ECG has to be done

I was confident today that i will take out the ECG perfectly after i had done it wrong the last 3 times. I pressed the button and the ECG started rolling. The 'first lead' came out good, the second was also nice, by the time i reached the third it stopped. "It must have run out of paper" with these words the nurse put to me in a ease.
               I was looking at the 'BPL' logo on the ECG machine and in my head 'Next i'll press this button and then that....' when suddenly my name rings in my ear breaking my analogue thought stream "Sarthak! Sarthak! come here fast". My duty time was already over nearly half an hour ago and next shift interns had already come in. I stayed behind only to do that ECG so that i'd be able  to handle things in states of emergency and no hands to help around. Dr. Durgesh had joined the institution as a MO just one month earlier to me and we get along pretty well. He taught me suturing, bandaging, NG insertion, catheterisation and pretty much all the basics of emergency medicine. Just like any other profession that needs team work Emergency Medicine also gets very interesting if co-ordination between partners click off.
                                       Same is with me and Dr. Durgesh who was calling my name at that moment just next bed from where i was standing. A young man of 38-40 had come in about an hour ago with loss of consciousness and alcohol withdrawal effects.We have had the the necessary and the patient's condition were stable. When suddenly Dr. Durgesh noticed 'NOTHING'. Nothing here means a lot, nothing to a militant is Safe, nothing to a teacher is a quite class, nothing to engineer means no errors in calculation, or simply nothing is nothing at all for anyone else but nothing for a doctor is a lot of things because none of the symptoms were present over that patient and we could see no movement of chest or limbs, absolutely NOTHING.

CPR

                             Without wasting any further time i reached the bed and immediately understood what Dr. Durgesh was calling me for. Within seconds my left palm was over my right which was placed over the sternum (mid point of the chest) of the patient. I was giving CPR (Cardiopulmonary resuscitation). "Get me the AMBU bag" - i cried for help to one of the replacing interns who immediately fetched me a over sized egg shaped self inflating air balloon which is used to push in extra air into the lungs of a person who is unable to breath or so. From the other side of the bed nurse was being directed by Dr. Durgesh to push in 1-1 ampule of atropine and adrenaline into the veins of the patient. With every five compression of the chest Dr. Durgesh will punch in a gush of air from the AMBU bag into the patients lungs. The power needed for the surge was so great that each time my body would rise from the floor while doing so, so at last i climbed onto the bed and started again with better stability.

Different age group AMBU bag

                                             I knew climbing on to the bed was a good idea from this morning where almost a similar situation had taken hold it's grounds and with a similar scenario setup i was doing CPR and Dr. Durgesh was pumping the AMBU. This man was 73 years old, heavily Diabetic and was brought in by his daughter with a hypoglycemic shock. Our profound measures to resuscitate him were going in vain and at last when there was NOTHING we decided to go in for CPR. After giving in all our heart we failed to start their hearts. This followed in the hardest part - Declaring the death of the person to the family.
                                     I was relaxed for i was sure i wouldn't have to do that but did wanted to watch and learn how to do so for my future references when it suddenly struck me 'The MO's were not declaring that person as dead. But WHY?!' This was something new & interesting to me. I knew the man was dead, the MO's knew he was dead, even the family was sure that the person was no more with them but then why was not he being declared dead? What did i missed from the scene? Was there still some hope? All these questions running inside my head and no answers were appearing i decided to ask Dr. Durgesh my only faithful companion in front of whom i could do silly mistakes and expect him to understand.
"Sir, what is going on and why isn't he being handed over to the family?" i inquired eagerly.
"The ECG has to be done yet" he answered  simply
"Why to waist ECG when we already know he's dead?"
"We'll it's our clinical proof & we can declare him dead only when the ECG turns flat" He understood my  confusion and cleared it out.

