You Look!

You look heavenly “he said”.

I gushed with estrogen.

You look old “he said”.

I gushed with epinephrine.

You look constipated “he said”.

I gushed with less thyroid hormones.

You look Pale “he said”.

I gushed with RBC’s lacking Iron.

You look worried “he said”.

I gushed with less serotonin.

You look expressionless “he said”.

I guessed I had Parkinson’s.

You look like Angelina Jolie “he said”.

I gushed with excess histamine release from an anaphylactic shock.

You look like you have a butterfly on your face “he said”.

I gushed with excess auto antibodies from SLE.

You look  hot, hot, hot, “he said”.

I guessed this was the last time I see him. He will never know what I took! ( Hint: Atropine OD)

The list is endless folks! As medical science is not limited and so is my poetry. Hope you guys liked it!

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What To Do Next? Part -I

 

“The best time to plant a tree is always twenty years ago. If for some reason, you did not plant it then, the next best time to plant a tree is now”.

I had involuntarily shared my interest to become a doctor to Kitty. She was a replica of Anne Frank diary. Most people obtain habits from influences with human relationships; I made my influences limited to books and novels. I tried to be regular at it, but often had to apologize to Kitty when I exceed a week or two.

This winter break when I got the opportunity to flip through those pages again, I realized that at 16, I had decided what my next 20 years would be like. At 16, I was locked in the boundaries of Saudi Arabia. Inspirations were showered through the Indian system of knowledge and I thought I would attain the highest attainable degree in the world like most of my friends, who discussed and shared their higher level of thinking in the lunch hour.

Two years after I departed from Saudi Arabia to finish my junior school, I was lost. I was not sure what I wanted in life. My dreams were fading and I was drifting. My dreams were not nurtured and motivated to that level. Then by the grace of the Nepalese Government, we decided to move to Dhaka. “Med school is cheap in Dhaka”, is what they said. People around me motivated me after that, they helped me to map out my dreams and they enhanced it with “pride” and called it a “great respect for our family” if I decided to go to a med school.

Plans are meant to be thought, processed, assimilated, digested and beaten up until something new emerges. That’s called life. You can’t map out your life like a building block but, you should have the courage to dream big, no matter what people have to say to you. Dreaming is your right and no one should rob you of that.

Turning into a general physician was my goal and after nearly two decades of unknowingly what life direction I would go, I completed it. But even after completing one goal, I am hungry for more. Life right now seems so undirected. I need a goal and a new direction. Where would I go, what would I do?

I cannot limit myself to just a “general physician.” I want more! Most people decide to choose London or Canada for under graduation. But I choose Bangladesh with full cooperation and with hundred percent certainty that my life would be different, if I choose to stay in a third world country. I would turn out to be humble and I would stay ground to earth if I choose to feel the pain and suffering of the normal people. I still remember how I had to convince my parents that leaving me in Bangladesh would one day make them proud parents. “Let me suffer today” I said and later on, I can get all the happiness in the world. Plant your dream today, who knows ?,it, might come true. I don’t write to Kitty anymore but she played a very crucial role in my life.

Motherhood South-East Asia

I recently had my twenty four hour work shift, it went well, if you asked. The very idea of nurses calling me up in the middle of the night several times was quite annoying to a certain extent but then I knew this was the price of getting into MBBS.

I had the opportunity of being the keen observer of the hospital, starting off with various wards, which I have not been posted, yet. The very striking ward was the antenatal ward, where most pregnant women, who are close to their due dates, were getting admitted. The ward is over loaded with women and it seems that Bangladesh is a baby producing factory.

As I was being an intern and checking the vitals (that basically sums up my work), I came across a lady, she was in her early forties and she was happy to be pregnant, when enquired about her choice to conceive a baby at such an old age, she gleefully said that it was “Allah” given. Similarly, I attended a patient who will be receiving chemotherapy for cervical cancer, (she has seven children), and she gives a very similar answer.

There is no control of birth; unmet need for family planning has made things worse for those that want to keep the maternal health status high up. The maternal health condition in Bangladesh is well versed than in Nepal even though things like birth spacing and use of contraceptives when husband is away are easily missed by women.

