If Wishes were Horses...

Wish you were here; there are so many things to share with you.

I can't deal with it anymore.

An Obeisance

It's that time of the year again... :)

Happy Ganesh Chathurthi to one and all!

Gone are the days…

(This poem was sent as an email to me by a school friend – Chandan. This is one of the best things you can be gifted on Friendship’s day – fond memories of the past. This piece has made me nostalgic; though it may seem very simple, each word in the stanzas below has a deep meaning associated with it.)


Gone are the days, my Friend…

When
School reopened in June
And we settled in our new desks and benches!

When
We wanted two Sundays and no Mondays, yet
Managed to line up daily for the morning prayers

We learnt writing with
Slates and pencils
Progressed to fountain pens, ball pens and then Micro tips!

When
We had lunch in classrooms, corridors
Playgrounds, under the trees and even in cycle sheds!

When
A single P.T. period in the week's timetable
was awaited more eagerly than the monsoons!

Gone are the days
Of Sports Day and annual Day
And the month long preparations for them

Gone are the days

When we used to talk with friends now we don’t have time to say ‘hi’
When we used to chat for hours now we chat in chat rooms
Gone are those days, but their memories will linger in my heart



(‘Cycle sheds’ was probably the word which brought with it many memories. There was this huge shed near the main entrance of our school which was meant for parking cycles and for parents to wait in case it was raining outside. We’ve had so much fun in that shade – be it scouting lessons or Independence Day practice. More on school-life in the next post… Too tired right now.)

Words

After a few days, I’ll have completed 6 months of internship. Wow.

I think each department has its own catchword. I’ve heard them so often now, from so many people around, that I’ve begun to think it’s a part of normal vocabulary.

‘Arre yaar’, ‘kya re’, ‘sun na’ are few benign-looking terms. I have to now make conscious efforts to avoid using them.

When I was posted in surgery, everything and anything could be ‘mobilized’. “Aniruddha, aaj hamare unit ke AP ka birthday hai. Ek cake mobilize karna hai.” “Aniruddha, mere liye ek pen mobilize kar na.” “Exam ke liye patients mobilize karne hain.” “There is too much work. Ek aur intern ko mobilize karna padega.” “Kahin se toh tincture benzoin mobilize kar.” The list is endless. (I wonder what happens to the object that’s ‘mobilized’.)

Another pet peeve of mine is ‘stat’. I want an ABG stat. I want his electrolytes stat. Give him soda bicarb stat. Give me a pen stat. I want an IV line stat. Didn’t I tell you guys to do his workup stat?

Recently, I heard someone telling a nurse ‘double stat’. “Staff! Give that patient atropine double stat!” Phew. Some people are in real hurry.

Things were slightly better in medicine. ObGy is next. Another 6 months of nonsense.

Status: Very sad. My co-intern literally cried because of the ‘hyper’ me. I should’ve been better with her.

No Time to Spare

There's so much going around. Cartooning. Strike. Tests. Studies. Internship. Travelling.

There won't be blog posts for sometime now. I need a break.

Money Matters...

We are all going on a strike along with the resident doctors.

If they accept our demands, we'll be paid 8000 bucks. Which I don't think will happen.

Anyways. Happy holidays.

Announcement

To avoid confusion and maintain continuity, all the comics of Incompetent Os have been exported to a new blog site. (http://incompetentos.blogspot.com/)

For regular updates, become a follower and keep reading Os's adventures!

(Meanwhile, all the other articles will posted on this blog. Ciao.)

Extern-Bashing Continues…

If this guy asks me one more question, I promise that I’ll wring his neck or cut his carotid.

That’s what any sane person would do, if constantly bombarded by sick questions. Every conversation that I have had with him was because of his foolish doubts. One day, someone should paint a question mark of font size 72 on this buffoon’s forehead.

