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Showing posts from February, 2020

Birthday Miracle

Birthday Miracle  Vijay Gopichandran Disclaimer: This blog is a deviation from what I usually write. This is an attempt at a fictional short story. “Sister, where is the gauze bin?” yelled Arumugam from the bedside. He was precariously standing with his hands in sterile gloves held up so that it doesn’t soil his 2000 rupees Arrow shirt. He was wearing a flimsy face mask, which did very little to shield the foul smell emanating from the foot ulcer that he was dressing that morning. Fine drops of sweat were oozing down from his forehead which now had wrinkled up with anger lines. He was irritated to note that he had meticulously packed everything required for this elaborate foot dressing, except extra gauze pieces. “These young house-surgeons are so inefficient. They don’t even know how to prepare for a dressing. In our times…..” started Kamala sister as she indignantly walked with a gauze bin towards Arumugam. “Doctor, you have been in this ward for more than 2 mo

Need for a paradigm shift in the treatment of diabetes

Need for a paradigm shift in the treatment of diabetes Vijay Gopichandran On 09 February 2020, we conducted an annual diabetic complications screening camp for patients with diabetes in the villages where we work. The findings of the camp, as usual, took me into a very introspective space. I was largely disheartened to see the poor blood sugar controls among most of the patients. Out of the 80+ patients that we saw on that day, only 10 had good sugar controls. I thought, “let me console myself looking at these 10 people” only to find out to my absolute dismay, that a few of them were not even patients with diabetes. They had been included in the screening by mistake! All of these patients are under treatment either with us at our clinic or with the public health system. They are under regular treatment. The camp day was spent reviewing their reports, making changes to their drugs, counseling them on what to eat, what to avoid, how to exercise, and referring them to higher spe

Helping them accept their diagnosis

Helping them accept their diagnosis Vijay Gopichandran Good evening! Today was a very long day at the clinic. We had an annual diabetes screening camp. This is a routine annual ritual that we perform year after year, in which we collaborate with a local organization who funds us, to organize a camp for screening our routine patients for complications. If we find any complications or early indications of them, we initiate appropriate preventive strategies. Often these camps are very disheartening to us from a clinical point of view because we unravel very serious problems that our patients develop silently. Many of our patients who have a well-controlled blood sugar level in a routine fasting and post-meal blood glucose test, show up as having abnormally poor sugar control over the past 3 months on the glycosylated hemoglobin test. This often slaps us hard on the face and wakes us up to the realities of practicing diabetes care in a setting with limited resources. On one hand, we h

Trust is a privilege

Trust is a privilege Vijay Gopichandran Yesterday a first-year medical student accompanied me to the clinic. This student is a very intense thinker and has ideas that are sometimes very radical, rebellious and sometimes outright revolutionary! He once told me that human beings are unable to fly because we don’t think we can. If all of us sat together and decided that we can fly, then we can. He gave a very elaborate and convoluted explanation for this idea, which I still haven’t understood. I have found his questions and interventions in the classroom to be intriguing. When he asked me on Saturday whether he could accompany me, I had no hesitation in inviting him. The three hours of the train journey and the opportunities for conversation would help me understand him and his thinking. There were many things that we spoke through the day and they were all interesting conversations. But one discussion that we had towards the end of the day, was the one about which I am goi