As an only son, I chose my parents over a life abroad. I regret it and I absolutely don't regret it. When I see some people posting their adventures in the English countryside or Scottish highlands, I get a pang of nostalgia for what never was.
And then I man up and move on.
A sweet little girl came in today for bilateral lower limb re-surgery. She wasn't on my ot table, but I happened to be passing by. When I entered the room she was crying, and nobody cared to soothe her. I patted her on the head and asked- /1
There maybe nothing much I can do for them, but in the end, they're all I've known. And it would ruin me if they suffered something and I weren't there to share the suffering.
Family over comfort. It is what men do. Quietly.
I will never know what I missed out on not going abroad. But I sure as hell know that my parents feel safe with me around, even though they were fighting me to go. They're happy now because I never let them feel as if I wanted it.
That's the secret. Sacrifice without tears.
That's all I needed for a very good day. We work in a resourced limited environment, not out of lack of funding, but sheer disinterest in patient care. At the very least, on my table, you will get whatever I can give. That's all we can do... our individual best where we are. /5
Holy shit! I just save saved a life 😱😱😱
Junior medical officer in the ICU called me over the phone come see a patient already on vent because of abgs showing paO2 40, pCO2 120, pH 7.00
I ran like the wind 😂
They were panicking at the head end of the patient /1
Today we had a patient come in for a surgery and he was in misery and pain. I went to the preop bay to give him pain killers. I asked the man standing with him for consent.
The attendant told me he isn't related to this patient. In fact he's never met the man before in his life.
I used to be such a huge hater of the Indian cricket team as a teenager, but as I grew older, they earned my respect. Especially Virat Kohli. Hands down one of the best sides in the cricketing world right now and my world cup favourites.
#CongratulationsIndia
But man of my word I am. I told the other anaesthetist to leave early, and took over from there. When the case ended, I gave her the nerve blocks and when she awoke, she was calm and quiet. I asked her, "any pain?" She shook her head no. "I promised didn't I?" And she nodded. /4
@paulocoelho
Well you're the first person I've ever heard say that about this. Next I visit a book store I'll buy some more of your books. Good karma goes around.
She nodded and stopped crying. From there on I rued my promise 😅 the case wasn't on my table, I was free to go home. But it was going to run overtime. I planned to give bilateral nerve blocks to keep her totally painfree, but they had to be AFTER the operation. /3
- why she was crying. She replied, "I'll have surgery again and it will hurt again when I wake up."
It broke my heart that she was worried in anticipation of severe pain judging from her last experience.
I looked her in the eye. "I promise you will wake up pain free." /2
But this attendant, and the friend that told him to come too, defied even valid logic.
I say I am impressed. I say I applaud this raw act of selflessness. I say they are better men than I, by far.
Sometimes, in our panic we fall back to primal instincts of bashing. Calm diagnosis is important.
How a reduced breath rate helped a broncho-spasming copd patient is for y'all to know. This ain't an educational account 😂 I'm just here to tell you cool stuff I did.
** Since some people are misunderstanding the thread.
1. I know it's my job. But sometimes we're proud of a quick diagnosis and want to share the feeling of doing a good job.
2. I was not on duty there. I came from another place out of courtesy because a junior asked for help.
It isn't even that he cared about the man. It isn't even that he did it because he was an angel of good will and kindness. He was just an average person. But to him it was something that people 'just did' for other people. Nothing fancy to boast about.
I was humbled by the casualness with which he said it, as if it were just a simple thing. He came to stand beside a random stranger off the streets, buying medicine for, running errands for, and taking post op responsibility for.
@i_srd
They don't know any better. When you grow up in a village with no future prospects, no vision and no one to look upto; the most powerful person in your locality becomes your role model. That invariably ends up the local mullah.
My mom got transferred to a new hospital and I'm so happy for her because it's got relatively light duties and work hours. She comes home looking very refreshed and alive. She's a old lady and she can't really work hard fulltime anymore, so I'm finally stress-free about her.
I consider myself a very good man. One that goes over and above for others, in my own way, but I would NEVER have agreed to take care of a total stranger. It is none of my business! I have my own life to live! I'm too busy!
A hundred different valid reasons.
I was taken aback. "What do you mean?"
"Yes," he replied. "One of my friends told me that there is a patient in the hospital. He's very poor and has no relatives, no friends; no one in the world that cares about him. He told me to come and make arrangements for him so I came."
