Price Of A Drop Of Your Blood!

Ever thought how much money your blood is worth? No? Read On!!

 

Organ donation statistics for UK can be seen here.

Statistics say the rate of organ donation in USA is 25 per million and Hong Kong is 5 per million.

Don’t even  bother knowing about the organ donation stats of India.

• Because a Google search would show you that the official records simply don’t exist (Correct me if I’m wrong)
• Surveys by Reader’s Digest says the rate of organ donation is as low as 0.05 people per million.
• And the following quote from Wikipedia suggests that even the organ donation among the 0.05/Million population is not really due to humanitarian reasons.

“Financial exploitation suggests that the donor (especially in the Indian subcontinent and Africa) are not paid enough. Commonly, accounts from persons who have sold organs in both legal and black market circumstances put the prices at between $150 and $5,000, depending on the local laws, supply of ready donors and scope of the transplant operation. In Chennai, India where one of the largest black markets for organs is known to exist, studies have placed the average sale price at little over $1,000.”

And in case u think 5000 $ is not much, be advised that Wiki says 87.5 % of our population was living with less that 2.50 $ per day.

• I say don’t bother about organ donation because Indians don’t even care about Donating Blood.. Here is my story which happened two days ago!

                                     

We had an admission on Saturday. The patient was extremely anemic and his Hemoglobin was around 6 gm% which is half of the desired 14-18 gm%. And he had a few other complications too (Cirrhotic Liver etc). We informed the relatives that he must be transfused at least a unit of blood as early as possible, and since our blood bank had run out of B+ ve group blood (thanks to lack of donors?) and since the local social worker could not find any members of the bank who could donate blood at that time, we asked if the relatives would be willing to donate. One wouldn’t probably think they wouldn’t refuse, but this is exactly what happened!

Doc: The blood bank is out of stock! Can anyone of you donate blood?

Wife: No No Sir! I cant. I’m already weak and i have lots of work to do in home daily.

Relative 1: No way! I have to go to work daily and I’m already lean

Even after explaining to them that blood donation is an extremely safe procedure and  donating 350 ml out of the 5000 ml of blood in our body would not cause any problems for the donor, they just simply refused to donate. They found some person who donates blood for money and he charged them an exorbitant amount for donating blood (nearly the patient’s one month salary, which the relatives were willing to pay readily). Only while screening the blood we found it was HIV + and unsuitable for transfusion.

They had no money to pay for another so called ‘paid donors’. And the patient was still sick. When we pressed the relatives to donate blood, they demanded discharge and took the patient away.

I hope the poor guy lives!

And i do not know with whom the problem resides?

• Is it with the relatives who care so much about themselves that they refuse to donate blood for their close ones?
• Is it with the government which has failed to educate the masses about the need for blood/organ donation?
• Is it with the so called ‘paid donors’ who charge money for donating even blood???
• Is it with the Donor i mentioned above, Who probably donated blood knowing that he had HIV, just for the sake of getting money?

I would say it all comes to the extreme poverty that envelopes our nation, which makes children illiterate by making them going to factories instead of schools,makes people senseless enough to donate blood/organs for money.

It’s when incidents like this and this and this happen, I’m ashamed to say I’m an Indian.

 

A Week Without Work

When i joined internship, my dad said that my real learning has begun.

And i learnt another important lesson during the past one week  “ A life without work sucks”.

Since we had a festival during my last duty day – Wednesday the 14th of Jan, we had no admissions. And i was looking forward to spend one week with nothing to do. But it turned out to be the most boring week of my internship.

It’s just that I’ve been soo used goto the wards by 8am and see the patients and do my paperwork by 9.30 and get ready for Rounds with chief, and after the rounds, do the necessary changes in the treatment as he ordered, Order/Collect Investigations. Counsel patients and their relatives etc etc that it felt totally weird for me to spend a whole week without any work and going to the hospital just to sign my attendance :’( And am already looking forward to my duty day tomorrow

I guess i love my work as much as i love to make a fuss about it…

Am still learning…….

Raghav

My blog has NOT moved

I’ve got two things to say.

1) The domain raghavendrakannan.in has been registered. Actually i thought of doing it a long time ago, and now it’s done.

2) So am moving this blog to www.raghavendrakannan.in hosted on Nxserve.net’s free hosting platform. Might move it to a paid host later on ;)

So you can visit my blog by clicking www.raghavendrakannan.in or http://raghavendra.nxserve.net

Looking forward to see u there

Raghav
20/1/09

Oh i decided not to move after all!

