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Monday, February 25, 2013

BEING AN ATTENDENT

BEING AN ATTENDENT----A REAL STORY
Place - RIMS, ranchi
By- dr सत्यम सिन्हा
कृपया खराब अंग्रेज़ी के लिए क्षमा करेंगे.)
An unknown number flashing on my mobile screen! May be any girl; any wrong number girl; any old link or any returning sentiments!.... “Hello!”.... Shit. It is called KLPD. Its not sounding like a female voice.. may be due to network problem, I consoled myself. But really it was a male voice. And the tragedy train just begun to rush into my life from this instant.

Emergency landing by an Auto, time 1:30 PM, Friday. A lady (30 yrs) was injured in road accident and she was brought here. Her husband was known to my father and so he rang me for help. It was a head injury. After primary treatment in emergency ICU, the case was referred to the Neuro indoor. This case was registered with PIR No. as a Police case, although it was not (what a facility!) but who will not wish to save money!

They were well dressed like belonging from an average middle class family. This helpedme because I introduced them to doctors and seniors as my own relatives (Bhabhi?).Bhabhi is appropriate word for her because if a girl comes to visit her, she will be most probably a Sali...and then I can have a chance to score!! Really, sometimes I am a genius!!
A politician type man (new undertraining roadside leader) was accompanying them. He was never in favour of RIMS. Continuously nodding against RIMS, he was forcing to opt for Raj Hospital. But the attendant (husband) was getting a point to suspect him. He may be having some comission for every patient, because in an earlier incidence also he had suggested for Raj hospital. But am I that big a fool? Who says RIMS is full of negligence? And after all, HAMARE MADHUKAR JI TO YAHIN HAIN NA!” He did not even remember my name (Madhaw). I too was interested in attending the patient because of the dream of visiting girls, although only one came and that too she was not beautiful, but however I added her in my list, expecting for some of her friends.

Before the patient was placed in the neuro ward, I went there, got the investigation slipfor CT-Scan from a PG Boss (Because I am a medico, so I can violate rules) and took the patient directly to CT Scan room, boycotting the long queue of waiting people (who were gazing at us with a suspicious look). I was in a hurry of getting the CT Scan done on that very day (Friday) as getting it done on the next day (Saturday) would lead to wastage of 3 days (this is what happens with common/ general patients) – obviously no doc. comes on Sunday. CT-Scan was done 3 times due to lack of experience & knowledge of technicians (contract basis par bahal hue the na!) and the hazard of radiation was always there. But as I was working for RIMS Director’s Souvenir (Pragati Ki Udan – A booklet about RIMS development), I was conditioned to see everything positively, specially any incident related to RIMS. So I explained it to the attendant –he whole 36 pages that I had written for RIMS in the souvenir. Earlier too, I had presented it to 10-12 persons. I was feeling like a Brand“Look! 3 times scanning. In other hospitals, they would have done only once.Hamare Yahan deeply diagnosis ki jati hai....and then a long lecture started about RIMS. I delivered to him t Ambassador of RIMS – Ek karmath nishthawan chhatra.

In the indoor, the politician type man was in a mood of having an argument with me..... .“You are all careless and irresponsible medicos.This RIMS is never trustworthy because of you,your rules and your thoughts. Govt. invests so much money on you and how do you repay?Neither do you want to serve in the village (R.D.) nor you are dutiful here. The only thing you have in your calendar is strike! Strike and again strike!! You will never come to know how important a life is! Poor people come here not because of your facilities and infrastructure but because they cant afford any other place. Unki majboori hi unke ummid ka karan hai.”

“You doctors start playing with dead bodies in 1st year of medical study, continue enjoying it in 2nd year as FMT and thus gradually you get an addiction of death. You lose your emotions. For you, a death is just like a kiss in a hollywood film, it happens here and there and everywhere.”

I was losing my confidence. Is this a debate competition? Then suddenly I woke up as a champ! I began recalling my talent, I was the winner in my school. And then I appeared as a super champ....

“What do you want? Everytime we are compared to God. But is this the way to behave with God? Atleast let us be simple human beings. We are also like you. (Bastiwalon se jhagada hue kuchh din hi beete the). We too have the fear of death when it comes to us...we do have the dreams. We could have gone for engineering or MBA and by this time, we would have been playing in lakhs in a metropolitan.But we are here because we want to serve. We have already burried our young life among the books (But ideally it should be among bo**** censored). And just imagine what we feel when the people for whom we sacrifice so much begin to attack us, even become misers in giving respect. Our self respect is also being snatched in fact... “, and again the same long lecture (36pages) I delivered breathlessly.

