About people

It seems people have started reading this blog!Hey,if anybody is reading,please leave comments so that I can churn out more drivel.
I keep meeting lot of people everyday during my work.So,the concept of 'personal space' is a bit strange to me.I keep poking into people's tummies(not to mention other things) and the concept of touching other people is quite natural to me.'You are violating my personal space '-what is that?
What is it that makes people so fascinating?Their little mannerisms,their subtleties,their way of speech....
Let me try and list out some things that make people fascinating to me.I won't take names because if they wasted their time reading this blog,they would feel offended...

• My boss' diplomacy-One of my ex-bosses used to be so diplomatic with people.He kept everyone in good spirits and never committed any faux-pas...
  
• My boss'(another one)-had this amazing habit of telling stories(I have written about one in the previous blog.
• My friend's habit of correcting my English(Hey,I grew up to be so...ok)
• My mom's habit of wanting to get things done(by me!) immediately.
• My senior's habit of workaholic-ness.(see,not so good English)
• One of my friends used to love sports a lot

Phew....It's difficult o remember little things about people...

• My wife likes dogs a lot.She goes 'oh,they are so cute....'
• My colleague likes 'tea'.Load him up with a bolus dose and he can go on for hours.
• One of my ward workers has dreamy,sleepy eyes.I am always tempted to get her checked for ptosis(a condition causing droopy eyelids).
• One of my house surgeons had this lovely voice(diva-like) -it was audible only on the phone.
• One of my colleagues used to smile a lot.(Being the meanie that I am,I used to tell her that her muscles were out of control).

I will write about myself in another blog(That would me more interesting and ruthless,I guess).

Anatomy of pain

I am back on track,reading again!I guess my blogs are going to become darker like my moods..
When people speak of pain,I don't think they realize what they are speaking about. I am used to enquiring about pain everyday during ward rounds,but I did not know how painful pain can be..
Some common examples of pain are:

• Body pain-You get this when you do something you are not accustomed to like carry a 50 kg gunny bag up the stairs and end up with a whining back.
• Pain of love-It appears when you are in love irrespective of whether or not the other person is involved.
• 'You are such a pain'-You get this when the other person is irritated by you.
• Painful achievement-This can be achieved by running behind a girl and getting slapped at first,but getting her phone number later on.
• Pain of labour-How can I ignore this!I suppose I will never get to know this but according to all my girlfriends,this is the pain that beats them all!
• Pleasant pain-The pain after...
• No pain,no gain-This is a sort of barter system where you trade pain with a lot of goodies!
• First pain,then nothing-This pain is used by anaesthetists as a sort of incentive before putting the patients to sleep.
• U r ok?No pain,no?-This is used by doctors to reassure themselves that they are doing a great job of saving mankind!

There are different methods of treating different pains.Obviously,they are trade secrets and I would be breaching my oath if I revealed everything.
Okay,plot drift--A patient recently came in for a vasectomy.We were happy that he chose to undergo surgery instead of his wife(She had heart disease).Pills and other methods are riskier and effectivel only for the short term.

Maintaining a blogbook

I had made a resolution that I would write something every week .So much for my resolve!
I keep reading this simple blog called 'Rhythmic dissonance' authored by Raj.A nice blog with simple epiphanies!
On the Fox television series "House M.D.", main character Dr. Gregory House has an epiphany in almost every episode.I used to watch this series when I was in England and used to like it a lot.Dr house is almost my idea of a senior doctor,one who has seen too much and done too much...although his epiphanies do help his patients a lot...
I wonder how novelists get so many words out of their mind.If I start writing something,most of the stuff that comes out will be related to medicine.So,how did Stephen King write so many horror novels?He could not have lived through all the stories.Take for example,Louis L'Amour,who writes Westerns.The moment I start reading Westerns,I am transported out of this world and into a world of deserts,guns,chasing waterholes and riding horses.
I have started doing gardening.It gives a good feeling to watch things grow from nothing and bloom in all their glory.The habit is quite expensive,especially for inexperienced people like me!First,we have to decide which plants to buy,get good soil,re pot them,water them daily,spray insecticides..to take proper care.I suppose I should start looking out for gardening blogs and subscribe to them.

Coming clean

It takes quite a bit of effort to keep writing this blog.The thought of other people peeping into your thoughts is a bit disconcerting.Let me see how long I can keep up.
My boss is quite an interesting person.He has served in the army till his retirement and is now working in a medical college.When you become old(!),perhaps you cannot stop sharing experiences.Hope I too have some which are worth sharing.
He was posted in a middle east country where there was a war going on with another neighboring country.One day,while going to the hospital,he was surrounded by some people who were brandishing guns. Luckily,he was wearing his white coat and carrying his stethoscope.They blindfolded him and took him to a remote place where he was asked to examine a patient and give his opininon.He did so and even though he was terrified,he maintained an outward calm.Later,he was dropped back to his hospital.
He keeps giving this example and says how lucky he was.
Moral of the story-Always wear your stethoscope if you do not want to get shot!!

