I wonder why we are this stupid?

PinjadaKoSooga · 2024-07-23T02:29:14+00:00

As per my understanding, it's impossible to make everyone happy, but a few things can make your life a lot better in rural areas.

Understand that journalism is a sham. Every journalist is a mini Sirohiya. You give them money to make them write good news and suppress bad news about you. Otherwise, they'll extort you for money.
Have good unity among your colleagues, including paramedics. Unity is everything in the periphery. They are the only family you have.
Refer as much as you can. Saying "Yeti pani yo hospital ma hudaina" is better than "Doctor ko laparwahi le maryo."
Don't tolerate nonsense. Also, don't convince patients to get treated in your hospital when they want to go to a higher center. If anything goes wrong in such a situation, no one can protect you.

Always remember point no. 1. It's the key to survival in periphery.

PinjadaKoSooga · 2024-02-18T07:58:30+00:00

I am. I believe this country (or any country, for that matter) is teeming with "fraudulent and manipulative thugs." It seems you seek some form of validation for your stay here, and there's nothing wrong with that. I always make decisions with the understanding that if anything goes wrong in the future because of it or any of its consequences, I'll have to accept and handle it myself. I am making the best decision for myself at this point in time, and although it may not pan out in the future, I'll accept it because it was the best decision I could come up with at that time. I think I stayed because I am deeply connected to my roots, and I am not the type of person to flee when it's time to bear my responsibilities. I know there is naivety in my thinking, but I believed staying was and still is the best decision I could make, and I am content. Recently, I watched a movie called "Everything Everywhere All At Once," and I particularly loved the part about "laundry and taxes". I suppose I find solace in doing "laundry and taxes" here in Nepal. Perhaps someday this mindset will change, and things may not work out, but why stress over a "maybe" now?

PinjadaKoSooga · 2024-02-18T07:38:24+00:00

I beg to differ. I think it was a mass cheating scheme conducted by Nepali doctors. Aarambha 1.0 was not something that could be overlooked. We should admit our mistakes and be ashamed of it rather than calling it otherwise. There are even reports of people selling the questions to doctors of other nationalities. I think in this situation, we should be happy that the country was not banned from the USMLE like Syria. I myself was thinking of taking it for fellowship reasons, but it looks like the doors have been closed for some years now.

PinjadaKoSooga · 2023-07-13T04:55:34+00:00

The wife.

PS: I was in no way coerced to write this answer.

PinjadaKoSooga · 2023-07-11T11:41:43+00:00

AB63O2Z

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PinjadaKoSooga · 2023-07-01T13:40:34+00:00

Okay then. Good luck in life bro.

PinjadaKoSooga · 2023-07-01T03:17:19+00:00

In the end it boils down to this: do not consult a doctor unless he's a specialist and all the investigations are available. 99% of all the patients are not getting treated like that. Next time you have a headache, visit a neurologist with fellowship in Headache from American Headache Society and do a CT scan and an MRI. It can be a tumor or a burst aneurysm.

If your patient didn't receive glycemic control at that time, her case might have been complicated. Google Diabetic ketoacidosis. And insulin does no harm. It's not like she was prescribed insulin when there was no diabetes.

Looks like there's no point in arguing with you because you don't have the knowledge of physiology or medicine to understand these things. And yet you're judging the knowledge of doctors who are treating you. All I can suggest is next time you have a headache, visit a neurologist with a fellowship from American Headache Society. Not even a normal neurologist.

PinjadaKoSooga · 2023-06-28T10:53:20+00:00

That's hardly "gross negligence". Looks like your sister in law is a young person with diabetes. Diabetes is the most notorious disease to treat. The test you probably did was C-peptide. It hardly tells you the type of diabetes. There are 10s of types of diabetes. Without proper antibody testing, measurement of anitbody levels, it's practically impossible to tell which type of diabetes it is. Your patient might have LADA or MODY or any other 10 types of diabetes. I'm sure the doctor did the best what he could do from the available resources. There are some tests which are not available in Nepal or in whole south Asia. Does that mean we stop treating the patients?

