Speaking doctors

Tired, rather drained out.We all feel that way. Maybe its the age.As I write these lines while still in CCU, out of the blue, Khalid (year one resident) all of a sudden, says, " Are you crying or do you have a runny nose!". He asks this with such empathy. I turn at him and seem bewildered. How does he know, that my heart is crying. Just then someone sniffs. Oh so Khalid heard those sniffs and correlated them with my very serious face. Both of us burst into laughter. That's what laughter is! After a period of two years, there is a wedding in my family, and the department does not have any replacement! Wow! Now that's news. So the scene is set. Family going to wedding. Me staying in hospital. The taking pictures with the bride and the bridegroom, while I can take all the pictures I want , with the ventilators, lines, canulas.Great fun. So lets take  a look at Matli. A place in interior Sindh where I was born. Small town. Two bazaars. One Government School for boys

S3 is a sound heard after S2. Usually second heart sounds splits at pulmonary area (left second intercostal area). If you hear splitting sound at the apical area, its S3 sound. This sound is heard with the bell of the stethoscope. Make sure you do not press too hard with the bell, as in this case the bell will be turned into a diaphragm! The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems like a failing left ventricle as in dilated congestive heart failure (CHF). S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by inrushing blood from the atria. Now that we have successfully learnt how to hear the third heart sound, I’ll leave you with this beautiful cup of flowers. Happy learning!

Time : 0905 hours. Venue : CCU Thoughts : Empty  Reason : Postcall Its the twenty second of this month. Six more days of cardiology. Three more calls. So far so good. Thoughts : still empty. Everyone knows that I m in ICU next month except me. Thoughts : still empty. Lets keep it that way.

I’m given a consult in psychiatry ward. This patient is schizophrenic, is on olanzepine and the reason for consult is for cardiac side- effects of the drug. About two years back, when I was rotating in medicine in Dr Faisal Mehmood' s team, he 'd a patient to see there and asked us to come along if we were interested. Of course we joined him. We did not see any patients roaming about that day. Dr Faisal told us that this is the only ward in which smoking is allowed by patients. And now , two years later, I'm asked to see a patient there. It scares me a little, but I still go ahead. The entrance has two doors, one followed by the other, and you can only enter if you have the password, or the guard (who's inside) opens the door for you.I peep in , the guard notices me and opens the doors. Its a little weird inside. On the right there is a poster about what to do when you hear voices inside you!   Then there is the TV lounge, a play area, two tables on which a patient and

As I wait for the over , its time for another post. I write because people read, and people read because I write! It's a vicious cycle! Seventeen days of cardiology! Seems like yesterday. The day starts as I wake up at eleven am. Good morning. People at my place are done with nashta, one of the masis is done with her job.Its pretty sunny outside. The newspaper has been read.I fix my breakfast, and also serve tea to the rest of the family. As I sit in the little lawn, I look up at the mango tree. It has started to grow little little flowers , and karis ( small mangoes) . This is the same tree which my uncle said will never bear fruit! Last year it had beautiful sweet mangoes. I call this tree 'hope'.  Mom lazily starts making lunch. I put in my essential touches in the cooking. As I start preparing for the call ahead, my mom forces me to eat literally everything edible in the house!   Its about two pm as I head for AKU. Its too sunny. Actually scorching. Sc

“You’re going to write a post about valentine’s day, aren’t you?”, says Sana (year one resident), when I met her in C2. Am I. Should I. Will I! We recommend him to go to Forum. I think and rethink, and then come up with the following idea…. Let’s take a peep at what  people are doing this fourteenth of Feb. Saima She looks excited, but that excitation is leading to nowhere. This morning she leaves an orchid in my black bag. It looks pretty, sitting there. She has plucked it from the garden in front of CCU. Dr Fawad is astonished, once he knows that, and tells Saima, not to do that to their flowers! And from my end, I actually never noticed those flowers, on the way to and away from CCU. During breakfast Saima asks Dr Fawad, “Did you wish your wife , a happy valentine’s day”. Dr Fawad smiles away, and says, “I’m postcall!” Whatever that means. Aini Floor rotation is driving her crazy! Last year she did her laundry and texted her friends, who did not respond as they w

