Anecdotes in Indian medical practice.
My experiences during my 34 years of medical practice and government services have been good, funny and at time stressful . On a lighter note there a large number of hilarious occasions which I have experienced, seen some happen and yet heard of some.
These anecdotes are bring compiled here to let all of you know the lighter, dangerous and funnier side of medical practice.
I was posted at remote primary health care centre, called Pasali, taluka Velhe, zilla Pune, Maharashtra , India.
This was in June 1987. A week into my first posting there was this epidemic of cholera , we were on field helping control it. Taking and sending stool samples was part of the work. A few deaths and a lot of cases made our life hell . All of 23 years of age and inexperienced, it was the paramedics who taught me the nuances of controlling an epidemic. My multipurpose worker , Arjun Jagtap was a hard worker, he was the lead collector of stool samples . With so many samples to be taken, he made people stand in a row and bent down with their buttocks exposed in position for the sample while he walked behind shoving a stick into each of their anuses collecting samples. Then it happened , he had just shoved a stick up a person’s anus and lo!! He just purged out a stream of stool with such force that it had Jagtap all smeared with watery shit.
It was summer and a government team came to visit our primary health centre at Pasali. Remote area, no water. Red mud, all red dust flew as a vehicle moved. By the time you traveled from the taluka place to Pasali and back you would be red all over . One of the visitors asked my driver, Arun Satpute, how do you people manage with practically no water and this red mud flying all over. Is there water for a bath daily. My smart driver whispered into his ears, Sir our doctor is a smart guy, he gives a bath tablet every morning, so we don’t need water to bathe. The man was taken aback , should he believe the driver, yet he thought it could be, doctors were demi god’s. Next morning he inquired with my compounder, Mr Mane about the bath tablets , Mane said I can’t tell you it’s doctor saheb’s secret, so he ultimately came to me to find the truth. I told him that the driver had made a fool of him. We all had a hearty laugh. Life was fun.
There were targets to achieve in family planning. One such target was intra uterine device insertions. The village folk desisted, but targets needed to be achieved. Rs 9 was the incentive paid to each women. Yet they wouldn’t budge..So we would take them into confidence, show them the CuT, tell them what it was, how it would have to be inserted, when it should be inserted , and why it was to be used. Then we would fill their forms, pay them Rs 9. Take their thumb impressions and throw away the CuT. They were taught if any government official ever came and examined them and found no CuT, they were to just say that it just got expelled last week. When the lady officials once visited one of the villages they found all things in order, but not a single woman in the list had the CuT in situ. They were flabbergasted , all the woman had the same answer , it just got expelled last week. They would never know the truth.
Male sterilizations were another target. We would visit every small hamlet to find out prospective targets for vasectomy. Even as our teams entered hamlets the men folk would vanish. We would go fro house yo house to find out un steriked men. None could be found. We stood in front a house, asked for the male member, his mother came out and yelled at us, even if you find him and take him and get his vasectomy done my daughter in law will yet get pregnant, so you fools better get her sterilized. We kept our faces grim, we couldn’t possibly laugh.
We had a small outfit called community health workers or CHV in short . They were trained in basic medicine, given tablets for fever, vomiting, loose motions , some bandage material , ORS and a thermometer. So they were the immediately available health personnel.They were trained regularly about how to use the thermometer and the medicines. In one such training, some trainer told them that the core temperature was the rectal temperatures. Now one of them, Mr Kumkar , a smart CHV went back with this newly gained knowledge. He tried inserting the thermometer into the anus of a fever patient, who happened to jerk and stand on insertion, leading to the thermometer breaking and the bulb being retained in the anus with injury. Kumkar on being asked why he did so , Sir you trained us that the the core temperature of the body is always measured rectally . So I tried it, unfortunately this mishap occured
My senior colleague was an experienced doctor. He was good at tubectomy. I wasn’t yet trained , so he would take me into the operation theatre whenever he operated, so that I too would be trained. The nurse in duty too was new and untrained. The patient was wheeled in, we were all scrubbed and with our operating gear. Dr Sharma stood on one side of the table prepared the patient and as he took the icision put his hand across to the nurse for a swab, Oh my God she was missing, I looked down to the floor and found that she had passed out at the site of blood. Sharma was cool, he siad you be the nurse today, she will recover soon by the time I finish this tubectomy, he was skilled and fast, he finished off in 7 minutes and then we picked up the nurse. Scary yet laughable.
I shifted to the city in1991 with a job as medical officer at Pimpri Chinchwad Municipal corporation. The work here was different, I was initially posted to Yashwantrao Chavan Memorial Hospital, later I worked at Jijamata and Akurdi hospitals before being shifted to the head office . Life here too is filled with funny experiences.