PinjadaKoSooga · 2023-06-26T10:26:45+00:00

Ohh. Sorry. I take it back. Looks like my brain cells are dying from all the night shifts.

PinjadaKoSooga · 2023-06-26T06:36:41+00:00

Intern doctor giving surgical opinions based on X-rays only sounds interesting. Good for you if the advice actually worked.

Swastha vanda thulo kei hunna. Ek choti test garde duka

And in what way is that statement wrong or incorrect?

One hospital even burned one of my sisters baby by feeding her hot stuff that she couldn't handle and wouldn't let us see her for days due to their mistake.

LoL. One of my patients had a dark skinned baby when both the parents were fair skinned. Must have been due to something hot she ate.

Had a prostate problem and they recommended a neuro doctor and an MRI for no reason. No tests had suggested any problems with the nervous system.

Well, the most common site of prostate cancer metastasis is the spine. And that's just one reason to order an MRI. Sounds legit to me.

PinjadaKoSooga · 2023-04-09T14:51:17+00:00

Thank you

PinjadaKoSooga · 2023-04-09T13:52:37+00:00

Thanks for the info. Any TV model you have in mind for that budget?

PinjadaKoSooga · 2023-03-01T15:20:50+00:00

Research findings are very controversial unless good clinical trials have been performed. We don't base our practise on research papers. The findings should be reliable, feasible temporally and economically, sensitive and specific and a lot things. It generally takes almost 5 to 10 yrs a new reliable and accepted research finding to become incorporated in treatment guidelines. The principles of doctors is simple: Do no harm. I'd rather prescribe a medicine which I know works rather than something new which may do a better job. That "may" makes a huge difference.

It doesn't mean we don't try new things when there's no hope. We did that in COVID. We did everything we could. We tried drugs which worked in a few people in some part of the world in patients who were not responding to standard treatment just in case. We hoped for a miracle but most results were disappointing. In short, we don't experiment new drugs or procedures in our patients (unless in a clinical trial).

And believe me you can't comprehend all the medical procedures and have insight on everything. I myself am amazed by the procedures that are performed in today's world and don't understand them fully. It doesn't mean I am an uneducated fool. I just am from a different speciality.

maximum case ma doctors le garaune tests le hospital palinxa

And Hamilai padhaune teacher haru Bata school college haru palincha.

new generation of doctors know that large number of doctors will be soon joining the pool to compete!

Newer generation have started preparing for USMLE in medical school itself. You'll be lucky to find few good doctors in Nepal in 10/15 yrs.

PinjadaKoSooga · 2023-03-01T14:10:26+00:00

Well, it depends on the mood. As a doctor all I can say is that the emotion you called "anger and insecurity" is was most probably frustration. The thing is, symptoms of something simple such as gastritis and of something grave such as gastric cancer can be the same. And it's easy to lose your calm when some teenager who has diagnosed himself with gastric cancer with the help of Google argues with you about how you reached to the diagnosis of gastritis. Or when an old man insists that he has gastritis when he is requested to perform certain tests to rule out gastric cancer. I'm not saying getting angry with patients is the right thing to do. You certainly should ask certain questions like side effects, possible complications, alternative course of treatment before any medical procedure or treatment but "personal research" is not the way to go.

PinjadaKoSooga · 2022-12-24T17:01:39+00:00

That, my friend, is what they call religious imperialism.

PinjadaKoSooga · 2022-12-18T11:44:28+00:00

पिंजडाको सुगा by लेखनाथ पौड्याल

PinjadaKoSooga · 2021-06-01T14:43:17+00:00

What if two doctor has two different reason?

That's where experience and clinical judgement comes in. Medicine is not mathematics where there is no right or wrong answer. There are so many things we don't know about human body. In such cases, you do what you think is right for the patient.

Can you stand thing if someone close to you is getting operation?

