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.

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 ;)

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.....