swallowing brick

The caterwauling could be heard in the corridor long before the  young adult male was carried in on a plank of wood. His head was lolling from side to side, a red trickle of blood oozed from the corner of his mouth. His checked shirt was discolored and stained.

Evaluation was difficult.

I had to push past an old woman beating her chest and a young one (wife?) throwing herself at his feet and hanging on for dear life.

Haemetemisis perhaps? Anyway,  emergency treatment had to be given. Perhaps if I started an IV line, pushed  in a stomach tube and washed out the stomach with ice water, the bleeding would stop long enough for me to send him to the nearest hospital. The sooner the better I thought. I did not like the look of the accompanying crowd. They were muttering in nasty undertones and one seemed to be drunk. The accompanying  crowd can get very nasty if there is a death. I did not really want one on my premises (I only have an outpatient clinic) or have it destroyed or the adverse publicity. (Death on the premises drives away patients).

He was conscious, oriented and passive when I inserted the needle. He actually seemed to enjoy the poke. The wife wailed louder. Another lady joined in (I think she was his sister.)

The stomach tube was another story altogether. He gagged, fought and  sat up. Determined to succeed (I am a great admirer of the Robert Bruce spider story if you fail once try and try again) I held him down and tried harder.

Suddenly, he pulled out the IV line. (This made blood drip on the floor as well). He pushed me to one side, fell to the floor and clutched my feet. I almost fell on top of him. My nurse and watchman attempted to get him back on the bed. My office manager started to yell and clear the room.

“Save me!” He shouted.

“ I am trying to,  but, unless you cooperate what can I do?”

“I want to be saved from you,” he shouted, “but you are killing me instead!”

“Nonsense! I am trying to save your life.”

“What is that stick you are pushing down my throat? I can’t breathe.”

I explained patiently, “It is not a stick, it is a rubber tube. I am trying to stop the bleeding long enough to get you to a hospital.”

“What will they do?”

“Probably put in another tube to see where the bleeding is from and then try to stop it. They might give you a bottle or two of blood.”

I could not make sense of his behavior. For one thing his vital signs (pulse rate 86/min regular as a ticking clock, BP 120/80, was not really consistent with vomiting that amount of blood.) Also he leapt off the treatment table with enthusiastic alacrity.

 ” Are you alright ?” I asked,  “If so, I will send you now itself to the hospital with the drip and the tube.”

He looked a little ludicrous. His hair was tousled and stuck with matted blood. His clothes were stained red. The IV was attached to one arm and the tube was hanging out of his mouth clenched in his teeth. He spoke with it in place like an old western movie.

“Ayoo!” he said, “I  am not vomiting blood. I just swallowed a brick dissolved in water to frighten my family. I got tired of their nagging about my drinking. I was hoping they would leave me alone. Let me go. If I stay here any longer, you WILL kill me.”

Gathering his clothes, he flung the tube down and pulled out the IV line. He went to the wash basin and cleaned himself up. My nurse and I watched aghast. Then he ran out of the room followed closely by disbelieving relatives.

“ A miracle!” shouted one of them, “I told you this doctor has lucky hands. She just has to touch you and you will recover.”

Well, a little community goodwill doesn’t hurt , And, in the final analysis, “All’s well that end’s well!”

 Dr. Gita Mathai

The writer is a paediatrician with a family practice at Vellore.

If you have any questions on health issues please write to

yourhealthgm@yahoo.co.in

medical studies

Medical Examinations

My batch mate had joined MBBS with us, but he took a year longer than we did to finish. He failed to make the grade several times along the way. It was surprising, the man was intelligent, articulate and came from a family of doctors. True, he was not very hard working, and had not come to the realization that you cannot really study medicine at the last minute, you cannot use crib notes and unless you attend classes and clinics you are likely to lose your way. (The patient to be  diagnosed in the exam is likely to look like a formidable alien with an out of this world disease).

I had not seen him in several years, and now he had re-appeared with  a good-looking intelligent daughter in tow. He explained that  she wanted to do medicine and join his alma mater. (Hopefully she was more hardworking than him).

“I want you to be her local guardian,” he said, “I don’t want her to make the same mistakes I did.”

He was an eminent surgeon now, and I did not want to embarrass him in front of his daughter, so I  whispered “how did you fail physiology?”

“They gave us a bloody frog. Told us to kill it ourselves for the practical. They killed the frogs for the girls though! Had to put a bloody skewer through the base of its brain. It looked like such a smug idiot sitting there.  I thought I would just give it a little shock before I killed it. Anyway we had to use electrically stimulate its muscle, that was the experiment. I touched the wire to its thigh and switched on the amps. It jumped out of the window. “

I said, “didn’t you ask for another frog?”

“I did, but the examiner had seen what I did. He asked me to leave and gave me zero. There was no hope after that.”

“Okay, but what about pharmacology?”

