Merry Christmas all

Christmas is in the air. The hospital has been decorated with lights and buntings festoon the ward. The staff will be starting their winter vacation soon and it is time to wind down and breathe a sigh of thankfulness for a full year. The staff has been unified in their service and I constantly thank God for the opportunity to work with such a wonderful team. Our Annual day program, on the 12^th, showcased the wonderful talent of all of our staff. We thank God for His constant presence, His protection, and His leading.

I would like to share three things about Christmas from the familiar Christmas story:

1. Christmas, though long awaited, was unexpected. The arrival of Jesus was a surprise to sleepy Bethlehem. Gods work is characteristically unexpected. He turns up in places and situations that surprise us. May we always be ready for His appearance.

2. Christmas demanded a choice. Mary chose to be a handmaiden. Gods work demands a choice on our part, one which we can make freely.

3. Christmas was seen by those who had the eyes of faith. All of Bethlehem and the jealous eyes of Herod missed Jesus even though Herod used the entire government machinery to search for the child. Yet, he was seen by humble shepherds and by the three kings. Christmas is seen by those who believe because they looked for him

May we be open to His work in and around us this Christmas.

Wishing you a Merry Christmas and a Blessed New Year. We look forward to 2010, our Jubilee year, marking 75 years of service as a hospital.

 

Annual day a huge success

The Annual day 2009 was a huge success. The staff displayed their wide ranging talent, with songs, skits, dances. A wonderful time was had by all.

Swine flu in LWH Manali

We had our first patient of swine flu in LWH Manali. A 32 year old male was admitted with typical symptoms. He tested positive and needed ventilation. He was transferred on the ventilator to CMC Ludhiana but expired over there. Our staff are now on prophylaxis.

The arrival of the unexpected

In the days of king Herod, wise men from the east arrived unexpectedly in Jerusalem. The arrival of Christmas was unexpected. God is full of surprises. His orchestration is ever beyond the calculated probabilities that we work with. The Christmas message is one of universal unexpected joy in the middle of the schemes and wiles of men. It always culminates in the worship of the Son.

May the joy of Christmas be yours this season.

The origin of homicide

Reading from Genesis 4: The origin of murder. Cain was furious and downcast because his offering was not accepted. The Bible says that God questioned his emotions. We assume our emotions, flighty as they are not the keys to profound life principles. However, the warning that “sin crouches at the door” brings the anticipation of evil as a consequence of wrong emotions. We are taught not to depend on our emotions, and often discard them as a willow the wisp wingers of evanescent feelings. However, the correlation between these tangible feelings and the state of our heart is too real to ignore. Cain was furious, and downcast. Be angry, the Bible says, but do not sin, and do not let the sun go down on your anger. It is an inescapable fact that all have at some point felt the hot glow of anger. The KJV uses the words glow with anger in this translation. A consequence of unrequited anger is often discouragement and depression. Anger, most often is a wrong emotion, since its seat is in unrequited expectation. Cain had no right to expect God to accept his sacrifice on Cains terms. But that is what he was expecting. Our sacrifices will be acceptable to God on His terms. The rebellion of Cain did not stop at this. It went on to produce anger and depression, even as his plants produced fruits and leaves. When we feel these emotions, a sobering question should by “Why”. If rightly examined, the answer could lead us out of this ravine that leads to disaster. The basis of God’s acceptance on us will always have to be on His terms, not on ours. And as sure as clouds lead to rain, un requited unwarranted emotion exposes the rabid hound of sin, straining at the leash of our door. Its desire will always be to destroy and consume us. Yet, we hold the key to its mastery.

When have we been angry or depressed? For some, these emotions are the fabric of life. It is time to examine these emotions, and ask ourselves that loaded question – Why? Perhaps it will unravel the warped weave of twisted logic that leads invariably to disaster and yield up the key to shutting out the lurking fiends that strain to consume us.

Pictures of ENT Camp

Over five hundred patients were seen and eleven major surgeries performed. This is an indication of the extent and the need for ent intervention in this region. People have just accepted their disability and live with their handicap, because the logistics of obtaining care are beyond their reach.

ENT Camp in Manali

The ENT camp in manali has started out with a bang, with over two hundred patients being seen the first day. Dr. George Ani and Dr. Anshul are the consultant surgeons. The team performed the first tympanoplasty ever to be done in manali yesterday with great success. We thank God for this provision.

