POWER OR NUISANCE VALUE

I was the only doctor posted on board INS vikrant.I used to do my job very sincerely and thus used to take rounds of pantries galleys and cook houses on a fairly regular basis.One day while walking to the sailors  cook house I saw the entire cookhouse and dining hall full of smoke of oil.On entering it I asked the chief cook what was the problem.He said that the exhaust motors of the three exhausts were not working and his staff was having a lot of difficulty frying 8000-9000 poories due to smoke.Vikrant had a staff of 1000 sailors and 200 officers. The cook house for sailors was below the sea level thus had to have a forced ventilation and exhaust system.

Since all the three motors for exhaust system were not working the entire cook house and dining hall was filled with smoke from the oil in which the cooks were frying "Poories".I was shocked to see the state and asked him why have you waited for all the three motors stopped.Actually at least one motor needs to be operational and two motors give a better ventilation

He said that they had complained to the electrical dept  when the first motor had stopped itself.But no one was listening.Since the cooks are class IV employees(NMER-non matric entry recruits) they come at the lowest rung of hierarchy no one listens to them.Neither they can stop cooking less they will get blanket treatment.(This is a type of punishment given in closed communities like on board ships where you put a thick blanket on a person and beat him.Since he is unable to identify who has done it there is no way he can redress it.) 

When I asked the deputy electrical officer why the motors were not repaired he told me that there were more pressing jobs like the A/c motor of the radar room and flight control office jobs were to be done.    

I cam back to my dept little frustrated and angry thinking as to what I can do.

In  the mean time two electrical engineers came for their promotion medical examination.(In Armed forced you are granted promotion only if you are medically fit).Without thinking twice I marked unfit on their medical forms and told them to leave.They were surprised (and also angry) by my action and asked how can i make them unfit without even examining them.I declared them mentally unfit(verbally and told them that they have failed in their jobs since they cant see the agony the cooks are undergoing.

Both the engineers left the medical dept hurt and angry and complained their HOD about the unjust treatment they had got.As expected I got a call from their HOD why they have been made unfit.I replied that I will not make them fit till the cook house exhausts are repaired.The HOD replied that "doc the exhaust motors have nothing to do with their fitness'

I replied that as a welfare officer it is my duty to look after the sailors and I will do whatever I consider fit even if it means using extra constitutional means and he is free to report this to the commanding officer if he wishes.

The catch here was-- he was in zone of promotion and any adverse comment from the commanding officer could have doe him.So he did not dare to take the matter to the CO(commanding officer).He also knew that I was a favourite officer of commanding officer.(I was not in the rat race as doctors have time scaled promotion.) So I used to be upright and tell whatever is truth.

As a result the HOD of electrical dept told both the engineers that their job for the day was to get the three exhaust motors and they need not do anything else for the day.

The result --All the three motors were repaired all the light and fans in cook house were repaired/replaced by afternoon.The cook house had a new look because as the lighting improved the dirt hitherto not seen was visible in cook house and dining hall. The chief cook in the afternoon made all the sailors to clean up the whole place and that place was shining now.

When both the electrical engineers came to me again, I promptly signed their promotion medical examinations congratulated them asked for cold drinks and snacks for them and explained to them the situation.To my surprise both of them were actually happy to help the sailors as they were not even aware of the problem.In a system the more influential people can get their jobs done easily and not so important persons are relegated behind.

After this episode the entire cooks and stewards were so happy with me I was really looked after for my entire tenure.In any party I was being treated like a VIP.Any corner of the party I may be standing i used to be served hot snacks and goodies.

Result--I gained 9 kg weight in 8 months.I was 56 kgs when I entered Vikrant and was 65 kg within the next 8 months.(I have managed to remain at that weight since last 22 years despite marriage, 2 kids and 40 + age)       
I FEEL IF YOU USE YOUR POSITION TO DO SOMEONE'S WELFARE IT AMOUNTS TO POWER BUT IF YOU USE IT TO HARRASE PEOPLE AND EXTRACT YOUR POUND OF FLESH IT AMOUNTS TO NUISANCE VALUE AND NOT POWER.. 