That night the patient again called me. Oh shit.. But “Yes, this is a doctor’s life”. I tried to feel proud of the sacrifice of my sleep.

When I was going to see the patient, it was around 1 AM at night. One man was weeping silently. I asked him about the tears, and he narrated the incident.His daughter (14 yrs) was admitted in medicine ward. Doctors had declared that she had Acute Renal failure in advanced stage. Renal transplant was the only option left, if the parents could manage it easily. And for this too, they would have to go to higher centres. Definitely they were unable to afford it, so they decided to stay in RIMS so that atleast she could die in comfort (As they thought). At that moment,the girl was anxious, dyspnoeic, restless. Her father requested the nurse for oxygen.But the nurse who was sleeping, replied arrogantly – “Who are you to decide whether to supplement oxygen or not? When the doctor will come, he will decide if it is required or not. Your patient is dying anyway. It is not wise to spend the Govt. oxygen like this. May be this will be lifesaving for some one else needing it actually.

I went to the bed with her father. But now the girl was at rest, with a calm and smiling face. She didn’t need any more oxygen even for breathing. I was standing still. Pause!! A lot of questions began to explode. Did their purpose get solved? Was the nurses’ logic correct? Or was she irresponsible towards her duty? Can’t we have a hope till the last second for a miracle to occur? Is it superstition.. was she dying with comfort? Could the oxygen supplement be of any help in this case?

In the Neuro ward, the attendant was tense & worried, waiting for me near the gate of C2 ward. As soon as he saw me, he ran to me and said – “Lagata hai yahan aake phans gaye hain kaa?” Actually his patient was vomiting and was restless. Although the condition was not so severe but in neuro ward,where everytime life is in 50-50 probability, his anxiety was obvious. He firstly reported to the doctor in Emergency, but no body came. Again he went to call but the doctor on duty replied – “Jao na ji, aate hain na 5 minute main! Tum aise kar rahe ho jaise tumhi mar rahe ho turant.” And then the doctor preferred to sleep rather than going with him to the ward. Ultimately he called me after losing all hope. I thought it was useless to go to the emergency again. So I preferred to go to PG Hostel. There was a PG Boss, quiet, laborious and caring, known to me.He was very popular among patients because of his dedication.

Saturday night, 1:35 AM. I was going to PG (Boys!!) Hostel 2nd time. My 1st visit came In my mind as a recap of a TV serial. 1st time during Saraswati Puja (then we were the junior most) ‘chanda’ collection. We got a chance to see this completely different form of medico life.At that time, most of us were excited to knock at the gate, because in 1st few rooms we had seen girls 1st time in any boys hostel. Our dirty mind were working fast. There are two types of rooms. First type – like a library, hardly any space to sit. (PG Aspirant and single-unpaired PG Boss), and 2nd type – well decorated with AC, internet, TV,girlfriend or wife. This time, as I had no idea as to which room I should go, I took the help of another Boss of my fibre to whom I had promised to arrange a girl friend. (Because the whole campus knows that I have many girlfriends and I have arranged for many of my batchmates).

In the destined room, as I was expecting, no specific signs and symptoms were present. Boss was busy on phone (probable symptom) and indicated me to sit. While he was talking.I concluded that on the other side of phone was the same ma’am (senior girl) for whom maximum of UG go to library as a routine work.Boss had to finish his talk and came with me to the ward.
Boss : Is this patient your own relative?
Me : Yes Boss (I answered with hesitation).
Boss : You are in 3rd year na?Then also you don’t know the condition and situation of this institute; surprisingly you are a stupid guy. Man! Here only those come who can’t go anywhere else or those who have to get a false medical certificate.
Me : Boss, what is the problem here? Is the staff careless or is the system defective?
Boss : No! Everything is not defective. We have the latest instruments and labs. Some nurses serve better than those in any other hospital. Their dedication is really appreciable.Some doctors are really dutiful and caring.Some senior doctors like are really hard working due to whom this institute is surviving. But some are still here who don’t want to work.The system is also much defective. Afterall its a Govt. hospital na?
He came to the ward and while prescribing medicines, nearby patients also started telling their problems. He had to give a complete round, although he was not on duty. While leaving he gave me a burning suggesting – “From now don’t bring your own relatives here. Not because I had to come here at night, but because of the absence of responsibility in the system”.

