Et Cetera

Uncertainty

noreply@blogger.com (Aniruddha Agarwal) — Mon, 28 Mar 2016 03:52:00 +0000

Sometimes I wonder why certain things happen, and at what point we went wrong.

But then, one doesn't really get to choose. And one cannot predict what will happen. Often, you will be taken by surprise and things happen which you would have never imagined, for which you were never mentally prepared. That's life; tough and cruel, mysterious and inexplicable.

Its easy to argue and say nothing is impossible. May be true, but not always I guess.

The only possible consolation is that you can tell yourself, 'what if...' and relive those memories.

Never thought I would be writing something like this, and that it would be so difficult to read my own mind. Its easy for an outsider to smirk, 'he/she has everything one can ask for'. But sadly, no one can see what you go through, everyday.

Poverty

noreply@blogger.com (Aniruddha Agarwal) — Sat, 26 Mar 2016 04:12:00 +0000

It was a cold day with an uncanny whiff of warmth. There were lots of people around, but they didn’t matter. We silently prayed for more sunshine and fondness, memories and experiences, lunches and dinners, an endearing talk, a long and unending conversation, a comforting touch, and a lasting hug. Often, we don't realize how poor we really are, and how painful this poverty is.

Future

noreply@blogger.com (Aniruddha Agarwal) — Wed, 16 Mar 2016 04:23:00 +0000

No, it cannot be this way for long. There has to be a way to make things work.

There cannot be a room with no doors. Life cannot be so unfair.

Few Questions

noreply@blogger.com (Aniruddha Agarwal) — Thu, 25 Feb 2016 01:59:00 +0000

What do you do when you need

To cry yourself to sleep every night?

To pray that a miracle'll set things right?

How do you row your boat upstream

Against the tide that has capsized your dream?

Against the storm that's turned off the light?

An Update

noreply@blogger.com (Aniruddha Agarwal) — Mon, 14 Apr 2014 02:49:00 +0000

Highs and lows. How things change, so quick.

Reading your older posts is therapeutic - it makes you believe you can survive the lows, yet again.

Unforgettable evening

noreply@blogger.com (Aniruddha Agarwal) — Mon, 22 Oct 2012 19:14:00 +0000

I can never forget this evening. Had the most awesome and learning walk near the shore with my mentors in full flow - philosophical and introspective.

I don't want to put this up like a status message on facebook. Its something i'll treasure my entire life - so I don't want random comments spoiling my taste.

A continuation of introspection

noreply@blogger.com (Aniruddha Agarwal) — Sun, 07 Oct 2012 16:28:00 +0000

(probably the last in the series)

We love to believe that people around us think like us - react like us. Or like we want them to. There exist people who can realize and live in an atmosphere of hostility and there are others who'd rather escape.

Everyone is alone in a tiny boat sailing through a huge ocean; holding on till the time waves will eventually take over. And eventually, they must take over. Its just how much time you survive without struggling with the waves; or how much water you are able to displace with your oars.

Looking forward to less serious thoughts in future. I hope my brain's listening.

...

noreply@blogger.com (Aniruddha Agarwal) — Sat, 22 Sep 2012 19:17:00 +0000

Often things are beyond understanding. Why should simple things complicate? Why should there be instances when you are held together with people you don't want to represent?

Why should people suspect ulterior motives when there aren't any? Why should you land up defending yourself when it's not your fault?

Bah. The list is endless - I don't feel like going on. Every time life brings you back to this square - where are you really headed? Maybe some people are destined to get things the hard way.

Sometimes one feels that it's rather better to go far away from all this than to adjust with people who are okay if you die under their nose.

People change... or do they really?

noreply@blogger.com (Aniruddha Agarwal) — Fri, 14 Sep 2012 19:04:00 +0000

A common perception says that time changes people. I really doubt it.

