SIXTH SENSE
Prof. Gangadhar Sahoo, Dean
IMS & SUM Hospital & Pro. Vice Chancellor, SOADU,
Bhubaneswar
Prof. Pati and myself were passing through the Casualty of our hospital in the evening. Outdoor had just been closed. It was very rushed. Casualty staff had taken their seats . One medical officer was busy in disposing the left over OPD cases. We were searching for a Paediatric patient, a boy of 10 years referred from our village for convulsion. I enquired the staff sister in charge about that boy. Fortunately that boy was just received in the Casualty. All official procedures were completed. The medical officer had administered all emergency drugs and sent a call to the pediatrician. Since all the beds were full, he was kept in the Casualty OPD in waiting.
It was very noisy. Sound of the trolleys, machines, monitors, movement of ambulances, added with the noise of the old ceiling fans and commanding voice of the hospital staff were capable of bursting the ear drums. In the mean time one bout of convulsion started and continued for a while. The relatives of the patient got panicked, eagerly waiting for the pediatrician to come and praying God for everything. Both of us consoled the worrying relatives and waited for the consultant to know the diagnosis, seriousness of the patient and help my villagers if required, so that they will feel secured and taken care of. In the meantime Dr.Pati told me one of his experiences when he was posted in a District Headquarters Hospital before joining medical college.
It was in 1979, just after PG, Dr. Pati was posted in the district headquarters hospital, Balasore. At that time Balasore hospital was a 30 bedded hospital, with only three to four MBBS doctors. No specialist post in any subject was opened. He was the only doctor with a postgraduate degree. Even if he was the youngest one, all doctors, staff, nursing sisters and non medical employees were paying him utmost respect not only for his degree, knowledge but because of his personality. He was simple, sincere, duty bound, amicable, witty, efficient, friendly, sympathetic and empathetic. In no time he became so popular that he couldn't get time to sleep and eat. Time was running smoothly. A great change had occurred in the hospital, patient care, staff management and administration. All the hospital staff were feeling like family members and the hospital was their family. This news spread like a wild fire. Patients from Balasore, nearby districts and West Bengal poured into the hospital. Within a few months the hospital patient turnover was multiplied to a new height. To the good luck of the hospital a CDMO (Chief District Medical Officer) in the form of Dr . Satpathy was posted. Dr Satpathy was a medicine specialist. He had served as a clinical tutor in the premier medical institute, SCB MEDICAL COLLEGE, CUTTACK, for four to five years. But because of personality clash with other colleagues he left medical college and joined as a medicine specialist in periphery cader. After being promoted to the post of CDMO, he joined at Balasore District Headquarters Hospital. He was staying in his official residence inside the campus. He was staying alone as his two children were studying in Board of secondary school, Cuttack. His wife was taking care of the children and old parents. He was very friendly with all his staff. Daily at 7pm he called a meeting. All staff including the matron had to attend the meeting. Review of day's work was done. Problematic cases were discussed. Opinion of the matron and treating physician was sought. If the patient needed any change in treatment, any help or referrals were decided. Meeting was being held in a very cordial and familiar manner. Meeting used to last for about an hour followed by a cup of tea and traditional snacks. Then the team went for hospital round. Evening round ended by 9 pm . Dr Satpathy bid farewell to everyone with the final words, " I am 24×7 available. Don't hesitate to disturb me at any time for any emergency consultation. It will be my pleasure to help a patient to get the best possible advice and treatment." This was indeed true leadership. This is how leaders lead by example. According to Dr . Pati he had learned many things from Dr. Satpathy, specially the clinical tricks. It was original, was Dr Satpathy 's trade secret, not found written anywhere.