“What is the time now? What should I do now? What if he doesn’t sign? How does one go to the first floor? Which train do I catch? How do I reach there? What time will the OPD get over? Who will reach the IPL semi-finals? Do you think this registrar is hot? Don’t you think she has a bad voice? Have you ever seen mosquitoes fucking each other? Where do I get that video? If I don’t have a ticket, will they catch me in the train? If I have forgotten my wallet, how will I eat in the canteen? What do they serve now? Why don’t you reply…?”

You know what, one day someone really pissed off with you will suture your mouth and put a 6 inch Dynaplast, reinforcing it with Crepe Bandage. Or better still – gag you with an inflated Foley’s balloon.

Just When They Thought They Are Smarter

Sometime back, I told you how some people deserve to get their asses incinerated.

Now this guy, an extern, thinks he’s very rich. Obviously, this does not mean that he can do whatever he wishes to. He comes to the OPD at 11.30 am, a good 2.5 hours late. After that, he has the cheek to ask me if there was too much work, with a sly idiotic smile. I care a damn, you bag of urine.

He joined with us on Monday. He didn’t report for the first two days, came on the third day for 10 – 15 minutes and today, as I said, this dog comes at his own ease thinking that he is some showstopper. I don’t care about the work, it’s hardly something. Besides, crooks like him don’t even deserve to serve patients. But the fact that bugs me is his attitude – totally not bothered. As if he is some gift to mankind. He is undiluted bullshit, crow-shit and shit of many other wild pigs mixed together.

She is no less. She thinks that she is a super-babe. In fact, she belongs to that category of pseudo-babes whom you wouldn’t want to meet. She looks like a plague-afflicted rat and her mouth doesn’t shut up. Just like him, she feels that just because she has paid some twenty-five thousand bucks to the BMC, she owns it. Sucker…

My batch-mates had to tolerate them for 3 days while I was posted in other sections of the department. They told me about how these two pieces of faeces had frustrated them too. Today, I got the opportunity of taking revenge. I don’t indulge in such things normally, never; I prefer to stay away and do my own work. I have a relatively high threshold. But I had to teach these Scylla and Charybdis a lesson. They need to understand that they are responsible if a patient has to suffer some inconvenience.

So, in the morning, when they presented their macerated faces in the OPD, they had to face nice music from the registrar (with whom I teamed up). The two maggots were marked absent – this must have surely set their bum on fire. From tomorrow, if they don’t improve, they surely deserve worse – like falling into a manhole full of methane and getting asphyxiated. Assholes falling into manholes – how cool is it.

This is what all people who don’t do their part of work deserve. Many people have a tendency to take too many things for granted, not realising how it can create unnecessary problems and inconvenience for others in need of help.

Hiccups

One of the most non-specific conditions for a physician to treat is hiccups (singultus). They usually have a very obscure cause and at times can underlie serious diseases.

A young man (non-diabetic/non-hypertensive) diagnosed with malaria presented with tiring non-stop hiccups. He was investigated three days back and the peripheral blood smear demonstrated vivax parasites. He was on artesunate along with other supportive care. He came at 11pm in the casualty and complained that his hiccups were non-stop, present since afternoon (post-lunch) and had caused him considerable exhaustion. He had no other complaints.

Luckily, he responded to injectable metaclopromide within minutes.

Another patient presented with features of gastric acid reflux disease and exhausting hiccups. However, his chief complaint was acidity, from which he wanted immediate relief. An intramuscular injection of rantidine allayed his acidity, but hiccups continued. This man was otherwise normal. I thought of giving him dispersible domperidone tablets; his hiccups stopped 10 minutes after keeping the tablet under his tongue.

I read up few papers on hiccups, their cause and treatment. Most of the literature has treatment based on trial and error; others consist of success stories (such as mine) without much backing. There is hardly any paper which does not mention remedies put forth by folk medicine. In fact, this adds spice to the otherwise boring allopathic life.

