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Wednesday, May 31, 2017

Joining Swami Vivekananda Youth Movement

Till yesterday, I had thought that I had joined Vivekananda Memorial Hospital.  But, yesterday there was an orientation session for new employees at this organization. And the events made me realize that I have indeed joined, or want to join, Swami Vivekananda Youth Movement, the parent organization of VMH.

SVYM's story is very heart-touchingly written in the blog of Dr R Balu (RB).

I am not aware of any other organization which has the story of its inception so beautifully and lucidly laid out. RB's experiences that led him to start SVYM are relatable. And he has made it possible to connect dots from those strokes of inspiration to the concrete structure that exists today.

But Dr M A Balasubramanya nevertheless described the same in a couple of hours yesterday. Some of his words dug deeper than I expected them to go inside my mind. I was expecting him to speak about how they had to undergo a lot of hardships and struggle to reach where we are. He did. But I wasn't expecting to shake my mind and say that SVYM now has presence throughout Karnataka and caters to lakhs of people under education, health, community empowerment, research, training, and ultimately development and achieved this growth over 32 years by not faltering even once from its core values of "Satya, Ahimsa, Seva, Tyaga". It sent depolarizations through some of my old neurons.

We had a brief on organization policies, accounting practices, etc.

After lunch, we went on a long trip to Kenchanahalli and Hosahalli campuses where other activities of SVYM happens.

Kenchanahalli is on the verge of being converted to a centre for socio-economic empowerment program.

And Hosahalli! Hosahalli is a beautiful campus in 24 acres. There is Vivekananda Teacher Training and Research Centre here. And befittingly, the tribal school right next to it. Dr Ramkumar who works there rightly puts it. After years of working in Bengaluru and other places,.  they come here with lots of experience and every day they face a new challenge. The tribal kids have their own culture. Their language is different. Their aptitudes and attitudes are different. There is sometimes more to learn from them than to teach them.

Challenges like these, and the motivation to work with principles to overcome these challenges on a regular basis is what makes SVYM truly special

Take this example from Vivekananda Memorial Hospital.

VK is an 11 year old boy who got admitted with Diabetic Keto Acidosis. We were counselling him and his mother regarding the importance of strictly taking insulin, even while in school. And we were concerned about them being not able to recognize and treat hypoglycemia. The mother was in fact very much aware of hypoglycemia and apparently she used to manage it at home using sugar water.

"But who will make sugar water for him at school, ma?" we asked her. She gave a blank smile.

We gave our usual advice. "So, keep a sweet something in his pocket so that even at school when he feels symptoms of hypoglycemia he can eat it".

She smiled and said "My boy is just a kid. He will eat the sweet whenever he likes."

Monday, May 1, 2017

VMH - first few days

Getting to Saragur from Mattanur is a tricky business. The shortest route isn't necessarily covered by public transport. My initial plan was to reach Mysore via Virajpet-Hunsur and then take a direct bus to Saragur. But later, I dropped it in favour of what my mom suggested - get down at Hunsur and take a bus that cuts through the corner.

So I did get down at Hunsur. Turns out, in Hunsur there are two KSRTC bus stations. One is for urban buses - the one I got down at. The other, inter-village rural bus service, is where I would find buses to Saragur. Luckily it is walkable distance between the two stations. At the rural bus stand, there was a bus to HD Kote. It's 11 more kilometres between HD Kote and Saragur. But there was no direct bus to Saragur. So I got into the HD Kote bus.

And that was the slowest bus ever. It stopped at every house and couldn't accelerate faster than a turtle. At HD Kote bus stand, there was a city bus going to Saragur waiting for me. This one was faster, yet slow.

Thus, I reached Saragur at 1.30. Half an hour late on schedule. Took an auto to Vivekananda Memorial Hospital. Ms Latha was waiting for me. She welcomed me and arranged my stay in the guest room next to the canteen (on the way to doctor's quarters). Although it is shared accommodation, currently I am the only one in my room. I quickly freshened up and reached hospital.

Said hi to Dr Chaithanya Prasad who was in General Medicine OPD and whom I had met last time I came to VMH a couple of weeks back. He asked me to get introduced to others. So I met Dr Sitaram in Orthopaedics OPD and Dr Sridharan in Paediatrics OPD. I also had to introduce myself to Dr Narendra whom I had met last time. I couldn't find other consultants. Then I reached Casualty were Dr Susan was writing something in a case sheet.