Flat ECG

                 But not for long was i satisfied - The ECG wasn't flat. Did that meant there is still chance??? And my very thought was answered by Dr. Krishna who explained the situation to the patient party since they were in a hurry to take the body with them. ECG will turn flat after sometime once the effect of atropine and adrenaline as well as CPR wears off. So until the CPR turns flat the body will not be handed over, death certificate will not be issued and the person will not be declared DEAD! During which so many mixed emotions turned up at the gates where the family is being consoled by the neighbors or by each other. Wives and daughters crying their lungs out and dehydrating themselves up. The only way to neglect all that is to make yourself useful again in saving other lives.
                                     The only humorous incident that happened that i had a bad stiff neck this morning but all the heavy exercise kind of did me good and i could move my neck in all directions again by the end of the day.

I want to see a Physician

My working days in the hospital as a intern has taught and showed me a lot of things in the past 3 months. So many recoveries, so many miracles, so many happy faces and equal number of deaths. People die in front of my eyes everyday, no matter how hard we try, their death somehow seems evident. Medicine saves lives but can't bring back the dead. Our life is in our own hands to cherish & nourish it.

                Everyday nearly 2-3 cases of poisoning reaches the emergency department who tried to commit suicide or moreover should i say tried to scare their family by making a drama. Drama because none of them take enough amount of poison that will kill them. They just make it hard for them selves and for the poor family members. Once during my duty hours they bring  in a patient who himself was accepting of having taken 'sulfas' a potent poison with 100% mortality rate. It's very rare when people survive after taking SULFAS. However this guy seemed alright except for looking drowsy. His family had made him drink soap water and make him vomit thrice on the way reaching here. Unless and until you know what poison has been taken it's very difficult to decide the antidote. We treated him according to the symptoms which clearly indicated some other poisoning. He had pulled this drama just to scare his family and to show them that he's a serious man who can even commit a coward thing like suicide. Each day number of such cases are being reported in our parts of the world.

Death comes as the end

                 Similarly a lot of other cases show up at the end stage of the disease. People keep on avoiding their problems and try out their home remedies to take relief. And when thing finally move out of hand that is when they remember a doctor. At this point it's difficult for us as well, people then not to reckon that. And over that they expect us to magically make the person fit in moments. We are doctors not magicians. Today with our advance life style and fast food fashion we invite a lot of unwanted and serious health problems. Surveys have shown even small children as low as age of 14 are having hypertension. People are now dying at an early age with Heart Attack being the most common cause. Every second person is having diabetes and every third is having arthritis or gout.
                 "What's the solution you ask?" The answer is simple - "Healthy Lifestyle". A complete self controlled and simple way of living promises you a long and disease free life. With the help of Lifestyle channels and the Internet people are well aware of what's good and what's not. To avoid the very common tormentors of life like hypertension, gout, angina etc. you should keep a check on what you EAT, the main culprit to all that is happening to your body. And the point where you have done your part comes in the role of a General Physician.

General Physician

                  A General Physician (GP) is your personal trainer to a healthy body, your coach to kick of diseases & your guide to a beautiful  ailment free life. A GP is your first step to the medical  world. He's the station master who directs you to specialists when required. Whenever we fall ill we shot for specialists which is not the very best idea. One should go to his family physician first as he knows you well, knows your medical history, knows your allergies and he is as good as a specialist when it's just a fever or stomach ache. He'll examine you and when things are out of his reach it's then when he refers you to a specialist. Going directly to a specialist has it's own merits and demerits like he will treat you in the same line of drug as GP if it doesn't require any special treatment. Also he'll charge double the physician's fee. It's hard to get a specialist's appointment and above all he can only treat and think in the direction of his specialization and none other.

ENT Specialist

Eye Specialist

Child Specialist

                
                                     For example a Cardiologist will keep on looking for something wrong with the heart and will not treat for any stomach related disorders and vice versa. Whereas a GP will look in general the whole body and it's different parts instead of referring to different persons for each part. A GP can treat from diabetes, migraine, jaundice, malaria, dengue, tuberculosis, hypertension, gout, arthritis, peptic ulcer, gastritis, psychosis, etc. to hypochondria, suturing minor cuts, fungal infections, psoriasis, alopecia, menstrual disorders etc. To sum up almost anything as long as it doesn't requires surgery or micro specialty like cardiomyopathies and nephrology etc.

