Sweating A.C.

They have installed new types of air conditioners in our renovated department. There is a central plant from where they circulate very cold water through copper pipes. For smaller places like lecture halls and offices, they have put split A.C. units on the walls, which are said to consume very little electricity. For bigger places like operation theaters and wards, they have installed air handling units. The thing i said to consume less electricity, though I cannot imagine how. If we go by simple physics, the degree of cooling required will consume that much energy no matter what. Perhaps it is new quantum physics that ordinary people do not understand. But the copper tubes sweat. If the air conditioner is put off, water drips from the tubes and collects on whatever is underneath. They told us to keep the air conditioners on permanently to avoid sweating, whether the rooms are occupied or not. It is true that the tubes do not sweat when the machines are on at all times. But the solution seems very costly. The nurse of the ward above the operation theater complains that the floor exudes water and the ward gets flooded. We had to put stones under cupboards and locker units, so that they would not rust. The contractor checked the drainage, which was OK. Now he says it is the sweating of the air conditioner. I wonder why such a thing has to happen only in our hospital and in my ward. The architect seems to be stumped, since no solution is offered by him despite multiple calls. I could always Google this to find a solution, but so can he, and he is unlikely to accept my solution anyway, if his behavior in past is any indicator of his current and future behavior. So all I can do is wait and hope for the best.

Security for Babies

When a baby got stolen from a civic hospital in the city, the matter reached the High Court, which directed the civic body to set up security measures to prevent theft of newborns from the hospitals run by the civic body. One of the measures was to place security officers outside the ward that had the mothers with their newborns. Since the hospital did not have sufficient number of security officers, private security officers were hired for the job. We started seeing them outside the labor ward, postnatal ward and the postoperative ward where the newborn babies were kept. We needed security at all places, but the administration expressed inability to give more security officers. A curious observation was that security officers were placed outside the antenatal ward too, where the babies were inside the women's abdomens. "How do they think anyone can steal the babies inside their mothers' tummies?" one of us asked. "They perhaps know that sometimes women deliver in the antenatal ward itself. They do not want to be pulled up for contempt of court. SO they covered that ward too." I said. "In the antenatal ward?" "Sometimes the patients do not tell the nurse that they have labor pains. Sometimes the nurse does not tell the doctor in time. Sometimes the doctor does not listen or does not make a diagnosis of labor. Sometimes more than one of these factors is operational. Women still deliver in the antenatal ward occasionally." "We must stop that." "Yes, we must. I keep trying. But I cannot control all people at all times. In the meantime, I am not telling administration that there are no newborn babies in this ward, or they might take away those security officers. It is sometimes better to let mistakes remain uncorrected."

Fun Meeting

It is generally agreed that meetings are boring, and usually useless. But if the meetings are involving different people that you usually do not get to see and hear, they could be fun. We had a meeting to finalize details of suture materials to be purchased for hospitals run by the civic body. Heads of various departments and their representatives were present, because the letter of invitation had categorically stated that they better be present. Different suture materials were being discussed one by one. “Let us have uniform standards. Let us write at the beginning of the specification of each suture, whether it is absorbable or nonabsorbable.” I found that funny. “We do not have to say it. It is the property of the suture concerned. When we name a suture, such description becomes superfluous” I said. They argued on it a bit. Finally the chairperson said, “let us state if it is absorbable or nonabsorbable. A lot of people are involved in the process of the purchase, and all of them do not understand these things.” I do not believe in shrugging shoulders, but I did anyway. The chairman was not a surgeon, was not very familiar with suture materials. Then they started discussing ‘polyglecaprone’. It was spelled as ‘polyglocaprone’. “Correct the spelling to ‘poly..’ er ‘polycaprone’ suggested a senior surgeon. “Yes, ‘polycaprone’ it should be” said another surgeon superspecialist. “Excuse me” I said. “I know there is ‘polyglecaprone’. I don’t know anything called ‘polycaprone’. Have you?” I asked a cardiac surgeon. He shrugged his shoulders. It seemed to be a day of shrugging shoulders. Good exercise for the trapezei. I looked at both the ‘polycaprone’ fellows. “Let it be ‘polyglecaprone’ they said one after the other. So it was ‘polyglecaprone’ in the final list. Then they started discussing another suture material, where the specifications described everything but the name of the suture. It just said ‘absorbable’. After great deliberations, it was decided that it should have a name. The proposer of that item was absent. They gave it some name. The next suture was suggested by ophthalmologists. It was to be 0.2 metre 30 cm 3” without any indication as to what these figures were to be. “There is some error here” I said. “0.2 meter is 20 cm. How can it be 20 cm 30 cm?” The proposer was more confused than warranted. Perhaps the work of writing the specification was delegated to someone else. “Remove 0.2 meter” she said. “What is 3”?” someone asked. Everyone seemed to be enjoying the show despite approaching night. “It is the needle size” suggested the ophthalmologist. “A 3 inch needle for an eye surgery” a lot of people roared. “Get the correct specifications and give them to us” she was instructed. Then we reached ‘polydioxanone’, which was spelled as ‘polydiaxanone’. “The ‘a’ has to be replaced by ‘o’ in the name of the suture” I said. ‘polydioxanone’ is fine was said by most others. It being a democratic meeting, ‘polydioxanone’ was accepted. Then they had ‘Mersilk’ on the agenda. “We cannot write ‘Mersilk’. It is a trade name. We have to write generic name, as surgical silk” I said. They agreed to it. “Also write ‘nonabsorbable’ as you had decided awhile ago” I said with a straight face. At this moment the surgeon who had spelled ‘polyglecaprone’ as ‘polycaprone’ suddenly woke up, and said “we cannot write ‘Mersilk’ because it is a trade name. That is the main error.” “I have already said that” I said patiently. “Everyone understands it is nonabsorbable” he said. “That need not be written down.” “I had said that a long time ago. That time you all said it was necessary” I said. “We should write ‘black silk’ instead” he said. I shrugged again. Either he was sleeping periodically, was slow to pick up conversation, or was doing it to get even for having his spelling error pointed out. Perhaps he was irritated because they did not offer tea or coffee. It did not matter which one was the right cause. Wiser course was to ignore aXXholes and move on, so that the meeting would get over and I could reach home by nightfall, about three hours later than usual.

