Thud.. thud.. thud..
Damn it.. Its the f***ing roof again, I thought. Why cant the Government get the roofs of all PHCs made of concrete??
Then it came again... Thud .. thud ..thud..thud ..thud...
huhhh?? wht the....
I was jolted back to reality. Where am I?? I wondered for a second, trying to orient myself in time,space.. and person. Oh yes.. Tarapur...
It was June 2005, the month of my Rural posting in internship. Generally , rural posting is considered to be a real pain in the -u-know-where! But ours was different. Myself,Sakil and Raghuvir had opted for Tarapur Peripheral Health centre (PHC). At that time it was considered to be the coolest, the most lenient. The MO was my immediate one yr senior. So he asked us to do minimum possible work. Raghuvir, unfortunately,was later shunted to Chinchni PHC nearby, and the poor guy was having a hard time cuz his MO was a sluggard.. so he had to run both the OPDs and manage emergency cases at nights too.. While we were enjoying our 30 day vacation!
But this one day, Sakil had to go to Mumbai for his guitar lessons and the MO had to go away for some personal work. And Dr.Parag Mahale, was the only available MO at the PHC..
The monsoon had just begin, and since the PHC is near the sea and on open ground, strong gale and heavy rains had become a regularity at nights.. to top it all, there used to be frequent power cuts and load shedding in that area.Interns generally are not provided with a separate room to stay and they r supposed to stay in the PHC.But since the Driver of the phc used to stay nearby, we were given his room.It was bang besides the mortuary and the post-mortem room.But what the heck?? we were not afraid of all this. When the wind used to blow thru the night, the loose asbestos roof of our room used to rattle violently , and so, it was almost impossible to sleep during the rainy nights with power cuts and all...
Thud.. thud..thud.. thud.. thud...
It was a clear peremptory knock on the front door.. It was 2 am.. i struggled to get hold of my torch..
"Kaun???" , I asked sleepily..
"Doctor Saheb.. main Nandu.. patient aaya hai.. emergency hai.. jaldi aaiye.."
"Ha, aata hoon"... Shit man, id hardly slept properly and this patient...
Struggling to put on my clothes, i groped the entire room for my tool (read:stethoscope).. Ha, got it!!
I opened the door and looking at the rain and feeling the wind, i felt like by the time i reach the PHC, i'll be blown away.. I took out the umbrella , but it was no use.. I flipped over in an instance.. I rushed towards the nearest shelter, the post-mortem room..
If u think this story is creepy and has anything to do with the mortuary, read on... :P
Then i ran all the way to the PHC , which was about a 100 metres away...
And what was here... a huge mob had gathered.. there were 5-10 policemen too.. apparently, there was a fight between two neighbours and one of them was hit on the head with a rod..
Oh man!! This had to happen this night only?? An MLC (Medico-Legal Case)!!
There was no electricity in the PHC , and the generator wasnt working too! Brillianto!!!
Ok.. calm down Parag.. this is ur First patient which you've to handle on your own! I told myself..
"Sister, Ek sage wala andar, baaki sab bahar!!!" I ordered on top of my lungs...
"Patient kidhar hai??" The senior inspector and sister accompanied me to the emergency room..
There was blood all over the place.. He was a young guy.. about 25 yrs old..
He was lying in a pool of blood.. and to make things worse, he was getting hysterical looking at all the blood he was losing fast...
"Doctor saheb, main mar jaaonga doctor saheb..."
"Arre kuch nahi hoga!! main aa gaya hoon na.. shant ho ja.. Kidhar kidhar laga hai woh jaldi bataao".. I tried to control the whole situation, tried to appear as calm as possible, though my heart was pounding as fast as the Rajdhani express...( bad simile , i know ;)
"sister, suturing tray.. "
How i wish electricity would come back.. but it didnt.. i'll have to manage this case in a God damn torch light..
I examined him properly.. there was a long gaping wound on his scalp which was bleeding profusely.. Pulse Bp everything was within the normal range.. Thank God.. no internal bleeding!!
"Sir, Suture tray.."
huh?? Ya .. suturing.. Now what?? Ive never ever sutured in my entire life.. Though Ive done episiotomy suturing in my Gynaec posting 3 months back, but my surgery posting was in october.. And i'll have to do this under torch-light... sighhhhhh...
I asked the Sister to hold the torch and the scissors..
Ok.. here go the gloves.. I hope this goes off well..
"Sister, Guaze piece.." ok.. now lets take a look at the wound.. hmm.. about 6-7cms long.. and whts this.. a bleeder.. damn!! (bleeder: An artery which gets severed starts spurting blood)
Ok.. catch the bleeder first and then suture the wound.. Breath Parag .. breeeeeeeeeaaath...
Here it goes.. Local anaesthesia given all around the wound, Taking the catgut i tried to catch hold of the bleeder. drat!! its so small n i can barely see anything.. My spect correction is definitely gonna increase after this..
Finally i caught hold of it and managed to control the bleeder .. now to the main part.. scalp suturing..
Ok.. Parag recollect the basics.. needle perpendicular to the needle holder.. movements supination-pronation... ok.. here it goes..
Moment i touched the skin, the dude started jumpin n shouting... wow!! this is gonna be one hell of a suturing...
Ok.. lemme give some more local first...
"Arre chup baith!!!".. and then ssssatttaaaak.. the inspector had given one tight slap on his face... there was no need of any more local i guess, as he laid there like a cadaver!!
Ok.. where were we.. hmm.. the first ever bite..
I strained my eyes and Tried to pierce his scalp, applying all my force i could muster from my wrist... The scalp is a very "tough" structure to suture.. Suddenly, there was a give away feeling and the needle went thru in a split second... i hope i didnt pierce his skull .. cuz the force was so much that i thought the needle wud come out thru the other side of his brains!! ..
Thankfully it didnt.. and so i reinserted the needle thru the other side.. damn it was tough..
And the knot in place, Yipppeeee!!! My first suture on skin.. that too on my own.. and that too in a torchlight!!!!
Im proud of you Parag.. i told myself.. ok.. now about 10 more to go........
after 15 mins of struggling with the needle holder, the torch light, and an unco-operative patient coming out of the Local , i finallly managed to get the suturing done..
"Sister, Dress him please, ill complete the paper work..." .. felt nice to get Bossy!!! ;)
So i went to get the paper work done, which proved to be much more tedious than the suturing... but i wasnt complaining..
So inspite of 2 pain in abdomen cases, one delivery and 3 other minor cases coming to the PHC by the time i finished the paperwork, which i had to manage them, i was all the time thinking about what i've done today.. My first Suturing!!!