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| Some of the babies and twin pairs I have delivered...... |
July 1st; 12.05 a.m:
The cell phone by my cot innocently blares the ring tone “Kal Ho na Ho” transporting me from the blissful realm of dreams to wide eyed, adrenaline pumping reality. At this hour, I know it could mean only one thing-an emergency on the way.
‘Madam, this is your patient Muthamma’s mother. She is in labour I think.” And so the saga begins. Muthamma arrives in auto and I in the ambulance almost simultaneously at the doors of the hospital. What Follows in the routine encore of any labour room world wide.-Muffle-scream-wince-push-sweat-I just can’t-Why not caesarean?.... Only at the end of it all does the staff have any time to wonder that the dialogues could have been more befitting from the doctor as much as from the patient! Muthamma is then shifted to the wards, with a smile and a cuddly bundle. I exit outdoors to the early morning traffic on the highway which is already in full force. The ambulance transports me back home.
I decide to catch some shut eye before the shower just as “Kal Ho na Ho” blares back.(I had set the song ‘Har ghadee badal rahee hai roop zindagi….” as my ring tone because I loved the optimism in the song. But now I have an entirely new interpretation of the song. The ‘kal ho na ho’ phrase is so apt. It has mercilessly erased the distinction between night and day transforming a week into a rapid blur of patients, examination, labour room, operating theatre…My caller tune is another revelation. Sometime ago it was “Ghunguroo ke tharah, bajtha hee raha hoon mein..” Until I realised that the patient’s were only too willing to bajao the ghunguroo further. Now it is “Ek din uth jayegaa maatee ke mol…” as a warning to those who attempt to push me beyond limits!)
“Madam, are you available this morning?” A male voice. It must be a patient’s husband. They still do not understand that they have to call the clinic for appointments.
“Yes.”
“Where? Same place?”
“Yes.”
“Time? Same time?”
“Yes.”
“OK.” The line goes dead. I always wonder what a casual listener would make out if given a transcript of that conversation. It could even be the kind you could put in a magazine inviting readers to complete the scenario of a story! The exciting possibilities and suggestions it offers tempts me to write one immediately too! But for now I just can’t. Two more but less provocative calls later, I give up on sleep.
The morning out-patient is another routine. The patients are all waiting in full force, some even glaring or looking at me disapprovingly as I am late by ten minutes. “Must have over-slept” was that their silent voice I heard or my own delusions?
The whole motley is present. The medical ventriloquists( http://shanyashas.blogspot.com/2011/02/ventriloquism-in-medical-practice_23.html), the shoppers ( medical term for patients who, when advised any kind of surgery, begin their journey from one doctor to another assessing their skills all the while pretending to hang on to every word. What they are really working out is the economics and the absolute necessity of the surgery unmindful of the gravity of the situation) and the second opinion seekers (these are patients who consult doctors in elite hospitals for fancy fees and THEN go to other places, to clear all the doubts that they had and could not consult that doctor for the inhibition of being ‘free’ in those five star hospitals and with those busy doctors!) are all there in generous numbers.
Then of course there are the genuine patients. Those who want a child as desperately as those who don’t, the droughts and deluges, the adolescents and post-menopausals…..and of course in our populous land, the pregnant patients. Their range is widest-some fifth time pregnant in as many married years and yet others just staying married between their pregnant years!
I mange to live upto their expectations-a welcome smile, admonishing only gently or following it up with pacifier-dialogues, juggling my poor grey matter to match that face with that name or enquire about a cousin or a sister who had delivered four months ago. But I fail miserably when one saunters in saying, ‘Doctor the problem for which you treated me has recurred.”
‘I’m sorry. Let me see the previous records.”
“Oh, I have not brought them.” I know better than to ask why. The standard reply in my part of practice is-“we shifted our house and then I lost the records.”
“What were your complaints?”
“Oh the very same then as it is now.” I am defeated on two accounts. An unsuccessful treatment and a memory that has deserted me even as I struggle to recall what this patient’s previous complaint was. As an after thought I ask, “When did you say I last saw you?”
