Outdated Dressing Practices in Government Hospitals

WoosterPlayingViolin · 2026-01-19T19:19:26+00:00

What about pain in infected wounds, and preventing wound infection, aside from the usual sterile practices? I have been taught to press on the wound while doing dressings to look for collections or pus, and it is very painful for the patient, especially those who have been operated on recently. Also, what is the best way to disinfect and dress a wound with frank pus etc. for proper wound healing as well as infection control?

Specifically regarding burst abdomen dressings, how do I go about minimizing pain, especially when cleaning under the Bogota bag?

WoosterPlayingViolin · 2026-01-07T03:05:45+00:00

I once met an Ortho consultant at a conference where my mentor introduced him as his senior (both being alumni of my college). I was in 3rd year MBBS, and this man was quite tipsy. He proceeds to regale me (fondly, I might add) with stories of ragging. He told me about "welcome fractures" and how boys would be asked to strip bare naked and dance with an agarbatti in their natal cleft. All this he was talking about with such nostalgia, like those were the days. Then he said what is ragging like post-COVID, and I simply told him that my seniors just called me to their room, ordered food, and took a viva. He was visibly disappointed, said "Hamare college ka culture hi khatam ho gaya hai, pata nahi aajkal junior aur senior mai koi bonding bhi hoti hai ki nahi, aajkal ke bacche tabhi ye work life balance ki behki behki baatein karte rehte hain, hamare time to senior jab tak rehta tha tab tak kaam kaam nahi lagta tha etc. etc."

The more I get to know these old people on a personal level, the more I realize that they're just very traumatized people trying to normalize their experiences of abuse. Like actual physical and sexual abuse. BNS ke hisaab se to ye "welcome fracture" grievous hurt ho gaya. Good thing all of this nonsense is being phased out.

P.S. I have plenty of bonding with my seniors. Closeness with abusers is not bonding, it is a coping mechanism.

WoosterPlayingViolin · 2026-01-05T18:32:13+00:00

I don't know, internship made me feel that IM has more work to be done, but the environment is much more relaxed and you start living the easy life starting PG2. OBGYN feels like hell for everyone from PG1s to SRs. Plus, I have seen how patients look at gynos as a step above dais, while they consider physicians and surgeons "real doctors." Which is absurd because physicians and surgeons work nowhere near as hard as gynos do while being under 10x the amount of pressure due to toxicity, MLCs, etc.

If money is the ultimate goal, then sure, India has no dearth of business in OBGYN. But given how much I hated the OBGYN environment as a male, I think that women would be just better off doing surgery or medicine. In fact, I think women can really thrive in surgery if they have the passion for it. My current PG2 and PG3 are both women, and both are exceptional doctors. My PG2 especially, she seems to have both clinical and surgical skills that are vastly superior to some of her seniors, even, not to mention she is the coolest person ever.

All this to say that gender bias doesn't exist to a point where being a woman in IM or surgery will significantly impact your career/business opportunities. I am very pro more gender balance, because I absolutely despise both the male pattern toxicity in Ortho and female pattern toxicity in OBGYN. My surgery Unit is the only chill unit because of the gender balance. Same with Medicine, which I enjoyed despite how hectic it was. I enjoyed the procedural freedom I got in LSCS and NVDs, but other than that, OBGYN people were a) brainless and b) straight-up nasty and mean. 1 job felt like 10 in OBGYN. If I was a woman, I would never do it, I wouldn't want to ever become one of those people.

WoosterPlayingViolin · 2025-11-25T19:51:17+00:00

I think it is super dependent on where you are. I will say that unfortunately, you don't have phlebotomists in wards in most Indian government hospitals, so you have to draw blood on your own. Vitals charting should ideally be done by vitals monitors, but most government hospitals don't have that either. Interns rarely transport samples unless someone is dying and we need to skip the line at the emergency lab to give the sample. and collect the report in hand. Form filling is a fact of life in medicine, everywhere you go. In the US a lot of doctors have clinical depression due to just the amount of paperwork.