Guyanese Gate in Indian Hospital

My hospital has a large number of entry and exit points. In order to improve attendance by personnel, the administration decided to install biometric attendance system. They installed a number of machines near the entry points, and hooked them up to a central server. Any employee could sign in at any terminal. In order to decide who logged in at which terminal, they labelled these terminals electronically. In order to be scientific, they labelled them based on their locations. The two terminals near the main gate were labelled "Main Gate 1" and "Main Gate 2". They recently installed two near the exit of my department. I logged out yesterday at one of these terminals. Usually I do not check what the LCD window says, other than it allowed me access. But I happened to see that it said the terminal was "Guyanese 2". I was surprised. I went to the other terminal nearby and checked what it was called. It was called "Guyanese 1". I Googled the word "Guyanese" to see if it had any meaning other than what I thought it meant. Wikipedia gave the following meaning of the word: "Guyanese may refer to: Something of, from, or related to the country of Guyana; A person from Guyana, or of Guyanese descent." I wondered what Guyana had to do with a civic hospital in India. I had my suspicions, which were backed by my wife when I narrated this to her. "They probably misspelled 'Gynec' as 'Guyanese'. Such things do happen" she said.

Microphone Troubleshooting

They had given us a lecture theater that we did not use for taking lectures. I had sat there in my undergraduate days as a student. But the computer and audiovisual equipment had been installed much later, and I had not used it before. The computer and the projector worked OK. But the microphone was acting up. It would produce strange grunting noises every now and then, almost at a rate of once for every three words of mine. "Does it do this every time it is used?" I asked the students. "Yes" they said. I continued to teach them, and it continued to trouble me. They did not seem to mind much, probably because the subject matter was equally unwanted for most of them. I was getting disturbed because I preferred to hear only my voice while I taught. I glared at the speaker a couple of times, but that did not improve anything. Then I had an idea. I took out my handkerchief, and wrapped it over the mouthpiece of the microphone. The grunting stopped immediately. I grinned all over my face, and so did the students. "This made my day" I told them.

Practical Gynecology and Obstetrics

I am happy to say that the fifth edition of my book 'Practical Gynecology and Obstetrics' has finally been published. The process had been quite difficult, with the PDF files printing weirdly on different computers, and the printer demanding a single file instead of different files for different chapters, and Pagemaker or Word format, as my files were. Anyway, it is all done, and the result is quite good. I hope the students appreciate the updates.

Soft Granite

I had learned that something very hard was said to be hard as a rock. I had also learned that granite was one of the hardest rocks. So when they fitted granite in door frames and as partitions in the loo, I was pleased. Some pleasures are short lived. When we moved into the repaired hospital building, the pleasures started wearing off, sometimes even before experiencing them. "Sir, the granite put in the frame of the door of the toilet in the office block is broken into pieces. The contractor has put the pieces together with transparent tape." "This I must see" I said. I had known a lot of uses of adhesive tape in the hospital. This seemed to be a new one. I went to see how they had done it. It was done well. You could miss the repair in the darkness of the loo. The repair is still holding three months later. Perhaps it is a new concept in civil engineering. "Sir, the door frame in labor ward recovery room is broken" someone else informed me. I had a look at that one too. There was a 2 feet X half foot piece missing from the door frame. "How did this happen?" I asked the nurse. "It broke when the trolley hit it while shifting a patient." "Get it repaired" I said. "We have not been given full charge of the premises yet." "Yes, Sir." I had to visit the urinal in the college building the other day, when one of the meetings there got unduly prolonged. They had big sheets of granite put between adjacent stalls. One sheet was almost entirely missing. Only an irregular jagged strip was left behind. It had been so six months ago, which soon after they had finished the repair of that building. Perhaps it was meant for better communication between two persons in adjacent stalls, when they had noting to hide from each other.

