CASUALTY DUTY – LEAVE
Those who have worked in Govt. Head Quarters Hospital will know how strenuous the Casualty duty there is.
In our hospital 3 doctors were posted every month in rotation and these 3 will do morning, evening and night duties in shifts. There was no week off at that time.
Taking leave during this posting was unusual and those who did take in unavoidable circumstances had to compensate in doing the duty next month.
One doctor “D” who was on Casualty duty had to go urgently to his native place as his father was serious. He sent the leave letter through a friend and left.
A few days later we learnt that D’s father has expired.
D returned after a week and we offered our condolences.
When he went to the Assistant District Medical Officer’s [ADMO} room to sign the attendance register the ADMO, who was not aware of the cause of his leave, started to bombard him.
I tried to in vain to warn him off by waving my hands behind D but he didn’t notice.
“Are you aware how much trouble you have caused by taking such a long leave during your Casualty posting ?“the ADMO said angrily.
D replied calmly “My father didn’t know, sir!”
“What has your father to do with it?”
“He didn’t know that he should not die when I am doing Casualty, sir” D said and walked out leaving the ADMO speechless.
“Oh! I didn’t know” he blurted. But by that time D had already gone out.
The ADMO sent a messenger after D. But D didn’t pay any heed.
About Me
- selvamani
- The name is Selvamani.R. I was born in Rangoon, Burma now known as Yangoon and Myanmar respectively. I had my schooling in I.E.S. .Khalsa School there in Rangoon and came to Tamilnadu, India, did my Pre-University in Sir Thegaraya College,Chennai and M.B.B.S., in Madurai Medical College. Later did my Diploma and Masters Degree in the Regional Institute of Ophthalmology, Egmore, Madras Medical College, Chennai.
Tuesday, July 27, 2010
DISTRICT HEAD QUARTERS HOSPITAL
BEST DIAGNOSTIC TOOL
Dr.P joined Govt. Head Quarters Hospital after doing M.D. [O&G]. He was one year senior to me.
In one clinical meeting he spoke about Caesarean Section.
Before the meeting I asked him whether I can ask any questions. He replied he wanted me to do just that as he was sure no one will..
He gave a good presentation speaking about his experience in the hospital.
When he finished his talk as no one raised any question I asked him about the tests for post-maturity and the timing of surgery.
I think he anticipated the question. He mentioned a lot of investigations and always ended up each by saying ‘Of course it is not available in our hospital”
When he was about to finish he said ‘The best diagnostic tool is a good obstetrician’s right index finger”.
It was too good a chance to let off and I immediately said “Of course it is not available in this hospital.’
This brought loud laughter from all. P himself received it graciously with a grin.
Later he told me that the possible riposte struck him also and actually complimented me.
Dr.P joined Govt. Head Quarters Hospital after doing M.D. [O&G]. He was one year senior to me.
In one clinical meeting he spoke about Caesarean Section.
Before the meeting I asked him whether I can ask any questions. He replied he wanted me to do just that as he was sure no one will..
He gave a good presentation speaking about his experience in the hospital.
When he finished his talk as no one raised any question I asked him about the tests for post-maturity and the timing of surgery.
I think he anticipated the question. He mentioned a lot of investigations and always ended up each by saying ‘Of course it is not available in our hospital”
When he was about to finish he said ‘The best diagnostic tool is a good obstetrician’s right index finger”.
It was too good a chance to let off and I immediately said “Of course it is not available in this hospital.’
This brought loud laughter from all. P himself received it graciously with a grin.
Later he told me that the possible riposte struck him also and actually complimented me.
Sunday, July 25, 2010
LIFE AFTER COLLEGE
PRIMARY HEALTH CENTRE – DD’S VISIT
As soon as I finished house surgeoncy I was posted in a Primary Health Center, as per routine.
It was in Tiruchi district near Karur.
There was already a Medical Officer and I was posted as Family planning officer.
He was senior to me by about 3 years. We will call him “V” hereafter.
We got along well together and as I was a novice I looked forwards to his guidance in administration.
One day a Deputy Director visited our PHC.
Though it was supposed to be a surprise visit, the District Health Officer who was on very good terms with the doctors, leaked the news and we were prepared for it.