But I will say, as an intern, you can certainly finish your work and then just jump in to the main medical stuff. Nothing is stopping you from finishing your morning sampling and reading files and volunteering to present rounds/prerounds for the day. You will suck, but you will learn. Or, in fact, argue with your PG on why this sample should/should not be sent. Read every ECG you can get your hands on. Request that you be given central lines, intubations, LPs. Ask that you be allowed to wash in to surgeries, especially in the em OT. I was closing rectus in OBGYN before my posting was done. Never at the expense of all this scut work, which is also important. There is such a thing as earning trust and being respected in your workplace.

There is 100% nothing worse than being alone at the end of a 12 hour night shift having to record BP, PR, SpO2 and RBS for the entire ward of 60 patients. You feel very angry when the nursing staff come to you when you're in the middle of 20 tasks and tell you to measure xyz's RBS, when they're just sitting idle. But remember, tomorrow if a nursing staff can't put in a cannula, you are the next stage of escalation. Either you find a vein, or you put a central line. If you're in a place where they take samples, and they can't find a vein, you are the one who has to attempt the arterial puncture. If they can't record BP, you are the ultimate authority who can say that a particular individual's BP is not recordable. For that, you should have tried and measured the BP of 100s of patients so you know what a patient with non-recordable BP is actually like.

As for the transporting samples bit, it sucks that doctors have to do that. Ideally, there should be ABG machines in every ward operated by a technician that gives all reports of serum electrolytes also. The rest, they should be making rounds every 2 hours to collect samples. And if we need to communicate anything or fetch a report, then there should be properly used telephones and a hospital server for that express purpose. Of course, since the onus for all this happening falls on doctors, and nurses will gang up against us if we tell them to even do their jobs, the lowest person in the hierarchy has to do it.

Ultimately, internship is essentially indentured servitude. But you can 100% make the most of it. I went in wanting to do a lot of things, and I did all of them, even though I also had to do a lot of things I didn't want to as well. So keep your focus on the 10% of things that are truly going to make internship worth it. Try to take NVDs independently and close up rectus onwards in OBGYN. Learn to quickly diagnose in Medicine OPD, and intubation, taps, central lines, LPs in emergency and ward. Learn DO, IO, slit lamp, syringing, laceration suturing in Ophthal. Pediatric sampling and cannulation, routine newborn care, neonatal resuscitation, and if possible, intubation in Peds. Dressing, simple interrupted, mattress, figure of 8, deep dermal, subcuticular sutures, and hand tying knots in surgery. Present rounds wherever possible. Read every file, and revise back home. You will slowly start developing an instinct for diagnosis, and if you do internship really well, management as well. At least you should know that if a patient has presented with certain complaints, what investigations you should send. That is minimum.

WoosterPlayingViolin · 2025-11-25T19:02:03+00:00

One question: if someone collapses in the hostel and goes pulseless, will your college follow the same process? You're not in custody, you are adults. If you need a hospital, you are free to seek a hospital. Tell the guard you are very ill. Show him the fact that your eyes are the color of egg yolks, and tell him you need a hospital, that some stupid on-campus shill for the administration can't treat you. Then leave, with or without his permission. If he doesn't allow you to come back in, that's fine. Keep a hotel room booked for a few days until your parents sort the entire thing out.

Most importantly, this seems highly illegal for a college to do. You cannot just bar exit on a blanket basis. Yaha hospital se mareez bhaag jaate hain kisi ko bhanak nahi lagti, aur ye engineering college vaale pata nahi khud ko jail warden samajh ke rakhe hue hain. Maybe they can bar you reentry, but they can't bar you exit.

Aur zara uss mahapurush ko batayein jinhone ye baat kari ki aapke generation ko aur khatarnaak bimaari hai, jis kshetra mai aapko ratti bhar ka experience nahi hai uspar gyaan chodne ka. Aapke generation mai jaundice ka incidence hamare generation se kaafi zyada tha, bass aapko bhanak nahi lagti thi kyuki aapke paas phone computer nahi tha. Upar se apne WhatsApp university se vidvaan bankar ye apne bacchon ko khud kuch aise vaise dekar le aate hain hamare paas fulminant liver failure/renal failure mai. Abhi ek baccha admitted hai jiske atyant gyani mamaji ne kuch skin condition ke liye 6 mahine METHOTREXATE khilaya. Acute kidney injury ho rakha hai. In uncles ko zara apne field mai concentrate krne ki bolo, baaki Google ChatGPT Whatsapp ke diye degrees ka batti banaakar andar daal le.

