DOCTOR TRAVELER

On my very first night call in Okhaldhunga hospital, attending nurse called me, ‘Bed no. 27 is having unusual behaviors’.   That guy had taken the canula out and bleeding from canula site, I just pinched the bleeding site and asked the nurse to have got dry cotton and the load diazepam shot. He received 50 mg IM shot in subsequent steps and fell asleep and open the vein with canula. On the same night after 2 hours of event, another guy started to show same behavior. I asked him to stretch his hands and abduct the fingers…it was… fine tremor. I said to nurse, ‘Have this man got detox till he sleeps.’ They wake up in the middle of night and start showing unusual behavior to other patients and hospital staffs. They come to nursing station with fluid holding in hands. Some take out the canula and need special FBI kind treatment. This is a cold mountainous place; possibly most of the people are habituated to alcohol to get rid of cold insult. Not the specific ones, most of the t

The kid with his grandma I saw the same kid with smiley face early in the morning while in morning round. It was on the way of hospital’s corridor we faced each other. I was about to cross past him, I asked him. ‘Hey buddy what’s up?’ ‘Well she is ok.’ ‘Arrright, what’s about you, then?’ ‘Me ok since she is ok.’ ‘Will you go school tomorrow?’ ‘Yeah, I am missing it.’ His grandma looked fine and happy and wanted to go home. She was discharged with subsequent therapy for her Peptic ulcer disease. She had pancreatic cancer though but we could not address it. I was going for tea in the middle of break, ‘sir sir…’ I heard from back side. ‘Thank you…!’ the kid was right there with his beautiful smile ‘You are most welcome, buddy.’ I just knelt down and poked his chick. ‘I hope we will not see to each other in the hospital.’ ‘Yeah you are right but we can meet outside the premises of this hospital.’ ‘Definitely dear…!’

Today early in the morning I saw an old lady with small kid presented to ER in Okhaldhunga Community hospital. She had got burning epigastric pain.   While asking about members in family, she is living with that little kid; her husband is no more with her. The elder son, the kid’s father passed away many years back and the daughter in-law, the kid’s mother is far away in Kathmandu who comes once in a blue moon. Younger sons do not look after her. She had been having pain for 3 days and similar episodes in the past though. While going through previous report, she found to have pancreatic cancer. While asking about socioeconomic status, there is virtually no one earning and supporting them. She has grandson, the kid who helps her make food and feed her.   They have some fields to grow foods. This time she came with Peptic ulcer disease (gastritis). While asking kid, he had his eyes full of tears, burying his face with his hands, ‘I study in class 2. I go to school reg

Two middle aged couple with their somber faces came to Okhaldhunga Community hospital. They look like they are from lower class family. They have one small daughter aged 8 years who had some cloths wrapped around her right arm. They came from extreme part of Solukhumbu walking on foot for 5 days. I am very much surprised that people come on foot to this hospital very far from here. This child has fall injury over her right arm and it was deformed. She underwent x-ray and found to have shaft of humerus fracture (bone of arm) which is partially displaced. She was planned for hanging cast. Father said to us, ‘ Ma sanga thorai paisa chha, chhori ko upachaarko lagi pudaina ki ? (I have less money, maybe it’s not enough for treating my daughter.)’ One of us asked, 'how much do you have?' Reluctantly, he looked at us, ‘Just twenty thousands.’ 'Twenty thousands…! One thousand is quite enough…!' Our paramedics said. The Couple surprisingl

National academy of Medical Sciences (NAMS) in Kathmandu conducts 6 mandatory training to its residents during their 3 years’ Postgraduate degree in different disciplines. One of them is Medical Education that is all about how to teach people especially patients and how to prepare class to the students or juniors and learning techniques. Others are Advanced Cardiac Life Support, Research Methodology, Basic Surgical Skill, Trauma Life Support and Palliative Care . This is the beauty of NAMS. We were privileged to get the 4 days’ training on Medical education getting it in brief way out of its vast contents. Some of them about teaching learning activities were knowingly unknowingly followed by us during our life and so many new things were revealed they were never been  in our mind. Teaching is not one way but it is two way or multiple way and it should be dynamic not the static. Lectures were given by the experts about medical education and they were worthy to take. One of the

While I was on line for my morning breakfast after hectic night duty in Patan hospital, I saw a man in wheel chair and I could see the happiness in his face. I asked him, 'How is your wife?' He smiled me back, ‘Oh she is fine and I became a father, doc.’ And I formally said shaking his shoulder, ‘Congratulation, god bless you both and your child.’ ‘Thank you, sir.’ I just casually asked him, ‘Where are you from?’ ‘Kalikot’ Kalikot kaha? ‘Rupsa’ ‘I have been there many times’   He just paused and surprisingly asked me, Are you sure?’ ‘Yeah I have been there many times’ ………………………………………………………………………………………………………… Yesterday one woman happened to me for regular check up in admission room of maternity ward at 6PM. She had shorter stature and had metal stockings on her leg for her club foot. She went through non stress test to estimate the health status of her baby inside her womb. It was turned out be reactive suggesting good status of baby. I asked her, ‘C