Thursday, November 29, 2012

# Beyond the clinics

It so happened that I came across a man in the medicine ward, two years ago. He was in his mid-twenties. He was so thin, so yellow with jaundice & totally disoriented. One look at him, anyone would recognize it as hepatic encephalopathy. Hepatocellular failure or simply decompensated LIVER FAILURE was the functional diagnosis.

However, there was something strange that kept me staring at his chest. There were strange marks on his chest and shoulders. Some 30-40 small circular scars (as if he was scarred of molluscum!) So I asked his attender how they appeared. I was told that they were cigarette butt marks which he self imposed on himself.

I scanned through his physique. I saw something else on the inner surface of his right forearm. Something in Tamil was tattooed in bold and large typeface. I took hold of his hand and lifted it up so as to get a better view of what was imprinted. 

It was a name of a girl.

The real diagnosis was LOVE FAILURE and not just LIVER FAILURE.

A broken bone can be fixed. But a broken heart??

Rising above competition

We live in a very competitive world. Very true.

Competitiveness is the positive force that keeps pushing us upward. It's the competitive spirit that keeps raising our expectations & helps us attain & achieve more. It makes us innovate, come up with better designs, perform better research, live improved quality of life and stuff.

But competitiveness can become a vice too. Negative competition, as it is called, can lead to jealousy, envy, enmity and hatred.

" Replace competition with collaboration & cooperation "

Negativism spoils competition when the compelling reason for the competition is a but a selfish motive.

If our real motive as doctors is to ensure better patient care, why should we be too much obsessed with personal success in terms of more abstract knowledge or more recognition or more money?

Let's join hands with others in making this world a better place to live. Success soon shall surrender itself at thy feet. You'd have won many hearts' reverence when you leave this Earth.

Have a nice day !

Sunday, November 25, 2012

Getting trained for marriage !

Training seems to be an absolute requirement these days!

Starting from the toilet training we had as young children, we continue to receive training of various sorts irrespective of whether we like it or not! 
I had to undergo 14 years of school training, 5.5 years of basic medical training and now 3 years of MD and further 3 years of DM. Not only these, even smaller periods of training, I had. Like the Bible training I had at Church, the training for PG thesis, training for Therapeutic Drug Monitoring etc...etc..
I also trained myself in Photography & basic post processing techniques.

After all these years, I can realize the value of training and the effect that it had on me. So I begin to ponder are people being trained to become better spouses/parents? Though I have some 2 or 3 years more probably before I'd get married, I feel I should get trained to shoulder the responsibilities that would arise.

Yes, we had Moral science classes at school, but I feel a greater need for more enlightenment into the principles that have made better spouses/parents.

So how??

As of now, I am not very sure as to how! But I see certain ways it can be done. I'll draft a plan how I can get this done. I going to train myself.
Here, I put some of the some ideas, I've got.

The Golden Principle:
I realize that I have some expectations of how my spouse should be. So would she, with expectations of how I should be.
So my plan is to make a list of qualities I desire to see in her and cultivate it in me. 

I also would read good books on this subject. Not those self help books. Books like "The Love Dare", I mean.

Maybe after drafting my plan, I would blog it. You can share your ideas with me too. 

- :-)

Have a nice week ahead.

Saturday, November 24, 2012

A Ray of Hope !

This is the first photo taken by me with my old point & shoot camera which actually stimulated me to take up Photography as a hobby. Nothing great about this photo but somewhere in it, I saw, 
A Ray of Hope.

If you like my photos and would like to have a look at them, use the following links
Facebook page :

Tuesday, November 13, 2012

At Rainfall

Inspired by Skyfall, Synapticsparks has come out with the lyrics to created an awareness of saving rain water. I wish I could get Adele to sing this for me in her ever sweet voice.

Just put on the Skyfall song which Adele sang for the James Bond movie and read the lyrics below in the background. You'll fell the need to save rainfall.
Here's the YouTube link to the song:

This is the end
Of monsoons and the misty winds
Feel the Earth dry and cry
Hear my tears fall again

For this is the end
I've feared and fought this moment
So cruel here I curse them
Swept away, and stolen

Let the rainfall
When it thunders
We will stand tall
And save it all together
At Rainfall
At Rainfall

Rainfall is where we start
A thousand drops and lives are caught
Where winds are high  and skies are dark
You may have my plumber, you may take my tap
But you'll never have a drop.

Let the rainfall
When it thunders
We will stand tall
And save it all together
At Rainfall

Where you fall I fall
Where you pour I plead
I know I'd never be me
Without your purity
Of your loving dew
Keeping me from heat
Pour your loot in our land
And we'll stand

Let the rainfall
When it thunders
We will stand tall
And save it all together
At Rainfall
At Rainfall

Saturday, November 10, 2012

The Autumn of my Heart

This is how I feel. This is the 50th post in my blog. This post was planned to the best but I don't feel like blogging. I feel depressed. And thanks to photography, I can express what I feel. 

Sunday, November 4, 2012

Not professional. Passionate.

To take this picture I had to travel for long on the highway in my bike. I stopped at one place and kept waiting for this fleeting moment. I like this photograph very much.

Iatrogenic Fear

What is the most common iatrogenic disease/morbidity?

Ask me and I'll tell you it's fear/anxiety.

You may laugh at it. You may either think it's not a morbidity or you may feel it's not so prevalent. Either way, I feel, is a wrong opinion.

So to prove my point I did a little experiment. I did this with goodwill hoping it would change someone reading this. I set out and randomly meet patients admitted in different wards during my Clinical Pharmacology posting. They ranged from simple cases of fever to cancer patients. I went to them and introduced myself as a student doctor. I spoke with them patiently and built a rapport with them.

As I was conversing with them, I came to understand that none of them were aware of what was going on to them, neither their diagnosis nor their treatment. Leave alone their prognosis. I could feel their anxiety. They were worried and were fearful of worse things that could happen to them. Some were even worried because a fellow patient with similar complaints was investigated with bone marrow aspiration (a invasive procedure). They were afraid that anytime their resident doctor would come and drill their hip bones too.

As I was still talking with them, they started bringing to me all the test reports that they had got done. They took out the X rays and CT films. They took out the big files containing all sorts of blood reports which were done in the private hospitals they visited before the came to JIPMER. They wanted me to tell them the diagnosis and the course of treatment.
(However their records were long and further I did not want to say anything to the patient that would hinder/disrupt their relationship with their treating physician)

And as positive controls I went and spoke with some patients in wards where I knew the patients were quite well informed. I could indeed feel a drastic difference.
Those with good prognosis were eagerly waiting to go home. Those with poorer prognosis were, of course, sad & worried. However they were well informed and they kept their hope alive.

Good communication is a strong foundation for any relationship and the doctor-patient relationship is no exception. It is even more important in relieving the patient of his unnecessary fears. Clinical rounds are conducted on a t.i.d basis in some wards (once by the final Yr resident, once by the SR and then by the consultant) but sadly very little information is passed on to the patient. Most often it is the resident doctor who keeps running around all day for patient care. However the patient is more impressed with the nurse who gives him/her the medicines ( the big-mouthed yelling sisters, I mean the sweeter ones:) because in communicating with her the patient finds care and compassion.

Cure occasionally, Relieve often, Console & Comfort always! - Anon
Thank you for patient reading.