At Ycmh there was this patient Mr Gurnani who was asthmatic with COPD and wished to be perpetually admitted. Hence he would come with new complaints daily just to stay in hospital. Apart from this he would get good non vegetarian food for us the staff and doctors to keep us in good relations to avoid discharge. Once we decided that it was high time he was discharged. Got his papers ready, some ward boy went and informed him of the impending discharge. Suddenly there was yelling in the ward, we rushed to see and OMG Gurnani was writhing in pain, my stomach aches terribly he said, he was in tears, I felt sorry, my colleague Dr T didn’t, he was in the know of Gurnani’s tactics He shouted at the sister, get the flatus tube, its only gases, Gurnani was hearing all this, as the nurse walked towards Gurnani with that massive tube in her hands, on seeing it his pain vanished all of a sudden. No pain now he said, please give me my discharge. The size of the flatus tube and what was in store was sufficient to let go the pain.
Kshirsagar was 55 years old, known to me and was not well . He wanted to be admitted but as no bed was available at Ycmh, he went to the local corporator, with whose influence a bed was arranged. He was always complaining about lack of facilities and also reported the same to the corporator, who in turn blasted the doctors . Kshirsagar suddenly had complaints of blood in stools. The doctor said a proctoscopy was needed. He explained yo Kshirsagar the procedure, showed him the proctoscope, all steel would be needed to shoved up his ass to find the bleeder, else the corporator would be angry again for not taking care of his patient. Kshirsagar pleaded , he didn’t need it, that night Kshirsagar the patient absconded.
This was at Jijamata hospital, I was posted as residential medical officer and had night duties regularly. Here it being more of a maternity home, there were a lot of deliveries. I wasn’t in tune with this and wasn’t sure of many things. I got my colleague doctor to teach and train me in obstetrics. He agreed, a patient had just come into the labor room. I accompanied him into the labor room. Tell me where to auscultate , where could I hear the fetal heart sounds. My colleague with stethoscope around his neck placed the diaghram and bell alternately on the ladies abdomen closed his eyes and kept hearing the FHS. He was cool as a cucumber, he said , Roy it’s simple, it’s easy, now you try. Even as he said that I looked closely at him, his closed eyes as if in a trance listening to some music …….this guy just had the stethoscope around his neck…. It wasn’t even his ears and damn it he could hear the FHS. I was shocked, is he going to train me, no way. I ultimately trained my self with lots of help from the experienced ayas and nurses and doctors.
I was on duty when a primigravida in labor was wheeled in. I asked the nurse on duty to take her to the labor room and prepare her, I would soon come in and examine her. As I was walking to the labor there was a huge commotion, the lady in labor was running out of the labor room awkwardly, fear in her eyes, her shrill shrieks, behind her were running our ward ayas…. What a scene. She was stopped by the security and our staff and relatives, cooled down , brought back to the labor table. It was then that I found out the reason. The sister on duty was six feet tall, over a 100 kg in weight, all hulk, towering above this lady in the labor room, in her white outfit and her large body structure just scared the shit out the woman who just took off from the labor room on seeing this hulk.
She came to with complaints of loose motions which increased on treatment. I asked her who was treating her and what medicine she was taking. She said her neighbour had given her some medicine, I asked to see them. She had half a strip of Dulcolax, I was shocked, she explained her neighbour had given them to her and she was having a tablet thrice daily since two days, no wonder the agravation in her visits to the toilets, he wasn’t a doctor neither was he a quack , just a smart neighbour who thought he could help cure her.
She walked into Akurdi hospital at 2 am in the morning with her 4 month old child, he was having multiple episodes of vomiting, the resident doctor on duty examined the child and asked to breast feed it which she did, the resident sat back humming a tune, she was embarrassed having to breast feed the child in front of him. In the morning she returned with the child at the hospital, no relief she said. She complained to the incharge doctor of the residents behavior today early morning. The incharge summoned the resident and demanded an explanation. His explanation was simple and foolish. He said he hummed the tune so that the child would relax and asked the mother to breast feed because he thought that the ingestion of milk would create a pressure in the opposite direction and hence stop the vomiting . What logic? Each one with his own silly ideas!
The lady medical officer examined her shy patient, she was was suffering from foul smelling vaginal discharge, , she gave her pessaries for a week, explained to her how to insert one each night. No sex until the treatment course was over she said. Other medicines for the couple were given. The patient returned after a week complaining of no relief. The lady officer inquired as whether she had inserted the pessaries daily and abstained from intercourse. Oh she said, she did insert a pessary daily and followed it with intercourse daily as advised. The lady officer held her head , how she had been misunderstood.