Most women are not familiar with the term of antenatal check up. Although, WHO has made it mandatory for pregnant women to take at least minimum 3 check ups, women are still not aware of such polices, instead, they seek medical attention when their due date arrives. What is the reason for policy making when health education is in limbo?

The process of pregnancy is a very important decision that equally both partners have a say in, but most women that I have encountered were either pressurized by their family or the husband himself or the hypocritical silent society that we are a part of.  Educating pregnant women about the birth process or informing her about how her body will change as pregnancy advances are keynote targets to save the extra patient load that most government institutions clearly fail to show interest.

Healthcare policy making is just a tool for the government to show that it abides by WHO, there are still patients who never get any antennal check up done, even if they did claim to get checked, its by a quack, when asked if she has done the basic investigations, she declines and even further she cannot even recall taking any iron pills!

This is the situation in hand, we live in the 21st century where neighboring countries are becoming super-giants in arms and ammunition and yet a primary care general physician has to face “Death of the patient- severe blood loss (Post-partum hemorrhage)!”

The Other Side Of The Computer

I have been in the other side of the computer for such a long time and I still will be for the next two years. It all started when I got a laptop for my 21st birthday. Well, I am not proud of the fact that I had my parents buy it for me.

There are several turns of events that happened afterwards. The side that I visualized from my computer was and is greener than the present that I have incorporated. So, before every break, I always kept looking forward to the place and people who were in the other side of the computer.

So eventually I slowly stared to understand my computer, I kept it clean, got mad when I could not connect with the other side and eventually it became my baby. One valentine’s days, I even declared that it was my true valentines after all. So things were so exciting, new laptop, new uses and new faces, news, stories, videos and more but at the end of it all it was always about how beautiful and wonderful the other side of the computer was.

I have been an habitual internet user for the past ten years and over the years, I have come to realize that the other side is always better than the life that I have created in the same location.

Why is that? Social media has changed the way that I had interpreted life.  There was a certain point in my life when I had to share every details of my life with friends and family, to create a buzz .I actually shared only the most happy or kind of happy moments of my life and I had no space for the sad and downtrodden moments of life. Friends who shared happy moments were someone to look forward. Also, friends who were not med students were more interesting than the counter parts.

So what happens when you do that is, you accumulate all the negative energy in your life and convert it to a conversation with a friend or you either burst in the middle of an event and you lose your balance in the social circuit.

“You don’t need friends, when you have social networking with 700 plus people.” Statements like that are randomly given by people who fail to understand the vicious cycle that social media does for one. What happens in reality, you will have a friend, best friend, and she is not in any social media sites at all.

So when does it start? Was it the initial stages of my computer use or after I got into the vicious cycle of social media. It’s an abnormal addiction; the thrill to post most amazing moments in one’s life is one of its kinds. At the same time, friends and family from different parts of the world, share their appreciation or dislike towards something that you post, has made social media more lucrative.

Med students in particular are the ones that are dominating the social media the most, from their mobiles at-least. It’s either the fact that studying all day and night for the next six months makes you the rightfully user of social media or they just like being in touch with their friends that often even when the exams are near ( nope, this aint happening).

So, you create a social propaganda. Random happy status updates or idiotic ones are just the ways of how one tries to justifying themselves in the crowd of social media. “Stay in it, with professionalism or personal details, but do make an appearance every single day for the rest of your lives”, that’s the tagline for social media users.

Use it or abuse it, it’s up to you but get it into senses that the other side of the computer, may not be the most beautiful thing that you have seen till now and the present that you create with the people who are there in your life are more valuable than the people who you constantly check upon (exception are parents).

How To Beat The Heat Waves?

I asked this very question to a doctor, few years back when I was not even a medical student. I usually expect people to respond to me. Even if they just reply with “I will let you know” or “I will respond in a while”. But when you go to a well paid medical institution for a checkup and expect a doctor to advise you and all  that you get is a blind stare at the window and “drink water” is all that he has to offer then he didn’t pay attention in med school at all.

