When the going gets good, the days simply fly. Feels like a blink of an eye and I am already done with a fortnight of rural posting. I had two OPDs and one casualty interspersed with several off days in between. My first day of duty there was in Female OPD, which is the busiest of all OPDs. Handling an OPD on our own, the feeling of authority, is something unique to the rural posting. I was a bit hesitant in the beginning because nowhere in the course of four years of MBBS have we been trained for this kind of activity. What on earth will I tell the patient if she should present with even a slightly complex problem, I wondered. But to my relief, we had our seniors with us and also the Residents and M.O to ask if we found any case difficult. Also because I had once before handled OPD for one day, back in UHTC, I had some experience backing me.
The OPDs all begin at 9, so we have to start from Nagpur at about 7.30 am if we want to make it there comfortably in time with the hour long travel and breakfast later. The patients were already in waiting as we reached, so we started almost immediately. