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Wednesday, August 24, 2005

You're too busy to call

......And people ask me why I'm sooo tired and can't call.



The last two days of my life have been spent in the operation theatre looking down on people with guarded abdomen and pain all over.


All this started on that fateful double emergency weekend when I felt a strange sense of niceness about an old man who came in holding his stomach telling me he hadn't moved his bowels in 4 days....Well normally he would have won himself an enema but something told me we should admit him and keep a watch on him.....Little did I know that at the same time my junior resident was feeling a little nice towards another person who had an abdomen as hard as an ironing board! Thik hai, it was important, nay, imperative that he be operated as soon as possible, so we set about getting his work up done so that the anaesthetists would agree to give him anaesthesia...


We did his blood count, sent his urine for examination and tried to get a chest X ray. That's when all the fun began...Our great hospital run by the great BMC with a Great Medical Superintendent and great Technicians inform us that the X ray machines are not working. After explaining to them that this is indeed an emergency and not an ordinary ward patient whose work up hasn't been completed in time, (Yes we do that sometimes) they finally agreed to get a portable X ray machine to take the X ray but also were quick to warn us, "quality ka koi bharosa nahi dete hain, jaise niklega usise kaam chalana padega" (no gaurantee on quality, you will have to make do with whatever image comes in).


It wasn't like we had a choice so we got that done. Then the anaesthetist says we're not on call, so please arrange for a private anaesthetist as its past 2.00 pm. It was a Sunday, little chance of finding a private anaesthetist who would come and work for just Rs. 200 ( that's right, that's all they get paid for coming to a BMC hospital ) but nevertheless I tried. One said I'm not going to come and waste 4 hrs on a Sunday, the other cleverly said she was busy and I should try and send the patient to Sion where there was an on call anaesthetist and the case could be done there. I called Dr. Broadwalk and asked him what to do. He says, "Its ok, transfer the patient." So I went up to the patient and told him what was decided. This dude for some reason or the other tell me that no matter what happens he wants to be in this hospital only. I warned him that his life was in danger. He tells me that he doesn't care even if he dies but he's gonna stay right here.Well he didn't die but he was sure taken to the limit.


Enter Monday and we do rounds as usual and suddenly Dr. Broadwalk says to me, "This guy needs to be opened." We rush helter skelter and get him ready for the OT. I shall spare you the nasty details but let me tell you he had a hole in the Intestine: what we call a 'Perforation' and it was leaking stools onto the insides of his abdomen so much so, that what is supposed to be pink and healthy was looking Yellow and severely diseased. We fixed him up in about 2 hrs and left him with drains on either side of the abdomen to relieve any fluid which may collect inside!


The second guy was taken with all the work up done and in him we found a perforated appendix. What that means is that he probably had multiple episodes of inflammation of his appendix and it finally gave way and punctured!!! This led to fluid in his abdomen and the hard abdomen with all the pain. He was left with just one drain on his right side.


I wish this was the end of the story but come Tuesday we had more emergencies happening with one persons umbilical hernia becoming strangulated (basically meaning that the hernia was cut off from blood supply causing obstruction to movement of the intestine and impending gangrene of the bowel). He was taken in and operated on and everything did not go smoothly. Firstly this guy was fat and I mean FAT! He had a belly girth of 48 inches. To top it off he wasn't prepared for the surgery and it showed. He passed stools in the middle of the operation and as if that wasn't enough he proceeded to Vomit on the table. This led my great BMC employed Dr. Broadwalk to exclaim, " What the hell, we are now operating in SANDAS."

The other case was this lady with a huge mass in the right side of her abdomen which needed removal. On the table it turned out that this was a huge cyst arising from her ovary which prompted the removal of her uterus, ovaries and part or her cervix.


As a result I haven't had lunch in two days, I had a migrane on the first day due to hunger which is quite common with me and am sooooo tired that I can barely talk to any of my friends on the phone and they probably think I'm being a real high nosed red assed creep who is the only one working and the only one who is busy and can't call!!!


You know what........ inspite of all this I've had to endure I loved every minute of cutting open all these people and removing some of their organs!!!!

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