Its a process of evolution and a matter of time before one actually knows the other person. Just as time heals, occasionally time hurts. Because over a period of time, you realize that the pretence of few people has actually fooled you, more importantly, wasted much of your time especially when you really trusted them.

But then, better late then never.

Solution to the problem?

Just move away from them, slowly but surely. It works but definitely brings about a bad taste in the mouth which often really persists long. They are better left alone in their own world of haughtiness and soon you'll be with new people around you, most often for the better rather than for the worse.

An Update

noreply@blogger.com (Aniruddha Agarwal) — Fri, 18 May 2012 17:31:00 +0000

Life’s too mechanical at the moment. Nothing new if you really want to know.

In a shell once again – till the time life gets a new direction.

Isn’t it better to keep things deep within you?

If you can’t donate – don’t die

noreply@blogger.com (Aniruddha Agarwal) — Sat, 07 Jan 2012 15:52:00 +0000

(This post is written for my college magazine - was rather forced to write such senti stuff)

What you are about to read, are hard facts bluntly put across.

That you still want to read it shows your naïve enthusiasm for some possible creative bravura. Do you really want to know what the best part about this entire page is?

… The fact that you can read it!

This man attending the eye OPD at PGI can’t read it. Because none of us who are reading it can offhand count even 5 people who have pledged their eyes. Is this statement wrong? No – the fact stares blatantly at us.

This patient has a simple question that we cannot answer. Has the Eye Bank received any eyes from any noble donor yet? Sadly, no! He breathes heavily and gives a poignant expression. Is his watering due to the illumination of the slit lamp or they’re just tears? It’s tough to find out and even more heart wrenching to think about. Maybe he has no emotions. He folds hands, bows and reaches out for his stick and nonchalant 9 year old daughter’s hand.

This patient is one amongst many who throng the Eye Centre of not only PGI, but God-alone-knows how many such centres all over India. But he tells me that people like him are few and ‘over’ privileged people with ‘good’ eyes definitely outnumber them. We agree. India has nearly 1.2 billion useless people who can’t help this guy even when they are dead. Offended? Think of living his life for even 2 days.

You know the best part of donating eyes? You don’t lose anything!

Too lazy to go and fill those forms? Disgusting!

It’ll disfigure the sacred body of my kin? Ignorance to the hilt!

So what’s stopping us? Wish we knew.

Getting a bad taste in your mouth? Then go for it, it’ll make you feel better. If you haven’t pledged your eyes yet, pull up your socks. Even if one-fourth of you pledge eyes after reading this, the purpose of this magazine is served. Talk to your family, friends, society and patients. Encourage them, teach them and counsel them.

Dear reader, we hope you got the message. Let there be light in the room even when you leave. You can enlighten the lives of at least two – and as science progresses – possibly more than 2 patients’ lives with your promise. Somebody tells us that if all people dying donate eyes – within 11 days no one in India would be cornea-blind.

We dwell in thoughts that someday this will come true and more people can wake up to a new life.

Spice of Life

noreply@blogger.com (Aniruddha Agarwal) — Thu, 21 Jul 2011 15:54:00 +0000

Till last year, the only time I came across residents getting emergency calls was when I was an intern. I distinctly remember an old ‘mama’ haggling around searching for that ever-so-frustrated resident to hand over the call. We didn’t have this spice phone system in medical colleges back home and were way primitive – so much so that we had to manage with pen and paper.

Things changed when I got into residency and was given the spice phone barely fifteen days after I joined. Along with the phone came strict instructions: ‘pick up every call, dare not miss any, answer and ask what the person needs from you’ by more than dozens of dominating seniors.

That bloody phone has achieved the record of ringing more frequently than the number of times I’ve had dinner at ODH. I like the sound of the woman screaming ‘welcum to… phooth phloor’ in the lift of ‘puraani’ PGI better than its ringtone. Not to mention the voice of people on the other side of the line.

