Their faces looked tense and they wore an anxious look
Together they swarmed in the long corridors, feeling protected
Each dwelling on the insecurities of the other
White coats were a big help and I wonder who used it for the first time and Why
To hide his limitations along with his new shirt and new tie
The coat gets longer as you climb up the hierarchy
Does it mean the student has less to hide and the resident has more
Probably its true
And a day comes when you are liberated from the shackles of white
You become that old attending who doesn't need that coat
Who doesn't need that tie.
Tuesday, July 20, 2010
Sunday, April 11, 2010
Psychiatry In General Practice of Medicine
Role of Psychiatry in General Practice of Medicine is very well established, specially in developed countries. Residents from Internal medicine as well as family medicine have roatations in Psychiatry during their residency period.
This article intends to be a little dossier for the medicine people who come across various Psychiatric manifestations in their patients.
Group 1: This group consists of the patients with multiple somatic complaints like unexplained and vague body aches, head aches, neck pains and several other pain symptoms which cannot be explained physically.
what to do? These patients require low dose anti depressants in combination with some anxiolytics. Low dose antidepressants have been known to work wonders with this patient population and have been frequently prescribed by the Psychiatrists.
Prescription choices can vary from Tablet Aculip H, Nexito Plus, Censpram Plus and several others. Start with BD dosing and treat for 4 to 6 weeks,most of the patients would show some improvement but if no improvement is observed than the patient should be reassesed for frank depression.
Group 2: This group consists of the patients with mild to moderate depressive symptoms like low mood, low self esteem, crying when alone, feelings of hopelessness and worthlessness.
What to do? Starting the patient on SSRI's is the best bet. Start with Fluoxetine 20 mg od or start on Escitalopram 10 mg od and raise to maximum of 20 mg od according to the patient response. Advise the patient to take these drugs in the morning as they may cause sleep disturbances if taken at bed time.
Word of Caution: Always figure out if your patient has any suicidal ideation or plan or has attempted suicide or self harm however vague it may be, it is a psychiatric emergency and should be best left for the psychiatrist to handle it.
Group 3: This group consists of patients with sexual complaints like erectile dysfunction , Dhaat Syndrome or premature ejaculation.
What to do? These patients are best treated with low dose Paroxetine along with phospodiestrase inhibitors like sildenafil and others. You can start with Paroxetine 12.5 mg and continue for 4 to 6 weeks.
Group 4: This group consists of patients with complaints of Insomnia or sleep disturbances or sleep difficulty.
What to do? Use clonapam instead of Alprazolam as it has low abusive potential than the later.
Thanks to Dr.Anupam Rathod for his valuable inputs.
This article intends to be a little dossier for the medicine people who come across various Psychiatric manifestations in their patients.
Group 1: This group consists of the patients with multiple somatic complaints like unexplained and vague body aches, head aches, neck pains and several other pain symptoms which cannot be explained physically.
what to do? These patients require low dose anti depressants in combination with some anxiolytics. Low dose antidepressants have been known to work wonders with this patient population and have been frequently prescribed by the Psychiatrists.
Prescription choices can vary from Tablet Aculip H, Nexito Plus, Censpram Plus and several others. Start with BD dosing and treat for 4 to 6 weeks,most of the patients would show some improvement but if no improvement is observed than the patient should be reassesed for frank depression.
Group 2: This group consists of the patients with mild to moderate depressive symptoms like low mood, low self esteem, crying when alone, feelings of hopelessness and worthlessness.
What to do? Starting the patient on SSRI's is the best bet. Start with Fluoxetine 20 mg od or start on Escitalopram 10 mg od and raise to maximum of 20 mg od according to the patient response. Advise the patient to take these drugs in the morning as they may cause sleep disturbances if taken at bed time.
Word of Caution: Always figure out if your patient has any suicidal ideation or plan or has attempted suicide or self harm however vague it may be, it is a psychiatric emergency and should be best left for the psychiatrist to handle it.
Group 3: This group consists of patients with sexual complaints like erectile dysfunction , Dhaat Syndrome or premature ejaculation.
What to do? These patients are best treated with low dose Paroxetine along with phospodiestrase inhibitors like sildenafil and others. You can start with Paroxetine 12.5 mg and continue for 4 to 6 weeks.
Group 4: This group consists of patients with complaints of Insomnia or sleep disturbances or sleep difficulty.
What to do? Use clonapam instead of Alprazolam as it has low abusive potential than the later.
Thanks to Dr.Anupam Rathod for his valuable inputs.
Friday, March 26, 2010
CONgratuLATIONS
How would you Congratulate if someone you know gets residency in US?
