Santhosh's ramblings

In one of my recent blogs I had talked about a person who wanted treatment for TB in our center and Diabetes elsewhere and how I had asked him who takes care of him, if the different diseases are being taken care of at different centers. Over last few weeks, the number of patients who are on treatment for their various ailments from different practioners or institutions have been many. A typical example is this 50 year old man who was brought to us by his wife and daughter. He did not seem too keen to see us. He had a bipolar disease for the last 20 years on treatment form Patna, has a chronic alcohol dependent stage, for which he has been to many doctors, and he has a psoriasis, for which he is on treatment from a homeo-physician. We evaluated him and found that he is in moderate liver failure, due to the chronic alcoholism. We asked, what is that you expect from us? They wanted treatment for Psoriasis only. After going through the initial discussions we told him, unless he stops alc

Quite a number of the patients who come to us are the in the geriatric age group. The lady about whom I wrote earlier, her issue on further reflection and questioning was, one of comfort than cure. The family was quite keen to explore options for cure, but what she was asking was for comfort and care. The health care systems they have been to, including ours is not built for comfort or care, but for cure. Comfort for an elderly is, the family around, people to care for her and basic amenities taken care of. She was not sure, once she goes home if she will get the comfort she was experiencing to some extend, in the palliative care ward where she was. But even what was being provided was not enough. Institutions do not allow family to be around to provide care and comfort in a hospital context. We want less disturbance to do the curing. We want all the relatives (other than may be one) out during rounds and nursing care. This is best provided at home, but will Medical care be possible i

This 75 year old lady was brought into our hospital a month back with distension of abdomen. Distension usually being of surgical cause, she ended up in the surgical ward. The next day, our senior surgeon recognized that she had a Renal problem and asked some of us to review. We saw that the lady had a chronic kidney failure with a creatinine of 2.9 – indicating that she has lost almost 60 to 75% of her renal function. An US examination confirmed our doubt. Being of elderly age, and not having options for renal replacement therapy – (Dialysis or Transplant) we did the best we could. We gave her drugs to control her blood pressure, electrolyte abnormalities and prepared the family for a palliative care at home. But the family was very insistent. Somehow she has to be made well, and they wanted to take her to a higher center. Being insistent, and having little trust in our “Diagnosis” and advice, the best we could do was to give them a referral letter. We did not hear from them for

It is a time of fasting for the Muslim communities all over the world. Large numbers of patients who come to us, are from this community, and every day the discussions with patients and families in the ward has been, how can we get them out of the hospital as soon as possible since the fast is on, the festival is coming up. Staying on in the hospital is not something they want to during such a time like this. Someone recently send me a message – why are you not blogging – I did not realize that it has been a week since I wrote – I told that person – It is a season of fast, I am fasting from activities I enjoy, but I did also communicate that this was not an intentional fast from blogging but a forced upon fast due to confusion from too many issues I am hearing each day, but not sure what are behind these issues…Needed time for the confused brain to ramble… Though the fast I talked about in the communities around is physical, what we are observing in our practice of health care

“Suffered in the hands of many physicians” – is what we read in the good book. For the lady with bleeding, who approached Jesus, she would have spent all her money and resources going from one physician to another, but not finding cure in their hands. Today health care in India is about “suffering in the hands of many physicians”.  There was this lady who came with an Ultra sound report to me yesterday. She has had an US which showed a dilated GB, and diagnosed as Cholecystitis and was referred by a well-meaning physician for urgent surgery. She already had been planning for IV fluids, admission surgery etc and had spent money on preparations. Some thing which was not indicated or required at all. Suffered because of ignorance of lack of knowledge – may be? I started talking to her and she said – she is on treatment for giddiness from Patna. This is common here. Treatment for Diabetes from Patna, TB from Government and Asthma from our hospital. I asked another patient recently

The husband walked in with his wife. He said, I have been taking her to many places for these skin lesions on the face, have spend quite a bit of money and  in one sense "Suffered in the hands of many physicians" - can you do some thing for her. I looked at her - her face and body was full of "Pappular eruptions" what we call in medical terms as PPE. I asked a few relevant questions to her about the illness and send her to the examining bed to do a full physical. Then I turned attention to the husband. Asked him about his job - he was a migrant laborer, and I was sure that he would have had some "extra marital affair" and started asking about his way of life, habits, contacts etc. He was polite but clear and articulate - though he was illiterate - I do not do any such things. I go out for  a living, others might but I have my standards! I was quietly reprimanded about my own attitude of seeing beyond what was there. I still was not sure, and I wanted to pr

Adam and Eve’s sin is an interesting incident to reflect on. The pattern of behavior has not changed much from what happened in the Garden of Eden to the current modern age! God had told clearly that these are the limits and a life of submission, within which they are expected to live. And the limits were put by an all knowing God, who knew that the finite human that they were, their faculties of intellect and reasoning, apart from God, will lead them astray! What was told clearly by God, was doubted by humans. Did God really say – was the question Satan raised. Eve knew the facts – God had told. But Serpent had a way of explaining away or turning Gods word into what was acceptable for human reasoning and desire! Trying to turn word into something which fulfills the physical desires, emotional fulfillment and intellectual reasoning – (good for food, pleasing to eye and desirable for gaining wisdom). This rational explanation of the word of God and responding based on that, led