The best part about the phone is that the person who’s calling you doesn’t know who you are. “Ophthal SR? JR? Consultant? On call? Today? Yesterday? Last Thursday?!”

Sometimes they call us ‘eye on call’. Like there exist ‘nose on call’ or ‘bum on call’ or maybe even ‘Douglas pouch on call’. One gynaecology resident (hard feelings meant) once called me ‘fundus on call’. I told her I’m ‘cornea on call.’ She didn’t appreciate the good joke; “huh?! But there is a fundus to be examined!”

“Ok, dilate her at 5.00pm!”

“But sir, she’s fully dilated and about to deliver!”

I didn’t appreciate the joke either.

As a part of ward duty, one thing I understood was most people spend a lot of time trying to prove that I shouldn’t have called for ‘such a flimsy reason’, instead of seeing the patient. “Sir, one patient has TB and pulmonary consultation has advised pleural tap.”

I get a reply, “So?”

I mean, what did he mean?

“Sir, how do we go about it?”

“Take a needle and do it!” – comes straight from New England Journal of Medicine.

Now, this was it. “Sir, from now on, why don’t you send patients to eye centre for chest tube and bronchoscopy to eye centre as well?” He got the message straight.

Moral of the story, just having spice doesn’t help. One must know how to use it as well.

Once, this doc from ESOPD calls, “Docsaab, yeh patient ke liye kal bhi call kiya tha, par koi aaya nahi ab tak!”

“Mein kal on call tha hi nahi, how am I supposed to know?!”

“Nahi nahi, mujhe nahi pata! You come here and sort out!”

“But I’m not even on call today!”

“Nahi nahi… I don’t know. Tum logon ko patient aakar dekhna padega. He needs urgent ENT consultation!”

“But I’m from eye!”

“Nahi nahi… blah blah…” Spice mobile has free outgoing, and he ensured full-vasooli.

Spice mobile has certain special uses too – for instance aiding in matrimonial alliances. And one fine day I found out how; “Sir, I’m calling from (some random department). Just wanted to ask, do you know this (random guy) from your department? Does he have any… you know… I mean… an affair or a girlfriend?”

Now tell me, that too on an emergency day, do you care a damn about how someone else derives entertainment in life?

All in all, Spice is a life saver for all those new guys who have just joined with us. So if any hard feelings, just consider it free with this magazine like those ‘PP – free’ messages.

Tales of Chandigarh

noreply@blogger.com (Aniruddha Agarwal) — Thu, 16 Dec 2010 03:52:00 +0000

It’s been a long time since there has been any activity on this blog. Here’s something very brief – I hope you understand that a resident’s life sucks.

***

Life’s been good in Chandigarh. Ophthalmology is one weird subject – I don’t know why so many people from one batch chose to take something like this up. Nevertheless, work is going fine. I’ve been able to do at least three extra capsular cataract surgeries and two lid repairs – though only stepwise and to be frank, partly. But no complains – at least we get to do something and they teach us with great care. I haven’t ruined anyone’s eye yet. Amen.

Hopefully, I’ll get to learn more about posterior segment now that I am posted in retina. But again, I need to open my books which are lying in a cupboard with dust settling on their hardbound covers. Someday, I shall overcome them.

***

Mom is here in Chandigarh. I miss home a lot – and you’ll understand how it feels only if you are living my life. As an outsider, you might just laugh it off. But it isn’t that easy.

The worst part is that whenever I come from home or whenever someone from home is returning back to Mumbai, my room partner has his emergency duty and I need to fight all that loneliness alone within the confines of my room. It’s difficult – hopefully these days will pass away soon.

While she was here, mom has arranged my room and kitchen so that I can have a decent life outside eye centre. Now I have all the facilities to cook good (?) food at home.

***

By the way, there’s a lot to cheer for. My new car has arrived today – it’s a Skoda Fabia. It’s cost mom and dad a fortune but it’s worth all the money. I’m just waiting to be perfectly well versed with all its controls and take mom n dad on a long drive so that they can relax and enjoy at least one weekend with me.