WORKING IN PSYCHIATRY

I had a chance to work in psychiatry dept after my internship and had a very valuable insight.
It was of immense help later.
While working in dockyard dispensary we had to go for the cell round at INS Angre where temporary offenders are kept and and INS Kunjali where persons undergoing punishment are kept.
I had a habit of stopping and talking to each and every offender to understand why he committed the offence.
While on round in INS Kunjali I was seeing a marathi sailor (Name probably Sambhaji pathre or so).I asked the cell in charge why he was punished.HE was punished for 60 days in jail for absent without leave.Thus I asked Sambhaji as to why he was absent.He said he does not remember.On getting suspicious when I prodded him further he just said that he was in Yerwada hospital and does not know the details.I decided to get to the root of the matter the details were shocking.  I realised that this sailor was in Yerwada mental hospital for over one year   admitted by his brother.He was from some village in Satara district.He had already lost his father in childhood and while he was on his annual leave his mother expired.In the shock of this he had an attack of schizopherenia.Thus due to his irrelaevant and irrational behaviour his brother admitted him to Yerwada mental hospital (at Pune).He was being treated there for over one year.When he recovered reasonably to regain his memory he told the doctors there that he is working with Indian navy.Thus they contacted the naval authorities who picked him up and got him to mumbai.since he was absconding for more than one year they court martialled him as he was not giving any satisfactory answers to their queries.HE was given a punishment of mulct(forefeiture) of pay and allownces for period of abscence and 60  days DQ detention in quarters(a term for jail sentence) with his job being kept intact being his first offence.
I refused to certify him to be fit to continue in the DQ and strongly recommended his transfer to psychiatry ward.Though with lot of resistance the sailor was transferred to psychiatry ward at INHS asvini (The 850 bedded naval hospital at Colaba Mumbai)where he underwent complete treatment and was absolved the charges from the court martial.
Why his brother did not inform naval authorities nor they bothered to see him in Yerwada hospital is really not known.May be the lure of property?
god only knows  

Another incidence when I was working as casualty medical officer two army police brought an middle aged gentleman for medical examination.He was a JCO(junior commissioned officer) Subedar who had put in 26 years of service and was about to retire after 6 months.He was brought for medical examination for fitness to be put in close custody(Equivalent to police custody awaiting trail).I felt something amiss.Someone who has put in 26yrs of blemish free service why would he run away? especially when he is anyway retiring.HE was brought back to mumbai by his grown up son who was working in Ahmadabad.The son also was accompanying him there.when I asked about his father's behavior the son said that he had noticed strange behaviour by his father.However he thought that his father was upset because his retirement was nearing.

Upon his mental status examination I realised that his answers were in-congruent and irrelevant. I realised there was something wrong and I declared him unfit for detention and to be referred to INHS Asvini psychiatry ward for admission.

The next day after his examination by the psychiatrist he was brought to my dept for CT scanning of brain where he was found to have a brain tumour(temporal lobe glioma).He was operated in INHS Asvini and was treated completely for the same.He was also absolved from a blemish in the last leg of his otherwise blemishfree service.

Working in psychiatry has given me very valuable lessons for life and medicine.     

At Dockyard dispensary

I was on an emergency duty at dockyard dispensary.At about 0030 hrs The colaba police got one naval commando (P G How- a sailor from Mizoram) with the complaint of being drunk and creating nuisance in public for medical examination.However being a maharashtrian I got talking to the police when I realized that the commando was being rounded up despite being innocent not involving in fight.In fact he had gone to bar to have one or two drinks when a fight burst out between two persons.He being a well built person and a commando decide to pacify the whole affair.During the commotion patroling police from Colaba police station arrived. The two fighting parties quickly disappeared and our friend being more simple person was caught up.Now the police got him to me for medical examination for being drunk.When I asked PG How he confessed of having consumed a bottle of beer,however he had no idea who were the fighting persons.
Now I used my uniformed status(You do your night duty in full uniform) to tell the police that I will take disciplinary action.Anyway the police were not interested in the naval person for obvious reasons that they just have to do procedural work without getting anything out of it..I signed and stamped on their papers of taking over the person.By this time It was about 0100 hrs.By this time the last boat going to Karanja(Uran) had already left.This would result in PG How being absent from duty without leave and would be liable for disciplinary action.I had to admit him in the dispensary for observation on diagnosis of altered behaviour and detain for night to save him form a punishment.
At about 0100 hrs VT sattion police got two naval persons with physical fight at VT (now CST)station for medical examination.The story was one of them was a sailor was going on leave by Mahanagari exp with his wife.The wife's boyfriend  (another sailor from navy) also reached.This resulted in fight between them.However the lady refused to identify the husband as her husband.The husband showed the police his tickets and his family i card to claim that he was her true husband.Police not knowing how to solve it got both the sailors for medical examination and palmed off them to me.I after their medical examination handed them over to naval police for further action.By this time it was about 0300 hrs.
Again I had to get up at 0600 hrs to discharge our friend PG How so that he could catch a boat to karanja.
Thus I could sleep for about 2.5 hrs yet not seen a single patient. 