                    
                               Sadly lack of this knowledge among the commoners is leading to a shortage of GP's in our country. As people shot for specialists in every medical emergency GP's tend to do specialization and are able to charge more. We can only help improve the health services in our country by demanding GP's and reducing the overall medical cost. The fist thing is you to have yourself a family physician whom you can reach over the phone or call home at time of emergencies, whom you can visit all year round and get your selves regular health check ups. Your GP can direct you to all the test you are to get done regularly instead of wasting your money on a big amount of tests which are not even necessary. He'll tell you what to eat and what not to if you have diabetes or gout. What to do or what not to when you have tonsillitis or hernia, and endlessly so many things. 
                   My 3 years of internship has taught me a lot of things but it has lead me to become a MD GP. MD because people slaves to their nature, will look for a specialist when ill and GP because what they actually need is a GP. Know more and help yourself, help the society or stay ignorant and witness the downfall.

A night at ICU

          My eye opened to a knock on the door. I checked my watch, it said 5:30 a.m just 2 hours since i hit the bed in the ICU doctors chamber. I could hear ventilator buzzers and nebulizers. I opened the gate and sister was standing mumbling something about a patient complaining about dizziness and blurring of vision. I knew what to do since i had attended her before going to bed. 

               Only last night i had joined the anesthesia department  which runs the ICU under it. It was my first day as well as first night. I got acquainted about the cases present there through the files. I being the only intern present there a anesthesia JR was to help me out. Out of 7 cases in the ICU 2 cases were in a very critical state and after instructing me how to handle them he left for OT at around 8 in the night. There i was all alone with two sisters to assist me and my only help was my knowledge.

     

Monitoring of the patients

                            I was supposed to monitor for patients Blood pressure changes, heart rate, SpO2 (measure of oxygen level in the blood) and a few other medical standard measures like pulse, temp. etc. I took a round and sat in my seat with the idea in my mind that they are all peacefully sleeping (or more likely unconscious) and i will sit for a few hours and leave at around 12 o'clock. But little did i know i would be working for the next 18 hours.
                           As soon as i sat down the sister calls for help. "Doctor! please open the vein of the patient at bed number 8, it's very feeble & i can't find it". If you couldn't how would i?! i thought to myself but still went in for the challenge and after a series of pricks and blood drops all over the bed sheet i achieved success. After wiping the sweat from my forehead i was just about to sit down then suddenly patient party of bed number 4 starts panicking as the cardiac monitor was not showing SpO2 readings. They thought that patient was gone but only the SpO2 probe wasn't working properly & i asked the ward boy to change the probe and things were back to normal again.
           "Doctor! BT Note" requested the sister. BT note stands for blood transfusion note which is a formality before transfusing blood to a required patient in which we write the transfusion details asking to stop immediately if any such transfusion reaction occurs. BT note was not a big deal for me, i had done that before also. But this time i realized i was the only doctor around and if some reaction does occurs i will only have to take care of the patient. My worst fear had  come true and patient did showed signs of transfusion reaction. Thankfully it was only high grade fever and not any other fatal reaction which i feared. "Stop the transfusion and give her paracetamol" i asked the sister.