Folk medicine has described various home-remedies to get rid of hiccups – from ‘gulp down two teaspoons of sugar’ to ‘have someone startle you with a loud boo!’ Indian folk medicine also prescribes various techniques such as drinking ice cold water or pressing one’s eyeballs gently. Pulling one’s tongue has been suggested as a good alternative. They probably have a scientific basis (like pressing one’s eyeballs stimulates vagal activity).

Good old Harrison does not have much information on treatment of hiccups. Adam’s & Victor’s Principles of Neurology (8th edition) mentions baclofen for persistent cases. Bradley Neurology in Clinical Practice does not mention anything specific. Goetz textbook of Clinical Neurology (3rd edition) has arguably the best line of management:

1. Chlorpromazine 25 – 50 mg IV or 50 mg per orally
2. Metaclopromide 10 mg IV or 10 mg per orally TID

Some published papers provide excellent views (historical and current medical) on hiccups. There are charts on various drugs that are effective (including atropine) and many authors have given protocols for treating intractable kind of hiccups. A case study is the most interesting of the lot – it’s about a man who was instantly relieved from persistent hiccups after a sexual intercourse!

Suggested reading:
1. A paper from British Medical Journal – ‘Management of Intractable Hiccups’.
2. A historical note on hiccups.
3. A paper describing various causes of hiccups.
4. A case report describing sexual intercourse as a potential cure for intractable hiccups (wow!).

A Night in Casualty

Night-shifts were a part of our EMR (emergency medicine registrar) posting and we thoroughly enjoyed them. We liked the kind of work that was assigned to us and were also able to understand how patients should actually be managed in an emergency setup. Besides, it was one month of legal 'night-outs' - with very little or no work after 3 am. After 3, it was five hours of complete non-specific gossip and nonstop laughter. Missing those days [:(]

A night in the Casualty is never like that in the EMR. You feel like a hermit trapped in a forest from where you can’t escape. You are doing nothing, just issuing ‘case papers’ and not even remotely concerned with the patient management. This was how life was in the last week:

After a long OPD in the morning where at least five multi-drug resistant tuberculosis (MDR TB) patients coughed on my face, Casualty was next on the list. There are usually two interns at night in the Casualty, unless of course one decides to escape. Luckily, that didn’t happen. We were two of us; the Casualty Officer allowed us to divide and my co-intern went off to sleep at 12 midnight. He was told to relieve me at 4.00 am.

Soon after he left, the horrid exodus began. One after the other, patients arrived and demanded immediate attention. I was examining a kid who was down with fever. Since he was really young, I was dealing with him first as you can never take chances with paediatric patients in the casualty.

There was no looking back – entered a lady with a breathless kid in her arm. The kid was only 3 months old. Rush! A woman with severe giddiness was brought by four relatives. Each relative was holding a limb – they didn’t even care to arrange for a wheelchair. A young married girl entered with a deep cut on her wrist, exposing her tendons. Obviously, I realised that it was a suicide attempt; her scared husband was dangling behind. Hesitation marks around the cut were confirmatory. It was a police case and the Casualty Officer was busy noting down the details thereafter (I had to wake him up!).

A hefty middle-aged man arrived with a towel covering his ear. The towel was soaked in blood. He had a fight with a guy in his neighbourhood sometime back. The fellow with whom he fought took a knife and chopped off half his ear. A lady in her forties came with a deep gash on her palm. She claimed that she cut herself while peeling an onion. I couldn’t believe her story because I did not find any reason why a female should peel an onion at 2.00am. Anyways, there was no time to argue with her.

There was a loud noise outside. It was the siren of an ambulance. Correction – there were three ambulances carrying accident patients. Within seconds, there was a flurry of footsteps and wheels of a trolley were heard clearly. A man was brought with multiple fractures on his left leg and a head injury. As I got up to examine him, another trolley was brought in, with a woman in a really bad position. She was trolley no. 1’s wife. As soon as I saw her vomiting blood, I handed the police ‘pink slip’ and she was immediately escorted to ESR (emergency surgery registrar).

