Showing posts with label personal experience. Show all posts
Showing posts with label personal experience. Show all posts

Monday, January 11, 2016

Medical Encounters: True stories of patients – Memoirs of a Physician By Dr. S. K. Jindal




Jindal Clinics is proud to announce the release of the latest book by Dr. S. K. Jindal - the medical director of the institute and ex head, Department of Pulmonary Medicine, PGI Chandigarh.

The book, meant for general reading chronicles the stories of some of the patients seen by the author during a career of about half a century. It provides glimpses of the trials and tribulations faced by patients and their doctors in their heroic struggles against disease and death. It also tends to project the physician’s handling of the myths and dilemmas about disease management and treatment modalities faced by different patients. 

The pen portraits reflected in this fascinating book encompass the lives of Prime Ministers, Governors, Chief Ministers, Judges, highly placed officials, army-men, police officers, newly married couples, precocious teen agers, wealthy men and farm labourers. It is a captivating story of life and living process. Full with vignettes from history, classical civilization, epics and mythology, it is enjoyable to read and meaningful for the doctors, the patients and the care-givers into disease management. A brief synopsis of its contents follows:
 
Foreword

Prologue

1.      The Childhood Adventures: Life in a community riddled with superstitions about health in a haunted house during 1950s in small towns of Punjab. Medical practice was rather scarce and simple maladies were often handled in medieval fashions.  

2.      Dissection Hall: Vivid scenes from the ‘dissection hall’ of the medical college (Government Medical College, Patiala) during the author’s first year of MBBS in 1966-67. Does the virtual dissection now provide the same attachment with human body?

3.      Patient with Scalded Palms: Lessons during bed-side case demonstration in the Skin Out-patient department. Was the reason of scalded palms in an otherwise healthy young man?

4.      Labour Ward: Melodrama in the busy ‘labour-room’ of the hospital while witnessing the first delivery by the author during the final year MBBS. 

5.      Bhag Singh: A former army soldier who used to brag about fighting with enemy forces and cockroach sized mosquitoes was admitted with cancer. Both he and the doctor were quite afraid of catheterization at night for urinary obstruction. 

6.      Emergency Ward: Facing the first death in the over-crowded Emergency of the Postgraduate Institute of Medical Education & Research, Chandigarh in 1972. 

7.      JP – The quintessential Leader or 1975: Story of Jai Prakash Narain during the period of Emergency in India when he was interned in the hospital at Chandigarh. His care was a real challenge for which the author along with senior doctors faced political reverberations.

8.      Sherlock Holmes: A senior police officer who suffered from a relatively uncommon respiratory disease, was quite reluctant. It was Sherlock Holmes who helped in treatment.

9.      The two oustees: Struggles and superstitions of two village folks who suffered from chronic respiratory disease, both were displaced from the land where Chandigarh was built as the state capital of Punjab after Indian partition.

10.   Culture Shock: A young man from Denmark developed illness while visiting as a tourist. Both he and his friend had a tough time in the hospital in the beginning; both got adjusted very soon. On the other hand, Griffth who suffered from chronic obstructive pulmonary disease was evading law because of drug abuse and trafficking.

11.   ‘Morrie’ of Punjab: A senior Professor had a chronic muscle disease; his life was almost a replica of the Morrie immortalized by Mitch Albom (see ‘Tuesdays with Morrie’).

12.  The American Dream: Handling of a friend with asthma in Seattle during Fellowship in USA in 1982-83. He was a tough nut to crack - willfully avoiding treatment for his problem.

13.  Pickwick Papers: Obese patients with respiratory sleep disorders. The main character like the fat Joe of Pickwick Papers was blissfully unaware of his illness.

14.  God’s own People: Patients with respiratory problems belonging to ‘below poverty-line’ category faced multiple hardships. Their innocence was often overwhelming and over-bearing.

15.  Perseverance: A resolute youth was determined to cure disabling emphysema of his grand-father. His misdirected treatment proved disastrous.