LIFE ON VIKRANT II

As a doctor on Vikrant life was never dull.It is an aircraft carrier was acquired in 1961 and was standing in sea 24 x 7 thus corrosion is rampant.So the sailors have a constant job of painting the ship.One day before annual inspection one of our sailors was cleaning a small engine room compartment with thinner before repainting.suddenly lights went off.Our sailor being a sincere one decided to finish the job before lunch.He thus took a candle and matchstick.As soon as he lighted the matchstick the thinner which had evaporated inside the small closed compartment exploded resulting in 30% burns for the sailor.He was brought to me immediately.I simply covered his open wounds with sterile gauze, put an IV cannula to secure his vein and gave him a pethidine injection and transferred him to our Hospital INHS Asvini at Colaba.You should never try and remove clothes in burns case as the burnt clothes are sterilised by the flame.Always put up an IV line as the swelling of body makes passing a needle more and more difficult as time passes.
Similar case happened a few days later when one sailor had his one hand almost severed.he was standing at the quarterdeck(the back end of ship) and was observing the crane lowering the whaler(a small boat)The metal wire which was going down over the pully just snapped and came back like a whiplash.This sailor was just outside the line of the metal wire thus it just grazed his left arm and forehand and literally peeled the skin from mid arm to mid forearm.Had the wire hit him on his head he would have died and had it hit on his shoulder it would have dislocated his shoulder.I quickly put the skin back and bandaged it and dispatched him to INHS Asvini. Both the sailors recovered in due course of time and were transferred to INS Angre (the base unit) to allow them to recover fully before being deployed on active duty.
People do not realize how life can be dangerous in forces even at peace time

life on vikrant

I was th PMO (principal Medical Officer) of INS Vikrant from 03 Jan 1990 till 20 Dec 1991 and had a great time of my life.Probably a lot of power fro a young officer of age 25.

A few interesting first hand stories I wish to pen down.

I still wonder that so many instances were seen by me then were taken as normal.Now after retirement I realize that life in Navy was not as safe and secure as I feel today in civil life.

Another instance was when we were sailing about 1000 NM(nautical miles)(about 1840 kms) west of Mumbai on exercise.We were doing exercise with submarine and aircrafts.During one exercise we had got batteries from a submarine INS Shishumar or(?Shankush) fro charging and given them new charged batteries.The submarine again dived back underwater.One of our sailor in charge of recharging the batteries opened the battery acid chamber.The sea was rough and there was a lot of pitching(up and down movements) and rolling.When he was inspecting the acid chamber suddenly the ship hit a wave and the sulphuric acid in the battery chamber spilled over into the sailor's eye.He had severe burns in his right eye and came running to me in the sick bay(dispensary in ship is called sick bay).I had never seen or even thought of sulphuric acid burns(for that matter any acid burns in eyes).I at first was totally confused and flabbergasted But my basics were reasonable.So I promptly washed his eyes with two bottles of saline.But the sailor was in deep pain and I had no instruments to even examine the eyes properly other than a torch. I just had Chlorocort (chloromycetin and cortisone) eye ointment which i put in his both eyes, gave him a calmpose tablet and went to meet captain.We had 6 Sea king helicopters on board.When I requested the captain that I need to urgently evacuate this sailor to INHS Asvini(The naval hospital at Colaba Mumbai).Captain R Ganesh told me that Doc the helicopters have a range of 500 miles(nautical).TO launch a helicopter he will have to come close to mumbai by another 500 miles. so @ 20 knots of speed of INS Vikrant it will take at least 24 hrs to close within 500 miles of mumbai.So he will not be able to launch it for next 24 hrs at least.With desperation I told him that if i could look after him for 24 hrs then there is no need to send him to mumbai.So he said then look after him and thank you very much.

Now I was in a stupid situation that I had a patient with sulphuric acid burns in eyes with no help whatsoever.I had a total experience of 2 years after MBBS.No medicine other than chlorocort,No one to consult(No telephone/internet,no book of ophthalmology to consult.On top of that all the sailors had a lot of faith-DOCTOR SAAB THIK KAR DENGE(Doctor will get you alright).

My worries were if his lower eyelid get stuck to the eyeball he will have diplopia(double vision) when he will look up.Fortunately he did not have burns to his cornea.I just kept putting the chlorocort ointment every three hours and kept his eyes clean.I was also praying throughout as a diplopia could mean end of his job.You really feel helpless i these situations.

Finally when we reached mumbai after four days I took him to the ophthalmologist as INHS Asvini he was surprised that the patient had almost healed wound in his lower eyelid.I heaved a sigh of relief and the sailor was telling the ophthalmologist that I am alright and my doctor was unnecessarily worried.

No of times I have felt this type of helplessness during my career but these leave permanent memories whihc you cherish even today.