Nurses Station

             While waiting for her temperature to come down BOOM! comes in another case from emergency medicine. Case of alcoholic liver diseases who also was suffering from withdrawal symptoms. Withdrawal symptoms are something that occurs in an addictive patient weather alcohol, smoking or drugs when it is stopped suddenly. The patient becomes heavily agitated and same was the condition over here. Patient was tied down to the bed and was screaming incomprehensibly. I called upon the JR for help. After few minutes of his arrival we were fixing canula in the patients hand. I was holding the patients hand with all of my body weight other wise the needle may break inside his body and will create messy situation for us. We succeeded eventually some how saving me from the patient who tried to bite me. "Give him a combo of Phenargan and Serenec (heavy sedatives) and he will sleep now" the JR directed me and left after reviewing the critical cases once again. But those heavy sedatives also didn't do us much help. The patient was still very hyperactive and free himself from the bondage 3 times. We again and again with the help of the ward boy tied him down and increased the dose of sedatives uptill 12 o'clock.
                                          Then rises yet another challenge for me when the SpO2 of the patient  decreased suddenly and immediate oxygen supply was required. I asked the ward boy to open the oxygen cylinder and started pumping oxygen through the Endotracheal tube directly into the lungs while the sister started suction on the bronchial secretions. After a desperate attempt for 10 minutes and heavy backache i could bring back the patient's blood oxygen to a satisfactory level. Her secretions had become very thick and i had to change her NG tube (naso gastric tube that is put through nose upto stomach, also known as Ryle's tube) which was again a very tricky job the patient being unconscious. How ever i had a good practice of this when i was posted in emergency medicine so without much difficulty i could change her NG tube.
                            After the last vital check ups of all patients i checked my watch - it was 3 am. I sat down at the nurses station and was surfing the my phone for any pending messages when a patient party approaches me "Doctor please tell me will my son live or not?!". "What?!" i said surprised getting up from my seat and looking for the patient if something just happened. "I don't care about the money, i have already spent 4 laks and i can spend more. I'll sell all my fields. Just tell me what to do?" I understood the patient party was emotionally exhausted. I tried to calm them down and give them hope, but there is not much hope left when the prognosis is negative. Their 4 year old child was struck with Gullien Bar disease in which their is very very minute chance of survival.

Nurses Station, Old man keeping
watch over his son's heart rate

                          Another case was of a young teenager who tried to commit suicide and  was brought in as a case of unknown poisoning. He was having sleep bradycardia and each time he falls asleep his heart beat will drop massively. His attendant his poor old father had to stay awake all night and kept waking him up each time his heart beat will fall below 40. That old man kept staring at the cardiac monitor. I asked the sister to inject 1 ampule of atropine so that the old man could also get some sleep and the boy's heart rate would stay stable for some time.
                              I looked at my watch it was 3 a.m and it was getting very hard for me to keep my eyes open. "Doctor, go and have some sleep. we'll manage now" the nice sister told me and i went to bed. In the morning things looked very different. How funny when you experience some trouble with your computer of bike and you take it to the service center it works just fine. Similarly when the JR's from anesthesia, medicine, pediatrics and surgery arrived in the morning all the patients were stable and looked good. I completed the daily S.O.A.P note (subjective and objective assessment plan) of the patients and left the ICU at 9:30 in the morning when releaving intern came in.
                                I helped my self to the anesthesia department for my attendance to the HOD where i was caught to attend the daily presentations. I sat there for next 1 hour with my eye half open and thinking of the event of the night. How every patient had to be looked upon, the mental status of the  patient parties, someone is ready to spend laks, some one is unable to understand the critical condition, some one wants to take the patient to higher centers. I sat there and thought of the life waiting for me in the future, the life which is not mine anymore but for the betterment of the mankind. To help the poor, the needy and most important of all to save a life. I returned to my room in the hostel at around 11 in the noon and within no time was fast asleep into my dreamworld.

Roofies for Rookies

A message on my phone read as follows :-

"A woman at a nightclub (Mumbai) on Saturday night was taken by 5 men,

who according to hospital and police reports,

gang raped her before dumping her at a Busstand in Mumbai.

Unable to remember the events of the evening,
tests later confirmed the repeat rapes along with traces of rohypnol in her blood. ...

Rohypnol,
date rape drug is an essentially a small sterilization pill.

The drug is now being used by rapists at parties to rape AND sterilize their victims.

All they have to do is drop it into the girl's drink.

The girl can't remember a thing the next morning,
of all that had taken place the night before.

Rohypnol,

Not able to remember your rape is even more horrifying

which dissolves in drinks just as easily, is such that the victim doesn't conceive from the rape and the rapist needn't worry about having a paternity test identifying him months later.

The Drug's affects ARE NOT TEMPORARY -
they are PERMANENT.

Any female that takes it WILL NEVER BE ABLE TO CONCEIVE.

The weasels can get this drug from anyone who is in the vet school or any university.

It's that easy,
and Rohypnol is about to break out big on campuses everywhere.

Believe it or not,
there are even sites on the Internet telling people how to use it.

Please forward this to everyone you know,
especially girls.