Touch the mountains and they smoke

The Psalms comes to life looking out of our windows, as we see the clouds descend and envelop the mountains. Indeed it is as if the mountains are smoking with wisps of constantly changing cloud haloing their peaks. A constant reminder of His presence.

 

Elephentiasis

B was a patient with a massive right leg from filariasis. He had been to many hospitals over the last fifteen years but no one was willing to operate on him. He had heard of Manali and came here to find out if we would help him. He could not wear shoes or pants and his misshapen gigantic leg dragged him around. ‘

He underwent a modified Homans procedure on the 5th November, and is recovering.

 

 

Come ye apart and rest

Jesus had told his disciples when it got too busy.. “come ye apart a while and rest”. He tried to make provision for this by going away. However, his plans did not always work ( Mark 6:31). People saw them leaving and ambushed them in their retreat. Jesus did not ignore them, but attended to their needs, having compassion on them.

Many are the times we are tired, and face similar situations. Not having time to eat is also familiar. However, when the crowd presses close, it has to be compassion that spurs the extra mile. Anything else will cause frustration. He taught them many things, the Bible says.

Let us draw close to the heart of compassion to help us in our crowded times.

 

Apple blossoms

Apple season in the valley. This year the crop has not been very good. However, the rains are on now, and the last of the apples still festoon the trees.

Harbinger of things to come

http://tinyurl.com/mdg29d 

The MCI and all other health regulatory bodies will soon be scrapped and a new regulatory parent body, the National Council for Human Resources in Health will replace them. Read about it in the URL above.

The MCI has been a hotbed of corruption. Invested with regulatory power, it has abused that power and spawned a generation of “donation doctors”, who have in turn soiled the practice of medicine with avarice. They have bartered and sold  the standards of the profession in the marketplace. This has in turn replaced trust with suspicion in the mind of society. Indeed the MCI has much to answer for.

I hope this new step will be the harbinger of change and it will not shrink from exorcising the current ill humour from our profession.

August newsletter

As summer wanes, we always breathe a sigh of relief. Relief for the knowledge that we have survived another tourist incursion and the muscle weary summer sprint for the year is now over. The hospital stayed busy throughout the summer months. Sister Victoria, our new nursing superintendent, has brought up nursing standards considerably. Philip stayed busy in the operating room and Anna was tireless in the OPD. The addition of Dr. Ritu Lakesar, our gynecologist, has been a huge blessing. We are witness to His faithfulness in healing through many, more stories of amazing recoveries. We are now gearing up for the Jubilee celebrations, of the hospital in 2010, as we celebrate 75 years of service in this valley. You can keep up with this on the hospital website under the “Jubilee celebrations” page.

Highlights for the staff so far have been a raise in salaries for all middle level staff, a “Ward clean up day”, “Independence Day celebrations”, and committees to initiate the Jubilee celebrations.

We continue to sponsor local children for higher education. This year we have sent the following students for training: You can read about them on the website under the “Sponsored Students” page.

· Thotwan Vashum (OT Technician)

· Tulwanti (Nursing training)

· Meena (Nursing training)

· Ashish Giri (Coaching for med school)

We hope to be able to finalize plans for the New OPD soon and to work towards starting that construction in the coming months.

Hold close

The days of the trial and crucifixion of Jesus are shrouded in despair, and death and suffering. All of us face these emotions, and quite of few have felt hemmed in by these ringwraiths of hell. Jesus manifested his glory in the grist of the mill, the centurion presiding over his death himself acknowledging “Surely this was the Son of God”. To manifest his nature in the throes of agony has to be from God. Any other alternative is from our flesh and will not manifest His glory. Press close while being pressed in. Salvation and resurrection come in ways we cannot imagine. Not one of his disciples could fathom or believe it when it happened despite being forewarned by Jesus himself that this would be. How we distance ourselves from Him, even when we stand next to Him. Hold close. The end may be a new beginning.

 

A miracle

Ram (name changed) was brought to our casualty unresponsive, without pulse, blood pressure or respiration, with the history of being electrocuted. His pupils were not reacting. Active resuscitation was begun immediately in casualty. His pulse returned, and he was ventilated over the next two days. Eventually he was weaned off the ventilator. He began to respond gradually and over a period of a month began to respond to command. This is an amazing recovery. We are looking at discharging him now, with the relatives taught to take care of him at home. We have seen some amazing recoveries, and we know this has to be God.