Though it was cool to have a blog under my own domain, changing themes and stuff, and having to take backups were pain in the ***

So am back to the comfort of www.wordpress.com :P

Are we doctors really self centered???

One of my friends commented that doctors are so self-centered!!

It was because i was complaining to him on phone about having to work on holidays / Sundays / Night shifts etc etc. He asked me to take a list of people who work similarly and compare my job to them, and then decide whether i should complain or not?

So here’s my list:

1. Army /Navy / Air force etc etc.. The defenses of our country.. (Though sometimes i wonder if they are on leave, considering the increasing frequency of bomb blasts in India, Whatever……)

2. The Cops

3. People involved in Transport Industry: Drivers, Conductors, Pilots etc (we’ll be dead ducks if they sleep on duty!)

4. Watchmen (Though i find most of them sleeping on duty!)

5. Scientists ???? They are too geeky to take a holiday? Probably?

6. Paramedical / Hospital support staff

7. Call centre employees

8. People involved in News/Television Industry… Maybe the On field reporters & cameramen, News Compilers?

9. Politicians (Though the general consensus is that they don’t work, i believe that they are always thinking about what to do when they don’t work, and that qualifies as working, at least for them :P Our country is kinda doing fine without them working anyway, so no worries)

10. Newspapers… Guess lots of guys work at night printing stuff and all during the days and weekends

 

Okay! Seems the list will go on and on and i guess we – the doctors are not alone & probably 1/3 of the working people in the world have crappy working hours as ours. And probably our job is better than some of the jobs listed above, cos at least we have the nurses with us, the occasionally hot patient, or the hot ‘someone’ from the family of the patient :D ( Gosh i broke like 3-4 medical ethics there) :P

Then why do we complain so often??

Guess most of us are probably Self-Centered..

And probably I’m the first Doctor to accept it ;)

Would you smile, when you know the end is near?

Would You Smile, when you know that the end is near? I probably wouldn’t. Before two days, i would’ve laughed if someone had said they would. Because i thought it happens only in the movies; i thought so until i met Mani.

You probably wouldn’t want to meet Mani. I wouldn’t have given him a second look if i saw him on the streets. He was tall, young, unclean (no offense!) and had a slothful aura around him. He had lost his father at an young age, lived with his mother alone, had no education and made a living by doing odd jobs. He was admitted in our hospital (on a charity basis) for complaints of fever on and off for one or two months.

I first met him when i sat beside him to take his history, on his day of admission.

“Your name is Mani?”

*He laughs*

“Excuse Me?”

“See Doc! My name is Mani but i have no Mani (Money), Ironic huh?”

I thought “A funny patient? Not bad! He’s not as bad as i expected!” So the routine of history taking dragged on. He had complaints of Fever on and off for two months fro which he took self medication with Paracetamol (The most common Anti-Pyretic, probably). And for the past one month, he had complaints of weight loss and lethargy. He had no idea if he had any swellings in the body or not, and there were no other relevant complaints/history.

On examination, he was pale and and his neck had swollen lymph nodes bilaterally, bilateral swollen axillary nodes, and spleenomegaly. So i ordered a busload of investigations, and decided to schedule a Neck node biopsy after consulting with chief @ the rounds the following morning.

His blood investigations were absolutely normal, with exception of moderate ~ severe anemia. I asked whether to send him for a Neck node biopsy, chief asked me to send for Bone Marrow Aspiration and Trephine.

The results came few days later. We had hit the bull’s eye.

An Histopathological Image linked from www.pathguy.com, showing a typical feature of Burkitt’s Lymphoma – A Starry Sky Appearance.

Mani had a type of Non Hodgkin’s Lymphoma – Tumor of the Lymphoid tissue – and most probably it was Burkitt’s Lymphoma.

Without boring u with the details I’ll say that Burkitt’s Lymphoma is one of the aggressively growing tumours in the whole body, and greater the staging of the disease, poorer the prognosis. Though early cases combined with effective chemotherapy is said to completely cure > 80 % of cases, Mani Had involvement of spleen probably, Neck and Axillary Nodes and Bone Marrow Involvement which pulls him down to Stage 4, the last stage. That leaves him with about a 25 – 40% of chance for Surviving up to 5 years, if he takes regular treatment.

And he would have to undergo a battery of tests like these to rule out involvement of other organs, and must have a rigorous Chemotherapy.

The problem: He couldn’t afford either of them.