‘Pink slip’ is given by the Casualty doctor to any patient needing immediate attention. For patients who are really critical, where one can’t waste time issuing a ‘case paper’, pink slips are used.

Next second, another wheelchair was dragged in the casualty. It was the third accident patient, involved in the same mishap. He was bleeding profusely from his skull. A young boy, around 17 came with his friends. He had fallen from a staircase and an iron rod made a 3 – 4cm hole in his lower back. A girl hurt her eye while playing with her friends. Her friends threw a stone that hit her left eye causing a grievous injury.

At 4.15am, I couldn’t sleep. I was in the hostel room with darkness all around…

[…looking forward to ESR where I’ll play a role in patient management. I hope I get the same (/kind of) co-interns like in EMR.]

The last Laugh

Some people can really get on your nerves. They can be so uncooperative and selfish that you feel like digging a hole in the ground and pushing their heads into it. Worse still, you feel like giving them an injection of rabies virus intracranially.

I was good with them initially. They started taking undue advantage. Now begins the fun. Some people deserve a taste of their own medicine. It’s going to be a nice week ahead, with six of us hell-bent on making their life miserable. Heh heh… you uncivilised asses, you’ve had it.

Don’t trouble trouble, till trouble troubles you.

Few Good Things…

This week in EMS was better than the last.
1. I managed to put an intravenous cannula in almost all patients in one prick. Even in a person who was convulsing.

2. I almost put a central line. Of course I needed help.

3. I managed to avoid needle stick injuries. That reminds me – I’m yet to take my booster for hepatitis B. Shit.

4. I’m lucky I have good co-interns. We divided the work and so that each one of us could sleep for at least an hour every night in the side room of EMS.

5. There was a huge raada in the casualty one night. The next day, there was a fight amongst the interns posted in paediatrics and EPR. Its fun to watch people fight.

6. I learnt (read: memorised) few sentences in Marathi. “Arre gap bas. Ek sui lavaychi aahe.”

7. We agreed to teach a police security guard how to collect blood. In return, he promised to save us in case an angry relative decides to wring our necks. However, the deal didn’t materialise.

8. We learnt how to use the police walkie-talkie. It’s a fun thing.

9. I’ve had at least a kilo of ice-cream this week. EMS is cool!

10. A friend of mine agreed to pole dance on my funeral, whenever it happens. According to her, that will attract at least some people to attend the ritual.

50 Questions

(More meaningful posts after 6th April – this is just to keep the blog alive)
1. ONE OF YOUR SCARS, HOW DID YOU GET IT?
I don’t have any

2. WHAT IS ON THE WALLS IN YOUR ROOM?
Nothing. I like it clean

3. DO YOU KNOW WHAT TIME YOU WERE BORN?
Yes. 8.15 am. Breakfast time!

4. WHAT DO YOU WANT MORE THAN ANYTHING RIGHT NOW?
Direction

5. WHAT IS YOUR MOST PRIZED POSSESSION(S)?
Family

6. HOW TALL ARE YOU?
179 cm

7. DO YOU GET CLAUSTROPHOBIC?
Nope

8. THE LAST PERSON TO MAKE YOU CRY?
My dad

9. WHAT'S YOUR WORST FEAR?
Being there all alone

10. WHAT KIND OF HAIR/EYE COLOR DO YOU LIKE ON THE OPPOSITE SEX?
Black eyes.
Black hair.

11. COFFEE OR ENERGY DRINK?
Umm… Coffee

12. FAVORITE PIZZA TOPPING?
Can’t decide…

13. IF YOU COULD EAT ANYTHING RIGHT NOW, WHAT WOULD IT BE?
Strawberry with cream

14. FAVORITE COLOR OF ALL TIME?
Red

15. HAVE YOU EVER EATEN A GOLDFISH?
Never. Yuck.

16. WHAT WAS THE FIRST MEANINGFUL GIFT YOU'VE EVER RECEIVED?
When I was a newborn. My sisters chose a very tiny and a-traumatic rakhi.