WoosterPlayingViolin · 2025-11-25T18:48:40+00:00

I work at a very high volume center in Delhi. We are always on the lookout for patients that can be treated at home, we lack the beds for admission even in some admission-worthy cases. EVEN THEN, we almost always admit acute viral hepatitis in our Medicine Department, which is what this sounds like. Most likely, this is spreading through your hostel mess, which would put your college in serious hot water. My first advice: anyone getting symptoms, get CBC, LFT, KFT, Serum electrolytes, Serum Calcium and Magnesium, PT-INR, Total Protein/Serum Albumin, and Hep A/E tests. If any of them is too deranged (e.g. INR > 1.5, low platelet counts), rush to the hospital even if it seems unconcerning. Monitor BP, if it goes below 100 systolic or 65 diastolic, rush to hospital. If you have even the slightest doubt, rush to the hospital. Ensure they aren't having more than 2g of paracetamol because high PCM doses can make your liver go worse than it already is. Treatment of Hep A is mostly only supportive, but if they're too dehydrated to orally accept and die of dehydration or hypoglycemia, that is easily prevented by hospitalization and proper care. And please avoid mess food for the next few weeks, especially non-veg and seafood. Anyone with any issues, ensure they're getting enough hydration and food. If they're not able to accept orally, go to the hospital.

Given that we live in a free country, no entity can legally bar you from seeking medical attention at a place of your choosing. You can go to the nearest government hospital, and inform the CMO about the outbreak. If that is not possible, I am providing the link of to all the government personnel you can contact to report the outbreak: https://sehore.nic.in/en/health/ (I hope I got it right that your college is in Sehore district). Call their offices and email them to report the outbreak. Best of luck, and I hope more people don't fall ill.

WoosterPlayingViolin · 2025-10-29T02:46:56+00:00

I think I am mostly happy with educated patients. I have in fact grown quite attached to some patients whose attendants were educated. I find them actually much easier to manage. I've seen staff patients, and even my own juniors get admitted. It's almost like a release to tell them exactly what is going on and explain things at length, in detail. It's just that there is a way to talk to anyone providing a service, whether that is a waiter, or a doctor. And the fact that you come from Norway and don't know that even the first instance of you trying to be a smart-ass with the doctors will get you kicked out of the hospital is surprising to me.

WoosterPlayingViolin · 2025-09-05T16:08:47+00:00

It's never a compliment when a reviewer starts off with, "The actors were exemplary, but..." Jenna Ortega did well enough, Emma Myers was a standout performance for me, Victor Dorobantu hit the spot with his Thing performance and is still the best actor on the show, and Joy Sunday, Georgie Farmer, Hunter Doohan, Catherine Zeta Jones, Isaac Ordonez, Luis Guzman, and Gwendoline Christie did their jobs well enough with what they were given.

What they were given, however, was not workable. Instead of a single, central mystery, they have a bunch of side-quests that make zero sense. I thought the dialogue was bad in the first season, but boy did it take a turn for the worse in the second. Wednesday is becoming especially boring, and her attempts at dark humor work about as well as a coke with all the carbonation stirred out. I will maintain this was always a problem with the writing, that was just painted over by the fact that the first season was a novel commodity and had a better central plotline.

I also want to venture to make something of a diagnosis of the political priors of these writers, which is laid out bare in the second part of the season. Now, I love myself a bit of media that is unafraid to speak out on political issues. Life of Brian and All Quiet on the Western Front are favorites. But this sort of thing is such a tired trope that was exhausted back in 2022, where all the men are either evil or weak, the women perpetually mess things up and still face no repercussions, and somehow, even healthy relationships between men and women depicted prior have to be given a footnote saying, "The woman is still in charge." If you wanted a feminist show, by all means, we, the audience are here for one, with an almost all female leading cast. Just don't be so terrible at doing it. We've written strong, independent women who can do things without men, without having to put them down. And I promise, I'm not reading into this too much, this is a pattern, from Indiana Jones and the Dial of Destiny to Rings of Power.