The rooms were thoroughly cleaned, family planning and other health posters were prominently displayed and we were in PHC quite early and seeing the out patients.
The DD arrived at bout 10 a.m.
As soon as he entered we saw he was in an agitated mood.
He told us why.
Just a few miles before our village the car has hit a calf-buffalo, which sustained some minor injury and the villagers have surrounded the vehicle angrily. Only after the driver has paid Rs.70/- [quite a large amount in those days] they were allowed to proceed.
I couldn’t help observing that the DD hasn’t offered to pay the money!
The DD said that we must be quite influential and well known in the area and asked us to find the person, get the money and return it to the driver.
I was perplexed as to how to find the concerned person.
But Dr V said calmly. “Oh! Don’t worry sir! We can do it easily. Please carry on with your inspection.”
“I will carry on with this doctor” he replied pointing to me. “You do the needful immediately.”
V left the room.
I stayed with the DD for sometime. As I was interested to know what V was doing, I went outside.
One PHC employee told me that V was standing behind the Quarters.
I went and saw that V was calmly smoking.
I asked him what he had done to find the person concerned.
He stared at me.
“How can we? “he asked. “Even if we did find out do you think he will repay the money?”
I was also thinking on the same line and asked “So what are we going to do?”
“We have to pay the money. There is no other way.
You go in and keep the DD company. I will come after some time.”
As promised he came to the room later, looking busy, with Rs.70/- in his hands and with a broad smile.
He said the person has come and paid the money to him immediately.
The DD was very pleased.
“I know that you doctors will be famous and influential here.
By the way where is the person?” he queried.
“I told him that you are an important officer from Madras and he ran away thinking that we might hand over him to the police.”
Needless to add the DD was very happy, the inspection went on smoothly and we got good remarks !!
Full marks to V for his presence of mind.
As soon as I finished house surgeoncy I was posted in a Primary Health Center, as per routine.
It was in Tiruchi district near Karur.
There was already a Medical Officer and I was posted as Family planning officer.
He was senior to me by about 3 years. We will call him “V” hereafter.
We got along well together and as I was a novice I looked forwards to his guidance in administration.
One day a Deputy Director visited our PHC.
Though it was supposed to be a surprise visit, the District Health Officer who was on very good terms with the doctors, leaked the news and we were prepared for it.
The rooms were thoroughly cleaned, family planning and other health posters were prominently displayed and we were in PHC quite early and seeing the out patients.
The DD arrived at bout 10 a.m.
As soon as he entered we saw he was in an agitated mood.
He told us why.
Just a few miles before our village the car has hit a calf-buffalo, which sustained some minor injury and the villagers have surrounded the vehicle angrily. Only after the driver has paid Rs.70/- [quite a large amount in those days] they were allowed to proceed.
I couldn’t help observing that the DD hasn’t offered to pay the money!
The DD said that we must be quite influential and well known in the area and asked us to find the person, get the money and return it to the driver.
I was perplexed as to how to find the concerned person.
But Dr V said calmly. “Oh! Don’t worry sir! We can do it easily. Please carry on with your inspection.”
“I will carry on with this doctor” he replied pointing to me. “You do the needful immediately.”
V left the room.
I stayed with the DD for sometime. As I was interested to know what V was doing, I went outside.
One PHC employee told me that V was standing behind the Quarters.
I went and saw that V was calmly smoking.
I asked him what he had done to find the person concerned.
He stared at me.
“How can we? “he asked. “Even if we did find out do you think he will repay the money?”
I was also thinking on the same line and asked “So what are we going to do?”
“We have to pay the money. There is no other way.
You go in and keep the DD company. I will come after some time.”
As promised he came to the room later, looking busy, with Rs.70/- in his hands and with a broad smile.
He said the person has come and paid the money to him immediately.
The DD was very pleased.
“I know that you doctors will be famous and influential here.
By the way where is the person?” he queried.
“I told him that you are an important officer from Madras and he ran away thinking that we might hand over him to the police.”
Needless to add the DD was very happy, the inspection went on smoothly and we got good remarks !!
Full marks to V for his presence of mind.