Disconnected everything and heard a long whoooosh as the COPD patient(whom I recognised on first sight) let out a held breath. I reduced my bagging rate to a comfortable 8bpm.
Watched as the heart rate went up within the minute to a 100, and the spO2 to 100% and next co2 70. /3
I had a crush on this cute tiny surgery resident. Then yesterday she asked me why the patient was saying weird funny things. She asked whether I gave her ketamine.
She pronounced it keta-mine instead of keta-meen. Instant crush death. Instaaant. I don't like her anymore.
Here's a discussing we don't have: The other day a child was brought in for hypospasias repair. On the OR table I examined him for anaesthesia and he had a bad cough. "case cancelled" is the label. I went out to talk to the dad and he said the child was totally fine at night /1
Bagging him furiously with an ambu but the O2 sats were 70%
The heart rate went from 60 to 20 right before my eyes. The MO screamed for a crash cart.
I calmly took the ambu bag from him and told him to just watch the magic. I did absolutely nothing. Just stood there. /2
What a strange age. The angry patriarchal religious cleric(mullah) who thinks women are merely fertility objects, that should hide in their houses, is lying in lithotomy position while female surgeons operate his anal fissures and haemorrhoids.
I was extubating a patient slowly, taking my time. This one obgyn resident, who was supposed to stay until the patient was shifted, was being snarky. She kept groaning about why it's taking so long. I got pissed off, but said nothing. Then she mentioned she'd been working 30 hrs-
The wife's money is the wife's money. The husband's money is also the wife's money. That's the rule. That's how it is and should be. What is there to argue about? Yes there'll be good times and bad times, but in good times, this rule holds firm.
Our professor of Breast surgery is such a lovely lady. She was so happy to see us give blocks that she wrote up a whole note in the hospital group.
p.s. our "senior" would rather see us dead than give a nerve block. We are NOT encouraged 😂😂 Only surgeons are encouraging us.
10/ So get that damn good. Keep those patients safe. Push that extra mile. You have to. You're the poor man's doctor and that's that. You didn't choose it, you were blessed with it. Have the balls to bear THAT burden. To be questioned by your colleagues. It ain't easy, its right.
@kamdar_j
I think ultimately it doesn't matter. We will inevitably regret something or another. So it is fair to go make a life that'll make you happy. But I can't do that myself.
-in a row. Then I started to see the signs on her face, and I apologized. She didn't understand what I apologized for, but she took it.
You never really know, until you know. Maybe someone being a snarky ass is just really tired.
A memory of women.
In my 1st year of FSc(highschool) I was notorious as an extremist mullah. In my 2nd year, as an unrepenting liberal (read as infidel here.) The shock the drastic flip they percieved in me always prompted my classmates to taunt me
@aashir_badar
In treatment, one must treat even a death-sentence prisoner. Despite knowing that after treatment he must go for execution.
You are confusing two things. Hate whoever you want. As a person, remember you will also have some hidden traits that others hate. Be wary of that.
How was your day guys? All the consultants of our anaesthesia department unanimously reported me to the dean for giving a patient a GRAM of iv infused Magnesium sulphate as part of multimodal analgesia. A single bloody gram!
"Patients aren't guinea pigs!" One said. Why? Well-
Your word was my command. You were my goddess made flesh. You tore me to ribbons between your love and your expectation. It was utter blasphemy. I have been a sinner since and my heart is marked black.
Where then shall I wash it clean? Blood is not enough.
Knowing I'd have had the sliver of a chance to die in her lap looking up at her beautiful face, it would have been worth it. All of me on display. All of me laid vulnerable. And all she asked of me was to not hurt her too much when-not if, I left.
Fool! I could not disobey!
@Iman3701
At least 5 years older than you. It really does matter and work out better. You should be in two different career stages. So atleast one of you is stable and the other moving along.
If you're both 22, you'll both be living off parents' money.
1/ Had a case of a manual labourer today. He was very anxious after recieving spinal anaesthesia, so I gave him some midazolam. It worked for the most part, but he asked if he could get something to put over his face(possibly to sleep?)
So I gave him a large sterile gauze piece.
@DaktarAlmost
No. There is no practice of regional anaesthesia where I work. Neither skill nor equipment is present. Maybe someday in the future it will be, but my equipment and skills are personal ones.
P.s. I think I missed a HUGE chance. Shoulda said, "You be keta-mine, and I'll be keta-yours 😉"
And then she'd throw a scalpel at me, and I'd deserve it too tbh.