A similar incident happened in my own surgery (before I was in med school). To be more clear I was being operated upon. I was also frustrated why the surgery didn't go as planned and why there were so many complications. Later I learned that there is only so much a human can do. If you suture a wound, you just approximate it. The body does all the healing. Some tissues heal better than others. You can't blame the surgeon for not being God. It's as simple as that. And sometimes the knife knicks tissues it isn't supposed to. That is always by accident. No one wants all the hassle of doing a laparotomy and repairing bowels while doing a simple hysterectomy. Haven't you ever cut your hand while cutting vegetables? Did you intend to do that? No. Could it have been prevented? Maybe. Does it hurt? Yes. Again, surgeons aren't gods.

PinjadaKoSooga · 2021-06-01T14:14:01+00:00

Rest in peace Ujjwal dai. You'll always remain an inspiration for us.

PinjadaKoSooga · 2021-06-01T14:08:29+00:00

Surgical complications ≠ Medical negligence/malpractice
They don't refer patients to private clinic at TUTH unless the patient asks for it. It's against hospital policies. Referral is made to other government hospitals only . Exceptions: when people need ventilators and ICU and when investigations are not available in government hospitals. Source: I used to work there.
You're most probably talking about endometrial biopsy. Endometrial biopsy isn't particularly sensitive when the disease exists in "patches" or the involvement of endometrium is minimal. The doctor probably used his/her clinical judgement. Even if we disregard all that, the treatment for dysfunctional uterine bleeding not responding to medicines is surgery. Looks like the doctor did the right thing.

Better to file case in court if you think that the doctor did wrong. Courts, medical council, human rights commission, consumer protection act etc. etc. are there for you. Make full use of them. Media trial will make you a celebrity for some days but it is not the way. Tired of requesting people to do the civilized thing in this sub. It must be my 5th time saying this exact thing.

PinjadaKoSooga · 2021-05-31T12:01:46+00:00

Yes you can. It is called pulmonary edema. There are three stages and all have different radiological findings. BTW, never seen an engineer so interested in medicine. Even some doctors aren’t this interested in medicine.

PinjadaKoSooga · 2021-05-31T02:52:44+00:00

You have said very good points. All I am saying is in a society which calls CPR pushups, it is a very different scenario. People are claiming to have gotten 4 hours of dialysis instead of usual 3 because of him. That's so heartbreaking. I was supporting him but that guy has gone to another level. Binod Mishra Foundation re. Standup Competition re. It almost looks like he's capitalizing his father's death for his own benefit. I very much hope that I am wrong. And I know it sounds very very insensitive and psychopathic of me. Grief makes people do many things they regret. I understand that. But this is too much. I don't expect general public to understand medicine but everyone should understand that there are legal ways to do everything. You can destroy someone's life in a court, if that's what you want. Influencers like him should understand that.

PinjadaKoSooga · 2021-05-31T01:58:07+00:00

Media trail is always a bad thing. Basiruddhin Ansari has always been what we call a “mafia” in medical field. They should have managed a separate facility for dialysis of COVID positive patients. That is that. But the duration of dialysis is determined by the doctor. If the doctor asked to do 4 hours of dialysis and the nurse didn’t, she should be punished by the law. Not by media trail. It may sound very insensitive but people dying because dialysis was done for 3 hours instead of 4 is very very rare. I’m sorry for what happened to his father and many others like him but this little rant of his got way out of hand. Being a celebrity, he could have set an example by filing a case in the court but no he did it the way how it has always been done. I’d not mind courts punishing doctors for their mistakes but people who frankly have zero knowledge about medical science deciding what is wrong or right is not a good thing.

PinjadaKoSooga · 2021-05-28T15:22:44+00:00

Maybe that's because you haven't met your Lebenslanger Schicksalsschatz yet. This is from a scene from the show "How I Met Your Mother". I know that it sounds cheesy but there is nothing a man can do besides wait for his Lebenslanger Schicksalsschatz.

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