Speaking doctors

I ve always been a morning person. Waking up early on a weekend has its own beauty, romance. Specially in summers. Catching the morning before the sun scorches. The breeze. The birds. It was a little late. But it was nine thirty when I woke. As I sat on the bench with the mango tree above, a koyal kooked, 'Koo oooo'. What could me more beautiful. I stare above me. I could see the mango tree standing tall. Bearing fruit now. Almost two inch long mangoes (Kairi).

Its interesting how different people living in different countries react to the same seasonal variation. We live in the land of samosas and pakoras. This association leads us to think of a wonderful cloudy evening. Winds blowing. Everyone having a smile on their face. Happy in the head for no good reason. Of jalebis and more. Chatnis and ketchups. Of youngs and olds and not so olds. So yes the rainy season approaches us again. I can see scores of medical students outside just to enjoy the hazy weather. Then there is the shop called 'Snacks n Things'. It sure is making good, or rather great business. Tea and more tea. Samosas and rolls. Age is not the bar today. Quiet a crowd. Meray bachpan kay din.. Takes me to the rains in my childhood (but the child in me is still there, pops up every now and then, surfaces and resurfaces.). How it used to rain. The typical interior Sindh rain. We used to soak and soak till our bodies ached. I had loads of cousins for compa...

Saturday passes away with cooking. Spaghetti qeema and salad with loads of greenery.  My younger brother has three servings and I can see spaghetti coming from his ears. A touch of imagination. ہمسفر نہ رہآ ہمسفر We have the PTCL smart three in one. But it’s a three or none. It decides to turn on and off on its own. So over my long weekend there is no internet wifi connection , TV and landline phone. We are left with the slow cellphone wifi. We chat and chat among ourselves till our mouths hurt and our heads ache. And it was the last episode of ‘Humsafar ’ yesterday. I can predict the ending. Fareeda khala will turn mad, the threesome will live happily ever after and Sara will die. “Woh  PTCL tha magar us kee service na thee, Kay dhoop chaon ka alam tha…”   The Misbah touch Our nation has a virtue. They continue to poke and provoke anyone with patience and then the one with patience eventually decides to erupt.Here comes the volcano. Its high time the nation accept...

Young lady (?? at least at heart), cycle one day 14 of oncological therapy. Was sent home on Friday evening (and again very late), for two days rest at home. Her family however decided to drag her to interior Sindh for that long awaited trip. Eight hours of travel. No joke. Currently readmitted on Monday morning at eight am (as usual), she looks rather disoriented. On exam : Slightly tachycardic as the most important round takes place today. The rest of the systemic exam unremarkable. Labs: Results still pending.  (As this was an elective admission and the nursing staff took her sweet time cannulating her and collecting her samples). Treatment: Depends on how she performs (in the rounds) today. Assessment and Plan : Continue same treatment as she shows some promising signs of improvement in the times to come.

  Day one of orientation. A three day event to get the new people oriented to the new system called AKUH. I smile and turn around to see if anyone else listens intently to the sarcasm of the song, but nobody is smiling. All new interns, residents and fellows accumulate in the auditorium. For all important events (and to impress newcomers) a background music is played which is an instrumental mix of popular Pakistani songs. As I enter I hear the following song’s music, “Chalay to cut hi jaay ga safar, aahista, aahista”. I smile and turn around to see if anyone else listens intently to the sarcasm of the song, but nobody is smiling. They all look pleased to be selected in this institute and seem to concentrate on nothing else. It starts officially. The first presenter, with the most interesting voice starts, “Welcome to the AKUH family!”. All that goes in my mind is that I’ve to report at ER front and am getting late. I leave the auditorium and the self praise . I already have th...

The venue is cafetaria again. I'm having the usual cheese omelette. (Cheese omelette! Yes because Beenish says that it has lesser calories than croissants.) . "It has been a long time since you've posted something Maam", says Rizwan (Our intern). "He is your fan as well?!", beams Beenish. "I'm probably the only one who actually reads her blog", Rizwan replies. "Well, these exams are keeping me busy, maybe I ll have more time to write when I reach UK", I end. Busy and the bug The whole day is busy. Almost everyone is caught by the flu bug. I am done with the runny voice and this has followed by the very husky voice. It will only improve if I give myself some voice rest. There is also some neck pain. I bend my neck till my chin touches my sternum. No meningitis yet. Day before while I was doing clinics with Dr Atta Khan, one patient jokingly said, "you look sicker than me!". I tried to smile amid the runny nose, sn...