Congratulations #1 " Arrey B*******, Kya baat kar raha hai, maza aa gaya yaar, oye badhai ho yaar, saale party de."
Congratulation #2 "Congrats yaar Saini"
Congratulation #3 " Arey suna hai you did not get into surgery in US, bahut mushkil hai yaar, I know"
Congratulation #4 "Sir, congrats, aapka second step bhi clear ho gaya"
Congratulation #5 "Acchha, aur suna kya chal raha hai, main toh so rahaa tha yaar, bahut sar dard kar raha hai."
Congratulation #6 "Aur phir kab ja raha hai"
Congratulation #7 " Khush toh bahut hoge tum aaj"
Congratulation #8 "Jaanu, I Love You."
Congratulation #9 "No eye contact, no conversation, no smile,completely ignoring the person in lime light."
Congratulation #10 "Just a big smile with earnest happiness showing on the face"
Congratulations #1 " Arrey B*******, Kya baat kar raha hai, maza aa gaya yaar, oye badhai ho yaar, saale party de."
Congratulation #2 "Congrats yaar Saini"
Congratulation #3 " Arey suna hai you did not get into surgery in US, bahut mushkil hai yaar, I know"
Congratulation #4 "Sir, congrats, aapka second step bhi clear ho gaya"
Congratulation #5 "Acchha, aur suna kya chal raha hai, main toh so rahaa tha yaar, bahut sar dard kar raha hai."
Congratulation #6 "Aur phir kab ja raha hai"
Congratulation #7 " Khush toh bahut hoge tum aaj"
Congratulation #8 "Jaanu, I Love You."
Congratulation #9 "No eye contact, no conversation, no smile,completely ignoring the person in lime light."
Congratulation #10 "Just a big smile with earnest happiness showing on the face"
Thursday, January 28, 2010
TrainED
It had been a busy day for him in Office but it was not the work that bothered Reddy, it was the train that he had to catch in the evening which was bothering him since he had no reservation for travel and the Tatkal system had left him high and dry without a ticket for the train. He had been warned that it was very cold and foggy in Delhi, where he was headed to so travelling without a reserved seat would be crazy. He had no option though, he had to go come what may, and he knew that.
He decided that he would go the old fashioned way and bribe the TT to get a seat.
Train was on time, Reddy had already checked in the afternoon on his computer. He decided to ask a friend to give him a ride to the railway station.It was evening and road was full of two wheelers competing with each other on their way to home, one beating the other only to get beaten by yet another. Reddy and his friend had left for the station good half an hour in advance although the ride to station was just ten minutes.As they crossed the bridge the old two stroke bike started make funny noises and Reddy knew at once that it ran out of gas, it was not the first time it had happened to him. Behnchod, said Reddy, it has to stop just know, could it wait till had reached the station. Lucky for him the petrol pump was nearby and after a few meters of pulling the bike they reached the filling station and filled the tank to resume their journey to the station. Reddy thanked his friend for the ride and rushed to the ticket counter for the general tickets and took a general ticket till Delhi.
Train was on time, just ten minutes late but on time considering other trains some of which were around ten hours late. Reddy asked the food vendor where the AC coach would halt and stood at the spot which the vendor had told him.
The train arrived whistling and made a halt with a screeching sound of the iron wheels coming to sudden halt with the brakes.
Reddy hopped on to the coach and few seconds later the train started to move. He started looking for a good spot to keep his bag or himself or both. The train was full and he could not find even a single vacant seat. The passenger who were already settled in were giving strand looks to him as if some alien had arrived in their coach. Reddy soon realized that his worst fears might be coming true and he might not get any berth to sleep on in the night.He put down his stuff in corner just outside the entry gate of the AC compartment and stood their. Soon the coach attendant came their and gave Reddy a long curious look as if asking him why he was there and at the same time saying him to pick up his stuff and go to the general coach but the attendant said nothing probably he thought Reddy was some rich guy looking at his well dressed personality, Reddy took advantage of it kept standing there for a while and than found a seat at the attendant's berth.
Next station was a big one and the onboard ticket checking staff was being replaced by the new TT's. Reddy was hopeful of getting a berth so he approached the TT and showed him his general ticket, the TT looked at his face as if gauging him on how much money could he shell out from his potential victim and then looked into his charts, with a shook of his head the TT announced there is no vacant berth and the whole train is packed. Reddy looked at the TT with a disappointed look and TT looked at Reddy with the same expression, one had lost his seat the other had lost his money.
He decided that he would go the old fashioned way and bribe the TT to get a seat.