My mom has this uncanny ability of dozing off infront of the tablet screen watching dramas after dinner, and the moment I slowly creep my hand towards the power button to close the screen and take it away, she'll bolt right up and awake; slapping my hand away. "I'm watching!"
Tomorrow is my last day of residency training at KTH anaesthesia. 4 years went by just like that. *Sigh*
I did the best I could. I came, and I went, and I'll be forgotten. Life will always move on.
@DesiGigi1
Lots of people have perianal issues like hemorrhoids, rectal prolapse, abscesses, fistulas, without ever being homosexual. Don't be silly. A medical issue is a medical issue. Not every butt related disease is because the patient had anal intercourse.
"what are you doing to her?" asked someone, as they watched me stroke the baby's little head and pat its little belly on the operating table before surgery.
"Nothing," I said, turning. "There is nothing I can do. She won't survive this. I just don't want her to feel alone."-
@eternalmoonrise
Hello, Anaesthesiologist here. Friendly reminder that C sections aren't the only emergencies you can expect. At times, even after a normal delivery you may end up bleeding immensely. either from episiotomies, atony or other reasons. If the blood doesnt stop, you might need surgx.
Everything happens for a reason and you will always be placed at the right place at the right time where you are needed most.
Today our ot list finished at 2pm. I wanted to go straight home. But for some reason I found myself sitting in the OT seating area. /1
This is a true Pakistani muslim in his true colours. This is who we really are. If someone does not comply by this swine's idea of oppression, they should be abducted or raped to "teach them a lesson". Spread this so his mother knows her son wants women abducted.
#duamangi
This little girl had multiple surgeries observed that anaesthesia guys cancel bad chests. She comes into the OR, sees the first person with the stetho(me)
She: *fake coughs* My chest is bad, I have an infection. Anaesthesia is cancelled. *looks around to see effects*
One of the worst attitudes that I didn't think was ever going to be a factor in my life is senior doctors here hampering your progress.
Quite literally they will neither tolerate your progress, nor progress themselves.
e.g. Seniors at my department don't know how to do-
I sneakily passed ultrasound guided iv cannulas to 4 different cancer patients in a private hospital in the past two days who had difficult/impossible iv access and multiple attempts.
They were afraid of costs since I brought in an ultrasound machine. Their faces lit up when-
Today a senior madam at work came to ask me something, and as soon as she entered my zone, she said, "Umair! Tum ne smoking start kiy hae? Ye kab se!?"
I said no way!
She replied, "acha tum se smoke wali smell arahi hae."
😭😭😭😭 Thousands of rupees ka perfume flop!
@Hamza_Dhothar
Yes, he should. It is a simple matter. While in active combat, the enemy is the enemy. When an enemy solider becomes a prisoner of war, he will be treated.
An enemy and a patient are different. Different times, different situations.
Yes, advixe maybe given.
@eternalmoonrise
Persistent bleed post partum bleed can seriously harm you. Though we consider pregnant women full stomach despite being off food, it makes our lives and certainly yours, a hell of a lot safer if you keep your stomach empty. Thank you.
I give up. I don't care anymore! I'm never auscultating the chest again. It's literally like people forget how to Fucking breathe when you ask them to take deep breaths!!!???
How did you even get through life this far without knowing how to take deep breathes?
And that's all she wrote folks. No parades. No people to say goodbye to either :( everyone had left for their villages.
Dr. U, signing out all quiet like.
Also additional stages of sadness = eat candy from Jan's deli to drown the emptiness in one's soul.
Heart breaking moment for me 😭😭😭
I was out of the hospital doing paperwork for my training rotations. I'll be leaving KTH very soon. While I was at an office, I got a call from a fellow anaesthesiologist, "Hey Umair, we need you in room 11, a baby needs a cannula in-
This is just embarrassing for a country that does so much bakwas on morality and loves being internal and external moral police, hashtags such as #کھسرا_کھسرا_ہوتا_ہے and
#randiinmandi
became trending. This is the level of Pakistanis' mentality. You expect to progress like this?
The more you consume, the worse you feel. The worse you feel, the more you consume to drown those feelings. The more you try to drown them, the more they drown you.
The dark samsara. The cycle of death and redeath. Dying with every breath. It must end. I must wake.
@healed_warrior
I wouldn't have known how to communicate it. The senior doctor still held his calm. I would have been at his throat, and achieved nothing.