One interesting incidence was cited by Dr. Pati . He was on night emergency duty in the 1st week of January. At that time a cold wave had engulfed whole of the northern Odisha and parts of West Bengal. At about mid night Dr Pati got an emergency call from the infectious ward . The call was about a tetanus patient. A boy of 12 years old with tetanus was admitted in the morning. He was examined and advised by the CDMO himself. Since Paediatric specialists were rare species at that time the CDMO was looking after those cases. Anti convulsant injection was given eight hourly. Injection morphine was kept as reserve, to be given when required. Dr. Pati with one hospital attendant reached the infectious ward , situated in an isolated place, about half a kilometer from the main ward . Dr. Pati with full winter dress , double sweater, monkey cap, woolen gloves and socks was still shivering. The old attendant wrapped by a rug holding a five shelled torch in one hand and a baton in the other, stamping it on the concrete road accompanied Dr. Pati to the infectious ward. The ward was almost dark barring two lanterns and two local made lamps by the only two patients in the ward, one a tetanus patient and the other one was a diarrhea patient. The tetanus patient was convulsing even after receiving adequate doses of medicine at 10 pm . His relatives being helpless had tied him to the bed with a rope. They were crying and praying. Both of them on seeing the doctor thought that their savior had come and knelt down, touched his feet and said, "Prabhu (O God!), save our child." Their eyes were reflecting their emotions, hopes and apprehensions. The sister was standing by the side as a helpless spectator with an expectant look if anything could be done. Dr. Pati was thinking what might the cause and how to handle the situation. In the depth of deadly silence a violent storm was blowing in his mind. A loud chorus with orchestra of traditional musical instruments was tearing the silence and deafening everybody in the ward. For last one hour it was continuing nonstop. Dr. Pati thought that at the dead of the night, when mother earth is in deep slumber and shivering in this biting cold, it was very unusual to hear this thunderous spiritual orchestra. Probably a group of insane people submerged in spiritual intoxication were enjoying. He asked to the staff sister to know the fact because according to him that noise might be the exciting factor for the prolonged and continuous convulsion. The staff replied, “Sir! They are a group of employees of our hospital. After receiving the salary they arrange a spiritual get together in the near by cycle stand. It is a routine for them on 1st Monday of every month. They perform a MELA (Pooja or worship) in the name of Lord Shiva. Everybody gets intoxicated after taking cannabis in drinks or in smoking. They don't create nuisance. After the Pooja they silently disperse. Today is their day.”
Dr. Pati was clueless. He sent the staff sister with other night duty staff to pacify them but in vain. He himself went there. Seeing Dr. Pati they got more jubilant and exited. Thinking that doctor had come as the ambassador of Lord Shiva. Someone offered him a chair and a glass of Lassi. Dr. Pati could smell the situation. His prolonged stay and conversation with the intoxicated devotees might aggravate the issue as they were not in a mood to listen to anybody. So he tactfully left the place and came back to the ward. He asked for the call book, put down a note of the situation and sent the call book to the CDMO, requesting him to intervene. The CDMO left a note, "Manage Tactfully” and returned back the call book. Dr Pati was hoping for help from his boss, but it created more problem for him. What to do? The time was 1 a.m. The party was continuing with more intensity, so also the convulsion, as if both were competing with each other. What to speak of the pathetic condition of the victim's parents! Their tears had dried up, body become motionless and voice speechless. Dr. Pati had lost all his patience. He asked for the police information form , filled it up and sent to the CDMO for signature.
After getting the police information from the CDMO thought the situation most probably was going beyond control. Immediately he dressed up and reached the ward of the turmoil. All present there were surprised to see him. The CDMO called Dr. Pati and asked him to imagine the situation if he would have signed the form and sent to the police station.
The police van could have reached, stopped the MELA (PUJA) and arrested a few members. Next day it could have fuelled an issue, employees on strike gheraoed the CDMO, rallies and sloganeering against the authority, so on and so forth. The situation might have gone beyond control. The CDMO told Dr. Pati, “I had suggested you manage tactfully by applying your common sense and intelligence, not by informing the police and manufacturing a greater problem." Saying this he asked the staff sister to give a cotton swab. Then silently went to the bed side, calmly put tight cotton packs into the ears of the convulsing boy and came back to the ward. After ten minutes he ordered the staff sister to see the condition of the boy and report. Then he left the ward. He never received any complaint thereafter.
Just when Prof. Pati concluded the story, the paediatrician had finished examining the child in casualty. He assured us nothing to be worried. The boy was to be shifted to a cabin as the noisy atmosphere in the OPD was the aggravating factor for repeated convulsion……..
The lesson learnt from the story is that a cotton swab could save the situation because of the sixth sense of the CDMO Prof. Satapathy.
NB: The story was written on the occasion of superannuation of Prof. Bibhutendu Pati, Prof. & HOD Transfusion Medicine, IMS & SUM Hospital, Bhubaneswar.
Prof Gangadhar Sahoo is a well-known Gynaecologist. He is a columnist and an astute Academician. He was the Professor and HOD of O&G Department of VSS MEDICAL COLLEGE, Burla.He is at present occupying the prestigious post of DEAN, IMS & SUM HOSPITAL, BHUBANESWAR and the National Vice President of ISOPARB (INDIAN SOCIETY OF PERINATOLOGY AND REPRODUCTIVE BIOLOGY). He has been awarded the BEST TEACHER AWARD of VSS MEDICAL COLLEGE,BURLA in 2013. He has contributed CHAPTERS in 13 books and more than 100 Scientific Articles in State, National and International Journals of high repute. He is a National Faculty in National Level and delivered more than 200 Lectures in Scientific Conventions.He was adjudged the BEST NATIONAL SPEAKER in ISOPARB NATIONAL CONVENTION in 2016.
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