Train was on time, Reddy had already checked in the afternoon on his computer. He decided to ask a friend to give him a ride to the railway station.It was evening and road was full of two wheelers competing with each other on their way to home, one beating the other only to get beaten by yet another. Reddy and his friend had left for the station good half an hour in advance although the ride to station was just ten minutes.As they crossed the bridge the old two stroke bike started make funny noises and Reddy knew at once that it ran out of gas, it was not the first time it had happened to him. Behnchod, said Reddy, it has to stop just know, could it wait till had reached the station. Lucky for him the petrol pump was nearby and after a few meters of pulling the bike they reached the filling station and filled the tank to resume their journey to the station. Reddy thanked his friend for the ride and rushed to the ticket counter for the general tickets and took a general ticket till Delhi.
Train was on time, just ten minutes late but on time considering other trains some of which were around ten hours late. Reddy asked the food vendor where the AC coach would halt and stood at the spot which the vendor had told him.
The train arrived whistling and made a halt with a screeching sound of the iron wheels coming to sudden halt with the brakes.
Reddy hopped on to the coach and few seconds later the train started to move. He started looking for a good spot to keep his bag or himself or both. The train was full and he could not find even a single vacant seat. The passenger who were already settled in were giving strand looks to him as if some alien had arrived in their coach. Reddy soon realized that his worst fears might be coming true and he might not get any berth to sleep on in the night.He put down his stuff in corner just outside the entry gate of the AC compartment and stood their. Soon the coach attendant came their and gave Reddy a long curious look as if asking him why he was there and at the same time saying him to pick up his stuff and go to the general coach but the attendant said nothing probably he thought Reddy was some rich guy looking at his well dressed personality, Reddy took advantage of it kept standing there for a while and than found a seat at the attendant's berth.
Next station was a big one and the onboard ticket checking staff was being replaced by the new TT's. Reddy was hopeful of getting a berth so he approached the TT and showed him his general ticket, the TT looked at his face as if gauging him on how much money could he shell out from his potential victim and then looked into his charts, with a shook of his head the TT announced there is no vacant berth and the whole train is packed. Reddy looked at the TT with a disappointed look and TT looked at Reddy with the same expression, one had lost his seat the other had lost his money.
Saturday, November 28, 2009
The Interview
A warm welcome
A hearty smile
The day looked good
As he reached in style
The wishes all over
The firm hand shakes
It is the confidence
Which mars or makes.
The first question
The answer instantneous
With the look in his eyes
He looked spontaneous.
You look organized
Your communication good
The interviewer was happy
And the interviewee so should.
A few minutes wait
The next encounter came by
Conversation was so heartening
That the time flew by
She looked glad
And he was beaming
Through his spectacles
Hope was gleaming.
A hearty smile
The day looked good
As he reached in style
The wishes all over
The firm hand shakes
It is the confidence
Which mars or makes.
The first question
The answer instantneous
With the look in his eyes
He looked spontaneous.
You look organized
Your communication good
The interviewer was happy
And the interviewee so should.
A few minutes wait
The next encounter came by
Conversation was so heartening
That the time flew by
She looked glad
And he was beaming
Through his spectacles
Hope was gleaming.
Wednesday, October 28, 2009
Standing Behind part 2
There he was again in those same green scrubs, with matching blue face mask and head and shoe covers, moving around finding his way to peek on the OR table just to have a glimpse of what was going on. One could almost see the big smile on the other side of the mask, see the gleaming eyes behind his spectacles, everyone could almost feel the energy. He kept struggling just like the surgeon for almost four hours trying to see as much as he can, trying to learn as much as he can.
He looked so happy today. He looked so alive.
He had been denied another interview today.
He looked so happy today. He looked so alive.
He had been denied another interview today.
Standing Behind
There he was in his green scrubs,blue face mask
and a matching head and shoe covers,
standing and staring,
staring at the proceedings in the OR,
careful not to touch any thing, careful not to touch anyone.
You could see through his eyes the terrible feeling,
that feeling which some of us know very well,
that feeling of disgust that only those who know can feel and those of us who have never gone through it can only imagine but would never know how it feels.
How it feels to stand behind?
How it feels to stand behind.
and a matching head and shoe covers,
standing and staring,
staring at the proceedings in the OR,
careful not to touch any thing, careful not to touch anyone.
You could see through his eyes the terrible feeling,
that feeling which some of us know very well,
that feeling of disgust that only those who know can feel and those of us who have never gone through it can only imagine but would never know how it feels.
How it feels to stand behind?
How it feels to stand behind.
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