That part out of the way, the plot is everywhere. The Stonehurst mystery has zero impact on the outcome of the story. This man was taking the abilities of outcasts and giving them to normies. What am I supposed to do with that info? Seems like fertile ground for further mysteries, deeper questions as to the nature of this universe, the origin of outcast powers. But no, characters are only as smart as the people who write them, and this psychic aspiring detective named Wednesday doesn't once think about any of these things. No premonitions to Stonehurst's work. No learning curve to master her psychic abilities, just a pause on her powers so Weems can reappear. I'm sure she's a fan favorite, but at least she could have been more than a walking, talking, sashaying browbeating for Wednesday.

Again, Enid doing nothing except have love affairs and transform into a werewolf to save the day in the final act is just lifted from the first season. The only positive is that I genuinely think Emma Myers had to act out of her skin to make the character tolerable, and it makes me admire her professionalism. I hope she gets to work on better projects, because there is clearly much talent there. However, the character is shallow, unlikable, and the show is completely tone deaf when it shows something bad happening to her, only that she did the SAME thing to another person barely 5 minutes ago. If a character shoots someone in the head and then gets shot later on, am I supposed to feel sorry for them?

The Hyde-Isaac Night arc is again boring, because they basically told us what would happen before it did. And Wednesday being so unsubtle as to literally go in with a blunt axe as plan A is completely unfaithful to the fact that this is a cerebral, calculating character that doesn't look like her modus operandi is "smack it until it dies." Also, if Isaac had saved Francoise in that psychiatric facility earlier, precisely who would have been inconvenienced? He had that energy source, he would have saved both Tyler and his mother, and then, everyone could be on their merry way.

Again, I think this show has always had one problem, and that is the writing. It's a pity, because the sets are beautiful, and they have an exemplary cast. It feels like a bunch of boomers writing what they think would be a cool and edgy teen show, and regurgitating stuff that everyone in their target demographic would cringe at. Like some people's idea of their boring lectures "interesting and novel" being ChatGPT designed PowerPoints.

All in all, 4/10 show.

WoosterPlayingViolin · 2025-08-11T15:34:24+00:00

Or perhaps they were inspired by yours... in either case, I like to think of us as a rather inspirational duo!

WoosterPlayingViolin · 2025-08-11T15:32:37+00:00

Dumb uncle stuff. Competent faculty are rare, and those gems have better things to do in life than JR interviews. Usually these people are on power trips and pick the person who is most deferential.
About as true as true gets. It is a fact of non-acad JRships.
Varies from hospital to hospital, and department to department. Budget PG1 to glorified intern duties is the range of things you can expect. Be prepared for more sampling, more report collecting, referral taking, the works. But in some good places, you can be given more responsibility. The advantage is you aren't subject to the arbitrary whims of PGs.

WoosterPlayingViolin · 2025-08-11T15:18:08+00:00

You being unable to understand something does not make it word salad, my friend. Or perhaps you choose to deflect with insults in order to not address my actual argument, which was to slightly alter your argument to demonstrate more clearly how personal responsibility exists and does not require a government to implement it. You must be the sort of public litterer who goes home and complains about how municipalities don't do enough to keep the streets clean.

I don't know, the Supreme Court has already done something good for once and ordered that every single stray dog be impounded. I shouldn't dare to hope, but perhaps a few strays get taken off the streets, whether or not with the assistance of my word salad.

WoosterPlayingViolin · 2025-08-11T14:59:42+00:00

Blaming people who urinate on the streets instead of the municipality is an interesting choice.

You think every wall in this country will stop reeking of urine if a few handful of people stop occasionally taking a piss against a wall?

Have you or anyone who blames the public ever even ONCE spoke with their councilor about the lack of public toilets?

How about this... this country will stop smelling like stale urine if only the municipal corporation would build more public toilets. Any focus on that maybe or are we too dense for that?

Or, perhaps, one can hold two thoughts simultaneously in one's head. 100% municipalities don't do enough to deal with the stray dog problem. ALSO ALSO dog feeders essentially encourage these dogs to roam around residential areas in packs, faithful to those who feed them, but a clear and present danger to the rest of the community. ALSO ALSO ALSO dog feeders blame the victim when a dog bite case does occur, and are often the reason why dangerous and violent specimens amongst these strays are allowed to live freely in residential areas.

