OTC Treatment

OTC treatment

My closest competitor in my medical practice is a pharmacy down the road.(I have my own pharmacy). He failed his 12^th standard but that does not prevent him from being an expert in the diagnosis and treatment of all diseases.

One day a  boy came in for his 16 year booster. His  mother accompanied him.

“Do you know why I don’t come to you for treatment?” she said.

“No.” I replied. I must admit I was curious. Her three children came to me for immunizations but nothing else.

“Well she said, ”it takes too long and it is expensive. I have to wait for the consultation, you insist on talking about diet, exercise and follow up visits---.” She seemed to think my interest in preventive health and lifestyle changes was not to be commended but deplored!

“Where do you go?” I asked.

“Nowhere. I just send my son to the pharmacy with my complaint written on a piece of paper and he sends me tablets.  I have been doing this for years.”

A few days later she developed an acute pain in the shoulder. The son was dispatched to the pharmacy. He was given some tablets which he then administered to the mother. Within an hour she started to swell up. Her son described it graphically.

“She looked like I was pumping air into her with my cycle pump. Her lips became even bigger than Angelina Jolie.  Then she started to itch and scratch.”

Her son ran back to the pharmacy with the medicine.

“Look,” he said, ”my mother is swelling up.”

“Let me see the tablets,” said the pharmacist.

He grabbed the tablets and pushed them into a crevice.

“Give your mother these.”

He handed over four tablets. The boy cycled home.

“How is she supposed to take these,” asked the father ,”one at a time or all together?”

They tried calling the pharmacy but the phone was “unreachable.’’

The son cycled back. The shop was locked.  In the distance he could see the pharmacist racing away on his motor bike.

 Meanwhile the mother was finding breathing difficult. Strange noises came from her throat. Her breathing was laborious and difficult.

The neighbours trooped in, and, after a lengthy consensus, they loaded her in an auto and took her to a hospital.  She was immediately rushed into the ICU. She collapsed and went into cardiac arrest at the doorway of the ICU. They managed to resuscitate her , but they kept her in hospital for ten days. The bill was huge!

They tried speaking to the pharmacist but he denied everything. All the transactions were unbilled in any case. He even pretended not to recognize the lady and her son.

fire extinguishers

Fire Extinguishers

The building inspector came to check my clinic and he accusingly said, ”there are no fire extinguishers!”

He was right. Given the shoddy work done by electrical contractors and  the inferior quality of electrical wires on the market , I realized he had a point. We needed fire extinguishers.

He came sleazily close to me, ”We can make an adjustment. You just pay me. You don’t have to purchase extinguishers. Ask your neighbor.”

My neighbor was running some sort of factory next door in a large shed. He was a shady character. Apparently he just paid off the building inspector every year.

I had visions of electrical fires and my patients being burnt to a crisp.

“I will buy the extinguishers.” I refused to pay the inspector.

As I was leaving I saw the factory owner standing outside. I peeped into the factory and lo and behold there were six fire extinguishers lined up against the wall.

“You have fire extinguishers?” I asked.

“Oh no, “ he said “they are too expensive. I just have empty casings. I have a supplier. Shall I text you his number?”

Much against my manager’s wishes, I ordered four real fire extinguishers and some red metal buckets to be filled with sand. My manager and  the factory owner became friends.  They had animated discussions about by idiocy.

A couple of months later, there was a terrible smell coming out of his factory. Apparently, he stored beedi leaves there. Someone had thrown a lighted cigarette or beedi  through the ventilator. The entire godown was a smoldering smelly mess.

He borrowed my fire extinguishers and tried to spray the inside through the ventilator. I was not sure how the extinguisher worked, neither was he. He decided to chuck the entire extinguisher inside, metal case and all. There was a muffled explosion.

Meanwhile a crowd gathered and some called the fire department. They were very annoyed.

“We just had our parade. There is a water shortage in Vellore. Our truck is only half full.”

The started the hose and a pathetic wispy spray of water came out.

Sand mining from the Palar river bed in Vellore is illegal. That does not prevent people from mining the sand at night. Trucks transport the mined sand through the by lanes near my clinic. One such truck approached. The public stopped it. They formed a line, took the sand and filled the godown with it. The fire stopped. The fire engine left with half its water unused. The lorry driver stood helplessly wringing his hands.

“Oh God ,” wailed my neighbor, “my godown is destroyed, my beedi leaves are burnt----- where will I go for money? It would have been cheaper to buy the fire extinguishers!“

The driver stepped forward, ”don’t forget you have to pay for my sand and my labour!”