Friday, July 23, 2010
HOUSE SURGEONCY
TRIP DURING HS
During our house surgeoncy we went on a 3 days trip to Bangalore, Mysore and Ooty.
It was a novelty as nobody has tried it before.
We were apprehensive of getting leave as in many units they allowed only 2 house surgeons to go on leave as they feared that work will be affected.
Dr.J.K. was an excellent clinician and teacher but also known for his strictness and harsh words..
Somehow I was selected to plea for the leave [scapegoat!].
During admission day just after OP hours we approached our chief.
I said “Sir. The house surgeons have all planned to go on a 3 day trip to Bangalore, Mysore and Ooty. Our senior assistant said he can spare only 2 of us."
Dr.J.K. stared at us first. We were just bracing for a scathing remark when he surprised us all by his reply.
He turned to his assistants and said “It is a good opportunity, you know. This is once in a lifetime chance they are having. They should all go. Convert all medications to oral. Post PGs for duties. Free them all for the trip."
Our joy knew no bounds. All of us except one lady who was newly married, went for the trip.
MS first said that he was not willing to make the trip. But seeing that all of us are going he feared that he would be burdened with all the work and he also came.
The trip was also very memorable but not as much as the fourth year trip.
Perhaps the future was mystifying us.
During our house surgeoncy we went on a 3 days trip to Bangalore, Mysore and Ooty.
It was a novelty as nobody has tried it before.
We were apprehensive of getting leave as in many units they allowed only 2 house surgeons to go on leave as they feared that work will be affected.
Dr.J.K. was an excellent clinician and teacher but also known for his strictness and harsh words..
Somehow I was selected to plea for the leave [scapegoat!].
During admission day just after OP hours we approached our chief.
I said “Sir. The house surgeons have all planned to go on a 3 day trip to Bangalore, Mysore and Ooty. Our senior assistant said he can spare only 2 of us."
Dr.J.K. stared at us first. We were just bracing for a scathing remark when he surprised us all by his reply.
He turned to his assistants and said “It is a good opportunity, you know. This is once in a lifetime chance they are having. They should all go. Convert all medications to oral. Post PGs for duties. Free them all for the trip."
Our joy knew no bounds. All of us except one lady who was newly married, went for the trip.
MS first said that he was not willing to make the trip. But seeing that all of us are going he feared that he would be burdened with all the work and he also came.
The trip was also very memorable but not as much as the fourth year trip.
Perhaps the future was mystifying us.
HOUSE SURGEONCY
TETANUS TREATMENT
One day in the dressing room in Operation Theatre I heard our Asst. discussing with the PG something about treatment of Tetanus. When I asked them they said they were wondering whether Penicillin is active against Tetanus bacilli.
I said it is very much active and that is why we are giving it to Tetanus patients in ID ward..
"Otherwise, why should we give it?" I asked.
The PG said that it might be given for secondary infections. I refused to accept it and said if Penicillin is not active then we should have been giving some antibiotic which is active.
They remained silent for sometime and the PG said to the Asst. that he will verify the text book and tell him the next day.
I intervened and said "What is there to refer? I am sure that Penicillin is active against Tetanus." and walked out.
Later one senior house surgeon who was present told me that their faces were a sight to behold after my vehement statement.
I quietly referred the text book and was relieved to find what I said was true.
One day in the dressing room in Operation Theatre I heard our Asst. discussing with the PG something about treatment of Tetanus. When I asked them they said they were wondering whether Penicillin is active against Tetanus bacilli.
I said it is very much active and that is why we are giving it to Tetanus patients in ID ward..
"Otherwise, why should we give it?" I asked.
The PG said that it might be given for secondary infections. I refused to accept it and said if Penicillin is not active then we should have been giving some antibiotic which is active.
They remained silent for sometime and the PG said to the Asst. that he will verify the text book and tell him the next day.
I intervened and said "What is there to refer? I am sure that Penicillin is active against Tetanus." and walked out.
Later one senior house surgeon who was present told me that their faces were a sight to behold after my vehement statement.
I quietly referred the text book and was relieved to find what I said was true.