Seems like ages before I had a day off. But finally it comes. Sunday as a funday.  The morning starts at about nine. The rest of the house still sleeping. I leave eggs to boil. Time to kick start day with a healthy breakfast. One banana, followed by the boiled egg. Thats the plan. Junaid (my brother) wakes up and agrees to fix tea. I offer him the boiled eggs and he reluctantly accepts.(Junaid says that boiling an egg is equivalent to wasting one!). I head for the little park with my books in one hand and the nashta in the other. No signs of the newspaper yet. Ok. Its a beautiful morning, just the right amount of cool breeze. Partly cloudy. Tazadum... I stick the headphones in my ears and turn on the radio. Its FM 107s birthday. They sound excited and rightly so. I peel my egg as the music continues to blare. The egg has never tasted better. Zabardast, my heart goes. Junaid brings in the tea. I sip away......... The newspaper arrives. Two huge bundles. The express tribu...

 As I proceed for the library, I meet the cute little medical student (I just do not know her name, and after knowing her for more than a few years its rude to ask her to introduce herself). "I love your blog by the way!", she greets me.  All I can say is that she made my day. Violins started playing, I could feel a cool breeze blowing, butterflies flying! (Dont I get carried away!) Oh another day! Coming back to my day, saw twenty three patients, or rather twenty three hearts with issues. And in the end all seemed similar. Similar hearts, similar histories, similar ecgs, and obviously the same old doctor, i.e., me!

I give my regular peek to the facebook and call it a day. Oh wow. One of those beautiful calls again! The sun rises beautifully. The weather perfect (atleast in the 23 C that the hospital interior has). Things under control. Plenty of patients, but manageable. Early dinner. Timely checkout round. This is a glimpse of heaven, right! Done with the day's work, Ayesha (our year one resident) and I finally head for the call room. The clock says its half past midnight. We chase the rest of the labs, offer prayers, I give my regular peek to the facebook and call it a day. Fifteen minutes pass. The nurse pages me. Your patient is tachycardic. She doesnot have fever, is not in pain. I ask the nurse to monitor the patient and inform in ten minutes time. She calls back, Doc, your patient is becoming hypotensive. We rush towards C2 ward. The rest of the night is spent along patient's bedside. Patient starts to get drowsy. I almost yell to assess her conscious status, "Aunty, ...

  No flowers , no butterflies, interesting. The Sunday post. Two whole days of laziness ! On call tomorrow. Stop, lets not think about it now, not at eleven am on a Sunday morning. Done with the usual Holiday delights. A hearty nashta, made especially by my Nani (Grandmother, who is on a two week visit), parathas, chatni (Mexican Salsa, gosh such fancy names for tamatar kee chatni), steaming tea. My heart goes garden, garden (Dil bagh bagh hona) I love the morning breeze, sipping tea under the mango tree, new spaper in hands. Occasionally, a bird pays a visit, a sparrow, humming bird, crows, birds I dont know the names of. My younger brother loves butterflies, he wants to see them in the garden, but as there are only few flowers , hence none visit. No flowers , no butterflies, interesting.         B idding Farewell The newspaper has allocated a good two papers on Moin Akhter. He passed away on 22nd. A man we all adored. When I was in primary school,...

"Don't mention people's names in your blog, one day they would make you say sorry", Dr Amir advises. Would they! I think they should enjoy a piece of literature. Anyways. The medical ICU team, our fate changed starting Monday.Now we work harder.Round every hour.Check and recheck every detail. Dont just sit around in the call room, and laugh over. Our team has become short. Our very tall Dr Saeed is on vacation. Our notorious, not so tall Dr S, has also left for a three day spree to Quetta. Just before leaving, postcall, he looked really happy, and said, "Ok Dr Zarka, miltey hain break kay bad (see you after the break)!". Ya ya , whatever.