Returning Flights

Returning Flights

My husband had a meeting in Varnasi and he invited me along. I did not really want to go. Even though it was the oldest surviving civilization, I had heard horror stories about the place.

Surprisingly, it had a slick new international airport. Once you left the airport, the city was unbelievable. There were pot holed roads, many vehicles and the locals did not seem to know that  we were living in India (that too Modi’s consistency) where we drive on the left side. Both sides of the road were fair game, as vehicles squeezed through every available gap.

In the hotel I found a travel desk.

“Do you have tours of the city?”

“We can arrange a taxi for you.”

“Who will explain the sights?” I asked.

“The taxi driver knows everything. Do you have a friend to go with you?”

“No” I said. Everyone else was attending the conference.

“Then” he said ,”its better if you don’t go.”

Anyway Varnasi was flooded and people were being rescued in boats. The Vishwanath temple was partially submerged. The roads were ankle deep in water.

When we left Varnasi I told my husband, “I don’t know if I will make my connecting flight. There is only an hour between landing in Delhi and leaving for Chennai.”

“It’s the same airline “ said my husband, “Indigo. They will book your luggage through.”

At Varnasi we found that Indigo had no such deal. We had to rebook. My husband was going to Hyderabad so he had a two hour layover. Our flight landed 10 minutes late, the luggage took ages to arrive and the flight was departing from the next terminal.

I ran all the way to the other terminal (it pays to do half marathon training) and I reached the counter 20 minutes before departure.

“I cannot load you or your luggage, “explained the ground staff, “the flight is already boarding. You have to be here 45 minutes before time!”

I let out a loud wail. ”I am a sixty four year old lady. I don’t know how to book another ticket. I have  to reach Chennai. I came here by Indigo. Your luggage g delivery was late. You did not book me through to Chennai. How can I stay here alone? I don’t know anyone in Delhi.” I cried loudly again.

Passenger sympathy was building up in the rest of the queue. “Arre “ a passenger shouted “don’t harass Mataji.”

“Okay,” she said ,” here is  your boarding pass. Take your luggage and run. We can’t load it”

I ran all the way to the departure gate. My check in baggage was rescreened and my nail file removed.

I ran to the gate. A car arrived to take my suitcase and me to the flight. My luggage was pushed in next to the toilet. I sat down and the flight took off.

Thank you Indigo. BUT I will never again ask my husband to book my tickets!

sporting events

porting Events
Vellore organized a marathon two weeks ago. 
“Are you running?” some patients asked me.
“No.” I said. The main reason was that it is a small town and I did not feel like running through the center of it!
I saw the race as I was driving to work through narrow roads packed with vehicular morning traffic. The runners started two hours late, they were weaving in and out of the traffic dangerously, no water was provided and no police presence. Many hailed autos or passing two wheelers and got lifts. A fiasco!
I think this is what happens because we do not respect sports or sportspeople.
I read some articles where the marathon runner from India said that drinking water was not provided by the authorities. I can believe it. My heart goes out to her. The state of our sports organization is in shambles. The truth can possibly be verified from camera footage. Team India’s doctor was a well connected radiologist. I don’t know if they had a physiotherapist.
In the Masters aquatic meet held in August in Chennai, one had to salute the spirit of the 72 year old who leaped off the high diving board. (I was scared even to look down).
Another 84 year old took off his clothes, informed the time keepers and dived into lane zero. Shortly after, an agitated young woman arrived with disheveled hair and in a nightie. She ran alongside shouting “get out get out.”
The referee went up to her and said “what is happening?” 
“I am his daughter in law “ she said , “I am in charge of him, he had by pass surgery two weeks ago---“
The old man (still swimming) stuck his head out of the water, ”I’d rather die in the water than lie down at home.”
Since he was the only one in his category, needless to say, he got all the medals. 
One enthusiastic 36 year old dived in for the 50 meters freestyle. He surfaced after a long time and then proceeded to flounder in the middle of his lane. A superfast ex-army swimmer finished the race. 
“Quick,” said the referee, ”go and pull him out , he seems to be drowning—“
The man and another swimmers cut lanes and pulled him out. There was no lifeguard. 
“Are there any doctors here?” announced the loudspeaker.
I looked around and then stepped forward. I was happy to see a grey haired physician also stepping forward.
“I hope you figure out what is wrong, “ said the white haired gentleman, “I am a PhD in biochemistry.”
The man had nystagmus so I managed to give him vertin. 
“You better go home after you feel a bit better, and see your regular doctor.”
An hour later, he felt so much better, that he took part in 100 meters freestyle and the relay. I felt so nervous that I watched him like a hawk.
Apparently with all the older swimmers and octogenarians diving and swimming, they had not bothered with a duty doctor.
In my relay team, we had an elderly woman, who disappeared just as the race was announced. One of the younger members of the team went to the changing room and found her stuck in her clothes. She had a three piece swimsuit with shorts, a regular suit and a skirt (not a burkini). She had managed to get tangled up in the whole thing! The other woman extricated her, while I pleaded with the time keeper,
“five minutes, please, she will be here—“
She was to start the relay with backstroke.
“How can I get in?” she asked.
The time keeper looked at her “ Jump in!”
“I can’t” she said.
Further delay while she went to the end climbed down the ladder and came to the lane.
The timer blew the whistle and she took off freestyle.
“Back stroke “ shouted the timer, “she has to do back stroke! I will disqualify your team.”
I shouted “back stroke , back stroke “ at her. 
She obviously could not hear. Her cap covered her ears and was tied under her chin. She switched to breast stroke midway.
Since we were coming last any way thanks to her antics and slow pace he allowed us to continue.
I entered for 50X4 Individual Medley. I am rather slow, (even though I got the gold). I saw my timekeeper disappear for a 2 minute break, have a cup of tea and return. Needless to say, I was still swimming-----.
It was good fun, I got two gold medals, three silver medals, my daughter (now old enough to be a master’s swimmer) got two gold and two silver, and we both qualified to represent Tamil Nadu at the Nationals.