The new audio system has been installed and right now I’m simultaneously burning songs on a drive for my car I’m going to spend at least this week personalizing stuff and I’m sure it should be good fun.

***

It’s a city full of crazy people. I’m talking about Chandigarh. I can go on and on; this topic is never-ending one. I feel like posting something on this topic every time I go to a general store here. I’ve already shared this with some poor batch mates (poor because they were compelled to her my non-specific ramblings) who had come to take the PGIMER entrance exam or pick up a seat after excelling in the same.

I guess I’ll leave this for some other post. Right now, my audio CD is complete and I need to verify it before packing it and going to sleep. Good night.

Status Update

noreply@blogger.com (Aniruddha Agarwal) — Thu, 27 May 2010 09:29:00 +0000

If you’ve been wondering as to whether this blog is still alive, I don’t blame you.
My life is finally back – and it has taken nearly 4 months for normalcy to return. But in the end, the entire shit seems composted.

It’s surprising where destiny takes you. You make new friends, while some people tend to drift away. Some people stand by you and how glad you are to have them by your side.

I hope things remain good. I hope some near ones who are still in the mess get their path soon. I’ve been through the trauma and I know how bad it is.

These last four months have been treacherous but have taught me a lot.

This post seems so raw and unfinished. It’s full of one-liners, with lots of emptiness about it. That’s how life is, I guess.

