Wednesday, July 25, 2012

Anupama in the PGI: We need reforms

After 4 days, Anupama succumbed to the accident as well as apathy of City Beautiful Chandigarh's Public Medical Care system, epitomized by the PGI (Post Graduate Institute of Medical Research and Sciences). Anupama was a 17 year old girl whose leg got run-over by a negligent CTU (Chandigarh Transport Undertaking) bus-driver (WHOA! Imagine that kinda pain). Negligent bus-drivers are bad enough but negligent Health Care System is worse. The system at the PGI is so overburdened that doctors just can't attend to all the lynched, broken and mauled people lying everywhere in the trauma center.

Doctors are not very sensitive to patients crying in pain; how can they be, they're right in the center of the din all the time and anybody would get desensitized to noises. After all, they have to do their job and not go mad.

Even my real sister and her husband, both of who are doctors have a hectic life despite the fact that they work in a rural area, the kind of a place where there's a desperate need for more doctors but they just don't want to work in places that compromise any material comfort and live spartan lives. Why should they do charity anyway, most of them are bright city folk that have studied medicine in some modern city and well understand the charisma (even the pain) of their profession. Almost all of them have had their parents pay their fee through their noses. It is bound to be difficult to forget all that and go serve the poor. Sorry to digress.

Anyway, the medical staff at the PGI is second to none in the country. The problem is, as like all other spheres of out country, the excessive population. There are just not enough doctors to take care of the everyone at the trauma center. I have had a personal experience of the scenario. 

In 2008, a fully loaded Haryana Roadways bus ran over my fathers foot and pulverized his toes. Fortunately there was an acquaintance of ours around a Police Jeep took dad to the GMCH (Government Medical College and Hospital) in Sector 32, Chandigarh. There the doctors bandaged his foot and referred him to the PGI as they didn't have the expertise to deal with the case. At the PGI, a few Chandigarh Police officials make my half-conscious father to sign a document that said that the accident was all my father's fault and he didn't hold the bus-driver responsible for the act. I don't know if this was done to extort money out of the driver to set him free or the driver was known to some police-wala. Anyway, at the PGI we waited for 12 hours before dad was taken into surgery. All the while we did all we could to "influence" the docs in emergency to tend to him (ah! it's in our blood eh!). When one senior doctor answered the call by one of the ex-directors of the PGI telling him to be quick in treating my father, he replied in frustration "I am sorry sir, there are so many patients here, I just cannot deal with the case immediately." 

Trauma Center, the name speaks for itself. It's traumatic for everyone present there, the patients, people accompanying them and as well as the doctors and the nurses. I however cannot understand why Anupama was left for three days without so much as her bandaged being changed. As is with the educated elite class of doctors and their system, in today's newspaper, there is a detailed report of what all the Trauma Center claims it did for the girl, refuting all blame of negligence and I know no one cares about my gut feeling but from the PGI officials say about it, it's like they know that such things happen at times so let's have a proforma to present in court. They're not even sorry that the girl died. They appear upset that the case has been sensationalized. Though one cannot blame them for being upset about media sensationalism, the manner in which they are retaliation to this is just plain unconscionable. 

The end result speaks for itself. Since gas-gangrene spreads pretty quickly so the fact the girl died of it speaks volumes about the care she was given. Had it been detected in time, it wouldn't have cost her her life, though the infected area of her leg, most probably, would have been amputated. The given fact is that they just did not tend to her case till the time the realized that gangrene had set in and by then it must have spread  

PGI is a living breeding ground for dangerous microbes. In the days that followed my fathers operation, he suffered post-operative infection by the notorious MRSA (methicillin resistant Staphylococcus aureus), a bacteria that is resistant to many antibiotics and causes blood poisoning and death, as well as Pseudomonas aeruginosa, another bacteria (that is not as dangerous as MRSA) but my dad survived. Gas gangrene is caused by a bacteria called Clostridium perfringens. We have to understand that these bacteria can be commonly found in the soil all around us, like the tetanus bacteria. Mind it that if tetanus infection sets in, it is 100% fatal, so if you get cut, it's a great idea to spend 20 rupees for a tetanus toxoid injection and not take chances (it's effective for 6 months anyway). Gas gangrene spreads quickly and is difficult to treat, amputation can be a big possibility.

So when the news said that gangrene had set into Anupama's leg, I wondered if she'd survive. From the day this girl met with the accident , I was surprised she'd survived, from the news updates in the days that followed about her condition (apart from the fact that girl was molested in sector 26 and there were other news of first degree murders in the city etc etc), my alimentary canal kept wrenching and telling my mind that this girl was not gonna make it. Bullshit with gut feeling, it was just a prediction based on personal experience of the condition of our government hospitals.

Is there gonna be some reform by the administration and the hospital to ensure that such tragedies will not occur again or is this just another life that got lost in thousands of others. The problem is that we all get used to bad things fairly quickly. Somebody gets molested, we say "shit! that's terrible." But the news follows in the days to come, our concern dwindles. After all we know that the police is always reluctant to lodge reports of crimes, we know there are goons all around, we know that the city is not exactly safe near midnight, we know that people swear on each other on roads and get into brawls in cafes, we know that there are country made pistols owned by many in the city, we know we all racist but who cares...pehele bhi chalta tha, ab bhi chal raha hai...chalne do. 

 Sad that the parents of the girl had lost two children before this and now are childless.

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