Friday, December 24, 2010

Life After KE
Nauman Mufti


After I passed my finals, the paid house jobs I could get were Cardiac Surgery and Chest Diseases. Cardiac Surgery was also called Thundi Ward because it was entirely air-conditioned. Summer was upon us and I loved being in an air-conditioned ward. While on call one weekend, I heard a lot of commotion. Loud noises were coming from the lower entrance next to Cardiology Ward. I went down-stairs. The gatekeeper at the entrance came rushing to me. He said Doctor Sahib there is a strange guy on a bicycle who wants to enter the hospital. He claims the he is a Professor. He pointed towards the person who was wearing a tracksuit and sweating from head to toe. I looked at the person and turning to the gatekeeper, I said, please let him in. He is indeed our Professor of Surgery, Col. Cheema.
The other surgeon we had was Dr. Jawaad Ahmad. He was the nephew of Ashfaq Ahmed, my most favorite author, intellectual and human being of the highest order. After a successful surgery, Dr. Jawaad would treat all house officers with delicious home cooked feast. However, during surgery he was the most fearsome of any surgeons, I encountered. He would throw instruments and his shouting curse words, though not directed at me, made my hands tremble. I remember after my first thoracotomy, which went flawlessly, he said to me Nauman, you should think seriously about becoming a cardiac surgeon. What he did not know was that when I had picked up the saw for thoracotomy, I had prayed to Allah, O Allah please do not let me harm this patient and I promise you I will never pick up the saw again. Allah helped through the surgery and I kept my promise.
After my paid house jobs, I wanted to do a house job in a Medical Ward. I vividly remember that one professor took his pen out to grant me the permission to do an honorary house job. He casually asked me so when are you going to take your PLAB. I said, never. I am going to USA. He put the pen back on his lab coat, without signing my application. This was the first symptom of the foot-in-mouth disease I suffer from. I have the knack of saying the first thing that comes in my mind, without assessing the consequences.
After my house job, I applied for many jobs within Lahore but had no luck. I finally found a job in Chak 25 GB (Guddu Barrage), a village near Okara. It was a Basic Health Unit (BHU). There was a residence for the Medical officer. I would have loved to live there and serve the village people however, there was a problem. The village people were using it to house their buffalos. Moreover, I was told that the electricity was disconnected because local people were stealing it to light their houses. I could get it connected without much trouble, provided I paid the outstanding bill. It was Rs 20,000. Being that my ‘salary’ was Rs. 2,000; my first 10 months salary would go towards paying the bill. In addition, they were not willing to accept installments. I was keen on doing the job so I decided to commute from my Temple Road residence. I would get my bus from Mozang Chungi at 6 AM to Okara. From Okara, I took another bus to reach Chuk 25. This bus was always crowded, packed with villagers and their animals. I reached the BHU by Noon after 6 hours. There were 20-30 patients politely waiting for me. I would then see patients, some of whom had never seen a physician. They were indeed very grateful. At 3 PM, it was time to head home for the 6 hr trip back home. After couple of weeks, my parents, who had by then moved to Lahore from Karachi, grew worried. One day I asked my Dispenser, if it was okay if I skipped a day every once in a while. Surprisingly, he was very pleased. Then he told me that that the doctor before me, never bothered to come at all and he (the dispenser) ran the BHU. He told me that I could do the same. I could not do that. Finally, we decided that I would come every other day. I felt very guilty, but 14 hr days were beginning to take their toll and my salary was barely covering the bus fare.
Luckily, after only 3 months at Chuk 25, I found what I thought was a better job in Shamke Bhattian only 40 km south of Lahore. What happened there is a story for another day.

Tuesday, December 21, 2010

The Way We Are.
By Mohammad Yahya

The two most abundant elements in the universe are Nitrogen (N) and Stupidity (suggest a symbol) and my clinic is no exception to it. I do not know whether it is stupidity or mere innocence on the part of my patients, but it does amuse me every now and again. As it provides happiness to me, I would rather call it innocence (although I know it is not). And I always make a positive effort to encourage my patients to keep contributing to this foolishness -- I mean innocence.

Once a patient called me at around 11 p.m. I was just about to go to sleep. Thank God had not already gone to sleep and woken up by this "important" query by the patient. He said, "I am Mr. Such and Such, you operated on me about 20 days ago." I recalled and said, "Yes, how can I help." He says, "You asked me to take a shower after ten days. I did take that shower" and he paused. Now I was getting worried about him. My sleepy head was turning brighter to be able to evaluate his problem. I wondered if he was all right. Was it that he had slipped in the shower? Had he caught cold? How the hell he could damage all the Coronary Arteries I had grafted by simply taking a shower? Had he dissected his aorta? A number of possibilities flashed across my mind. Worriedly I asked him, "Are you alright? Is there anyone around you to help?" He innocently said, "Everything is fine. I took shower ten days after the operation as you advised. Now I was just wondering when it is OK for me to take shower next time."

