20
Jan
10

a bit of background

The hospital is the final referral centre for all paediatric specialties in the region. Patients from all the hospitals in the city and nearby towns, besides neighbouring districts. Some even from other countries referred for specialized treatment. Well funded, hence well-maintained. Minimum interference from government agencies.

The Chief calls the heads of different departments to his room, introduces everybody, asks them to make me “feel at home” and assigns me to a paediatric gastrointestinal surgeon, who will be my guide and counselor for two years. And my first thought is, “Why a GI surgeon, of all people? I don’t want to have anything more to do with perforated ulcers or bleeding esophageal varices.”

I have seen enough of them over the years. And made some frantic, yet calmly manipulative phone calls. (The surgeons can sense panic; it’s something they are taught in the operating rooms.) “We have a stable, but possibly bleeding baby, we have IV access and have sent all the labs, her gases are okay, she will need further observation, though. We’ll send her up to you if you’re busy. We know how much you guys have to cope with!” Never mind the saccharine; it’s the specific words that make all the difference in your pitch. Always pays to put in ‘stable’ and ‘IV access’. And the admission is always for observation.

I’m a hardened veteran at this, having worked on the ED floor for almost 10 years now. I have waged pitched battles against the combined forces of severe disease, fatal trauma, unconcerned management, disdainful specialists, unhelpful laboratories, demanding policemen and aggressive relatives. And I still get nervous when a really sick neonate is brought in. Invariably the paediatrician on call is doing something incredibly important at the very moment you try to get in touch with her, so you end up examining the baby. For the record, I know what to do; I know the immediate management – try the paeds’ number again. And I was getting tired of this. I had to get this phobia sorted out, I couldn’t work like this. I have no problem once the baby has crossed the crucial one month line; it’s the neonates that trump me.

So I made the obvious decision. To come to Russia and train in pediatric emergencies and neonatology. Actually I did a lot of research on the available options, about seventeen seconds’ worth. (I had gone to medical school in Russia on a student-exchange programme, you see, which meant that I speak Russian like a native. And it was my home for nearly seven years — the best part of my youth. I was beginning to miss both the country and my old friends, especially after a vacation to Moscow last year.) So I took a two-year break from work, left my wife, daughter (love you both, miss you like hell!) and warm weather (don’t miss you that much) back in India, bought a crate of books on paediatrics and neonatology and a pediatric stethoscope and took the next flight to Russia.

And here I am. Loving it, hating it, persevering with it. And here are some notes from my journey.

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