Tuesday, July 20, 2010
HOUSE SURGEONCY
STRANGULATED HERNIA
For surgery we were posted in Prof.P.V.G unit. We all did good work, enjoyed it and were appreciated.
One admission day a case was transferred from medical unit as 'acute funiculitis'.
All of us examined the case and agreed with the diagnosis except RS.
He said it looked like 'Strangulated Inguinal hernia”. The senior assistant examined the case again but remained firm in his original opinion.
When the chief came for night rounds he showed the case and described it as 'funiculitis' referred from medical unit.
When the chief was about to cross over to the next bed [without examining] the assistant added in a joking manner "Our house surgeon here thinks it is strangulated inguinal hernia".
The chief examined the case by moving the cord slightly with his thumb and forefinger and immediately said "Take him up for surgery !".
Our assistant was lamenting why he said about RS's opinion and it is all a waste of time and we will find only inflamed cord.
But on opening he found to his surprise that it was indeed strangulated inguinal hernia.
To his credit he immediately said that all honor should go to RS.
All of us congratulated RS.
For surgery we were posted in Prof.P.V.G unit. We all did good work, enjoyed it and were appreciated.
One admission day a case was transferred from medical unit as 'acute funiculitis'.
All of us examined the case and agreed with the diagnosis except RS.
He said it looked like 'Strangulated Inguinal hernia”. The senior assistant examined the case again but remained firm in his original opinion.
When the chief came for night rounds he showed the case and described it as 'funiculitis' referred from medical unit.
When the chief was about to cross over to the next bed [without examining] the assistant added in a joking manner "Our house surgeon here thinks it is strangulated inguinal hernia".
The chief examined the case by moving the cord slightly with his thumb and forefinger and immediately said "Take him up for surgery !".
Our assistant was lamenting why he said about RS's opinion and it is all a waste of time and we will find only inflamed cord.
But on opening he found to his surprise that it was indeed strangulated inguinal hernia.
To his credit he immediately said that all honor should go to RS.
All of us congratulated RS.
Sunday, July 18, 2010
HOUSE SURGEONCY
PLEURAL EFFUSION
On one admission day in the late night hours I saw a lady patient with breathlessness in Casualty.. I diagnosed it as pleural effusion, admitted in female medical ward [in which I was working] and showed it to the assistant Dr.V.
He agreed with the diagnosis with reservation and asked me to take an emergency X-ray.
I was very confident about the diagnosis and protested vainly saying that the patient is dypnoeic and ought to be aspirated right away.
We took emergency X-ray which confirmed the pleural effusion, went to the DAP quarters and showed it to him.
He asked me whether I can do the aspiration. When I said I was eagerly waiting for it he checked whether I knew the procedure and permitted me.
I and R went to the ward and got the 3 -way adapter [it was a luxury at that time].
When I hit the intercostal space clear straw colored fluid gushed through and the patient felt comfortable immediately.
"Makes you feel proud, eh?” said R who was present with me from the beginning.
I nodded happily.
"Yes" came the voice from the assistant who had come quietly and had been watching the procedure.“I wish I had your confidence!” [Nothing like blowing your own trumpet whenever possible !!]
On one admission day in the late night hours I saw a lady patient with breathlessness in Casualty.. I diagnosed it as pleural effusion, admitted in female medical ward [in which I was working] and showed it to the assistant Dr.V.
He agreed with the diagnosis with reservation and asked me to take an emergency X-ray.
I was very confident about the diagnosis and protested vainly saying that the patient is dypnoeic and ought to be aspirated right away.
We took emergency X-ray which confirmed the pleural effusion, went to the DAP quarters and showed it to him.
He asked me whether I can do the aspiration. When I said I was eagerly waiting for it he checked whether I knew the procedure and permitted me.
I and R went to the ward and got the 3 -way adapter [it was a luxury at that time].
When I hit the intercostal space clear straw colored fluid gushed through and the patient felt comfortable immediately.
"Makes you feel proud, eh?” said R who was present with me from the beginning.
I nodded happily.
"Yes" came the voice from the assistant who had come quietly and had been watching the procedure.“I wish I had your confidence!” [Nothing like blowing your own trumpet whenever possible !!]
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