“I passed but only just. Scraped the bottom of the barrel. That bloody professor called us all in volunteer for an experiment. Claimed some of us were going to receive diuretics and others placebo. Wanted to record effects and side effects. I took the tablets, pissed like nobody’s business and then passed out. After that I slept for 24 hours.”

That did not sound like an infarction of the rules to me. “That’s all right. They have to record the side effects anyway.”

He looked sheepish. “It turned out that I had received placebo. She almost suggested that I go to the mental health center for evaluation. I think my reaction skewed her results.”

We had weekly tests in pathology and so slackers were caught very early on in the semester. He had found a way around that also. He and a friend studied half the portions each and then copied from each other during the evaluation. They consistently received pretty much the same marks and life went on. Then the evaluator wised up and gave one a zero and the other centum. Instead of leaving well alone, they went together to the head of the department to fight.

“Its not fair, we copied and I have failed and he has scored full marks.”

“Aha, “ announced the registrar, “I wondered what was going on! I am cancelling your entire evaluation. You have to come in every Saturday and complete the portions”.

Many in the class were annoyed with his cheating. True, he never aimed for more than 50% and he never tried to get a prize in the subject, but it was an irritant.

One of the girls went to a restaurant for lunch on pathology day. She ordered a leg of tandoori chicken. It was enormous in size and the bird had obviously fractured its leg somewhere along the way. It had healed but was deformed with a bony bulge mid thigh. After she picked all the meat off the bone, she carefully washed it and took it back to pathology class. The tables were carefully set. In the place where he should sit, she removed the specimen meant for him to identify and kept the chicken leg.

“For once,” he told me, “I was happy. I knew what the specimen was osteogenesis imperfecta in a child.  I usually did not even know which organ it was!”

I vaguely remembered the sequence of events. The registrar came in, and he lifted up the chicken leg and went into ecstasies over the bone. The registrar looked like he was going to throw an apoplectic fit. “Idiot,” he said, “not only do you eat chicken for lunch, you have the guts to bring it here and play the fool.”

The daughter was better. She passed with flying colours and then disappeared into the greener pastures in  the USA.

 Dr. Gita Mathai

The writer is a paediatrician with a family practice at Vellore.

If you have any questions on health issues please write to

yourhealthgm@yahoo.co.in

why run?

Why Run?

I have always been a runner, but as I became older speed, regularity and discipline became a problem. My feet do not obey my brain’s command to “go faster. ” With family commitments, irregular domestic help, power failures and the monsoon it often seemed easier to just fall by the wayside, sleep a little longer and run tomorrow. I realized I needed something to keep me going. It seemed a waste to just run with no motivation, no weight loss and no end in sight.

My son suggested I do half marathons and my daughter said “why not?”

She found out details, I joined the Chennai runners and the Hyderabad Runners. I signed up for the Chennai half marathon in 2010. I was the oldest woman running, the organizers were apprehensive and I had a dedicated policeman on a bike following me. He suggested that I stop and get into the ambulance several times. ( I think he was tired of riding so slowly)!

I am deeply appreciative of the young runners. There has always been someone waiting even when I am pathetically late to sprint with me across the finish line shouting “come on aunty! You can do it!”

My biggest fear-- I don't want to come last.

(I haven't yet!). There are always stragglers after me. A few injured, a few with vital equipment like shoes missing and others just unfit.

In the last half marathon I ran  a lady was vociferously accusing the organizers of secretly increasing the distance she had to complete!

If the organizers are considerate, and think maybe they will also be older one day,  and with a lot of prodding and emails from me I sometimes manage to get a "veteran runner" ( over 45 ) and this year a "super veteran" (over 55) category. This means that in the categories I often manage to get a ranking. (It is not as disheartening as coming  20 from the bottom! Though sometimes in these categories they do not separate the males from the females.

In the last race I ran out of 1260 participants there were 262 women, I was the oldest and the next after me in age was 51!

I signed up for free Hal Higdon training and recently Runners world half marathon training plans.

I do not really manage to stick to  their schedules. The weekly long run is impossible. They have speed training and splits. Instead I run 4-5 miles  (7-8 km) at a steady slow pace every day. (No improvement in speed or distance in 5 years), but I finish. I have never discontinued a race.

I follow the cross training plans with swimming ( won 5 golds and one silver in the masters swim meet in velacherry this year 2013)

I hydrate the night before the race but  not during as India still does not provide portable toilet facilities en route.

I eat like a maniac after the race.

I am not thin and all this activity has not made me lose weight, but I can eat as I please and unlike all my close relatives) am not diabetic or hypertensive.

My life revolves around training from one race to the next.

Running that distance and for that length of time is about mental discipline and physical fitness. You have to run past the pain and through the acute loneliness-- There is just you an open road ipod music and an aching body.

Dr. Gita Mathai

The writer is a paediatrician with a family practice at Vellore.

If you have any questions on health issues please write to

yourhealthgm@yahoo.co.in