I quit!!

Image stolen and mutilated from here

So yes. I quit.

My job.

I am no longer attached to the Ministry of Health. And no, it had nothing to do with the previous post.

I know this is not news to some of you guys, but I thought I'll come out of the er.... closet and make an announcement to the world in general. In fact, this whole quitting thing took place some time ago, catalysed by a number of events, and is to blame for the dearth of patient related posts on the bloggie. Also responsible, I think, for the reduced traffic. As one so-called fan put it, "I really liked your angst filled gut wrenching posts more than the twinkly happy ones". Hmmm....

So what does this mean? It means I'm no longer prowling the wards in high heels or lurking inside clinics. In fact, I won't be seeing many patients for the foreseeable future unless I want to (like volunteering at women's health clinics and in health camps). It means I joined a university as a lecturer, for a substantially lower pay, I might add. It means I'm doing a bit of teaching and a lot of research. It means I no longer work weekends, night shifts or casualty rotations. It means I don't have to be on-call and get the jitters every time the phone rings.

I hear you, gentle readers screech out "why???" in tones of outrage.

Like I said, there were a number of reasons. I saw the vacancy advertised in the paper and decided to go for it. It meant having more opportunity to go places and see things, like here and here and here and here. It meant not being stressed like I've described here or having moments of frustration and sadness like here and here.

It may be because I want to spend more time with Darling, just chillaxing, just the two of us. The ability to go pee whenever I want to (note cartoon) is also a great advantage, since I have had patients/relatives diss me when I get up to drink some water or go to the washroom instead of writing out their cards.

I'm really happy at my new job... I work in a nice office, in air conditioned comfort. I work with a great team of like minded people. I have research assistants and a secretary to ease some of the boring work. I don't have to wear saree everyday.

Will I ever go back? May be. It was something I negotiated when I went for the interview... so yes, I may do a clinical degree as well. It's nice to know I still have the choice.

So yes, I think it's all for the best.

Happy weekend all!

Shame on you!! (A tale of irony, failure and blatant discrimination)

And the star player is.... (wait for it ladies and gentlemen) the Ministry of Health!

Image from here

Of course, I need to add a disclaimer that I wasn't a witness to the sordid event, and that I heard it from a number of parties who were present.

Another sunny day in sunny Sri Lanka, a batch of young post-intern doctors, their SLMC registration cards all new and shiny, were attending an orientation programme organised by the Ministry. At one point, an official clambered on to the stage to deliver a lecture on "Communication, public relations and attitudes". Blinking owlishly at the audience, he has proceeded to deliver (very badly) a lecture in Sinhala.

After a short while, the Tamil speaking doctors have requested that he speak in English, as they were unable to follow what he was saying. A reasonable request, one would presume.

At this point, the official has snidely said "if you cannot understand, go outside and wait. You will be given a summary in English as a handout at the end of the lecture".

Stunned and horrified, yet maintaining their dignity, these doctors had walked out, followed by a few of their Sinhala speaking colleagues. Although the majority of the crowd had been outraged, few had the self assurance to join them. However, complaints were made to the organisers, followed by the assurance that this "official" will be pulled from the programme.

However, the drama continued on to the next day, lectures were still delivered in Sinhala, while the Tamil speaking doctors were taken (bussed?) to a different venue, where lectures were in Tamil.

In a time where we all speak of ethnic cohesion and reconciliation, I see this as an insult to all Tamil speaking persons and to all doctors. I see it as a personal insult to myself and my beliefs. I am shocked, disgusted and ashamed... but on further thought, I don't think I'm really surprised.

They talk the talk... but do they really walk the walk?

Snake in the grass!

Literally...!

Image from here

A few days ago, hopping out of the car and striding ahead to the house in front of Mum, I notice a black and yellow shoelace lying on the path. I stooped to pick it up and realised that

a) No one at home wears lace up shoes anymore

b) Shoelaces don't taper off towards one end

I shrieked and jumped back as my brain processed the triangular head with the wicked eyes and the familiar mottled markings of a baby Russel's viper, and my muscles worked on a survival instinct of their own. The fellow was tiny, compared to the monster in the picture above, actually looked more like this.