We had to break down the news to him and his mother. While we expected him to break down, it was his mother who broke down and fainted. Mani, on the other hand, was as calm as ever. When i said “I’m Sorry” he just smiled and said “It’s okay doc. I always knew i had something really bad, like cancer”. Seeing my puzzled expression, he added “You know! Only good things happen to good people and the opposite is also true”. And he shifted his eyes to the magazine in his hands.

We had to refer him to the Government’s Cancer Specialty Hospital which was a bit far away. They give subsided treatment for poor, but there is always a long queue waiting for those, so i wonder if he would get his’ in time. I wonder if he could afford the minimal charges they levy there. I wonder if he would have had a better chances of survival, if he had come straight for a complete check-up without taking self medication with over the counter drugs? I wonder what the 19 year old boy did, that came to haunt him back and made him think that he deserved to die of cancer!

I probably would never know answers to all those questions!

But i wish Mani all the luck in the world! Hope he makes it ;)

Raghav.

Two deaths, a Cake and a Coke – My New Year Eve

 

So this is how exactly my new year eve went….. The Orange Quotes are my thoughts

6.30 am: Got up wondering if i should bunk work and ask others to cover for me and escape somewhere “God Please”

8.30 am: Finding out that two of the three residents were unavailable, and a single resident and four interns including me were firmly stuck till tomorrow morning.

9.30 am: Call from casualty. “Doc, think we have a cardiac failure” “Okay shift him to Cardiac Care Unit Pronto! We’ll be there” “Come on! Not so early in the morning”… Off we go running from the OPD to the CCU which was like at the other side of the hospital.. The Pt had just entered and the CCU resident was attending him.. The Cardio monitor showed he was in Ventricular Tachycardia and before we could give him DC cardio version we got a flat line. Successive attempts at cardio version failed and he was gone. “Wow! One gone in the morning! This is gonna be a great day”

9.50 am: We come back to the OPD again, promising to return to fill up the case sheets of the dead patient as soon as OPD ends.

12.00 pm: OPD ends and we go to casualty to attend emergency medical cases, as they arrive.

1.30 pm: “Dude! It’s New year Eve. Why don’t’ we order some good food”     “Yeah! Why not?”  So the five of us ordered a feast and had lunch together and went off to sleep.

4.00 pm:  Got a call for few respiratory distress cases. “Thank god nothing’s severe” “Staffie! Send him off to ward 7”

5.30 pm: “Dude! why don’t we celebrate NY here”  “What exactly is ur plan”  “Crackers and cakes?”  “Add coke too ”

Off two go to order the cakes and get the crackers. We while away time helping the casualty intern to dispense trivial cases.

6.30 pm: Resident asks to come with him to Ward Rounds. “Nah am too tired! Take Vicky with u” Off they go..

6.45 pm: “Where is this hot nursing intern i saw today noon? ”

7.00 pm: The two who went shopping came back. “Man we got our dinner parcels too”  “Ur awesome! We’ll have dinner as soon resident & vicky comes ”

7.30 pm: Ambulance Siren…. “Doc! An 19 yr old case of RHD with MS with MR with Hypertension with C/O breathlessness” “Geez all that! Wheel her in” Patient was Cyanosed and on Auscultation had Bilateral Crepitations. “Great! Does She have Pulmonary Odema too”  Oops Swollen Legs “Dammit a failure?????” 

“Somebody intubate and start ambu and shift her to CCU”

“Staffie! Inform resident to come to CCU”

“Salya! U stay here.. We are going to CCU”      “Thank god, The casualty is near CCU”

8.30 pm: Another Dead patient.. “Gosh we’ve lost two already! How worse is the night gonna be?” The walk from CCU to casualty seemed to take a long time.

8.45 pm: Resident says “We did whatever we could have, guys! Cheer up”  “Yeah right”

9.00 pm: “Hey where’s the dinner?”

9.15 pm: “Hey where’s the dinner?” 

Staffie: oh it’s too cold now… Shall i get someone to reheat it?

Resident: Never mind! I’ll take u out for dinner!  “U mean ur gonna pay the bills too??? woooooot”

So we all go for Dinner and come back by 10.00 pm. We leave Salya back to tend any emergencies as they come, and we get her a parcel instead. “Is this gonna be enough for u, Sally?? ”

10.00 pm: A old guy comes with body pain. Apparently he came with same complaints yesterday and also the day before. “Come on Man! This is a casualty for emergencies” “And it’s new year Eve ”

10.30 pm: Eyes Drooping. “Where is my Ipod?”

