It's Lagan Season

Last week, as I travelled from Alleppey to Ranchi, few of my staff called me and told that there were very few buses available from Ranchi to come to NJH as it was 'lagan season'.

'Lagan season' is the season of marriage in this part of the country. The connotation is for the auspicious period when marriages can take place. The present marriage season has started from sometime during the second week of May and will extend to the last week of June. Someone told me that it could go all the way to the middle of July. 

Why the great interest in the 'Lagan season' for NJH?

It's all about the hospital becoming busy. The patient numbers come down to a great extent during this season. The reasons . . . everybody is going to someone's wedding. There are no vehicles to come to hospital as most of them will be booked by marriage parties. 

Soon after I arrived at NJH last Sunday, I had gone for a haircut. The barber and few of the customers were surprised at my decision to come back so soon after I had left for Kerala. One villager quipped, 'Sir, you should have taken a longer break. It's so hot and it's marriage season. There will be hardly any patients'. 

But, we've not been so much derived of patients. There's quite a good number of patients coming to outpatient as well as inpatients. We've been busy. 

Then, we receive patients who just want to get cured just in time for a wedding in the family. Basil is quite used to young men and women who want to have a perfect teeth just in time for the big day. I had a family whose middle aged mother was dying of tuberculous meningitis, who wanted me to keep the lady alive till a wedding in the family was over. But, then that never happened.

2 years back, I had a peculiar request. A father and his son who going to getting married in a couple of days came to Outpatient. The father wanted me to ensure that the son did not cough even once when the wedding ceremony was going on. He just wanted me to prescribe a cough syrup. And the son was totally asymptomatic.  

I sometimes wonder how the concept of the 'Great Indian Wedding' has permeated to the rural areas of the country . . . when the whole world stops, when there is a wedding in the village. 

Or was it always like this since the ancient days ? ? ? 

What a place ? ? ?

It is not more than 5 months since I put up the snaps of a very cold winter in NJH. I even had a snap taken of the temperature measured on that day . . . January 8, 2013. 

But, today was a totally different day. The temperature was so high that our thermometer was not enough to measure the temperature. I wonder if it was at least 55 degrees Celsius. 

Good for all people who are away on vacation. But, the better news is that we've been having good electricity supply since the last month. So, not an intolerable summer . . . so far. 

Of course, we would be happy to have some rains . . . Lord, please send us showers of blessings . . . 

The Unfortunate One .. .. ..

I took first call last Monday after quite a long time. It was quite a busy one and got quite a wide array of cases which would have put a Medical College to shame, especially the newly opened ones. 

But, the best case was the first Cesarian I did for the day. A usual case of 'you know what'. 

It was about 9 pm. I was just planning to go for dinner when CJD, a 35 year old lady arrived in labour room. She had been trying to deliver at home since early morning. With the sort of heat we've been having of late, she was so dehydrated and worn out. To complicate matters, she had undergone a Cesarian section for her last child birth which was 2 years back. 

That was the last thing I wanted after a quite busy day in outpatient. 

And after the details emerged . . . I was sure I was sitting on top of a time-bomb. 

Cesarian done 2 years back while she was preterm. The baby was a girl who was just 1800 gms. The family was of course quite anxious for a boy. And her blood group was A negative. 

Per vaginal examination revealed that the labour was obstructed. I initially thought about doing a instrumental delivery, but I was not confident about the outcome, especially the chance of a rupture uterus. 

From the onset, I tried to refer CJD to Ranchi. But, the family looked hardly bothered. We have a protocol of not doing a repeat Cesarian section without the provision of at least one unit blood. And it was difficult to get a pint of A negative blood. And the family had made no effort to even think about it, leave alone arrange it. 

I had to take a decision and go ahead with some intervention. After much dialogue, I agreed to take her for a Cesarian section. The hemoglobin was 10 gm%.

The Cesarian was a mess. There was too much adhesions. 

The baby was sick. And continues to be sick. And it was a girl. 

We asked the mother whether the family knew that the baby was a girl. 

However, considering the attention the family never gave to CJD, I wonder if they knew well in ahead that the fetus was a girl. 

The baby is very sick. We've been telling them to take the baby to a higher centre. But, they are hardly bothered. 

And CJD was the first patient of the night. I became free only at 5 am the next day. There were 2 more complicated labour patients, who needed Cesarian section and then one elderly man with a myocardial infarction. But, then the list of patients with the varied hue of diagnoses of the day, in another post.