She is also new here. We spent some time seeing patients and talking about the hospital. Later, at 4, there was a meeting of all RMOs. They were talking about mobile units, their functioning, any problems they are facing, etc. Small corrections to duty roster was also being made. I was asked if I could manage emergencies and assigned to Kenchanahalli for Friday night.

After that there was rounds. After rounds, I sat in casualty for some time. Then, when I was about to leave, Dr Susan was taking a case for next day's grand rounds.

Wednesday morning, sharp 8 am. That's when grand rounds begin. All doctors come around a case that is being presented. Today's case was a lady with pregnancy induced hypertension and anemia. Dr Susan presented the case under the mentorship of Dr Padmaja. There was a brief discussion on the management of such case and the failures in ANC.

After the case presentation there was journal club in training hall where various people presented different journal articles. Dr Shreyas presented his own research on obesity and vitamin D levels. Dr Jyothi presented a study on thyroid disorders in HIV patients. Dr Dennis (?) presented on National Health Policy. The National Health Policy topic is so vast that it was not even half finished at the end of the given time.

After the presentations there was an announcement that a community dinner is being planned the next night where we would cook and eat ourselves. I volunteered to bring firewood and start fire, along with John, Eric, and Shubham. Others volunteered for preparing various dishes.

Afterwards there was rounds. And after rounds I went to casualty. I also sat with Dr Haripriya who had asked on the previous day to read the medical log book of an HIV patient to figure out what the striking points of his history was. We discussed this along with Shubham and found various points like the low adherence, the weight variations (or lack of it), etc.

That evening Dr Padmaja, took the firewood volunteers away from rounds to find out a place for the oven. John is an expert in fire making. We found a place close to Dr Prashanth's residence. The group of Bengalis who worked at the hospital was also staying right next to that place. They helped with the firewood and also with setting up the oven.

Then, I got a call from Dr Prashanth who would demonstrate bladder wash on a patient who needed it every day for me. Since Dr Prashanth would go on a 10 day leave the next day, I had to do the bladder wash to make sure this patient's catheter wouldn't get blocked. Unfortunately, this patient's condition worsened the same night and he was referred to KR Hospital because we suspected perforation.

I tagged along in the casualty that night with Dr Susan and Dr Jyothi who were having tag duty. Had late night dinner which Dr Shivambika prepared. Then went back to my room to sleep.

Thursday morning we woke up at around 5:30 so we could complete the 5 procedures that were pending - three lumbar punctures and two pleural taps. I did one of the lumbar punctures.

After rounds, had to take care of orthopaedic and surgical patients too as Dr Prashanth was on leave and he was taking care of them before. I was feeling slightly disorganized and tense during this day.

Later, in the night, I went to the community dinner. Fire was already taken care of. Cooking was half way through when I reached. Chole was being prepared by the Shubhams when it began to rain. And boy did it rain?

We had just gotten things to safety of the guest house next to Dr Prashanth's when the rain started becoming heavier and heavier. Some of us had run to the Bengali settlement to see if making Puri would be feasible. But by then rain was too heavy and we had to abandon that plan.

When the rain finally finished taking its toll (including several people who slipped and fell in muddy water), we organized in the guest house and started eating whatever we had already prepared.

It was a merry night with mimicry show by Bharath and training in deadly combat skills by John. The carrot halwa was superb and so was the fruit salad. I slept very happily that night.

Joining Vivekananda Memorial Hospital, Saragur

I joined Vivekananda Memorial Hospital as a Resident Medical Officer, on 18th April, Tuesday, around noon.

VMH is a secondary care hospital started by Swami Vivekananda Youth Movement at Saragur which is a place almost 1.5 hours by bus from Mysore, but just one hour by private vehicles.

There is a one year course called Fellowship in HIV Medicine offered by this hospital and educational institution that I plan to join later.

I had visited this place a couple of times earlier. First as an attendee in a research workshop back in my second year of MBBS and then, in the first week of April, as a prospective student and employee. At both times, I have felt that this place works in a well organized way.

I am sure this place will help me become a better physician and a better person.