Status: Introspective. Relieved. Thankful. Wishful.

```

noreply@blogger.com (Aniruddha Agarwal) — Thu, 18 Feb 2010 18:27:00 +0000

To life,

I quit.

If Wishes were Horses...

noreply@blogger.com (Aniruddha Agarwal) — Sat, 12 Sep 2009 06:27:00 +0000

Wish you were here; there are so many things to share with you.

I can't deal with it anymore.

An Obeisance

noreply@blogger.com (Aniruddha Agarwal) — Sun, 23 Aug 2009 17:38:00 +0000

It's that time of the year again... :)

Happy Ganesh Chathurthi to one and all!

Gone are the days…

noreply@blogger.com (Aniruddha Agarwal) — Sun, 02 Aug 2009 17:55:00 +0000

(This poem was sent as an email to me by a school friend – Chandan. This is one of the best things you can be gifted on Friendship’s day – fond memories of the past. This piece has made me nostalgic; though it may seem very simple, each word in the stanzas below has a deep meaning associated with it.)

Gone are the days, my Friend…

When
School reopened in June
And we settled in our new desks and benches!

When
We wanted two Sundays and no Mondays, yet
Managed to line up daily for the morning prayers

We learnt writing with
Slates and pencils
Progressed to fountain pens, ball pens and then Micro tips!

When
We had lunch in classrooms, corridors
Playgrounds, under the trees and even in cycle sheds!

When
A single P.T. period in the week's timetable
was awaited more eagerly than the monsoons!

Gone are the days
Of Sports Day and annual Day
And the month long preparations for them

Gone are the days

When we used to talk with friends now we don’t have time to say ‘hi’
When we used to chat for hours now we chat in chat rooms
Gone are those days, but their memories will linger in my heart

(‘Cycle sheds’ was probably the word which brought with it many memories. There was this huge shed near the main entrance of our school which was meant for parking cycles and for parents to wait in case it was raining outside. We’ve had so much fun in that shade – be it scouting lessons or Independence Day practice. More on school-life in the next post… Too tired right now.)

Words

noreply@blogger.com (Aniruddha Agarwal) — Tue, 21 Jul 2009 07:07:00 +0000

After a few days, I’ll have completed 6 months of internship. Wow.

I think each department has its own catchword. I’ve heard them so often now, from so many people around, that I’ve begun to think it’s a part of normal vocabulary.

‘Arre yaar’, ‘kya re’, ‘sun na’ are few benign-looking terms. I have to now make conscious efforts to avoid using them.

When I was posted in surgery, everything and anything could be ‘mobilized’. “Aniruddha, aaj hamare unit ke AP ka birthday hai. Ek cake mobilize karna hai.” “Aniruddha, mere liye ek pen mobilize kar na.” “Exam ke liye patients mobilize karne hain.” “There is too much work. Ek aur intern ko mobilize karna padega.” “Kahin se toh tincture benzoin mobilize kar.” The list is endless. (I wonder what happens to the object that’s ‘mobilized’.)

Another pet peeve of mine is ‘stat’. I want an ABG stat. I want his electrolytes stat. Give him soda bicarb stat. Give me a pen stat. I want an IV line stat. Didn’t I tell you guys to do his workup stat?

Recently, I heard someone telling a nurse ‘double stat’. “Staff! Give that patient atropine double stat!” Phew. Some people are in real hurry.

Things were slightly better in medicine. ObGy is next. Another 6 months of nonsense.

Status: Very sad. My co-intern literally cried because of the ‘hyper’ me. I should’ve been better with her.

No Time to Spare

noreply@blogger.com (Aniruddha Agarwal) — Sat, 11 Jul 2009 18:12:00 +0000

There's so much going around. Cartooning. Strike. Tests. Studies. Internship. Travelling.

There won't be blog posts for sometime now. I need a break.

Money Matters...

noreply@blogger.com (Aniruddha Agarwal) — Tue, 07 Jul 2009 14:30:00 +0000

We are all going on a strike along with the resident doctors.

If they accept our demands, we'll be paid 8000 bucks. Which I don't think will happen.

Anyways. Happy holidays.

Announcement

noreply@blogger.com (Aniruddha Agarwal) — Sun, 05 Jul 2009 09:52:00 +0000

To avoid confusion and maintain continuity, all the comics of Incompetent Os have been exported to a new blog site. (http://incompetentos.blogspot.com/)

For regular updates, become a follower and keep reading Os's adventures!

(Meanwhile, all the other articles will posted on this blog. Ciao.)

Extern-Bashing Continues…

noreply@blogger.com (Aniruddha Agarwal) — Wed, 03 Jun 2009 15:52:00 +0000

If this guy asks me one more question, I promise that I’ll wring his neck or cut his carotid.

That’s what any sane person would do, if constantly bombarded by sick questions. Every conversation that I have had with him was because of his foolish doubts. One day, someone should paint a question mark of font size 72 on this buffoon’s forehead.

“What is the time now? What should I do now? What if he doesn’t sign? How does one go to the first floor? Which train do I catch? How do I reach there? What time will the OPD get over? Who will reach the IPL semi-finals? Do you think this registrar is hot? Don’t you think she has a bad voice? Have you ever seen mosquitoes fucking each other? Where do I get that video? If I don’t have a ticket, will they catch me in the train? If I have forgotten my wallet, how will I eat in the canteen? What do they serve now? Why don’t you reply…?”