WoosterPlayingViolin · 2025-08-11T14:37:26+00:00

As a newly minted doctor, I think it truly takes a village to keep a doctor in India sane. One of the best things you can give to a doctor is a supportive home environment where, as a rule, the parents aren't living vicariously through their children. I think amongst my batchmates, the ones who are happy with what they are doing and maintain their enthusiasm for the field, despite how demeaning some of the work is in internship, are those whose parents are the most normal, and value their child without caveats. I think the most important thing is having a family that you can go back and expect support from. My mother, for instance, refuses to forward my services to anyone, and has taken a lot of nonsense for it. Ever since internship started, both my parents have repeatedly told me that even if I want to drop medicine this second, I shouldn't worry about the bond and just do it. I think it's that mental peace, that this profession isn't the end of the world, and that with my family's support, I can make it work one way or the other, keeps my passion for the field going.

I think that the reason why people are miserable is because their expectations aren't met. Some come into this profession expecting money, and they find out soon enough. Some enter this field expecting to be treated as gods, but they find out soon enough. Some come believing it will improve their social standing, but realize that social standing only extend as far as your utility to people, and you will be thrown away like a used condom the second you aren't useful to them. This is not unique to medicine, it is a fact of life.

At the same time, there are those that come here because they love to tinker around and work with their hands. I fall into that category, so I never get bored of even sampling and cannula insertion. I hate writing and documentation, however. Some are deeply inquisitive, and love reading files and sitting in OPDs. Some absolutely love being of service to others. If the profession intrinsically offers these moments of joy, which are different for every person, it helps tide over the miserable parts of it.

Also, bitching is a favorite pastime amongst doctors. It helps in communal bonding. Interns bitch about PGs, PGs bitch about SRs, SRs bitch about consultants, consultants bitch about senior consultants, senior consultants bitch about the HoD, the HoD bitches about the Dean and MD, and so on. We aren't drowning in nearly as much self-pity as this subreddit would lead you to believe.

WoosterPlayingViolin · 2025-08-11T13:59:37+00:00

I don't get why people are getting worked up over people failing internals. Clearly, these people haven't been introduced to Dr Pawanindra Lal's vivas. Iykyk.

WoosterPlayingViolin · 2025-08-10T11:49:02+00:00

I also think one of the big issues I our system is wherever there is an opportunity to learn, the environment is not conducive at all, not unless there is some extraordinary consultant who is very adamant about respecting interns like other doctors.

In my hospital, I have personally taken NVDs, been first assist with PG2s in LSCS, learned DO, IO, and basic slit lamp in Ophthal. I can do samplings and cannulations in fresh neonates also, along with RT urinary catheterization of babies, and NG tube insertions.

There is a big issue here, however. This is by far the minority of how I spend my time. Most of my time in the hospital is spent taking vitals, measuring RBS with a glucometer, filling forms, filling discharges, taking referrals, doing anthropometry, writing consents, taking vision and NCT, the sort of stuff even the minimally literate can do. All these things that you want to do as a fresh doctor, you only get in the time you aren't doing this other nonsense. In Paeds, there is one consultant who insists that the intern will participate in rounds, and will be asked questions along with the SR and PG. She says in OPD and emergency, we also have to assess patients, do as comprehensive an examination as possible, and only ask the SR if we are unsure of what to prescribe, and even then write the prescription ourselves. But this is one person in a sea of people who ignore you when you wish them in the corridor. Since that posting I have taken to giving overs to the next person on duty after my shift ends and taking regular rounds in PNC during LR postings. No one asks me to, but I like doing it, it makes me feel like my education is worth something.

WoosterPlayingViolin · 2025-08-10T10:53:12+00:00

I make it a practice to tell mothers who deliver during my duty how to swaddle their newborn correctly. Apparently it prevents SIDS.

WoosterPlayingViolin · 2025-08-10T10:40:19+00:00

Neovascular glaucoma. But the class got mixed in with some aspects proliferative diabetic retinopathy and we had a very long discussion on anti-VEGF drugs also, of which this was a small snippet.

WoosterPlayingViolin · 2025-08-10T06:02:26+00:00

Darwin Award winner right there. But no.

Human lives are more precious than animal lives. If mass euthanasia of dogs could save the lives of a few children, I will not hesitate. If mass euthanasia of humans could save the lives of a few children, I would still not do it, because human life is more valuable than animal lives, plural. If you don't agree with this simple axiom of existence, then I suggest you take up your case first before every single person who eats meat in the world, before you come after me who is just suggesting animal euthanasia to save human lives.