Girls,
be careful when you're out and don't leave your drink unattended.

(added - Buy your own drinks, ensure bottles or cans received are unopened or sealed;
don't even taste someone else's drink)

There has already been a report in Singapore of girls drink been Spiked by Rohypnol.

Please make the effort to forward this to everyone you know.

For guys - Pls inform all your female friends and relatives."
This is imp message pls spend some time to read it completely...n pass it to all.

------------------------------------------------------------------------------------------------------------
So i thought of throwing some light on the article as well as the product. Rohypnol is just a trade name and the real name is Flunitrazepam. Which is used by psychiatrist on mania patients to calm them down and provide them sleep. They use benzodiazepam grouop of drugs.

But perticularly fluniterazepam has a adverse effect that it can cause retrograde amnesia i.e. the patient wont remember ample details. Other facts are true in the above message. But there is no effect of it causing infertility. Victim will still conceive and in future also she can achieve pregnancy. It can only cause harm to the fetus only if victim is already pregnant.
Fluniterazepam's most dreadful adverse effect is that is may cause coma or even death if given in higher dose and it's action become stronger if taken with alcohol, which is the case mostly. But then again let me assure you guys that this drug Rohypnol or roofies is not easily available. it can only be obtained on prescription that too in 1mg dose. Also rarely used in india. It has been banned in most posts of the world and is classfied as scheduled class 'A' drug and possessing it without proper medical prescription is illegal. It is common in Singapore, south Afrika,  norway etc but not that much in India. For more details check out yourself Date Rape Drugs or  Rohypnol

Know more and be safe or be ignorant and suffer the consequences. It's completely your choice. 

So called inspection

Nearly a week ago we were informed to make ourselves prepared for N.M.C (Nepal Medical Council) inspection & we were looking quite forward to it. Since years unknown such inspections have been taking place now and then but still hasn't been able to turn a single stone of this college.

I think this is so because they don't use the element of surprise. They happily inform the college well in advance granting then enough time to make preparations for their proper welcome. This is the time when our college sparkles up. Every department has quit a number of names in the list of the doctors working there. The actual number may be not even 1/4th but during the inspection days all the faces become visible walking around the OPD and the canteen.
I myself got introduced to few of the new faculty members on the supposed day of inspection. On my way i saw the nursing students nicely dressed, waiting for the inspection team with flower bouquets. Notice had been published earlier itself by our well reputed MS issuing orders for all of us (doctors,  interns and JR's) to look sharp and formally dressed. 

People formally dressed

So be it, i also went in wearing my best attire with a batch on my apron saying 'Dr. Sarthak Chakravarty'. Let's us also enjoy the attention sometimes. My colleges also walked in wearing formals and looked ravishing. Inspection time is kind a like a carnival in the hospital, people running up and down inquiring weather the inspection team has arrived or not, sweepers cleaning every bit of dirt from the floor, ward attendants spraying room freshener all around, all kind of patch work going on which kind a made a few corners totally unrecognizable. Mess swelling up with all kinds of delicious mouth watering recipes which gives almost the same food everyday for rest of the year. Doctors have taken on their aprons after dusting out from the almirahs. And many similar changes were seen around the campus.

People trying to look busy

"They have arrived" came in the news. Everybody trying hard to look busy, engaging themselves in something or the other. I being posted on the top floor of the OPD waited nearly 4 hours for the team to reach here. Yes i was all prepared, i knew how many faculty members were there & what their names were (all mugged up), i knew how many students were posted, what topic is being taught, what all operations are being done, yes i was ready.

The team arrives, goes upto the HOD, shakes hand. Asked the JR a question or two and that's it. It was over, done, finished..... no one asked me anything. All mugging up went in vain, down the drain. I knew i should have worn in the imported perfume but no i had to use the stupid NIKE deo! Well nothing to do now but we all were definitely happy that it was over and no more formals from tomorrow, thank God for that.
I just hope the college doesn't shuts down before i complete my internship  and hopefully not as the heads of management have masters in the art of bribery. Other than that who doesn't likes a bit of carnival mood now and then ;)

Visit to the Minor OT

Never it occurred to me that assisting a minor procedure could be so much fun.

