Santhosh's ramblings

D (death) is a topic we seldom talk about. Or if at all we talk, we talk it over for a short time and then move on to other immediate and urgent issues. Last few days, some of us have been constantly faced with or heard about deaths of many around us. Last week, practically every day, one person would have been brought dead to our casualty. Elderly, neonates, young girls and middle aged. Maybe it is the severe cold around this part of the country, that they are unable to reach the hospital in time. In the middle of these, a middle-aged lady in her early 50s, known well to many of us passed away after a short spell of illness due to cancer, away in Western India. Then we had the untimely death of the young surgeon in Odisha, who was known to many of us. There was a young boy of 14 years with whom our team had spent time planning for his re-education (check my previous blog) who was brought in with suddenly hepatic failure and died in less than 24 hours. During these events, there h...

As I walked into the emergency, the sight I saw was chaotic. One elderly lady who had been brought dead was being taken out of the emergency. There was a very young girl, probably less than 20 undergoing cardio-pulmonary resuscitation. There were two other children quite sick on oxygen and support. Two Doctors were struggling hard to resuscitate this young girl. Her heart rate was less than 30, she had no spontaneous breathing and was brought in just then referred from another center. I joined the team and tried our best with various methodologies of resuscitation for more than one hour, but she succumbed to the cardiac event she had suffered by ingesting Aluminum Phosphide, a deadly poison. She looked very young and innocent. And we had no idea what had prompted her to take this drastic step. A few minutes later as we were explaining to the family, the nurse in charge pulled me aside and told me the story. This nurse, while we were trying to resuscitate the girl, was talking to t...

Unusual for us, we found ourselves on the road this time on Christmas eve and Christmas day. For me personally, I did not look forward to it. Brought up in the tradition of Christmas eve carols services, (which has been given up many years back when we moved out of our home state) Christmas morning services, meetings with friends etc., a Christmas on the move was not something I was happy with. So to motivate myself, I reflected   on the Christmas story and took comfort in the fact that Mary and Joseph travelled 90 kms on foot (in full term pregnancy), Shepherds travelled from far outside town, into town, late in the night or may be early hours of the morning, the wise men set out on a tedious long journey…..Till someone pointed out that these people travelled out of dreams visions and political compulsions, and I was left wondering what vision dream or political compulsion drove me this Christmas…. I took a book to read during the journey and the back cover caught my attent...

As we look around in the global leadership circles, political and otherwise, we are clearly seeing some common trends. The type of leaders that seems to connect with the majority are those who can appeal to the perceived aspirations of the powerful and the majority. Or the middle class who are the majority. The connect is through the power of rhetoric, and charisma, offering them what they want to hear, generally an immediate promise of a resource rich economy. Some use polarizations based on certain groups or ideologies as the binding force, but whatever it is, it the ability to connect and offer what the so-called majority seem to aspire that set these leaders apart. The aspirations of the majority are, what they themselves see as best for them, the resources they require. The person who can “connect” is their leader and even adulated by some as their “saviour”. For e.g., If they have been longing for bread and these leaders, respond – “Last many years they have not offered w...

The last few days, spending time in my home town and state, has been an interesting time. Primarily reliving memories of my parents who passed away recently as I tried to sort out some legal and other paper work. I spend time with friends and relatives, banks and government offices sorting out paper work.  During the various sharing of memories, we would talk much about the legacy left by parents, but at the end, would come back to one matter – the current Surgical strike on money by our respected Prime Minister. No talk in the last 4 days, happened without some discussion on the money issue. Which was in one way revealing - how much our lives are linked to “money” and how life revolves around money and the resources we need and have…. Sitting in a bank manager’s office for three days, filling up forms and papers (not for this crisis!) I kept hearing stories of people who walked in to ask opinion from the manager how to survive these crises. There were many who through this su...

A casual conversation with the husband and the curt reply revealed many things. The issue was around can the patient stay for a few days more in the hospital. The immediate response was, sorry we have run out of money, we must take her home. I called the husband aside and told that, whatever the hospital expenses we will take care of, take care of only the drugs. He was not keen. The patient was his wife. She had a Cardiac illness – a valve narrowed, which she did not know about. She was brought with a stroke and in the hospital, the underlying heart disease was diagnosed. They never had any check-up prior to this though she was symptomatic. Subsequently, she went into severe cardiac failure, and had to be on ventilator for few days. Back in the ward, she developed pneumonia and had to go back to intensive care for another few days. Throughout all these ups and downs, the husband was with her. At one point of time, some of us discussed and thought of explaining to the husband, the...

A few days back in one of our social networking groups there was this discussion on “clinical examination in Medicine” – recovering a lost art. There were discussions regarding the importance of the same, at the same time the challenges of doing a full examination in the midst of very busy OPD with each doctor seeing 40 to 50 patients in an hour or so. One of the senior consultants remarked about the 6 th sense we need to develop if are to work in busy set ups, where one develops a sense of recognising patients who need full examination and evaluation. As I was participating in the discussions, I was taken back in memory to my early experiences in the art of clinical medicine under a very astute clinician. I remember, one evening as a Junior Medical officer, working up a patient for about 2 to 3 hours, and coming to a possible diagnosis of “Malabsorption Syndrome” after a full history, clinical examination and investigations. I was quite satisfied with myself, having been able to...