This article comes after several days of torment. The sun is brighter in our part of the world and humidity is its best friend. I have lost my natural sleep patter, felt agitated and well, suddenly, I go into weakness fits of some sorts which has shifted my regular day-to-day life pattern.

 How many of you have these phases where you drink a huge amount of water every day to avoid the heat?  And in return, you feel weak and sleep a lot. The reason behind this is, when you drink large volumes of water, without equivalent salt intake. The salt content in your body decreases and you have low blood pressure and eventually the sleep aggravates the low blood pressure by increasing your venous return to your heart when you lie down in your bed.

To avoid this sequence of sluggishness, it’s better to take items that have a small amount of sodium chloride like any form of juice and fruits. Water is always advised but limit to 2-3 L with regular daily meals which contain ideal salt is perfect as well.

Also, one must not worry about how much sweat you produce in one day. Sweating is actually helping the thermoregulatory centre to maintain your body temperature of 37±0.5 degree. Sweating is a mechanism which helps shed some extra heat. Its better you use deodorants to avoid any mal-odorous encounters.

If you find anyone with a possible serious indication of sever heat exhaustion or heat stroke. Its advised, start with removing the person from that area to a cooler area, use a cloth dipped in cold water to actively promote evaporation from the skin surface and go to the nearest hospital when things are not getting better like when he /she is not responding to what you have done.

Other thing that must be kept in mind when you deal with heat is, what kind of clothing are you wearing? Radiant colors like black and well any dark shades are clearly not encouraged in the summer and factors like what is your cloth made of? Cotton is excellent, avoid polyester.

Other factors like, what do you consume on a regular day to day basis? Most of the food that you eat generates heat due to basal metabolic rate and henceforth a light diet for lunch and dinner is advised with plenty of fruits to add to that.

Please take care of your heath in the summer, it offers warmth and more sweating which might lead to cold problems like running nose. Those that sweat a lot ( night sweats ) when you are not unconscious, might get running nose the next day because the sweat which does not gets evaporated, causes rapid fall in body temperature and making the body susceptible to unwanted viral infection. To avoid this, you need a good cooling system; otherwise you will have to constantly change your clothes.

I can write some more “out of the text” points for those that truly follow what I have to say but this much for today.

The Day : Good Bye Nepal!

I am like a material which gets parceled in and out of my country. It does not make a difference, to the wide majority of people, if I was here to increase the population of Nepal for several days. Everyone is busy with whatever daily activities that they are doing. I come at a time when friends and family are so engaged in what they do, that it breaks my heart to ask them to stop doing that routine to spend some time with me. I don’t complain. I love the silence, the self satisfaction of doing something so peacefully that it makes me reach another dimension of life.

Life of a TCK is very simple. Your country seems to be a vacation spot. It’s my appearance most probably, the side bag that I always carry around my hips, gives a false illusion. The shopkeepers ask me if I want stones and I have actually been successful in making everyone believe that I am a tourist in my own country. I carry that side bag for three reasons, a) to keep my belongings b) to have enough space for something that I like to buy and c) to make the false illusion. I actually like the extra attention that people give. I have always been receiving it since I was a kid in different areas of the world.

My last day is mixed with emotions of guilt, anticipation and my appetite suddenly increases to a certain extent. The reason for the later is the fact that my self- conscious mind makes a good point; I can’t enjoy this food from tomorrow so let’s gulp as much food as possible. My weight always invariably increases over the vacation.

Garden of Dreams was the last stop in my map. Who says that this place is solely used for snuggling? Yeah sure, it is actually a hub for couples and if you are one of them, there is a private spot for you guys, you just need to climb several steps to reach there. Dragging my mat and elbow rester, I reached the center. The natural beauty that beholds you is amazing, add the music of the birds and water flowing nearby, it does make you wander is this heaven after all? I had to drag myself from there, it was not easy to say goodbye.

Summarizing my stay in Nepal in one sentence, I would have to say, extremely peaceful and self sedating. Starting from the Health Camps that I stayed in and the catching up with old DAV friends to the time when I went to My Republica to attend the chit chat session. Each and every memory gets stored in the fun side of the brain; making memories like theses which gets automatically stored up without any memorizations are the ones that last longer.