11.00 pm: “Dude wake up!”  “Wow i already slept off? What Da?” “Nothing!” “Godddd  ”

11.30 pm: Okay lets push off and have fun with crackers. So we drive for few km and come to a lone spot and set off the crackers.

11.50 pm: “Guys! lets go or else we’ll miss the cake”

11.58 pm: Reached casualty. “Thank god! I wont miss the butterscotch cake ”

00.00 am: Happy New Year Everyone. We gobble up the cake and drink coke. Wish everyone a new year and it’s 1.00 am

1.45 am: “Staffie! Gonna Sleep”

4.00 am: Knock Knock! Huh? “Doc! We Have an Accident” “Vickyyyyyyyy ”

6.30 am: “Dude! wake up! Happy New Year Again”

I went to room for a quick bath, came back by 7.45 am and made the grand rounds with professors and came back again by 12.00 noon and then zzzzzzzzzzzzzzzz

 

Guess Celebrating New Year @ Duty was not as bad as i expected :P, except for the 2 deaths.

2009 would be better! i hope ;)

Raghav :)

Second Thoughts….

 

Am i really doing what i wanted to do?     Was i really supposed to be a doctor?

These were the thoughts that entered my mind after read this post from this wonderful site called Lifereboot. Surprisingly the same thought has been going thru my mind for like the past 4 months. It’s funny because, being surrounded by doctors all around since childhood (Dad, Mom, uncle etc) all i wanted was to be a doctor. And i suck at Math anyway, so i couldn’t have been a Engineer, CA etc etc . And i guess i was to honest to be a lawyer So i was happy to get into medicine and remained happy till my under graduation.. All these changed when i entered my internship.

A month into my internship i discovered how different studying medicine and practicing medicine is. (at least here in India!). Just when i thought i can close my books for a brief period of one year, i discovered i had to learn even more to grasp the practical aspects. Although it was enjoyable, it was probably not what i expected. The practice of medicine – as of now – has been totally commercialized and businesslike. I wonder if i spend more time doing paperwork rather than seeing patients, just to save myself in case someone decides to sue me.

This was not the case ten years ago. This was not the case when my dreams of becoming a doctor sprouted. In my opinion, there is no honor in Medicine now. It’s just a business where doctors treat patients as cases and send them hefty bills, and a bullfight where the patient sues the doctor for no mistake of his. I know this doesn’t represent each and every doctor/patient, but this is the broad picture as of now. I wonder where it all begun to go wrong?

Only two days ago i happened to see this nice movie: Just like Heaven. Reese Witherspoon is a doctor in that movie and this is a convo form that movie.

“Reese Witherspoon:      But what was I doing
                                    with the rest of my time?

                                    When I think about my life and I…
                                    All I can remember is working.

                                    You know? Working and working
                                    and trying so hard.

                                    And for what?

Mark Buffalo:                You help people.
                                    You save lives.

Reese Witherspoon:      Yeah. Including my own.

                                    I saved my life, for later.
                                    I just…

                                    I never thought
                                    there wouldn’t be a later.”

Those lines touched my heart. It’s just that we loose so much of our lives, just to help others, and most often it goes unappreciated. (I’m working on 24 hrs duty on the new year eve, while the rest of the world is partying and it sucks! It really does ) I know Medicine Pays, and it pays well, but of late i find myself questioning whether is it worth the trouble?

I know i sound like i hate to be a doctor, but i really don’t. I guess each and every job has it’s own pitfalls and difficulties. My friends think I’m so lucky to be a doctor and i think that he is lucky to have a fixed hours job. Probably i would be whining like this, whatever job i got into . Guess the grass is always greener on the other side.

And as luck would have it, the only field that interests me is surgery and it’s hectic as hell.. I hope to get a residency in surgery, when i finish my internship few months from now.

Cheers for > tension and < life  

I guess I’m not ready for a re-boot yet, but I’m sure i will whenever begin to hate medicine.

Raghav.

 

P.S: What about You?  Are you satisfied with your job? Have u ever had second thoughts about what you are doing/planning to do?  Share :)

The Beginning!

So here it is!!!

My blog number three in one year. A lot has occurred in the eight month interval between my second blog and this, and am a lot more wiser now than i was eight months ago (i hope!). While my older blogs were immature and childish (and hence deleted), i hope this one would prove to be a better experience for me and also to the visitors.

Lets see how this turns out! and Welcome :)

Cheers,

Raghav.

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