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Showing posts from February, 2009

Conquest of Death 4

CONQUEST OF DEATH 4 (I WILL ABIDE BY YOUR ADVICE) (ARDS) One afternoon, as usual, I was about to begin taking tuition to a batch of medical students. One of my students suddenly started talking, “Sir, my uncle went out of town. There he developed fever and pain in the perineum. He consulted a local doctor. The doctor advised him to undergo an operation. My uncle came back and consulted his family doctor. The family doctor also advised him to undergo an operation. He got admitted into a hospital near his residence. The operation was not successful. He is worsening; his general condition is deteriorating, “she was narrating fervently. “Worsening?,” I interrupted my student and said, “This is perineal, perianal or ischiorectal abscess, I guess! After proper incision and drainage, and antibiotic cover, the patient should improve! If the drainage is inadequate, the operation can be revised to provide adequate drainage……““Everything has been done, but instead of improving, he is worsening an

Conquest of Death 4

CONQUEST OF DEATH 4 (I WILL ABIDE BY YOUR ADVICE) (ARDS) One afternoon, as usual, I was about to begin taking tuition to a batch of medical students. One of my students suddenly started talking, “Sir, my uncle went out of town. There he developed fever and pain in the perineum. He consulted a local doctor. The doctor advised him to undergo an operation. My uncle came back and consulted his family doctor. The family doctor also advised him to undergo an operation. He got admitted into a hospital near his residence. The operation was not successful. He is worsening; his general condition is deteriorating, “she was narrating fervently. “Worsening?,” I interrupted my student and said, “This is perineal, perianal or ischiorectal abscess, I guess! After proper incision and drainage, and antibiotic cover, the patient should improve! If the drainage is inadequate, the operation can be revised to provide adequate drainage……““Everything has been done, but instead of improving, he is worsening an

Conquest of Death 3

CONQUEST OF DEATH 3 (DOCTOR! I AM PAIN-FREE) 'You will need to undergo surgery (operation) immediately,’ I advised. I was at a patient’s house. This was my second visit to his place; the first being four days ago. ‘Operation?’, my patient was perplexed. ‘Yes!’, I remarked. ‘But doctor, now I do not have any pain in my stomach. It has stopped suddenly!’ ‘Suddenly! That’s what is dangerous!’ Not convinced fully, he said, ‘Please discuss this with my family doctor.’ His family physician’s office was nearby. I went to him personally and explained it to him. Our conversation went as follows. ‘Doc, four days ago when you referred this patient to me, he already had an appendicular lump, fever, tachycardia (fast pulse). I advised him to get admitted into the hospital for treatment, but because of financial constraints, he requested treatment at home. With a great reluctance, I started the treatment. However, I also explained to him to watch for rising fever, increasing pulse rate, increasi

Conquest of Death 2

CONQUEST OF DEATH 2 (BURIED IN THE RUBBLE) (FECAL PERITONITIS)‘It’s already two and a half hours! How long would you take?’, the anesthesiologist was grumbling. I was engrossed in the operation. So I ignored her. ‘It would be unsafe to continue giving anesthesia for a longer time----‘ I was alarmed. With the sense of a surgeon’s duty and compassion, I said, ‘Isn’t it equally unsafe to leave injuries untreated, especially perforations? It’s criminal!’ ‘Patients of fecal peritonitis do not survive! She already has contracted fecal peritonitis!! (Feces infecting the sac in which the intestines are contained)’, the anesthesiologist emphasized. ‘For want of better drugs to combat infections, for lack of better supportive measures in the hands of medical fraternity to manage septic shock, let her die, but certainly not for surgical negligence and not treating these injuries like perforations!’ I said. An elderly lady was buried in the rubble following collap