ICU Day twenty five. Young female, enthusiastic, carries a blinding torch in her pocket, addicted to blog writing, history of admission in ICU for a month, back in April 2010. Now readmitted for a two month rotation, to hopefully expertise in passing lines. Continue same treatment for another month! On examination : CNS Seems sedated postcall (though is off sedation) GCS fluctuating. CVS Blood pressure dropping due to hunger. Pulse tachycardic. Respiratory settings Vent --- man this washing machine is beyond me! CXR --- was OK on residency admission.(patient clearly refuses to get another one done) GIT Feed ----- needs something beyond "economy" Gut sounds Audible to all ID Never rotated there. Investigations Not done due to limited salary! Treatment given in ICU Good (so far.......) Assesment plan Patient looks comfortable. Continue same treatment for another month.!

Yes , so its finally happening! Its that time of the year when people start to get sarcastic.”I’m gonna sleep tonight and wake up after one whole year!”. Anyways, for the docs working at AKUH, its been a tough year.Specially for us, year twos.An year of fourteen months.Before even autumn could come , our residents started to shed.It started with Mohsin, then it was Asad, then Naeem,  followed by Mohkum and eventually Saima Mangi.We had ‘fauji’ training the year round. Fourteen months were easily divided into five months of oncology, five months of  gastroentrology, two months of Neurologly, one month of pulmo and another month of ICU. We had ‘fauji’ training the year round And now , lets welcome third year! Third year……………. New team……….what team, myself and an intern…………..an intern who doesn’t know the system.Has no pager, and by the time he has one , wont know how to operate it….. And then the attendings… The rush calls, what would we do in them … The morning m...

Its Sunday, I get ready for my call, arrange food in my tiffin for the tough day ahead.As I head for the hospital ,the rest of the city seems to be asleep.I gather my energy and tell myself, its ok, its the last call in oncology! Almost five months, and it definitely does not seem like yesterday! . It all started with wing (private wing).One month there.I was blessed with the luxury of an intern,whose claim to fame was that he’d gotten married the previous month.An elderly lady, with metastatic carcinoma of ovary was admitted for management of gastroenteritis.Once done with history the patient said, “Doctor, all I want is some HIV drips and an early discharge tomorrow!”. My jaw almost dropped to the floor.”Oh sorry doc, I meant to say IV drips”, she gave a sheepish smile. That month eventually passed smoothly. The chiefs then forgot to displace me for the next three months Subsequently followed by a gap of five months I again landed in oncology, but this time around it was floo...

Calendar says its 8th of November,2010. My heart says its call two today in oncology. Its Sunday , while the rest of the family starts for the lazy morning, I hurriedly rush for the hospital. Its the usual day in hospital, plenty of patients ,only this little doctor to sort out the mess. As usual all the stable patients turn unstable, and together… . . . . I love oncology’s craziness! ”Do you take drugs Aunty” I ask the patient, with a smile. On the back of my mind lingers on the thought that I’ve to give intrathecal chemotherapy.Done with clarking three patients, I proceed for the chemotherapy.Every thing set, LP needle, GP pack,pyodine, midazolam, consent. I call the staff for assistance in positioning the patient. Patient’s room stinks…she has passed stool. “Clean it up”, I tell the staff. Ten minutes pass.Meanwhile I clark the fourth patient. I peek into the earlier patient’s room.Everything nicely cleaned up!”Lets start” I signal the staff.Two and a half ml of midazolam, no r...

The clock ticks 0815.The auditorium starts to fill in.The session proceeds.Some are good,some wonderful,some awful,some hilarious! This author’s main interest is nashta……after an attention span of 30 minutes,the soul starts floating.I stare on the right, then on the left…people seem to concentrate….actors , I think! I pull my headset out,and stick it into my ears, “'baharo phool barsao!’” the radio blares.A mischievous smile spreads.I look at all the likes of Saima Kamals, Ayeshas and salute their patience! Finally Our chief Dr Nauman comes on stage and announces the magical words……’’thank you all!’’ And with this comes the best part of the day, all the young (and beautiful) doctors proceed for the healthiest of nashtas….. samosas, croissants,french toast!