Tuesday, October 21, 2008


I'm not sure I like the rain anymore.

Yesterday, I forgot to take my umbrella, had to take a trishaw to the flat and then got frickckin' wet anyway, because my neighbour had a lorry parked down the lane and the trishaw couldn't negotiate the last 100 yards home.

I was wearing a red saree.

I discovered that the afore mentioned saree is not colour-fast.

I ended up trailing pinkish streams of water all the way along the living room, past the pantry and into the bedroom.

In an absolutely foul mood, soaked through, I tear off the offending saree and dump it in the laundry basket... failing to notice that two of Darlings light coloured office shirts are in it.

Saree has been banished from wardrobe.


On the positive side, the flat is no longer like an oven when I get home from work.

And heavy rains means we get less admissions. Of course it does mean that those who do come are the dead-or-dying. Sigh. Oh yeah, it also means that those who don't have a dry place to sleep in also get admitted. So no real difference in number of admissions... :S

The hospital corridors flood too... and I always get paranoid about worm infections and take vermox "just in case". It's not very nice squelching along, with damp hem of saree sticking to ankles. The lift guy advised me to keep my umbrella up even when walking the corridors "because Nona, the roofs were built only to keep the sun out, not the rain".

Yup, I think that settles it. I don't like the rainy season.

Sunday, October 19, 2008


Sigh.... joints and muscles I wasn't even aware I had have been aching for ages. I have been working the night on 6 of the last 9 days. Of course, this is after working the day shift as well. Even Darling got tired of me coming home well after 10pm, but to be honest, on most occasions I chose to stay back... I couldn't leave the ward until I was sure that X's BP was stable and Y was out of pain, and Z had stopped vomiting blood.

I'm not a saint. I did it not for the love of humankind. X is 90 years old and is in absolute suffering with a dozen medical problems that will push him to the grave sooner rather than later. Y had crashed his bike while drunk, killing someone, and Z is a wife-beating drunkard.

Ideally, I should not care less. Yet they are my patients, under my care, in my ward. They are my responsibility. It would be wrong if because of a lack of something on my part, someone should die a little sooner or that someone else spend a sleepless night due to pain.

This is my job. It is my responsibility and it's not a very comfortable one. It's a horrible feeling to come in the morning and realise that someone has had unnecessary pain because the morphine had been prescribed 8 hourly instead of 6 hourly. Lapses do happen, because in spite of everything, I am human, and I'm just an intern. And when they do happen, I am so very very sorry.


Ouch, ouch, ouch. Achy muscles suck.

It's also that time of the month.

Since panadine is the strongest painkiller I use, drug-relief is minimal. What I really need is a hot bath and a good foot rub. I shall have to settle for a cold shower.

I've got lots of comments to reply to... thanks to all who took the trouble, your input is appreciated. Will update when less crazy-busy.

Work again tomorrow. Tomorrow's a new day - a new week.


3 and a 1/2 months down... 8 and a 1/2 more...

Monday, October 6, 2008

Daily ditties

Sri Lankans frustrate me in general.

Those in my ward are frustrate me in particular.

But they are my daily fare.... my bread and butter, so to speak. Every day I ask patients about their bowel movements and whether they are peeing comfortably. I stick my finger up innumerable back-sides. I poke and prod and tap and listen. I feel sweaty and uncomfortable and sick at times. These days, dehydration is almost a by word. And still, in spite of doing our best, patients don't do what's best for themselves... why do people have so much trouble in taking responsibility for their own health?

Take the guy in bed X for instance. After devoutly fasting for 20 days, he decides to prematurely break-fast by going on an alcoholic binge.... which lasted till sunrise. He then lands in our ward with a ruptured stomach ulcer, bleeding like mad and has to be rushed into emergency surgery. After days of being kept nil by mouth, we cautiously asked him to drink water - and water only - not exceeding 30ml an hour. The next thing you know the guy is found with a huge buriyani in hand! Aaarrrgh!!!

Then there's the fellow who stabbed himself in the stomach with a bread knife. He seems to have wriggled it around a bit also because his bowels were cut and torn in multiple places and he needed 6 hours of surgery in the wee hours of the night, ICU care and constant monitoring after that. After looking disgruntled for a day or two, he starts yelling at the doctors accusing them of starving him to death. After frustrated conversation and repeated explanations that food will kill him if taken too early, our only conclusion was that next time, he should aim slightly higher and to the left. Hmmmph!

My last casualty saw three admissions with bad diabetic foot ulcers. All three patients had delayed coming to hospital by at least 2 weeks after developing what was initially a small sore. This is in spite of repeated verbal and written information by doctors, nurses and medical and nursing students of the importance of foot care and getting early treatment. One foot ulcer was actually swarming with maggots!! (Eeeeuw!!!) They all turned up after 11pm in the night and all had to undergo amputation. Depressing.