weight lifting

The young man had fixed an appointment to see me. He stood just inside the door wringing his hands.

“Do you remember me? I came to you ten years ago.”

I did not remember him but was eventually able to track down his records.

“I want to become a body-builder and go for the Mr. Tamil Nadu competition.”

A worthy ambition. Unfortunately he was twenty four years old (Arnold Schwarzenegger started at the age of fifteen years) and had a stoop and skinny arms and legs. I could not even imagine a six pack on his abdomen.

‘’You need to train four to six hours a day,” I said.

“I can’t “ he said I work for my father. He makes me work for twelve hours.”

“Perhaps you could join a gym?”

Vellore is dotted with gyms. There are exclusive “male only” gyms with paintings of Sylvester Stallone and Arnold Schwarzenegger. Their faces are lopsided, their muscles bizarre unanatomical  and disproportionate.  They have untrained “trainers” and no aerobic equipment at all. This is in stark contrast to the elite gyms that cater to the affluent in Vellore. Those have qualified trainers, separate timings for ladies—there are even ladies’ gyms.

He joined an “Arnold Schwarzenegger” gym. His trainer was very enthusiastic. “I can get you to the  competition in  two months”, he said, “just follow my plans.”

I kept a close watch on all that was going on.

“Eat six egg whites, and 200 gms of beef a day” said the trainer.

The man protested, “we are Hindus, my parents are vegetarian, my mother fasts three days a week.”

It seemed to be a no win situation.

“Perhaps ,” I suggested, “you could buy an induction stove and a microwave and cook in your room?”
He has shifted to the terrace so as to have room for his exercise. Apparently there was a half room there where he lived.

One day his mother screamed, “the house is on fire I can smell the burning.” Father and mother followed the smell to the terrace. They boy was cooking beef with ready made masalas.

That was the end of his protein supplements.

The trainer suggested packaged tablets and supplements. “This is only whey protein and creatine.”

I refused to allow him to take  it. The internet was full of articles about adulteration of supplements and although creatine is a natural substance, its effect  hasn't been well-studied over the long-term. Researchers still aren't sure what effects it might have on the body, particularly in young people, or how effective it might be.

So we were back to eating Rajma and Kabuli channa.

“When is the competition?”

“Its two months from now” he said.

“Why don’t you try next year?” I asked looking at his ribs and skinny arms.

He was determined and went for the trials.

“No 7 & 9” said the judge.

Very pleased because they had not even climbed on to the stage, he stepped forward.

“You can go home.”

They were eliminated before they even started.

The trainer smirked ,”everyone listened to me except you. They all took supplements.”

He looked around, they were oiled, rippled and ribbed.

Dejected he left.

They next day he came to see me again.

“Don’t worry, “ I said, “you can put all this health and stamina to good use. Start  marathon running. You will be healthy long after the supplement users kidneys have packed up or they are caught like the Russians in the Olympics this year.”