It began with the very 1st case in Ophthal opd when a young girls enters the room with a Chalazion in her upper eye lid (a painless swelling). That day was meant to be special coz our senior who consulted the case had sent her off with some medicines but she again showed up after an hour or so and i knew this was a sign for us to operate her. A chance for me 
to learn to excise a chalazion (observe only of course), and for our 1st year resident to learn it from the consultant how to create a grand level of comedy in the minor OT.

As soon as the patient turns up, without waisting anymore time i run to sir who was busy downloading meera bai bhajans from youtube, and pursued him for operating. Once he said yes without wasting any time i rushed to minor OT (dilating pupils of few patients to be reviewed) and got their clearance. While sir was checking out the patients in the ward i helped myself to fetch the instruments required for the operation.

"Yes the instruments are ready for use, are you about to start?" asked the sister in charge. If i'm here then definitely we are about to start... why else would i be running up and down three stories then - i thought to myself but still said "Let me confirm with sir first" and i was glad that i said so because on my return with the news of available instruments
sir asked me to proceed with the blood investigations required before any procedure first.

And the chase begins as soon as the patient returned with her blood reports at 2:45 in the noon. Time is important to mention for that our OPD timings are only up till 3:00 o'clock in the winters. Sir said "No, not possible today. Call them day after" as next day was a holiday. Patient party requested for that day itself because they had come a long distance and were staying in a hotel who's bill they'll have to pay for another two days. Finally sir agreed and i 
sprinted towards the major OT to bring the weapons of 'Chalazion's DOOM'

"Sister please give me the 3 instruments i had requested earlier" i said, but this wasn't her. "What instruments?" came the reply. Then i again explained the whole thing to her and was asked to follow her after a long wait as she didn't knew which were the keys to the sterilization room. I followed her upstairs then through a large hallway to a room
very simillar looking to our existing OT rooms, when i realized this was a another OT which is just locked away unused. 

There inside that room was a table in the center and on that table was a glass box. In that box there were ophthal instruments. "Which ones do you want?" asked the sister. How would i know??? ok fine i had seen one of them before but didn't know about the other two, to my surprise nor did the sister. So now by this time i was googling for the instruments
picture while sir, resident and another intern and the patient party all waiting for me in the minor OT to appear with the instruments which i was to see for the first time in my life. Later on i  did discover the fact that they were anxiously looking for me and desperately trying to call me without knowing my number!!! i wonder how. But anyways, finally all the
three instruments were in my hand and after nearly 20 mins i was pushing my self through corridors towards minor OT.

If you are enjoying this then please let me tell you that the fun part is yet to come. I entered the minor OT where sir and junior resident were preparing. Next to them was a nurse standing and watching them in a somewhat confused manner. I Could understand why, as sir stammers while speaking and she wasn't able to understand anything. Lying on the bed was
the young girl who seemed a bit scared and was obvious. "Sister  give me the drapes" said sir. Sister looking at him confused. "Give him the  cloth to cover the patient" i said "Oh you mean eye towel!" exclaimed the sister (smart one, didn't see that coming) "Yes yes eye towel & towel clip also" sir continued in his stammering voice.

Meanwhile JR checked the girl for anaesthesia reaction on her forearm and me marking the site to calculate the erythma if any. Once it was eshtablished that patient will not react to LA sir simply filled her eyelid with lignocain (local anaesthesia).

The struggle begins - when sir asked the JR to clamp the chalazion. The JR being her first time was extra careful with the patients eye and after few tries couldn't clamp her where entered Arnold Swatzinegar of terminator 2 'our sir' and just like terminator who will save John Conners and care for no one else - sir started clamping the chalazion with no care
of where he's going or what he's clamping. On the top of that the patient is shouting & crying her lungs out - "it's paining it's paining" she shouted. "Why is it still paining?" said sir and injected some more lignocain in her eyelid and it all flushed out. It was totally unnessary as the girl was only scared and not under pain of any kind.