Another patient phoned to see me regarding itch in his foot three years after I had replaced his Mitral Valve. I asked him to come to the clinic at 5 o'clock the following day. He says, "What? 5 in the morning?" Anyhow, he came at 5 p.m. the next day.
I greeted him, "Aao ji kis tarah tashreef lay aae o."
"Rikshay te baith ke." he replied innocently.

A patient's wife asked me on fifth post op day, pointing towards the patient, "Can he sleep on his side?"
"Of Course, he can." I replied proudly as if it was a great honour for me to allow him.
The patient smilingly said, "Yes, he (me) is right. I slept on my side last night and nothing went wrong."

A diabetic patient's wife reported to me on the ward round that her husband went hypoglycaemic at 4 a.m. She told me that she gave him a glass of juice and the things were back to normal in no time. I praised her much, "You did the right thing. Even if we were here, we wouldn't have done any differently."
She proudly smiled and said, “Yes Doctor Sahib, with his longstanding diabetes, I know much about this disease. That's why I made sure to give him 'Diabetic Juice'."
What a great way to relieve hypoglycaemia I wondered.

Love to all,
Yahya

Thursday, December 16, 2010

The Way We Were

By Nauman Mufti

We were in final year now. The emphasis had shifted completely to clinical medicine. In Medical and surgical wards we were now taught by the professors themselves. Majority of our teachers were excellent and loved to teach. Some were friendly while others had an intimidating aura about them. During ward rounds, they travelled in an entourage of Registrars, house physicians and medical students. Although terrifying and humiliating at times our clinical education was top notch.

Most of our clinical rotations were at Mayo Hospital. The only exception was that Ob-Gyn rotation which was at Lady Wellington Hospital. For our group, it was the last clinical rotation. To our surprise, our group comprised of both boys and girls. Kamran Hameed, Javed Ajmal, Imran Nazeer, Nasir Javed and others were there along with Zahra Haider, Naghmi Shirin, Mehr-un-Nisa, Raheela Ajmal, Rubina Aslam and others.
I remember that towards the end of our rotation we decided to go to Lahore Fort (Shahi Qila) as a group. We arranged with the bus drivers to take us there. To our dismay, when the day of the trip came there were no sign of any buses. Desperately, I tried to convince Imran Nazeer (the only one in our group who came to college in a car) to make a couple of trips to transport the girls there, but he refused saying that he was not allowed to have any girls in the car. I offered to drive the car but we could not convince him. In the end, all of us walked all the way to Lahore Fort. It was not a bad walk for us boys, however I felt bad for the girls, some of whom were wearing high heels. We were a bit tired by the time we reached the entrance of the majestic fort. We found a good spot close to the entrance and sat down for our picnic. No longer had we sat down when we saw four of our class fellows from another group appear from nowhere. They hovered a few yards away. Was it a coincidence? I know not. After the snacks, we told a few jokes and saw the splendor of Shish Mahal. Then we walked all the way back to KE. Soon after that we were studying for our final professionals.

We started our life at KE, 32 yrs ago, unsure of what lay ahead. We were rowdy during some lectures. However, we hung on every word when the lectures were good or we were intimidated into submission. We studied hard at times while at other times we goofed off. We shared smiles, laughter and sorrows together. Along the way, we made friends. We had class trips where we danced sloppily to English songs and stole pastries from girls. We had small group parties where we celebrated our successes. We shed tears on our failure to pass a sub-substage. We flew kites on Basant together. We lived in hostels, homes and empty places. Just for fun, some of us crashed wedding parties, stole petrol and rashly drove our motor bikes.

We pulled pranks on girls and wrote poems about them. While girls gossiped about boys and gave them funny nicknames. However, it was a taboo then and perhaps even now to admit that some of us fell in love. Mostly the old-fashioned Mir and Momin kind of ‘Ishq’ where the Aashiq could not gather the courage to express his feelings to the girl he loved and chose the cowardly way to suffer silently. I do not know, but maybe the girl in question never had a clue of what was going on. The vice versa could have been true also but again, I have no way of knowing.