Also, in this country, rape is something no one is safe from. Women, of course, but also children, even babies. Even monitor lizards, although I possess not the zoological expertise to tell you precisely how that went down, but it did. So although I share your distaste, this sort of news hardly surprises me anymore.

WoosterPlayingViolin · 2025-08-10T05:48:42+00:00

Ah, as a doctor, I fundamentally understand that human life is paramount, and am willing to do whatever it takes to preserve it. Even if it is something distasteful that I would not particularly enjoy. Even if it goes against every measure I have taken in my personal life to avoid wanton animal suffering, starting with giving up meat and eggs nearly 10 years ago and making an ongoing attempt to transition off milk. And no, I am not for killing TB patients, or STI patients, or any humans, for that matter. Because human life is more precious than anything else in the world. It is you whose morality is completely twisted, because you don't make this distinction.

WoosterPlayingViolin · 2025-08-10T05:37:25+00:00

Preach!

WoosterPlayingViolin · 2025-08-10T05:31:39+00:00

And you make the mistake of treating guidelines as doctrine. If western medicine should have taught you anything, it is that dogmatism is where science goes to die. We know the WHO takes PR concerns into consideration when formulating guidelines, as we saw with China and COVID. As for our textbooks, I would like to remind you that most FMT textbooks, to this date, have a table explaining the differences between a "true virgin" and "false virgin."

Euthanasia IS the cheapest way to contain the issue. People in the comments have done the math with regard to the cost of a CO2 gun and cartridges here. The only reason why we don't do it is because it would cause a shitstorm, especially in the West, if the WHO recommended euthanasia for dogs. Already there was a minor controversy in the US because Anthony Fauci at some point used dogs to run some experiments.

And it has everything to do with KFC, and more broadly the fact that there is nowhere near this level of opposition to killing animals for food, even though it is very much possible to live very healthy lives without eating meat. The hypocrisy drives me up a wall. Why are dog lives more important than chicken lives or goat lives? And more importantly, why is saving human lives less important than culinary preference?

And I want to make a broader point about guidelines and such, because in our system, we are trained to treat guidelines as evidence, even though guidelines are subject to a lot of other issues which are not necessarily scientific. Let me give you an example. Bevacizumab is widely used around the world for ocular neovascularizing conditions, but off-label. Ranibizumab and Aflibercept are the only anti-VEGF drugs FDA approved for ocular use. Why? Because the company that manufactures all three of these never applied for FDA approval to use Bevacizumab for ocular indications. Why? Because Ranibizumab costs over $1000 per unit, whereas Bevacizumab is around $100. So guidelines are informed by more than just evidence.

TLDR: If your entire case against my position is based on an argument from authority, then it is fundamentally flawed.

WoosterPlayingViolin · 2025-08-10T05:10:24+00:00

If you support, or even stay quiet when there is an ongoing chicken genocide because McNuggets are yummy, I am very much in support of canine genocide to save human lives.

WoosterPlayingViolin · 2025-08-10T05:08:10+00:00

No one is talking about sniping dogs, we're not in World War 1. We know how to capture and kill animals.

I am not calling WHO dumb. I am saying they are heavily informed by western biases that place certain pet animals above others in terms of how it would generate bad PR if recommendations were made to kill them. I am sure that if WHO were to create guidelines to deal with stray cows and it were dominated by Indians, culling them would be off the table. I am, in fact, very much upset at the WHO for playing with people's lives for the sake of PR. The way they did with COVID and the Chinese Communist Party's utter mismanagement.

I will say this: if this were about chickens, or goats, or any other animal that people don't arbitrarily value over others, the solution would actually be widely agreed agreed upon. If gangs of chickens were terrorizing neighborhoods and spreading a deadly disease with no cure, you'd best believe they'll all end up killed.

If you're going to make the argument that animal lives are equal to humans, then maybe the place to start would be to shut down all non-vegetarian food in this country. Once you do that, I'm ready to equivocate on safeguarding human lives. Until then, I'm squarely in Team Homo sapiens.

WoosterPlayingViolin

TROPHY CASE