17. DO YOU HAVE A CRUSH?
Yes

18. FAVORITE CLOTHING BRAND?
Express

19. WOULD YOU FALL IN LOVE KNOWING THAT THE PERSON IS LEAVING?
Yes

20. SAY A NUMBER FROM ONE TO A HUNDRED:
4

21. WHAT’S YOUR WEAKNESS?
A smile

22. MET ANYONE FAMOUS?
My grandmom

23. FIRST JOB?
I’ve been forever jobless

24. EVER DONE A PRANK CALL?
Yes... long time back

25. DO YOU THINK EVERYONE OUT THERE HAS A SOULMATE?
Of course

26. HAVE YOU EVER HAD A SURGERY?
Yes, once. It was many years back.

27. WHAT IS THE BIGGEST TURN OFF OF THE OPPOSITE SEX?
Superficiality

28. WHAT IS ONE THING YOU LIKED ABOUT HIGH SCHOOL?
We had a kind of food fest called Anand Bazar. Annual day used to be great fun too. Pai sir’s lectures were amazing. Wow. I can go on and on.

29. ANY BAD HABITS?
I think too much

30. DO LOOKS MATTER?
Yup

31. HOW DO YOU RELEASE ANGER?
By going into a shell

32. WHAT'S YOUR MAIN GOAL IN LIFE?
To live for people close to my heart

33. WHAT WAS YOUR FAVORITE TOY AS A CHILD?
Cars. I loved to drag them around.

34. HOW MANY NUMBERS ARE IN YOUR CELL PHONE?
More than 300

35. WHAT DO YOU LOOK FOR IN A GUY/GIRL?
Gentleness, humility, looks and above all, enough grey matter

36. WHAT'S YOUR FAVORITE ICE CREAM FLAVOR?
I love all, without nuts

37. DO YOU HAVE A COMPUTER IN YOUR ROOM?
Yes

38. PLANS FOR TONIGHT?
I can’t enter so much data in my brain

39. THE FIRST THING YOU NOTICE IN THE OPPOSITE SEX
Panache

40. FAVORITE THING TO HATE?
People who push others with their elbows

41. WHAT DO YOU LIKE TO DO IN YOUR SPARE TIME?
I waste it doing nothing

42. FAVORITE SEASON OF THE YEAR
Rains

43. WHAT ARE YOUR NICKNAMES?
Ani

44. FAVORITE SUPER POWER?
Umm… does Dexter count as one?

45. HAVE YOU EVER REALLY AND TRULY HAD A BEST FRIEND?
Yes, I do

46. WHAT IS YOUR HAIR COLOR?
Dark Brown

47. EYE COLOR?
Jet Black

48. WHO WERE YOUR GOOD FRIENDS IN HIGH SCHOOL?
Aaron, Adrian, Leo, Talwinder, Dino, Ankush, Glen, Tejas, Anjali, Mayur... the list isn’t complete.

49. KISSES OR HUGS?
Both :)

50. RELATIONSHIPS OR ONE NIGHT STANDS?
Relationships

25 Random Things about Me

This blog post is inspired by Yash; I hope this facebook cycle continues so that we get to read more random stuff about people we know.

Coming straight to the point:
1. I’m too complicated. It’s something to do with my unusual neural circuitry.

2. I hate cockroaches and dirty insects. I hate people who can hold them with their antennae. They make me vomit. Ack. Puke.

3. I usually hang out with only a few selected people. I’m choosy and don’t talk to many people around me. Most people in a crowd stink. Skunks.

4. I can get emotionally attached to anyone close enough. I fear losing people.

5. I’m a tennis freak and can watch it for hours together. You’re going to have a bad time if you bother me while I’m glued to a match.