I had started to become bitter, yesterday’s call had not ended so nicely. I was about to write regarding people’s tempers, what makes them loose them. Why can’t they smile more often. I once read somewhere that people from the subcontinent have serious faces. Is it because of their economic state. People of Indonesia share the same financial crunch, but they smile!     Its spring, the rain says! Just as I was about to fume out, on this blog (to be exact), I woke up with the smells of parathas, fried eggs. The weather seemed strange, breezy hazy, and then it started to drizzle. I couldn’t help but smile.Its spring, the rain says! Spring brings in colour, hope..       The newspaper has a whole supplement about Faiz. I ‘ve never really been poetic, but his verses are beautiful And yes, its 13 Feb so we are celebrating 14 Feb tomorrow! The day when every one acts cheesy. Even the student lounge is displaying red hearts. Its interesting that this valentine’s day , this doc

Its 8 am. I have an hour till my duty finishes. Half-heartedly I head for cardiology meeting. I almost stumble on a pointed object on the floor.   Here they usually speak a language which is alien at least to this doc.As I enter the dark room, I almost stumble on a pointed object on the floor.I try to appear cool as if nothing has happened. Dr Abid is presenting something about lipids in a very monotonous tone. He goes on and on about this study and that. Dr Atta Khan takes his power nap , thrice to be exact! Then comes in the tea! Sidra (intern) , looks at me and we smile at each other. Tea is accompanied by fresh ties , coated with till! The packet is rotated all around the meeting room. In a minute the room filled with doctors is replaced by munchers.   And remember, we were talking about reducing cholesterol! About eating high fibre diet, about exercise. In the meeting Dr Amir Hameed continues his archery on Dr Abid. Post meeting Dr Abid looks broken…

Its 8 am. I have an hour till my duty finishes. Half-heartedly I head for cardiology meeting. Here they usually speak a language which is alien at least to this doc.As I enter the dark room, I almost stumble on a pointed object on the floor.I try to appear cool as if nothing has happened. Dr Abid is presenting something about lipids in a very monotonous tone. He goes on and on about this study and that. Dr Atta Khan takes his

It’s gastroentrology clinic. A young male enters.Tall, slim, ambitious! A boy like any other boy. “Otherwise I won’t get my new job!” Saima starts her history. He has hepatitis B. He is least bothered about what this may lead to. “Doctor, I have just one month, I don’t know how, but I want this hepatitis thing treated within that period, otherwise I won’t get my new job!” Saima is clearly shocked. Clinic finishes. Saima tells me this story and asks me to post it. She is shocked that this young boy is not worried about the health implications of his disease, but only worried about his new job. Well, Saima, this is a poor country, where getting a job is what life means. And, well ignorance IS a bliss! Thank God he does not worry about his hepatitis. Maybe this kid could get an early virologic response, with treatment. Remember, every cloud has a silver lining!

Cardiology night float… He goes on with his drill of proving that she has SLE! It’s eleven am. Still at home. I have to report in hospital at four pm. Five more hours to go.Cardiology night float is thought to be one of the most nerve wrecking rotations.It requires a lot of running around.. This month I have about fifteen calls.Half of them with Dr Ashiq and the remaining half with Dr Abid. One of the fifteen done. The first call was with Dr Ashiq. He is due to appear for his clinical exam in the middle of this month and examines each patient as if he is in CPSP! Every lady that he examines with a remote cardiological finding….. he goes on with his drill of proving that she has SLE! As I headed for my first call, CCU appeared to be a very cold place. Post one call, it’s not that cold. Though it does seem like a man’s world there! In CCU everybody has an encounter with ‘CCU Jamshed’ (the unit receptionist). There are very few men who talk as much as he does! His one line