Medicine in Hills

We have this hospital that has come in seven hills, while I was totally unaware that there were so many hills in the city. In fact I did not know about even one hill in the city. There has been some conflict with the civic administration and the this hospital's management. It had to do with the hospital refusing to give 20% free beds and free medicines to poor patients admitted on those beds. Finally they arranged a meeting with our clinicians to decide which medicines should be given free. Our heads of Medicine, Surgery, and I were called early morning to meet with out counterparts and reach a consensus on the matter. The consultants came 45 minutes late. while our boss and we waited for them. Our morning's work was kept on hold. Someone was carrying out the work, but our input was kept on hold. They finally arrived and the meeting began. The introductions were made. "Where is the obstetrician and gynecologist?" I asked. "They are busy" the youngish looking physician said. Both my Boss and I were stunned. "One gynecologist should have come from your hospital. Our most senior heads of departments are here" the Boss said mildly and smiled. "The duration of my clinical experience and your age in years are about the same. Any way, carry on the work." then he left us. The meeting continued. The visitors wanted to cut down drastically on the list of medicines that the civic hospitals provided to their patients. Our Professor of Surgery refused to cut down anything, because principally it was wrong. The young physicians kept arguing with him, until I finally lost my patience. "Let us put things straight. Today is my post-emergency day. My wards are full of patients, and I have to see them. You said your gynecologists are busy. But this is your work, not mine. They cannot too busy to do their own work, especially when their patients are only a fraction of your occupied beds, which I understand is thirty. In comparison, my ward has at least forty patients under my care, and there are five times as many under care of other gynecologists in my department. I am upset when you claim your gynecologists are too busy to come here. You want us to cut down on the medicines you would give free to the patients, which gets us in trouble if any patient dies in your hospital later for lack of medicines.." The physician got up and left without saying anything. After some time, her colleague got a call, listened, got up and left. Then he came back, declared there was an emergency with the other one, and he had to take her back urgently. "We have all facilities in this hospital" I said. "If there is an emergency, we can get her treated here." I was thinking of the traffic jam they had been telling us about, which had delayed their arrival in the morning. "No, no. I have to take her back" he stammered and left. The meeting could not continue when only one surgeon from their team was left behind. So we left too. I wonder if it was truly a medical emergency that made them go, since she had been looking absolutely a picture of health until she walked out of that room. Perhaps it was a call to her bosses, who advised her to go back abandoning any discussions?

Canting

I have spent thirty six years in my institute. I joined as a student in 1975 and have remained here for all these years. One would expect I would know all places in campus. I thought I did, until I heard someone say, "Let us go to canting". The word 'canting' was uttered as spelled, the rest was said in vernacular. I was surprised. This was a new place. So I turned around to see where they went. The walked into the 'canteen', which was the local equivalent of a cafeteria.. I was surprised briefly. Then it dawned on me that the speaker did not know English, and did not know the word 'canteen'. He had first heard someone say it and heard it as 'canting', and had used it as such since then. Perhaps all his buddies used the same word for that place. I heard a few others say the some word subsequently. Perhaps they were his buddies. I suppose the owner of the canteen does not mind, because they are customers, and they pay for the food and beverages they consume there just like others who call the place 'canteen.' If the color of their money is the same, why criticize someone only because he pronounces the word wrongly? That reminded me of one of our patients. She had had a cesarean section in the past. Then she underwent a vaginal hysterectomy, and some complication when I was on vacation. When I came back, she said, "It is surprising I did not have any complication after a cesarean section and had a complication after a normal one." "What normal one?" I asked. "This operation" she said. "What do you mean by a normal operation? There is no normal operation." "Normal means from below, by vaginal route" she said. So she was using the word 'normal' from the term 'normal delivery' indicating 'vaginal route.' "It is not called normal" I said. "It is a vaginal operation and can have complications just as abdominal operations can have complications." The urge to use a foreign language without knowing it can be misleading, sometimes dangerous.

Canting

I have spent thirty six years in my institute. I joined as a student in 1975 and have remained here