Jimi Hendrix and the fighter pilot

You begin to write about something and go somewhere else.It's called 'Plot drift',I believe.
I was just ruminating about the effects of music.I don't know if it has a therapeutic effect or not,but I find it very soothing.It steadies my nerves and improves my mood,which is morbid most of the times.
I don't know why Jimi Hendrix killed himself.His songs are so variegated and colourful.I am sure they came out of his brilliant mind.Are brilliant minds restless?Did he get bored after achieving so much in such a short time?Anyway,we lost a few hundred songs due to his impatience.Look at the output of other restless souls like Bob Dylan,Beatles etc.How poor our lives would be without all of them.
The driver of the bus which we travel in everyday is impatient as well.I heard that he has been a lorry driver in the not too recent past.He is super confident and drives as if he is on a 2-wheeler.He makes narrow turns and overtakes everything in his way.He should have been a fighter pilot.

Colours of Goa

I have been wanting to write this from many days but something or the other came up.So,here it is finally.
I went to Goa for the first time in my post graduation days with the guys(actually one guy!).We had a conference in Mangalore and decided to visit the famous 'Miami' of India.It was a low-budget venture since we didn't have much money.We got what we wanted,alright.It was sunny,the beaches were blue and the water was delicious.We swam at all the beaches...Calangute,Anjuna,Baga,Vagator etc. and also sipped the local special-cashew pheni.We did all this in one day on a bike-taxi and stayed in a small room for one day.I had decided that I was going to go back again and again.
Four years later...
I and my family decided to go to Goa.I forgot to check the season(It was monsoon) and I thought off-season meant less number of tourists.The rains started lashing us from Karwar and I thought since Karwar was 'Malnad' region,the weather was so and that there would be no rain in the coastal areas.The rains didn't stop.When we got down from the bus in Panjim,Goa had turned from blue & sunny to muddy,cloudy and rainy!It rained continuously for three days.In spite of that ,we visited all the beaches,went on a cruise and went to some temples.We saw more of Goa than I had seen the last time.
Moral of the story-Offseason means that it is the wrong season to visit!

Clinical Language Practice

I had posted a 9 year old kid with an abscess for incision &drainage in the operation theatre.I had to do it under local anaesthesia,sedation and my sweet talk!So,I started trying to soften him up in my pathetic Telugu & Tamil(The kid knew both & I didn't know both).I tried all through the procedure with gems like "valli irakka?","noppi unda?","ayi poyindi","nidra po","nidra vastunda?","valli irakka ante sollu"etc.I struggled throughout the procedure(not with the procedure but with my communication skills).
After the procedure,I called the mother of the patient in to pacify the patient a little bit.
Guess what she spoke to her child?
"Enappa novu agtha ideya?Alabeda mari,agi hoythu"
Kasthuri Kannada!!I didn't know whether to laugh or cry!!!!

Surgery-Art or Science?

Continuing from my last blog,one of Gawande's essays dealt with the proficiency of Indian surgeons.Having worked in quite a few places,I can vouch for this.At the junior level few can beat us in terms of exposure or skill but people in other places like UK,US are more structured and focused in their training & approach.
We routinely deal with all sorts of cases-urology,plastic surgery,pediatric surgery etc.General surgery means,in general,all of surgery!!
While learning to do surgery,we are faced with a dilemma.Daring or caution?Learning to find a balance between these two and improving surgical skills requires experience in itself.

Hand-washing

I recently read a review about 2 books written by a surgeon named 'Atul Gawande'.I decided to buy the books and after 2 weeks of persistence managed to end up with a book called 'Better-A surgeon's notes on performance'.The book deals with a lot of aspects of health care(American-not surprisingly!).
One chapter is about handwashing or the lack of it.
The author describes how clinicians ignore to wash their hands after examining every patient.
As far as India is concerned,this problem is more rampant.I don't know about the central institutes but as far as Govt hospitals are concerned,there won't be any bedside disinfectants.You either have to find a tap & wash ur hands with soap or use spirit which is unpleasant.
When I was working in the breast & endocrine unit in Portsmouth,one patient had complained to the nurses about the fact that I & a colleague of mine(incidentally a Sardarji) failed to wash our hands after seeing each patient.This had irritated me no end.
The problem in India is mindboggling.It is difficult to find disinfectants for such large hospitals and there is no guarantee that the solution will not be mishandled.So,should the doctors pay for it out of their own pockets?
I am sure if we adopt this simple measure in our wards,we can prevent a lot of cross-infections.