I am very much addicted to my country, my people and my family. I will miss the people, the variety of faces, the variety of dialogues and their unending battle to survive in one of the poorest countries in the world. I will miss the occasional fights by couples in the local bus or the time when I had to travel in a microbus with more than 30 people. I will miss the patients, that described their symptoms in pure Nepali, I will miss the way I tried to counsel them for a diseases, It’s a new experience overall. I will even miss the stuffy smell in the roads that throw unconditional house waste, It’s my country, it’s my pride and no matter how anyone try to undermine it by calling the roads, or the garbage management poor , I will always appreciate the good’s and the worst of my country without any bias.

[You Can Check Out the picture of Garden of Dreams in my FB page.]

Interview with a Baby (Neonate): Q

MM:I am actually shocked you agreed to an interview, I mean you are just 10 days old. What changed your mind?

Neonate Q: I want the adult population to get some facts straight, and what a way to start by giving this exclusive interview to you.

[A neonate is a designated term applied to babies which are up to 28 days, after that they will be termed as infants.]

MM: what was it like to stay in a uterus for about 9 months?
 Neonate Q :To be frank, it has its pros and cons.

The pros:

  • It’s damn warm there, I don’t know how she maintained the heating system there, but it was always warm and cozy.
  • The food that we got from her blood supply was always sufficient for me and sometimes when I wanted more, she would allow, we did not have any limitation.

[2/3rd of the calcium, 1/5th of protein, 4/5th of the total iron are drained from the mother during the last 3 months]

  • It was probably the best months of my life as I slept recklessly most of the time.

The Cons:

  • This outer world is cold and insensitive. The day I was born, they cut of the umbilical cord, the main supply of all of my nutrients.
  • They made me cry after few minutes and I did not like the smell of oxygen. 
  • They forced me to work now-a-days to earn my food by sucking action and sometimes when I want more milk she doesn’t understand and I cry more. She controls my feeding pattern now!

MM: So when your kidneys started to function by the end of the first 12 weeks, you started to secrete urine and you constantly ingested it, what do you have to say to that?

Neonate Q: I am not proud of the fact that I ingested my own urine on a daily basis but I did not have much option. As you see the sac, the gestational sac that I was in, only had two kinds of fluids: amniotic fluid and urine.

MM: Did you ever felt the urge to pass your stool? (Fetus usually don’t pass stool)

Neonate Q: No, fortunately my mother was careful; she never caused any kind of distress on me. My anal sphincters were contracted most of the time and since there are no toilets in the uterus, I thought holding it for about 9 months was a good thing to do!

MM: In the starting of the interview you mentioned the fact that you wanted the adult world to get some facts right, what are those facts?

Neonate Q : I speak for all the neonates out there. I don’t want our population of neonates to decrease and I definitely want the neonatal mortality rate to decrease!

First, I want the government to provide proper antenatal care to mothers.

Second, I want the adult population to understand the implications of having a baby, don’t resort to abortion and plan your pregnancy

Thirdly, Adults are reckless when it comes to drug intake, do you know that the following drugs causes teratogenic effects on us, meaning that we will be born deformed if they consumed it in the early stages of pregnancy:

  • High dose Aspirin
  • Antmalarial drugs
  • Corticosteroids >10mg daily
  • Antibiotics like chloramphenicol,tetracycline,quinolones
  • Antamoebic : metronidazole
  • Vitamin A large dose
  • Anti hypertensive other than methy dopa, anticoagulants
  • Antiepileptic drugs.

 I do agree that some mothers take drugs before they realize that they are pregnant. What I advise such mothers is to keep a record of their menstrual cycles. They should be careful about drug intake!

I know many doctors prescribe theses drugs to mothers so that they can survive and we get compromised but that is an exception that we can tolerate. We don’t want our creator to die and suffer and if she gets healthy we can return again, all we need is the same dad!

MM : Thank you neonate Q! You have entertained us throughout the interview process.  I would love to take your interview again when you grow into an Infant.

Neonate Q : For sure!