16.  Mr Prime Minister: Visit to Nepal for a medical consultation. The Prime Minister had an exceptional medical knowledge.

17.  Mountain out of a mole hill: Pleasure of curing small problems which looked threatening to others. But one needs to know the problem!

18.  Corporate Honchos: Treatment of the rich and the mighty. One of them who suffered from a respiratory sleep disorder was quite secretive about his visit to the doctor.

19.  ‘If a man’s lungs pant with his work’: Problems of handling two senior judges who suffered from brittle asthma! The severe and almost near-fatal attacks used to develop with an electrifying speed. 

20.  Erythrocyte Sedimentation Rate: Misconceptions about and misinterpretations of non-specific medical tests! The test report was a good excuse for the two patients to repeatedly visit the hospital.

21.  Teenage Hiccups: Abrupt and angry outbursts of sick teenagers who needed tender care.

22.   Weakness of the Powerful: The powerful politicians including Chief-ministers and Governors who suffered from asthma or other respiratory diseases were as weak as the ordinary folks. Inhalation therapy was particularly difficult to teach and gullibility was the greatest weakness.

23.   Marital Woes: Sickness as a stigma for ‘soon to marry’ girls and boys. One young lady who suffered from asthma defied medical advice with serious consequences.

24.   The Stigma of Inderjeet: Isolation of young Inderjeet for her tuberculosis. She conquered her illness with courage and bravery.

25.  University Dons: Teachers at the University were generally difficult to convince. Professor Ahuja used to underplay his illness, while several others were over concerned, sometimes about hypothetical illnesses.

26.  Swami Anand: A pious and spiritual man who imbibed the greatest human values! 

27.  The Devilish Test: Misinterpretation of a simple medical test brought an engagement almost to a break-point. It was the medical counselling which helped.

28.  Yasin Mohammad: A bear performer who suffered from asthma was quite magnanimous. Petty favours by unrecognizable patients proved to be pleasant, sometimes even embarrassing.

29.  Barriers: It was difficult to communicate with an old man with hearing impairment. Yet the old man was quite satisfied!

30.  The Big League: The VIP attitudes of a few senior officers often interfered with good medical management. It was always better to shed the mask of bigness while seeking treatment.

31.   Holy Water – The Last Wish: A holy priest was afraid of admission in the hospital for the fear that his last wish may not be fulfilled. The medical personnel and the facilities need to respect the wishes of patients with terminal illnesses.

32.   One More world to go: ‘Not to be defeated’ attitude of a terminally sick patient.

33.  Dilemma of Critical Care:  The real question is ‘When to opt for assisted respiratory support?’ 

34.  Knowledge – Explosion: 21st century – the era of lung transplantation, advanced life-prolonging treatments and internet with a quagmire of information.





The book is available for purchase at: 

 Partridge India    000 008 10062 62



www.nobleandbarne.com



Wednesday, August 26, 2015

150 bronchoscopies completed

We have completed 150 bronchoscopies in just over 1 year.  We were able to diagnose 63 new cases of sarcoidosis out which 56 were EBUS procedures. 18 malignancies were also diagnosed.
The current EBUS number is about to touch 100.

The data is as follows:


Tuesday, March 31, 2015

100 bronchoscopies completed

Our centre for interventional pulmonology has completed one year and alongside --> 100 bronchoscopies. Thanks to God and patients who made this possible.

Thursday, July 24, 2014

More than meets the eye

More than meets the eye


'There is more to this than meets the eye.' I used to think that this was just a turn of phrase; however, after joining a medical career it became a living truth for me. A recent example will suffice.

A 54 year old lady, presented to me last week, with a history of long standing asthma for the last 18 years. It was poorly controlled and managed, with her requiring frequent nebulization therapy and repeated short courses of oral steroids. She appeared to be chronically malnourished and indeed, on examination, her BMI was 17 kg/sq m. One often forgets, in this modern era of inhaled bronchodilators, what asthma can do to a person. She was a small reminder that we are only one step above the previous generation in the treatment of this disease. Although much research is going on, except for the reliable beta agonists and corticosteroids, the other medicines available are insufficient to control asthma on their own.