8/ life savings just to afford getting to the hospital. He'd rather have risked lose the child, than live through the horror of finding means of bringing him here again. It fuckin hurts, but that's the burden we bear in the 3rd world. There is more to medicine than protocol.
1》Heard from someone today that a senior anaesthetist wanted to cancel a case because of >180 systolic bp on table in an aged patient. The surgeon told the senior anaesthetist to, and I quote, "burn your medical degree if you can't treat a bit of hypertension." because he was
Had a brief but real heart to heart with a patient today.
late teens young lad in for gynecomastia surgery. It wasn't my case but it piqued my interest. Went in and the dude looked nervous and uncomfortable. His chest was covered with a drape, but he looked rigid. /1
3/ He mentioned he's slept on the roads looking for work. Maybe this was a treasure to him. I took a few more and put them in his pocket.
#gratitude
#thelittlethings
Just giving y'all an annual reminder(that I re-upload every year) that I ONCE HUGGED A PENGUIN. 🐧
Every time facebook brings it up, I am reminded of peak life. Back when I could just fly around and hug penguins. *Sigh* F this.
The OR closes at 4:00pm.
She thinks I still put her cases under anaeasthesia at 3:59pm because I love my job.
I think I put the cases under because I love her.
@DrMattThomas1
You're holding the laryngoscope too high and you're in too deep.
Let it rest on your fingers. Don't grip the blade. It is NEVER about "power," be gentle. You get a view just at the base of the tongue, aim at not going in too far or you'll see nothing or worse, see and not reach.
Some relationships leave you with your words flowing like an open artery: red, hot, urgent! Love and words; words and love, like life itself.
Some leave your words sliding like grains of sand under gentle desert winds.
Some others dry them like a desecrated corpse.
7/ What do you think went through that father's mind when he signed that paper? Do you think it was "just an elective case" for him? He was desperate. Desperately poor. That hypospadias might as well have been a TOF. To us, it was as simple as refusing the case. To him it was his
9/ I had to be, HAD to be, more than just a doctor. I had to be his shame and his honour. The shame he would bear that he could not afford to get his child private surgery(who wouldnt have cancelled.) The dented honour when his child kept reminding him how uncomfortable he was.
Lol so I went to work yesterday and this female surgery resident was wearing sindoor(?) red paint across her hair to signify marriage(?)
Ofcourse, it's a super unique sight to see in our society so everyone was a bit excited and gossipy over it.
@viswas_mr
Anaesthetists are absolutely shit at taking histories :/
UNLESS they are hell bent on cancelling a case. They will diagnose the patient's great grand mother with a hereditary glycogen storage disease just by question the patient lol.
*Just to join the trend bandwagon*
Those who have any doubts about my degree or me being a doctor:
Saalon! mujhe khud bhi yakeen nahi araha ke me doctor hun. Tum chuthyon ko kya yakeen dilaunga. 😂
If you were to suffer a wound upon your body, would you clean it regularly, or would you smear filth upon it and let it rot? You would clean it.
Then why do you let the wounds of the heart and mind rot? Instead of pouring clean water upon them, you foster them with added poison.
I am so proud of myself that I've finally learnt to remember to take a reusable cloth bag with me to the local market to pick up stuff. God, there's a mountain of them stuffed in the storeroom.
I do not miss her. I miss the 'me' that loved her. I miss loving! I miss the way my heart leapt with excitement when I first saw her every morning. I miss when I hated to leave her and found countless excuses to stay.
I miss who I was for her. I miss myself.
So that's that then. My worst fear realized. I came, I went, and I couldn't teach anyone anything at all. I learned personal skills and became very good at what I do, and as I leave, I haven't been able to convince a single other person to invest time to learn the skill.
"Don't become your parents, Umair. Don't become your parents. Don't become your parents. Don't become your parents."
10 years later
*Becomes my parents*
Today I was giving a patient a femoral nerve block under GA right after induction so that I can have good pain control and vitals. It takes me about 5 minutes on a bad day. I was half way through my syringe when this ortho guy showed up all,
Our obgyn residents think labour analgesia is bullshit. They yell, scream, and patient-shame their way through labour.
We have no labour analgesia program and nobody think it's even worth wasting time on.
3rd world public hospitals 101.
If you tell a crying, laboring mama that you're "disappointed that she's not prioritizing her baby," by asking for pain control, please remember that you are not my patient and I have no obligation to be nice to you.