The Clinician

 The evening was pleasant in Kottayam medical college hospital that day in 1975 ,the year that produced one more doctor,number 8299 in kerala state,with the licence to kill ,heal or prolong the misery and pain of life.

He was ecstatic,the first day of internship and that too ,surgical posting under Dr Muhammed Iliyas,alleged to be the fastest surgeon in the campus.With the dirty white coat and the steth lying around his neck like Siva's snake,he felt on the top of the world and his height grew by nother 5 inches after the results were out.

The surgical ward was full and silent after the closing of ops in the dusk.The only noise was the gossip whisperings from lady bystanders and the baffled patients sighing and moaning.He was content with the young sister posted for that night.All in all ,all under control and as natural as you could expect in a surgical ward.The great silence before the storm.At around 9 pm ,the first call of his life time, occurred.'Dr !,  One male patient in ward 9 is restless.please come and see. ' The doctor in him woke up too quickly.The war has started ! 

The patient was a middle aged male,a little hefty awaiting GJ the next day. He was totally restless,semicomatosed,froth from the mouth,dyspnoec,sweating heavily.He was in a fix ,soon recovered and shouted to the nurse ' oxygen please and an IV line'.He had already diagnosed Acute left ventricular failure and a barely noticeable smile has dawned on his face. ' sister, start an aminophilline drip and a lasix injection'.

By this time the headnurse had come and watching the heroics of the new recruited God,she asked ' shall I call the on duty surgeon Dr.Subramanyam ?'Yes please ,was his response.Soon Subramanyan Sir arrived on the battle field on his horse and assumed command.

He(surgeon) was observing the patient calmly and  asked for  the case sheet and was reading it slowly and steadily.( The intern fretted over the the precious time being lost fot treatment ).Slowly Subramanyan sir came in to action and asked the nurse ' when did he had the last meal '.The nurse was sharp ' he didn't eat this afternoon because of nausea'. 

By this time,the captain ( the surgeon) had taken out his sword fron the sheath on a comando mode and ordered ' sister, push in 3 vials of 25 percent dextrose and be fast'. She was really fast.After the third vial ,the patient stirred and asked ' where am I ? and tried to sit up.All symptoms disappeared as if a miracle.

Subramanyan sir turned towards the new intern , I mean ' me' for sure,patted me on the back and said mildly ' Hariharan , you should read the case sheet before saving the patient acutely !! This is a classic case of Hypoglycemia ,the patient had insulin at 7 pm and skipped his meals from noon,which you are going to face often in your career '

I wished the earth before me to open up and embrace me to it's depths like Sita. Yes my career as a doctor has begun well and a solid lesson learnt the Hard Way.Thank you Subramanyan sir,that helped me in saving atleast 10 patients in casuality and wards in Ottapalam taluk hospital.