Panic and pandemonium reigned for a few moments and with the help of the neighbours, the offending critter was hacked to pieces... I didn't watch (too busy with a mini trembling fit inside my room), and although I am all for the sanctity of life and live and let live mindset, I was not in the mood to suggest catching it and sending it to the snake lab of the Colombo Medical Faculty (where the snake venom is milked for experiments).

Daboia russelli is one of the deadliest snakes in Sri Lanka... the venom wreaks havoc on a number of body systems, messes up the clotting, poisons the liver and kidneys, causes dangerous heart rhythms and can damage the nervous system, i.e. you're pretty much screwed. Antivenom is available, but it's a polyvalent antivenom (common remedy for several types of snake bites) that's is imported from India. Although quite effective, it causes unpleasant allergic reactions - fever, chills, rashes, itching, clogged throat, and in about 40%, anaphylaxis, which is life threatening. In fact, a patient once said to me "Doctor, I died and went to hell twice and crawled back. Once when the snake bit me, and once when you gave me the injection".

Dr. Asitha de Silva and his team recently published an article in PLoS Medicine, which will revolutionize how snakebite is treated in SL as their method can reduce adverse reactions by over 40%. Hurrah for the doctors who are doing something to take snakebites out of the "neglected disease" category!

According to the Annual Health Bulletin, 39,321 patients have been admitted in the year 2007 to Government hospitals following snakebite. Most are probably from non venomous snakes, but that's one of the biggest problems we face - difficulty in identifying as the snake is often not brought. Of course when they DO bring the snake, that can result in complications as well. I have my share of snaky stories... just like most of the other docs out there...

Once the patient was accompanied by a 3 foot long live cobra in a gunny sack, which was jumping around like crazy and obviously enraged. The relatives kept egging me to peer inside the sack and confirm the identity and I kept saying no effing way. Finally, they killed the fellow and put it in a glass jar and brought it back to the ward... gah!

On another day when I asked "did you see the snake?" the patient signaled to his friend, who promptly dropped the snake at my feet. I screamed and leaped on to my chair before you could say "fatal haematotoxicity"... and then realized that the snake was, thankfully, dead. That is of course no excuse and I swear that incident is responsible for my crop of grey hairs.

Yet another day a couple of teenage rasthi-types walk in holding a jar that had a coiled up krait. Apparently one of them had felt "something" and then noticed the snake. I was quite pleased since we had a suspect, and careful examination (I went over his skin with a magnifying glass) showed that the guy hadn't been bitten after all. I asked him to stay for 4 hours observation just in case (as he said he felt something), but next thing I know, they had disappeared, leaving the snake filled jar on the floor of the corridor, where to my horror, it was kicked by an unwary labourer and went rolling around the ward! Much frantic scrambling later, the snake (still in the jar) and I were eyeballing each other from opposite ends of the doctor's table. It took another 4 hours to find a labourer who was willing (read - not too scared) to hand the snake over to the Faculty.

So what do you do if, gods forbid, you or someone with you is bitten by a snake?

1. do not panic and run around (muscle activity = the venom will be absorbed faster)
2. remember that most snakebites turn out to be harmless
3. do not cut or suck at the wound, don't apply ice
4. wash with soap (if available) and clean water
5. remove anything that might constrict a swelling limb : bangles, rings, watches etc.
6. immobilise the limb, if possible at a level below the heart. If it's a leg, splint/tie it to the other leg, or use anything handy (e.g. an umbrella) as a splint. The victim would need to be carried, which is all the better since that minimises muscle activity.
7. don't tie tourniquets (reduces blood flow to the whole limb and may make things worse)
8. don't give aspirin or ibuprofen; paracetamol may be given if pain is severe
9. take the victim to the nearest government hospital - most are equipped to deal with snakebite
10. don't waste time searching for or killing the snake. Even dead snakes can give a "reflex bite" and you may become the second victim!

Stay safe, all!

Back...! And rushed off my feet*.....

So yes, back in sunny, warm, humid Sri Lanka, which is very similar to sunny, warm, humid Malaysia, except here I do not have the luxury of having air conditioned surroundings practically 24/7!