“I didn’t. Since you are asking, you had seen me about eighteen months ago….”was the sheepish reply. As medical students we were expected to have good memories but not one of our professors had ever told us how long we were expected to retain any sort of information about a patient!
It was three in the afternoon as I bundled off the last patient, with a fast fading smile and a growling tummy when “Kal Ho na Ho” chimed again!
“Madam, I am Ramya.” I would know her even if she had only said hello. She was a perpetually tensed expectant mother. By this time, I was so used to getting her calls at such odd times and places as in the toilet or while operating or at 1 am(can’t stake claim on ANY time or space as mine) I grunted a greeting. I was to do a caesarean section on her on the third July.
“Doctor, can you prepone that C-section for today?” Again not an unusual request.
‘Today? You should have called me much earlier. I have to inform the operating theatre, the anaesthetist, the paediatrician….’ I whined.
“Yes doctor. But my husband was very busy and was not sure if he could be free.” Or the daughter-in-law and mother-in-law did not want to miss any of the TV serials till 3 p.m. Note also that the husband’s time and job take precedence over mine. However I must admit she is a shade better than the others who finish viewing even the ‘Crime story’ or ‘Crime diary’ on TV till 11p.m and then come asking for emergency consultation!
‘OK. Will four o’clock be all right? You could come to the hospital right now you know.”
“I will come…But please do the surgery after 4.30.”
“OH!” I don’t ask her why. It is because Rahukalam on Tuesdays is between 3 to 4.30 p.m! (I have the mnemonics grand-dad taught me for calculating Rahukalams-Mother Saw Father Wearing The Turban Soon…Monday: 7.30 to 9.00p.m; Saturday: 9 to 10.30 p.m; Friday: 10.30 a.m to 12 noon; Wednesday: 12 noon to 1.30 p.m; Thursday: 1.30 to 3 p.m; Tuesday: 3 to 4.30 p.m; Sunday: 4.30 to 6 p.m)
As I step into the hospital lobby, I realise it is past lunch time and ask for a cup of coffee from the next door canteen. The tepid beverage is a uniquely secular concoction-tasting like tea if you imagined it was or like coffee if you wished it was!
Much to my mounting tension, I deliver Ramya by Caesarean, the baby with the sex of her choice. I have encountered scowling faces though not outright rebuke when I have delivered a girl when the whole family craved for a boy or less often the vice-versa. I am indirectly made to feel uneasy; as if I had any say in the sex of the baby (I idly wonder what if it was really the case? The obstetrician to be held responsible for delivering a baby not of the sex of their choice! A wonderful clause to the already existing long list of medical negligence!) The colour of the toilet tiles, the stain on the nurse’s uniform, the constantly coughing fellow patient all come under acute observation when the desired sex baby is not delivered. These grouses are the basis for claiming discounts in the final bill at the time of discharge!
I can’t hope to go home yet as the evening round of out-patients are already waiting, impatient and oblivious to the mice in my tummy. By the time I finish seeing the last of them it is half past eight and I realise that I am yet to have the first meal of the day.
It is not just doctor’s day today, I realise as I get home. It is also mother’s day, wife’s day and daughter’s day. Son wants help with his essay, daughter with her project, mother wants advice on some medications and hubby is hungry-it is his first meal too! I juggle at the fridge door and hob, in-between calls from a patient who wants me to spell out the medication for tummy ache-just in case, as her family is travelling. “And oh, something for diarrhoea, body-ache, fever and any other thing you can think of doctor?” Yeah. Hope I remember to charge you for phone consultations too when you come the next time!
As I climb into the bed almost asleep, I realise I have not looked at my cell phone that was alerting so many SMSes throughout the day. The inbox is flooded with greetings for the doctor’s day-medical representatives, some colleagues, friends, patients…. I smile as I go through each of them. Finished with it, just as I am about to set it beside my cot,”Kal Ho na HO” chimes again.
“Shantala madam? I am Shilpa’s mother-in-law. She seems to be in labour. Can we bring her to the hospital?”
“Yes,” I sigh.
I look up at the clock-It is 12.05a.m, 2nd July, beginnig of another doctor’s day!
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| Cat nap (pastels and charcoal on paper) |
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