Tuesday, September 10, 2013

Urethroplasty

A patient had injured his perineum with a straddle injury, sustained a rupture urethra, and needed a suprapubic catheter. He has been visiting hospitals for the past three months, where he had radiological imaging but no definite date for surgery. He had a short segment stricture of his urethra. He underwent a repair and urethroplasty and should be fine to be discharged home soon.


Patients who have recourse to medical services have only the issue of having to pay for it. Medical insurance companies help, but this industry is heading towards trouble, with hospitals overcharging and bleeding the system. One can imagine that in ten years time, all bills will be viewed skeptically and soon restrictions placed on treatment, the way it is now in the United States.

What happens to patients who are not insured? The government attempts to meet this need with the Smart card and the RSBY program, a project of the NRHM. This ensures free treatment for those below the poverty line.This program works well, however, one does find many smart card holders riding up to the hospitals in latest vehicles!

What about the poor below poverty line who do not possess a smart card? They are left to fend for themselves. It is not only the economic condition of the patient, but the availability of hospitals willing to undertake for them.

Mission hospitals have long been havens for the poor and disadvantaged. The word mission now has come to mean different things to different people, much maligned and ill treated. However, they still can be places where the focus is still the poor.

How to maintain and run them, is another issue altogether, one fraught with many challenges and battles.

The bottom line however, still remains, the successful treatment and solace brought to the sufferer. We are grateful for all who allow us to do what we do. 

Monday, September 9, 2013

Those whirring home movies



Part of our childhood memories is that of our family sitting in the darkened living room, watching the wall light up with projected memories of home movie film accompanied by the whirring of the movie projector.  What did we watch? Images of our birthday party, our outing to the Lalbagh park or the zoo, a building project, ride on the motorbike. Fragments of our childhood, captured, and revisited by our family, strengthening the bonds between us with unfeigned glee and shared laughter.

The whirr of the projector has now faded into oblivion with the advent of new technology. The plasma screen has expanded to such a gargantuan size that it has now annexed all space and attention in the living rooms of today. What do families watch today? The offerings that are made on commercial channels now feed our brains, and more importantly becomes the childhood memories for our children. Really? Is that what we want them to remember?

Together times are now compartmentalized, and individuality has erected walls between siblings and parents, carefully cloaked as the characteristic cool of generation X. I dread to see generation Y.  No more are rituals of remembered family memory celebrated and revisited. Cartoon network, CNN, Hallmark, and Jay Leno are the conductors of our evenings, playing their scores to numbed brains.

Can we shatter this commercial shell? Even with todays technology, it is easy to capture the growing moments and record it for posterity, to be revisited, replayed as our children grow, reminders of the love and the bonds that undergird the family. How many families do this? Digital photographs can easily be made into slideshows and with the click of a button set to music.  All at no cost at all except the effort of creation.

America’s funniest home videos was a refreshing change from commercialization, bring the focus back on families.

The bottom line being not even the movie, or the technology, but the family in its ritual of celebrating each other and a shared commonality, however we choose to do it.


Saturday, September 7, 2013

Thanksgiving is our insurance



THANKSGIVING IS OUR INSURANCE


We are often confronted by dire situations, situations that seemingly have no exit point from the danger or disappointment that cloaks them. Ever so easily our mind strays towards internalizing and personalizing the negative emotions that result from our interaction with the people or the circumstances in that situation. We can so easily come to harbor resentment, hurt, or unforgiveness. We can so easily camouflage anger or disappointment that can threaten to cloak us permanently and distort our very character. This insidious invasion may not even be evident to us, and may only be obvious to those close to us.

What is our protection in such circumstances, and how do we fend off these hounds of hell baying at the doors of our character?

  • ·      Can we try and find things to be thankful for in the midst of circumstances?
  • ·      Can we name those things one by one ( The old hymn “Count your blessings” comes to mind).
  • ·      Can we thank Him for each of these things, and make them the focus instead of focusing on the negative?


This will neither change the circumstances or the people involved, but this will surely change our reactions to them, allowing us to be more just in dealing with them, and make relatively more unbiased decisions.

“Count your blessings, name them one by one,
And it will surprise you what the Lord has done.”

“Have no anxiety about anything, but in everything by prayer and THANKSGIVING, let your requests be made known to God.” …. Phil 4:5-7


Friday, September 6, 2013

Tools



TOOLS


Every tradesman has his favorite tools. There are certain tools he uses for specific jobs, and there are tools he uses for routine work. Every time a tool is grasped, it fits into his fingers in a particular way, a well worn, comfortable clasp. It is like treading on a path one has often trod upon before, a comforting reassurance, that I have that tool to use. The master craftsman uses tools to work magic in his trade. Wielding them to do his will, he shapes, cuts, incises, scrapes, and stitches. The tool obeys his leading and guiding, working its often unpleasant way into the material at hand. The end result brings life, healing beauty, function and wholeness.

It is a pleasure for others to watch a skilled craftsman at work. The fingers move skillfully, using the tools to accomplish a masterpiece, or a part of it, portion of a whole project.

Carpentry, model making, motorbike repair, surgery… all these tasks have at its center tools, without which the task is ill accomplished. Each is a skill, developed over time, time spent with tools.

A rusty stiff tool is very difficult to use. A tool that has been used for years is reassuring in its functioning.

A new tool often needs breaking in, needing to  be used till it functions smoothly.

An old tool often needs resharpening, unpleasant for the tool, but a process that allows the tool to retain its cutting edge.

Every tradesman also has a shelf of unused tools.. tools that are too old, or don’t work that well.

The tools he does use regularly are often kept oiled, and ready to use for the next big job at hand.

No tools complains about another tool in the toolbox. Tools are used together to accomplish the task at hand.  One tool may be for cutting, another for polishing, another for grinding, but they all work in concert together, and all the tools are needed to complete the job.

We are tools too, in a Master Craftsman’s hand. We are used, to mould, shape, and influence those around us. What sort of tool are we being, and what are we aspiring to be? 

Any one can be a tool, we just need to obey.

Monday, September 2, 2013

Time


This quote from Benjamin Franklin captures the need to prioritise the passage of time. Time waits for no one, passes by, an ever rolling stream. It our limited hours, so many things and people scream for attention, clawing and claiming ownership. We often live our lives rushing from emergent task to another, living in what Stephen Covey has described as quadrant one activities. Urgent, but not important. What about the important but not urgent activities that steer the course of our lives? Another way to prioritise times is by the times dedicated to the most important people or things in life. We often find the most important people sidelined. God, our spouse, our children have to make do with second best and the left overs of our busy patient schedules.

Steering a course optimising and balancing all these priorities is not easy. The Scylla and Charibdes of the urgent and the overbearing threatens to squash our skiff into nothingness and eliminate choice. Reclaiming this choice requires the skill and discipline of a master navigator.

"So when the great scorer comes, to write against our name,
It matters not if we won or lost, but how we played the game."

Some practical suggestions I am still trying to use:


  1. Decide the priorities. Decide who or what are the important things in life
  2. Actively set aside time for them. for example quiet time in the mornings, time with family in the evenings. This will mean rising earlier, and coming home from work earlier. 
  3. Limit your activities to those that fit in with the priorities. Saying no to other good things, but not the things which may be the best. 
  4. Enjoy the times you do spend with your focus areas.