Dr Shirahatti is hereby directed to explain in writing…..

I was despondent, standing outside the Dean’s office clutching an official looking paper. By this time, I knew the contents by heart. ‘Doctor Shirahatti  is hereby directed to give an explanation in writing within twenty four hours as to why action including criminal proceedings should not be instituted against him’ The entire tenor and contents of the letter rankled.

Sion Hospital was a 1400 bedded hospital run by the Municipal Corporation. The occupancy invariably was near 110%. The wards were chock full. Patients were accommodated on mattresses laid on the floor. While making morning rounds, you had to carefully step over the “floor patients” There was this peculiar rule that stated that we could not refuse admission to any patient even if all beds were taken. Among the most crowded were the surgical wards.

Due to overcrowding, surgical supplies frequently ran out. ‘No stock’ was a standard reply to requisitions from the ward. Most nurses resorted to over requisitioning of stuff that they hoarded to tide over shortages. Most of surgical supplies were kept under lock and key and doled out to residents grudgingly by the nurses. Sometimes even these reserve supplies ran out and there would be trouble.

“Shortages are a fact of life in our hospital Guru” My registrar Rajesh informed me. “Make sure that you have a reserve stock of your own for dire emergency situations. If the patient seems to be well to do, request him to buy two Foley catheters though you will be using only one on him. The extra catheter can be used if we get a poor patient who can’t afford to buy it in case the ward runs out of catheters. It is little comfort to a patient of retention of urine to be told that we can’t catheterize him as the ward does not have any” was his sound advice.

Most of us House surgeons would hoard surgical items. The most expensive but prized item was the ultra thin Prolene suture used for vascular injuries. Special tubes used for chest drainage, nasogastric tubes to drain the stomach , urinary catheters were jealously hoarded. Intravenous cannulae were precious. Most house surgeons would carry a small carpetbag stuffed with these goodies to the OR. There was a very robust barter system in place. If you wanted a Foley, it would cost four intravenous cannulae in exchange. A nasogastric tube would cost you an IOU to be redeemed later. A house surgeon was considered to be efficient if he could produce any item from his bag like a magician pulling a rabbit out of the hat. Woe betide the house surgeon who was found lacking!

It was the end of the financial year. The hospital had run out of grants for supplies. ‘No Stock’ appeared on almost all requisitions. It had come to such a pass that even the most prudent nurse admitted defeat. My carpetbag had become very light. We were in trouble. We had utilized almost the entire stock of our reserves. To top it up, the emergency was heavy with a steady trickle of admissions.

This sixty year old man was admitted with retention of urine. His bladder was distended and he was in agony. It was obvious that he needed a catheter drainage. The ward had no catheters. With trepidation I scoured my carpetbag. There was no joy here either. Something had to be done immediately. I called Krishna a fellow house surgeon from the other unit. “Sorry Guru, I used the last Foley yesterday. I don’t know how I will manage my emergency tomorrow”

Sudhir,  my fellow house surgeon and I held a battle conference. “The only place where we can get a catheter is the VIP ward. The place is chock full of unused supplies” said Sudhir. But they will not lend us a catheter, I protested. “I am not suggesting a loan. I think we should take a catheter lying around in the VIP ward. We can replace it quietly later” If we get caught? We would be in a most awful trouble. Sudhir had an idea. “You know, the nurse on night duty is a little..Ahem, sweet on me. I will distract her and you pinch a Foley” I was doubtful but we had no alternative. Our patient was rolling in his bed groaning. That decided us.

We walked into the VIP ward. Sudhir got to work with the nurse. Soon the nurse was giggling and totally engrossed with Sudhir. I saw a bunch of catheters. I picked up two, just in case. I turned to leave and bumped into Dr Vino Bhave, our Dean! He was standing behind me all the time and had seen me pocket two catheters. His face was hard. “Stealing hospital property are you boy?” he thundered at me. It was for a poor needy patient, I timidly tried to explain. He made me write a loan chit to the nurse for the catheters. Sudhir and I were crestfallen. The next day the attendant from the Dean’s office handed me the official looking envelope.

The only person who could save my skin was the Prof. I went to his office and showed him the letter and confessed everything. His eyebrows knitted. “Go down and meet the Dean. I will see you there in ten minutes” was his short reaction.

I waited outside the Dean’s office. Mrs Kane, a matronly woman who was the secretary called me to her office and offered me tea. I refused, my mind in a turmoil. Prof swept into her office. “The Dean is waiting for you Sir” Mrs Kane ushered him in. I applied a ear to the door of the office. I could hear raised voices.

“Vinod, what stupidity is this? At worst this is a minor misdemeanor. You cannot penalize him for trying to treat his patient by any means possible” I could sense that the Prof was furious. Our Dean was a short rotund bald man. He was a very successful Cardiologist before he decided to turn administrator. Even now his residents, consultants themselves would speak in awe about his clinical skills. He had pioneered coronary angioplasty in the city. He was short tempered  and would explode at short notice. He also had a explosive laughter that lay very close behind his short temper. “How can you defend the indefensible, PJ? The boy stole hospital property. He needs to be punished” “Since when have you become ossified Vinod? God knows how the residents manage patients when things are not available. He did not take the catheter to sell it. He was to use it on a patient. Do you remember our days as house officers?  We were as bad if not worse than these boys. The escapades that we got into! Do you recollect the time when you…” Prof’s voice fell. I pushed my ear harder against the door ignoring the disapproving looks by Mrs Kane. Try hard as I might, the voices were just murmurs. Suddenly both exploded into laughter. I relaxed knowing that it was going to be OK.

Suddenly the door opened and I almost crashed into the Prof. “Eavesdropping I see. Should we add this to your list of misdemeanors?” Prof’s voice was stern but his eyes twinkled……

Author: drshirahatti

I am a surgeon, specializing in Gastrointestinal Surgery...I have headed the Departments of GI surgery, General Surgery and Medical Education.....I also was the Dean of two large government hospitals in Mumbai.....I like reading about cultures and like to travel....

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