Non productive work

I was on temporary duty at Okha at INS Dwaraka.This is a logistics base for all the ships operating near pakistan waters. while working there as medical officer outside the dispensary on one afternoon I saw a soldier running up and down with a rifle held over head.Obviously he was undergoing rigorous punishment.

I asked the supervisor for the sailor as to why he was given the punishment? So he told me that he was absent from duty.So I was curious to know so after 15-20 minutes when he was given little rest I started talking to the soldier who was being punished.He happened to be a maharashtrian so I started talking to him in Marathi(his and my mother tongue) as to why was he absent without leave?

He told me that he went on leave to his native place near sangali in Maharashtra.However his daughter fell ill towards the fag end of his leave and was taken to the hospital at Miraj.He sent a telegram stating the reason so he was given advance of his next year's leave.However his daughter never recovered and expired in the hospital.Now with no leave left he remained absent without leave to perform last rites of his daughter on the tenth and thirteenth day.This resulted in overstayal on leave.Thus when he returned back to unit it was a serious offence as per military law.

The authorities were sympathetic to him but their hands were tied by the rules.So they gave him the least punishment of 24 days DQ (detention in quarters)(Like local jail) but preserving his job and all other benefits.

During this period he had to undergo rigorous punishment like rifle drill which I was witnessing.

I realized that this was a futile effort.So I decided to meet the executive officer.I asked the ExO(executive officer) as to why are we wasting efforts.The ExO asked me as to what I was thinking? I told him to give me the authority to supervise this man's punishment.He reluctantly agreed.So now I met the soldier again and sat with him.I told him that instead of just running up and down with a rifle holding above his head he can do some constructive work for next 16-17 days.I asked him to create a garden in front of my dispensary in the memory of his daughter.The soldier initially did not understand but on telling him that it was instead of his rifle drill he was convinced.I told him I will not supervise him and he will be left on his own to do the work.Every day he used to sincerely work fro three hours with very short breaks and in about 15 days he created a wonderful garden.By then it was my time to come back from temporary duty. I was almost in tears to see the fantastic work he had done.On asking him about it he said 'Sir I am a small man and my daughter is nobody that the garden will be named after her.Neither I know whether the garden will remain for a long time but that is all I could do in her memory.I need this job for my wife and other kids and I am grateful to the authorities that they are considerate.I am also grateful to you that you gave me an opportunity to create a garden instead of just running aimlessly and getting angry at army and my bad luck but now I am happy.During every moment of working I was remembering my daughter and at the end of this period I am little satisfied.With tears in our eyes we bid adieu.I dont remember the name of soldier and I shall not disclose name of the ExO for obvious reasons.

I learnt a lesson in motivation and a different memory

Naro Va Kunjaro Va

I was doing casualty duty in the dockyard dispensary on a sunday morning.At about 10 am the dockyard security officer brought one sweeper for medical examination with a complaint that he was drunk on duty.

Since I had worked in psychiatry I started doing mental status examination by asking questions to the patient.On asking him the sweeper said (SAAB, MAIN ZOOT NAHI BOLATA)sir I am not lyingI was asked to clean a manhole where a dead dog was blocking the drain. I got down the man hole to pick the dog. It was badly rotten and as I tried to hold its tail the tail separated and came in my hand.I got severe nausea due to the putrid stench and I vomited.It was impossible for me to do anything further so I came out had two drinks and then again went down the manhole and picked the dog in bits and pieces and came out.I was helpless.

The dockyard security officer told that the story was true

Now I asked the dockyard security officer as to what he had to say?

He said that sir if this person gets down the manhole in drunken state and does not come out I will be hanged! So what do I do?

Now I was in a dilemma as both of them were right in their own way and I was asked to sit on judgement.

What do I do?

I gave the certificate in a non commital state.

The patient agrees to have consumed two pegs of alcohol however he does not appear to be under influence of alcohol.

This leaves the onus on the prosecuting authority.

Till date I dont know whether I am right or wrong.

I wish to put a few experiences in this as a no of people may say nothing happens with two pegs.

While working in Psychiatry I was asked to do the first examination of a soldier who was referred for psychiatric admission.Despite repeated attempts to elicit history of excess alcohol consumption the soldier was telling he always consumes only two pegs which are issued to him.(Soldiers are issued two pegs of rum thrice a week in their messes as a recreation)

Despite repeated questions he kept saying that may be once in a while when his friend is not in mood he may consume a third peg but certainly not more.

Finally when I asked him how does he consume the rum so he told me that when the bar opens at 1900 hrs he takes his 2 pegs and drinks them neat.That's when i realised that it is not only the amount but the way you consume the alcohol is important.That's how he was always drunk on duty at 2000 hrs.

Each patient teaches you something