Finally we were able to tame the lion - clamp the chalazion that is. Now a incision was made and all the puss was scooped out. Now sir said "we will cautery the point" and turned to sister "give me the spirit lamp" Sister again looking at me, no not because she didn't understand sir but because of the weird fact as what he was asking for?!!! 'Spirit Lamp c'mon man i haven't seen spirit lamps since my chemistry lab in schools. So obsolate. Nor did we have one there. Then what to do? 
"There's a cautrey machine here" sister said "I don't know to use one" came the reply.
Holding the patients hand (i  had to coz she was again and again touching her eye) i asked my fellow intern to run outside and fetch us a bundle of matchsticks. Witout loosing any time he left the room and before blinking to the eye he returned with a packet full. Sister still confused what to do with them as sir was asking her to light up a gauge piece soaked up
in spirit. I don't know what it was - sir's stammering accent or a really dumb nurse who made me watch and enjoy the moment without interrupting. As i continued to watch - sister is once handing over the spirit bottle to sir, sir holding the bottle, then she is taking out a spirit swab, taking back the bottle and handing over a gauge piece to sir. Then she started cleaning the matchstick with the spirit swab and was finally instructed  to stop by the JR who i suppose was done enjoying the confusion. She asked the nurse to light up the swab and the dumb nurse did so holding the swab in her hand and most immediately it caught fire, all of it & the nurse dropped the swab on the floor of the OT. Our terminator oops i mean sir, without loosing anytime ducked and started heating the cautery on fire and cauterized the chalazion scar.
Finally ointment applied and the eye dressed by pressure bandaging the patient was let off with proper advice and antibiotics.
All the above mentioned events occurred within 20 mins and will last in my memory a lifetime. 

Medicine field give you something new to learn each day, something new to explore with each case and largest of all adds a
meaning to your profession.... apart from all the humor.
looking forward to more fun field experiences which will one day make me a successful doctor even in handling the most treacherous situations.

Duty begins with a blast

It's now been 2 months since i have started my Medical internship at UCMS teaching college at Bhairahaawa.

Had a super duper starting - My 1st day was emergency duty & on the very 1st day i was assigned to put sutures on a scalp of a guy who had come in about 3 hours ago after having a big fight at home because of inter familial conflicts.
Well if a man got to do his duty he's just gotta do it. I called upon Mukund my very good friend a final year student back then. He also didn't hold any experience  in this particular art of suturing. After a good boost up from the MO incharge and mukund i entered the male ward. The injured was very well prepared to sleep and was already very comfortable over bed. After getting him to position i started shaving his head over the injured region with an incision blade (no razor was available). My hand shaking & mukund cleaning of bouts of sweats over my forehead. Soon the field was clear and there i was holding the "cutting edge, piercing 3.0 curved non-traumatic needle" (yes it's that long a name) in my hand, with an artery forcep and toothed forcep the other. Oh i almost forgot the injecting Local Anesthesia part. It's actually fun, you inject the periferal skin with 'lignocain' and keep doing that while small spurts of lignocain errupt all over the place. Anyway, now i was half a way through my suture by piercing the poor guys scalp a lot of times and don't know how many times saving my finger from that needle. Now comes the tricky part... what i had learned before was how to suture a straight wound but whats this?!!! This wound was in 'Y' shape, WTH! not which side was i supposed to move?
Now kicked in my common sence, or you can say it was a combined thought from me and mukund that let's stich one side first and we'll come back for the other later (only if i had learned sewing back at home, lol)
The trick did work and at last both of us were very happy that some how we managed to stop the bleeding from that poor fellows head & then MO incharge enters the ward. 'Good Job' he said and i was just wow, patting my self in my imagination which seized with the next word from my MO - "what about the other cut?"
"What other cut?" & then we found out that there was a another linear injury next to the one we have stitched & this one had escaped our eye. 
After a long painful back aching repeate of events finally we got a victory to make that guy medically fit.
And then the events continued for the next 15days throughout my emergency posting, from snake bites to poision suicidal cases and much much more.
Over all it was fun and fun still continues coz everyday in medicine field is a new experience, something new to learn everyday and somethings to make your life more meaningful. My adventure as an intern continues.....