I was analysing the truth. Really some are good like him, but many are negligent. And the lives of patients is more important than this statistical analysis. If only one doctor is irresponsible, this means one life is being lost every day. And specially in conditions where the patient doesn’t have any recommendation from ministers or medicos like me.
While returning from medicine shop, near the fountain I saw Putesar of my village.His father (40 yrs) was a labour in Kolkata. There he fell ill but was neglected initially. Later when he consulted the doctor, it was too late. Cancer was diagnosed. He spent all his money there,and when every penny was lost, he decided to return to his village so that he could take his last breath near his four marks and die in front of his family. He was waiting for his death every second.One day it came in Newspaper “Now complete treatment of cancer with RADIOTHERAPHY is available in RIMS (July 09). Patients of Jharkhand now don’t need to go anywhere else.” Some of the villagers collected money and suggested him to go to RIMS, although some were suggesting for TMH or BHU. But he wished to arrange for the marriage of his daughter so that he could see it before dying. But here in RIMS, he could not get Radiotherapy, bcoz it’s not available here.

Doctors told him to go somewhere else, but he didn’t have any zeal and enthusiasm for it. He had spent his money in early investigations and medicines. Although I didn’t have the strength to face the situation, I had to go with him. The patient was lying in cachexic condition. “No need to worry or fear. You have atleast one year. Who knows the power and will of God. He takes care of everyone. “koun janta hai kab chamatkar ho jaye“– I was trying to console him.But instead he began to smile – ““pandi ji marz ke bare me bhale aap hamse jyada jante hain,par mout ke bare me to mat hi bataiye..–” Definitely medical science may teach me more about disease, but when it came to death, he was a scholar no doubt.

After some days he died in his village but left thousands of questions in my mind. Was it correct to publish it in the newspaper like this? Is false advertisement is more important than the life of common man? Is it a simple death or the death of a common man’s hope regarding RIMS? Was the investment in treatment against his will fruitful.” Would it have been better to arrange for the marriage instead of treatment?The question was not whether treatment is given here but if this false self-appreciation in News Paper hadn’t come, he might have gone to some other institution.

To my patient on Monday, doctor advised for blood transfusion urgently. Blood group AB negative. And coincidently or by foul play, it was not available in RIMS. I tried in other blood banks, but with no success. After a long struggle, we could manage two units from Bokaro. Although it was life saving, but we still needed atleast two more units. That politician type man took me to RIMS Blood Bank and said– “I know blood is available. You are a medical student of this institute. Try to get it.” I was surprised, how did he know? But I tried my best. I got the same reply again – “AB negative is not available, try to consult after 2-3 days. May be we will be able to provide it.” Then the politician took out his mobile and dialed the number of an MLA. While talking on phone, he gave a cunning smile to me. After some time he got the blood.

I was shocked. What was this? Before this I used to think that we medicos are supreme, only we can violate and modify the disciplines (sometimes outside the RIMS also). But in this case MLA is the supreme and we are just like a common man. But still the bigger question was that, Does it happen with every common patient, even in emergency situations?

Any way, next day my patient was advisedsome investigations. But the investigation slip was kept by the nurse. Consequently the investigation could not be done. The relatives called me but as I had my exams on the next day, I explained them my inability to come and promised to visit the next day. Next day in the morning the patient and the relatives were scolded by the doctor for not getting the investigation done. Also this critical case was not handled with specific modification due to nonavailability of investigation eport.When I visited there in the evening, the nurse explained me the reason to me. Actually it was a police case, so only the hospital trolley staff could get the investigation slip and only he could take the patient for investigations. But because no trolley of Neuro ward was vacant and the staff was not interested in bringing a trolley to the 4th floor of Neuro wards, he didn’t take the pain of bringing a trolley for the patient.And thus, no investigation was done.I, taking the advantage of being a medico,got the slip, took the patient for nvestigation,got it done, felt a bit relaxed, and came to my hostel.
Of oh! My mobile started ringing at 2 am.I became so angry, almost willing to break it.But cooled down seeing the patient’s number.I received the call. But alas!! I was shocked. I just couldn’t believe it. An apparently smiling normal (obviously injured) person whom I visited a few hours ago was dead. Reason – delay in investigation – delay in diagnosis – delay in specific treatment. I had no other option left than to repent, as she might have been saved if I had visited her earlier. Although she was not my own relative, but I felt a relation. Several times I had felt joy, when she had told that she was feeling well due to my help. Was it a fixed final destination, which could never be altered?

Its already 2 months since this incident.Now I am busy with my exams. I also forgot about the incident like most of the readers will.But one good news, I got many new girlfriends through the visitor girl. If you need, try to be the attendent or call me on 9709033291. Hey listen, I am getting calls. Remaining in the next story.“Hello.... excuse me! Bye readers!! ... Hello! Oh you are so naughty dear....”
By - सत्यम सिन्हा 

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