As you can imagine, being out of sight does not really translate to being out of mind, and I have come home to a *huge* pile of written (i.e. official) correspondence that needs to be followed up on and loads of other commitments, family, work, friends on my pending list.

To add to this, hours after I land, I learn my cousin has been diagnosed with typhoid, and also that my Mum has dense cataracts in both eyes, needing quick surgery. So, cousin was started on antibiotics, Mum goes in for surgery, and the next day Darling gets severe food poisoning and needs to be hospitalised. Thankfully, all are out of the hospital now but Mum will get her other eye operated next week and Darling is back on a "normal" diet and eating goodness knows what, so I'm feeling very gloomy when I think of the next few weeks.

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*Needless to say, posts will probably be few and far between... and shoe post will be delayed until i have a pedicure... I cannot model ze pweety shooze while having ugly feets! :)

Status update...

Finally... free internets!

*falls dramatically onto a couch and pants in relief*

Yes, dear friends, 'tis me, live and kicking and mooching around beautiful Malaysia.

Actually, I'm doing anything but mooch, being here on training - and the intensive would be an understatement to describe the program so far! We leave the hotel at 7.30 in the morning and the last lecture finishes at 6.00pm, so I am usually exhausted but have to to group work and individual work as preparation for the next day.

They've put us up in a fairly swanky hotel with a lavish buffet breakfast... and if it were not for the academic commitments, it would feel like a wonderful holiday away from the hecticness that was my life for the past couple of months. The rest of the food is rather meh... Malaysians tend to favour very oily, meaty rice which I couldn't tolerate after the first 2 days and I've been surviving on soup and sandwiches for the last couple of weeks. My other grouch was having to pay an exorbitant amount for the internet at the hotel... and finally after days of begging, the course agreed to give us a free connection, so yay!

I think I've mentioned before that Malaysia is shoppers paradise... but only if you have the stamina for it! The malls are huge and numerous and varied, but finding good deals (yes I DO believe in value for money) takes time. I did spend a couple of days shopping with friends, but to be honest, most of the weekends were spent lounging around in a truly decadent way, just enjoying the time to myself.

The only downside is being away from Darling for so long... and even with frequent calls and skype, I miss him with every fibre of my being. I yearn very badly for the moment I can rush into his arms and hold him tight.

It looks like even after (in spite of?) 3 1/2 years of marriage the flame still burns, more intensely than before....

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P.s. : I have got loads of new shoes I am dying to show off... someone please remind me to do a shoe post when I get back!

Tired....

I am so utterly and chronically exhausted that even lifting a finger seems to be too much effort at the moment. This post is being fueled exclusively by my emergency stash of toblerone mini's.

I guess we all go through this sometimes... burnout, maybe... maybe just feeling out of sorts.

I've been wearing the same half a dozen sarees to work for the last month. Why? Because they are made of nylon, i.e. no need to iron, just rinse, drip dry and wear. Unlike the more fashionable Hyderabad cotton sarees that are a PAIN to starch and iron. Speaking of starch, does anyone else use the spray on type available at supermarkets? Darling swears they keep his shirts crispy all day. He doesn't trust me with his shirts because the last time I starched one, it was so stiff, it could have walked off and hung itself in the closet.

I have spent the last 5 days marking MCQs, on paper that has been designed to be marked by a machine and not by humans. Said machine broke sometime ago. After a couple of hours, the coloured dots start to swim in front of your eyes. I hallucinate about them even while at home. Life has become a binary black hole. Adding insult to injury, the payment is like 2 rupees per paper or something.

Not sure this post makes sense... need to sleep.

S&M in the car

So there we were, on the way to work, listening to Rhianna belt it out.

Angel : "Come on, come on...."

Darling : ........ (raised eyebrow)

Angel : "I like it, like it...."

Darling : ".... sweetie, do you know what this song is about?"

Angel : "sure I do - cupcakes!!"

Darling : "er.... you are absolutely right..."

Angel : (happily) "I always am!"

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Of course, a discreet Google search while at office proved me wrong.

Oh well...

And yes, world, this is a sign of life!