Now, after twenty-six years, some of us are professors in academic institutions while others are renowned surgeons, and physicians. A few left medicine to pursue other careers. We are all spread out in Pakistan, Saudi Arabia, Malaysia, United Kingdom, Canada, United States and perhaps elsewhere too. Regardless of where we are today and what we do, we all remember the times we spend together at King Edward Medical College in the heart of Lahore, Pakistan. We are all bound together by our memories. Yes, the memories of the way we were.

Memories
Light the corners of my mind
Misty watercolor memories
Of the way we were
Scattered pictures
Of the smiles we left behind
Smiles we gave to one another
For the way we were

Memories
May be beautiful and yet
What's too painful to remember
We simply choose to forget
So it's the laughter
We will remember
Whenever we remember
The way we were

Written by Alan Bergman; Marilyn Bergman and Marvin Hamlisch for the 1975 Movie by the same name and sung by Barbara Streisand.

Sunday, December 12, 2010

The longest year
By Nauman Mufti


Fourth year started with a class trip to Murree. Irfan Shami and his friends arranged the trip well. Although I did not go, when the trip was over I heard so many lively stories, saw so many gleeful pictures that I feel as if I had gone. For many days after the trip saw many people with a dreamy look perhaps still playing the video of the trip in their head.
It was also the year we were introduced to Forensic Medicine. We learnt about how to gather contact trace evidence and which poison did what to the human body. We also learnt that FJ girls would be coming to KE to do lab work at KE. My enthusiasm for the subject waned however after we attended an autopsy. The gruesome scene and the smell took away any excitement we may have felt about seeing the FJ girls who have come to witness the autopsy.
Although fourth year the least rigorous year academically in my opinion, the third professional exams were delayed by about four months. Suddenly we had a lot of time at our hands. If my memory serves me well Saeeduddin utilized this time by promptly getting married. I imagine people in hostels may have gone home. I stuck around at my Temple Road place. I spent my time playing Squash and Billiards at the Engineering University and playing Chess at home.
Mercifully, the third professionals were upon us. Soon we would be in our final year.

Saturday, December 04, 2010

My recollections of the Third Year

By Naghmi Shirin


Nice recollection Nauman, but I must clear at this stage that except for a few who used their feminity to get through, most of the girls were very hard working. The reason that rarely a girl failed her exam was that they did not have those extracurricular activities that you guys had.

In the third year, we encountered real patients. One girl student left medicine because she abhorred touching the patients. In Mayo, we had a large variety of patients from all over Punjab. History taking was the toughest and the most boring task. However, it was a nice change going to wards in the evening to prepare our cases. We had started feeling like doctors.

There were quite a number of interesting personalities who taught us in wards. There was one Asst Prof.Khurram, who used to draw a line around him and instructed every female student not to cross that line.

We were extremely afraid of Prof Lakkar. One of our friends Maryam Hassan was related to him. Once she invited us for lunch. When we were seated, all of a sudden Prof Sahib appeared. We could hardly swallow. Later she told us that he was her khaloo and she was actually staying at their residence. However, after that we avoided paying any further visit, although her khala was an extremely nice lady.

Wednesday, December 01, 2010

Third Year… A transition from basic to clinical sciences

We were in third year now. Clinical ward rotations had started. Instead of useless dangling on my neck, I could now use my stethoscope to listen to heart sounds. Physicians practicing clinical medicine now taught us at patient’s bedside. We encountered some brilliant clinicians such as Prof Aziz of TBCD ward, Prof Mahmood Ali Malik of Medicine, Prof Rasheed Lakkar and Zafar Haider of Surgery. I also got a chance to brush up on my rusty Punjabi by communicating with patients. Finally, it started to feel like we are on the road to become doctors.

We also started studying pharmacology and pathology. We were the first class that Prof Bilquees Jamal taught in KE after her UNO job. Her lectures were interesting and her personality even more so. I still remember her description of the ‘muscarinic man’ illustrating the pharmacologic effects on acetylcholine on body. We also heard some good stories of her days at the UNO. We also heard some colorful Punjabi words and jokes.

Prof Zafar ul Aziz taught us Pathology. One day I decided to wear Shalwar Kameez to his lecture. Big mistake. He singled me out and had me approach the lectern. He wanted to know if I was son of a political figure. When I told him that my dad had served in the Pakistan Navy and had now retired he wanted to know why he had retired. I also remember that in our professionals, quite a few boys failed and none of the girls did. I found out why he was like that but that is another story.

With so much going on the third year went very fast. It was hard to believe that we surpassed the midpoint of our medical college. Soon, we would be real doctors.