? And then it bursts out. These are not occasional events but in this part of the 'shining India' it is quite common. 600 such patients each year in this one hospital! At least one of them had taken money from a lender at 4/100 per month, making it 48% interest. And I heard this from other patients too, a net work of local financing systems which are owned and run by powerful mafia pushing the unsuspecting poor into abject poverty, in these 'good days' of India. And the next bed was a lady delivered at a local hospital, 9 hours prior to being