Local natti (Himachal dance)

Great show by the hospital staff, with an almost extempore local natti. 

Independance day celebrations

Independance day flag hoisting was performed in the courtyard of the hospital. Shri Naveen Tanwar, Pradhan, Shri Yograj, Up pradhan and Smt Pushpa ward member presided. A local natti dance performed by the hospital staff was a great hit.

Welcome visitors

It was so wonderful to see Drs. George Ani, Ashish Jaison and Joseph Mathew again. Dr. George is an ENT Surgeon in CMC Ludhiana, and Drs. Joseph Mathew and Ashish are emergency physicians training in Australia. Auld lang syne indeed.

Extradural hemaotoma

A tourist was found unconscious in his hotel room after two days and brought to the hospital. A CT scan showed a huge frontal extradural hematoma. A frontal craniotomy was done and the hematoma evacuated. The patient was ventilated and later transferred to a tertiary hospital where he was succesfully extubated. He recovered consciousness.

 

Choleduodenostomy

A sixty year  old presented with history of jaundice and sudden abdominal pain for which she was admitted in a hospital outside. She had a cholecystectomy and cbd stone removed in 2003. Imaging had shown a huge cbd stone and hugely dilated cbd.

On exploration the entire right hypochondrium was sealed off with adhesions. The CBD was 3 cms across.

A choledochoduodenostomy was done. 

Sarcoma leg operated on

A man had come with a slowly growing tumour of the right thigh. It was about 10 cm circumferentially and stuck to the muscle and skin. Excision and grafting were done.

Fracture penis repaired

A young Nepali male came with the history of turning in bed with an erection when he heard a snapping sound. He had ruptured his corpora cavernosa. His urethra was also found ruptured. He underwent repair and urethroplasy and is recovering uneventfully. 

Fracture penis repaired

A young Nepali male came with the history of turning in bed with an erection when he heard a snapping sound. He had ruptured his corpora cavernosa. His urethra was also found ruptured. He underwent repair and urethroplasy and is recovering uneventfully. 

Using Live Writer

Just started using Liver writer. wonder how it will go.

Our boast

The world structure as we know it is built on self glorification. All our systems, regardless of the field are built on building up oneself. The kernel of rebellion is right here. Following god would have to shake the very foundation of established structures, whose philosophy often creeps unwittingly into the fibre of our being. A very conscious choice has to be exerted to go against the grain, and re establish the right order of things, in which is His delight. The very struggle to know and understand, fundamental distinctions of the human race lead to towers of Babylon that stand in open defiance to the Lords order of things. Yet, the tower never started of with that intention. The process of knowledge and discovery will deviate unless trained by the undergirding to consciously always boast in the Lord. Every area of our lives, internal and external has to follow this runner at the risk of becoming a creeping vine that strays away from the source of all life. Can we truly say all our discoveries, and all our aspirations are rooted in Him? Can we say our every attempt at life has this undergirding? Help me to know and understand this. Let us be able to say "We boast in the Lord". 

He will keep you

Difficult circumstances. Trying times. Uncertain futures. Painful experiences. 

Through all of them, the words from Isaiah 26:3 holds out hope. Hope with a promise. That He will keep you in perfect peace. However, this is a three part promise. The promise of peace, and being kept in it is linked to two aspects of our being. Our mind being stayed in Him, and our trust in Him. 

Trusting anyone is not easy. The older we get, the more difficult it is to trust. Our past experiences condition us with memories of trust betrayed. This fuels distrust which can become a stronghold in itself. The ability to trust however, is the secret of keeping our mind stayed in Him, and the key to appropriating the promise of peace. 

The engine in this cycle is the ability to trust. Rarely will we give our trust away. However, once given, it becomes easy to trust those we love. The key to this trust is knowing the person we trust in. 

Let us place our trust in HIm, and our restless minds harried with cares and doubts will be stilled with that peace He promised. 

Summer season is upon us, with the influx of tourists, local and foreign. Combine this with the usual rush of patients and have the makings of a very busy OPD and full wards. 

Philip is currently away, in Bangalore, and Dr. Nitin Peters surgeon from CMC Ludhiana is covering for a while. 

Stay tuned for updates in the future.