Coming back to the case; after taking the history and examining her - to repeat myself again - I thought "There is more to this than meets the eye" and ordered further workup. Lo and behold, she came a week later with an X-ray full of alveolar and interstitial opacities. Our patient was accompanied by her brother, who was an X-ray technician. Now, there is a tendency in our part of the world to attribute almost all X-ray abnormalities to tuberculosis, and more so in medical and para-medical staff. Even worse, this gentleman was a veteran radiographer, with over 15 years experience. I had a hard time convincing him of further workup; throughout  the consultation he kept looking at me out of the corner of his eye!

Anyway, they came after a few days with an HRCT of the chest and serological investigations. I was pleased to see that my hunch was right and she was finally diagnosed to have ABPA or Allergic broncho-pulmonary aspergillosis, which is much prevalent in this area. Her brother was all smiles!!


The 'TB' X-ray




Typical mucus plugging



Extensive bronchiectasis and centrilobular nodules


ABPA or allergic bronchopulmonary mycosis (ABPM) is an allergic reaction to colonization of the airways by fungal elements, most commonly Aspergillus species ( hence, commonly ABPA rather than ABPM!) It affects a substantial portion of asthmatics, especially those suffering from severe or difficult to control asthma. The diagnostic criteria are still evolving; also there is no clarity on whom to screen for the disease. The pointers in this case were:
  1. Difficult to control disease
  2. Severe disease
  3. X-ray abnormalities 
However, the clinching point was the phrase - 'There is more to this than meets the eye!'

Wednesday, June 25, 2014

Story of a Sesamoid

Story of a Sesamoid


Dr. Aditya Jindal
DM Pulmonary and Critical Care Medicine,
PGI Chandigarh

Consultant Pulmonologist
Jindal Clinics


The year was 2003.I had finished my internship and was trying to psych myself for the dreaded entrance exams to MD courses. Needless to say, I was failing miserably. Then a cousin suggested a skiing trip to the Garwhal Himalyas. It seemed just the thing, so I made my reservation and headed for the hills.

We went to Auli, a hamlet situated 12 km uphill of Joshimath, on the great pilgrim route to Badrinath. The snow clad hills and the fresh air were liberating. After being fitted out with the skiing gear we hit the slopes, all too literally. It was a beginners course and the first thing one was taught was how to fall. One of the instructors even boasted he knew fifty ways to fall!

Soon, one fact emerged – I was the only doctor for miles around. My nascent ability was soon put to the test when I received a message one fine morning – while I was out skiing  – requesting me to attend a young British  lady who had taken a tumble somewhere on the slopes.
The history was that of falling on her right hand. As I went to see her , morbid thoughts of Colles’ fractures and elbow dislocations were hammering inside my head, not to mention the butterflies fluttering in my stomach. Though I had done a lot of hard work during my internship, this was to be my first taste of independent decision making; never had I felt the need of a senior so badly.

Anyway, on examining her, all I found was an area of tenderness localized over the base of the right thumb. I had seen a small clinic in Joshimath when we had arrived, so I sent them there to get an X-ray done and prescribed some painkillers, of which they had an ample stock already!

We met an dinner that day and I was solemnly informed that the X-ray showed a fracture. I asked to see the X-ray; one point I noticed initially was that the doctor who had reported the X-ray was a BHMS. The moment I saw the X-ray I burst out laughing, for the ‘fracture’ was nothing more than a smooth round sesamoid bone lying lateral to the head of the first metacarpal bone! 

I explained this to the couple and told them nothing more needed to be done. I returned home soon after, after refusing payment from the grateful couple, feeling refreshed and with a renewed belief in the medical profession.