You know what, one day someone really pissed off with you will suture your mouth and put a 6 inch Dynaplast, reinforcing it with Crepe Bandage. Or better still – gag you with an inflated Foley’s balloon.

Just When They Thought They Are Smarter

noreply@blogger.com (Aniruddha Agarwal) — Thu, 14 May 2009 18:31:00 +0000

Sometime back, I told you how some people deserve to get their asses incinerated.

Now this guy, an extern, thinks he’s very rich. Obviously, this does not mean that he can do whatever he wishes to. He comes to the OPD at 11.30 am, a good 2.5 hours late. After that, he has the cheek to ask me if there was too much work, with a sly idiotic smile. I care a damn, you bag of urine.

He joined with us on Monday. He didn’t report for the first two days, came on the third day for 10 – 15 minutes and today, as I said, this dog comes at his own ease thinking that he is some showstopper. I don’t care about the work, it’s hardly something. Besides, crooks like him don’t even deserve to serve patients. But the fact that bugs me is his attitude – totally not bothered. As if he is some gift to mankind. He is undiluted bullshit, crow-shit and shit of many other wild pigs mixed together.

She is no less. She thinks that she is a super-babe. In fact, she belongs to that category of pseudo-babes whom you wouldn’t want to meet. She looks like a plague-afflicted rat and her mouth doesn’t shut up. Just like him, she feels that just because she has paid some twenty-five thousand bucks to the BMC, she owns it. Sucker…

My batch-mates had to tolerate them for 3 days while I was posted in other sections of the department. They told me about how these two pieces of faeces had frustrated them too. Today, I got the opportunity of taking revenge. I don’t indulge in such things normally, never; I prefer to stay away and do my own work. I have a relatively high threshold. But I had to teach these Scylla and Charybdis a lesson. They need to understand that they are responsible if a patient has to suffer some inconvenience.

So, in the morning, when they presented their macerated faces in the OPD, they had to face nice music from the registrar (with whom I teamed up). The two maggots were marked absent – this must have surely set their bum on fire. From tomorrow, if they don’t improve, they surely deserve worse – like falling into a manhole full of methane and getting asphyxiated. Assholes falling into manholes – how cool is it.

This is what all people who don’t do their part of work deserve. Many people have a tendency to take too many things for granted, not realising how it can create unnecessary problems and inconvenience for others in need of help.

Hiccups

noreply@blogger.com (Aniruddha Agarwal) — Thu, 07 May 2009 18:20:00 +0000

One of the most non-specific conditions for a physician to treat is hiccups (singultus). They usually have a very obscure cause and at times can underlie serious diseases.

A young man (non-diabetic/non-hypertensive) diagnosed with malaria presented with tiring non-stop hiccups. He was investigated three days back and the peripheral blood smear demonstrated vivax parasites. He was on artesunate along with other supportive care. He came at 11pm in the casualty and complained that his hiccups were non-stop, present since afternoon (post-lunch) and had caused him considerable exhaustion. He had no other complaints.

Luckily, he responded to injectable metaclopromide within minutes.

Another patient presented with features of gastric acid reflux disease and exhausting hiccups. However, his chief complaint was acidity, from which he wanted immediate relief. An intramuscular injection of rantidine allayed his acidity, but hiccups continued. This man was otherwise normal. I thought of giving him dispersible domperidone tablets; his hiccups stopped 10 minutes after keeping the tablet under his tongue.

I read up few papers on hiccups, their cause and treatment. Most of the literature has treatment based on trial and error; others consist of success stories (such as mine) without much backing. There is hardly any paper which does not mention remedies put forth by folk medicine. In fact, this adds spice to the otherwise boring allopathic life.

Folk medicine has described various home-remedies to get rid of hiccups – from ‘gulp down two teaspoons of sugar’ to ‘have someone startle you with a loud boo!’ Indian folk medicine also prescribes various techniques such as drinking ice cold water or pressing one’s eyeballs gently. Pulling one’s tongue has been suggested as a good alternative. They probably have a scientific basis (like pressing one’s eyeballs stimulates vagal activity).

Good old Harrison does not have much information on treatment of hiccups. Adam’s & Victor’s Principles of Neurology (8th edition) mentions baclofen for persistent cases. Bradley Neurology in Clinical Practice does not mention anything specific. Goetz textbook of Clinical Neurology (3rd edition) has arguably the best line of management:

1. Chlorpromazine 25 – 50 mg IV or 50 mg per orally
2. Metaclopromide 10 mg IV or 10 mg per orally TID

Some published papers provide excellent views (historical and current medical) on hiccups. There are charts on various drugs that are effective (including atropine) and many authors have given protocols for treating intractable kind of hiccups. A case study is the most interesting of the lot – it’s about a man who was instantly relieved from persistent hiccups after a sexual intercourse!