6. I just love ice creams. Especially the ones without nuts as toppings. I’ve had entire family packs at a time. More on ice creams and experiences with the female selling it at Chicago in some other post.

7. I’m a perfectionist.

8. Politics is not meant for me. I can never tackle bureaucracy. I like straightforward people who don’t pretend about stuff.

9. I keep saying ‘oh fish!’ and ‘hai na?’ every now and then.

10. If given an option, I would choose to be a sea sponge. That way, I would get to laze around all my life with my bum attached to the floor. I don’t know who made me a human.

11. I like to stay low-profile. I think life’s more comfortable that way. You needn’t get noticed for any damn reason. No wonder sea sponges are so cool.

12. I can never reach any place on time. Punctuality is a huge struggle. On an average, I’m at least an hour late everywhere. I’ve been threatened, warned and rebuked but to no avail.

13. I’m religious and spiritual. But I don’t go overboard. I don’t agree with atheists.

14. I like to paint. If only I could get some time. And money to buy canvas.

15. I think most people are buffoons. If you look closely enough, you’ll realise.

16. I’m a perfect Leo; the kind described in books – word-to-word. There’s not a slight variation from the typical description. Lions rule, you know.

17. If I hadn’t taken up medicine, I would be doing zoology, molecular chemistry or finance.

18. I love India. I hate Indians who hate India. Jai hind.

19. I want to do an internship under a professional photographer, especially someone who holds interest in bird photography and landscape photography. Sounds cool.

20. I’m a vegetarian. I live on plants and leaves. If Brontosaurus could manage on them, even I can.

21. Rains are cool. Especially when you are outdoors with just the right company, without a windcheater and the sky is glutted with clouds. Winds, storms and lightning are even better.

22. I don’t mind living the rest of my life on a desolate island surrounded by sea with only fruits and berries to fill that darn muscular bag. I mean stomach. But of course.

23. I love to think that I’m the biggest fan of René Goscinny and Albert Uderzo. For some reason, I think Fulliautomatix rocks.

24. I can waste hours together doing nothing. My palm says that I have a long life. Shit.

25. I think one day I’ll spend all the money I have. Too bad they don’t teach you good economics in school.

Now, I’m waiting to read about you guys.

Whatever It Means

Travelling to college is annoying especially with the construction of Metro Rail adding to the existing traffic congestion. You just can’t help but sit in a rick and stare at the world outside.

This is exactly what I was doing today morning, wasting nearly an hour stranded at one spot. The rickshaw wouldn’t budge an inch. There was nothing much to stare at either; except a little girl who probably had wandered from a nearby beggars’ hutment.

She wasn’t accompanied by anyone else but was unperturbed nonetheless. Hopping about, she discovered a rope that was tied to a low hanging branch of a tree. The rope was tied at both ends to the branch in order to make it an ingenious swing. The ten centimetres thick rope was reinforced by knots in certain weaker areas. But that didn’t dampen her spirits. She promptly sat, made herself comfortable and began swinging on the rope. She wore an ordinary black dress; it wasn’t tattered, neither was it new. It looked castoff but that didn’t bother her.

Her hands held the rope firmly enough so that she didn’t slip and gently enough so that the jute fibres didn’t poke her palms. Her smile widened as her speed increased – in direct proportion – as a mathematician would put it. She was alone, with no one around, her eyes weren’t looking for anyone either. She was totally on her own but made most of those moments. At least that’s what I could make out. I wish I could photograph and capture that moment so as to prove this to you.

I wanted to ask her name. But then, I just assumed it to be Life.

Whereto?

I know nothing, nothing at all. At times, I’m not even receptive to that same old question. Maybe it happens when you don’t know anything.

I’ve never been so confused. I’m lost. I don’t know what helps getting out of this. It’s suffocating; there is no time. I don’t mind if someone else lives this moment for me. At least I won’t blame myself at the end of it.

Maybe it happens when you don’t know anything.