In ‘Military Matters’ you just need to be fast enough even in the hospital

MH Khadki, the hospital of our internship, was a wonderful place. We were exposed to new experiences every single day. The ‘faculty’ was generous and willing to share their experiences in managing patients. We absorbed everything we were taught because we realized that treating patients was entirely different from studying about diseases in a medical school, and needless to add, more rewarding as well.

One such teacher was then Major SDK, our only Paediatrician. A gentle soul, he always addressed us with the title ‘Bhale Aadmi’ that can be loosely translated as ‘My Good Man’. My friend Kris Rau finally chose to become a paediatrician, possibly because no one previously called him ‘Bhale Aadmi’! Major SDK was totally devoted to the care of his young patients, and willing to spend a long time by their bedsides. Even as he managed their illnesses, he would give us simple bedside tips that had helped him in his decision-making.

He had a tough, no-nonsense Matron to assist him in his duties. Major Kapoor was a stern, non-smiling but very efficient nurse. We interns believed that Major SDK was a little overawed and perhaps intimidated by her mere presence. She pretty much ran the ward her way, and was often heard advising even Major SDK, who always agreed with her suggestions. The younger staff nurses were only seen in the ward and never heard. Matron Kapoor was never seen to have failed in starting an I.V. infusion, irrespective of the age or size of her tiny patients.

It was, therefore, an honour to be chosen by Major SDK to present and discuss a paediatric patient in M H Khadki’s monthly clinical meeting, the very first after we joined internship. I clearly remember the small boy, perhaps two years of age, who had come to us in a state of extreme breathlessness. He was diagnosed as a case of Acute Bronchiolitis. I had participated in his management and had even celebrated his recovery after nearly a week of intensive treatment.

Poona those days faced fairly cold winters. Major SDK had a kettle spewing steam all the time by the child’s bedside. He would visit the child numerous times on any given day. My job was to keep that kettle going, and record the child’s vitals every half-an-hour

The miraculous recovery of the child by the end of the week spurred Major SDK to send the details of his illness for inclusion in the monthly clinical meeting. I was chosen to present and discuss the case.

I spent days preparing my presentation on epidiascope slides. The small X-Rays were carefully numbered. I accessed every book on Paediatrics in the hospital’s small library. Major SDK made available some journal articles for me to go through. We discussed the sequence of my presentation multiple times. I had a slide towards the end which stated that our Paediatrician will now come and discuss the case. He tore it to pieces, and said, “Bhale Aadmi, you managed the patient. You spent long hours by the bedside. You are the one who has read all about Bronchiolitis. Why would I come and discuss the case? That responsibility is also yours!”

The adrenaline surged in my veins. This would be absolutely the first time I would be facing professional doctors in a clinical meeting. There were trepidations in my heart and for once, I was scared.

The clinical meetings at M H Khadki were well attended those days. Apart from all our staff, a good number of teachers and residents of AFMC/ CH SC/ MHCTC Complex made it a point to attend those meetings. Our Wet Canteen had a great reputation of serving delicious Samosas and hot Jalebis with tea at the end of these meetings. I suspect many came for these meetings just to enjoy these snacks. The question-answer sessions were lively. I didn’t know how well would I be able to acquit myself

The appointed hour finally arrived. I went up to the lectern to deliver my presentation. The presentation went off well enough. If I was anxious, I did not let it show. The dramatic presentation of the child and his subsequent recovery were duly presented. I even discussed the entity called bronchiolitis without stumbling.

The chair appreciated my effort and then invited questions and comments. From the very first row, the tall and handsome figure of Colonel A S Chahal, Professor of Orthopaedics of AFMC rose to ask a question. My heart was in my mouth.

“You mentioned that the child’s heart rate was 180/minute. How could you count that fast a heart rate?” Well, I knew I did not have the child’s ECG in the case records. ECGs were few in those days and almost none in the Paediatric Wards. I quickly blurted, “You just need to be fast enough with your counting!”

The whole house burst out in loud laughter that went on for quite a while. Col Chahal grinned and sat down. The meeting was closed and attendees invited for the ritual tea.

And for many years afterwards, total strangers kept coming up to me and ask, “Are you not the one who said ‘You just need to be fast enough’ to Col A S Chahal?”