Come to think of it, our countrymen and women seem to have a particular affinity for coming to hospitals in the middle of the night for quite routine complaints. I guess they finish up the house work, sort out their accounts and bills and feed the poor and hungry before they come. Almost every casualty has an admission or two where the patient has been constipated for days... sometimes weeks... who then decides that they want to move their bowel at 2 o'clock in the morning! Honestly, if they came at a decent hour that day... they would have got prompt treatment, a date for endoscopy and been sent home quite comfortable... instead of having to sleep on the floor because there are no beds. And probably wouldn't have had a sleepy doctor (virtual pitchfork threatening alarmingly) getting irritated at their complacence.

Finally there's the guy in bed Z... the bane of my existence. He has multiple anal abscesses caused by constipation, caused by his not taking his thyroxine for 3 frikkin years. The abscesses are oozing pus (eeeuw... why am I in this profession?) and the area needs to be kept meticulously clean with frequent dousings of salt water. And he refuses to wash. Instead he asks for more tablets and pills and injections. Jeez... he frikkin refuses to wash!! (Did I say that already?) And he refuses to go to the toilet - which is the root of all the evil in the first place. The only thing that finally got him to the bathroom was my dark prediction (said out loud and to the ward in general) that unless he does so, his bottom will completely rot and fall off.

Well, that's all for now, folks. I have to go early to the ward tomorrow... there are more back sides that need examining.


Saturday, October 4, 2008

Dr. Lakshmi Indunil... a tribute

I never knew of your existence
Until you ceased to exist on this earthly plane

Your memory blazes like a torch in the hearts of all those you served
Blessed are the many who felt your healing touch

I did not know you, sister...
Yet even in your death, you teach me much

May you attain the supreme bliss of Nibbana


Words by those who did knew her...

"...she was incredibly kind, if someone was ill, she'd get on the bicycle of the messenger and go to attend to that patient..."

"...when she requested a transfer because of this fellow's threats, the respectable people in the village - the grama niladari, principal etc. - petitioned for her to stay..."

"... I can't imagine anyone shooting her... shooting her is like shooting a butterfly..."

Wednesday, October 1, 2008

Occupational hazards

I think I'm going to quit medicine - it's becoming bad for my health.

Apart from the minor heart attacks and nervous breakdowns caused by patients, the getting-yelled-at by the relatives because we hadn't given the patient soup or papaw or something (dude - this is a government hospital. All we can afford to give is rice and curry for all 3 meals.. be thankful!) and the occasional romantic overtures from the more inebriated, hospital life can become a threat to safety, peace of mind and even life.

A friend of mine had her chain snatched a few months ago. She was leaning over to examine a patient who ripped off her chain (causing deep cuts around her neck) and run out of the ward. He was subsequently caught and found to have swallowed it. X-rays showed the chain and pendent - close to 2 sovereigns of gold - lying there as large as life in his bowels. So he was given laxatives... and everyone patiently waited for the chain to pass. Eeeeuw. The chain didn't come out, the patient was taken in to remand, and that will be the last my friend hears about her necklace. Honestly, if it had been me, all ethics would have been put aside and the patient would have been sliced open on the operating table the very next day!

As a precaution, I don't wear any jewelery to work. Not my wedding rings. Not even a necklace or a pair of earrings, unless a particularly festive mood calls for a pair of imitation danglers. Rings interfere with the scrubbing at theatre, and it's difficult to pull on a pair of gloves in an emergency. Earrings get caught in theatre masks and caps. Chains get snatched. I sometimes walk home alone, down a couple of poorly lit streets. Who knows what type of desperate weirdo will accost me?

The there was the murder.

Lady doctor shot dead in Hambanthota
. She was a group mate of some of my colleagues and the atmosphere in the ward yesterday was one of deep shock and distress. She had been a lovely girl, they said. Quiet and unassuming and totally unlikely to get embroiled in arguments.

Apparently there had been a disagreement with an army soldier and this guy had stalked her for months, tracked her down to her quarters and shot her in front of her father.


We treat many personnel from the armed forces on a daily basis, some for routine surgery and some from the front lines who come for specialized trauma care. There are plenty of stories, some heartbreaking, some shining examples of courage that I don't blog about, simply because I don't want my posts to raise any unnecessary red flags.

My point is that even though we're very kind and give them priority at every point, sometimes we have to be firm. Many's the time I had to tell patients (or the bystanders) off for not following medical instructions. Sometimes information needs to be repeatedly yelled out before it can penetrate the thick Sri Lankan skulls. Goodness knows how many of them walk out of the ward bearing a grudge and even now may be plotting to kill some medical officer or the other.

It's not just the forces personnel. This is a nation of twisted, violent and ignorant people and at hospital we deal with the scum - drug addicts and dealers, mafia hitmen, government hitmen, kassippu brewers, pimps.


I think I want a nice, safe job... with set working hours, in a comfortable air conditioned environment among people who are not sick.