The doctor prescribed Lycored tabs ( lycopene extract )to the patient to be taken twice daily. As usual doctors writing is never legible to any one except the pharmacist. In this case the writing was worse the pharmacist read it as Glycored.. ( anti diabetic ), patient was having a leukoplakia patch . He thought if he doubled or trebled the dose he would be better earlier, so he had them two tablets twice daily, he began feeling dizzy, he had sweating , he just wasn’t well. He came back to the doctor, he fainted in the OPD. On examination his blood sugar was dangerously low. He was given dextrose shots after which he regained consciousness. On inquiry the mismatch of medicines was detected. This is the dangers of ineligible writing. Definitely not funny to the patient.
The resident doctor at Akurdi hospital called me up, he was frantic, he said there was something unusual with lady who had come in for a delivery. He couldn’t explain, he said he had also called my senior and incharge doctor too. We both reached the hospital at the same time. He was sweating as we entered the labor room. The lady lay prone on the labor table, she was in pain. The scrotum of the baby was protruding at the introitus, the resident hadn’t seen such a case before. We explained to him it was a case of extended breech. Oh he said he hadn’t heard or seen this presentation before.
The patient was a case of dog bite. Dr S at Akurdi hospital was on night duty. He saw the patient and asked him to come in the morning OPD for the anti-rabies injections. The patient was scared and anxious, he asked Dr S if there was any risk in delaying the injection until tomorrow morning. The answer he got shook him, Dr S said that he could be just knocked down by any vehicle as he left the hospital now in his way home, so why think about this risk. The patient looked at the doctor in disgust as he walked out.
This person was a regular patient at Jijamata hospital who walked in mostly in the evening after OPD hours for treatment on flimsy grounds. He always demanded an injection when there was never any need for one. If he wasn’t obliged he would create a ruckus. He was a pain. It was then that one smart medical resident decided to teach him a lesson. He gave him a jab of lasix. He also gave him a tablet of diazepam and lasix as bedtime dose. Next day he came again, he was quiet, he said it was highly embarrassed as he had wet his bed in his sleep yesterday.
The young man was a womaniser. He walked into the OPD and whispered into the doctors ears. Would the woman he had intercourse with yesterday get pregnant. He said that he had used condoms. The doctor explained failure with condoms is hardly seen, no need to be anxious. It was then that he said, he had checked doubly. How asked the doctor. He said post coitus he had filled the condom under a public tap and observed that there was absolutely no leaking. The doctors mouth opened wide his eyes popped out at the mans ingenuity.
There was a ruckus that night at Jijamata hospital. It was 2 am. The senior corporator had wheeled in a patient complaining of severe dizziness, accompanying him were 5 to 6 more people. The nurse noted the pulse recorded the blood pressure. The doctor was called in. He came , examined the patient in detail. He shouted at the patient for coming with flimsy complaint after getting drunk, he requested the corporator
not to bring in such drunks at night, they needn’t be given so much attention . The patient pleaded , swore that he was not drunk, no one would listen. The corporator too was angry. Some medicines and a shot later , the crowd left with the patient. It was then that the ward boy blurted out, Sir, he said, that man is a teetotaler , he never drinks. The smell of alcohol was from our breaths, remember we just had a couple of pegs late night. The doctor stared into oblivion.
The health inspector was on field cross examining family planning beneficiaries . The woman in the slum was being questioned. The Auxillary field nurse was tense. He went through the beneficiary records . Oh her husband was a condom user, she was on oral pills. Why the hell was the family in double protection mode. As he delved deeper he was even more shocked, she had a copper T or intra uterine device inserted one year ago. He looked at the auxiliary field nurse, she looked away. Ok he said , to the lady , how are you now , do you receive service from our field nurse regularly. Yes she said , the nurse is kind and visits regularly, only last week she had registered her for her second pregnancy, she was now 18 weeks pregnant. The health inspector asked for a chair , looked at both the ladies and asked the field nurse to explain . She did. She said some are paper beneficiaries. Targets had to be met. Yet she assured that the lady was been keenly followed up for her pregnancy and all due care would be taken. The health inspector swore never to inspect any beneficiary henceforth .
Many tales, though funny can’t be out into print for many reasons. There are so many incidences that I today am unable to recollect. Will add them as time passes by. Looking forwards to any such incident you have faced in my comment box.
These stories are endless. Will update some of them later, bye until then.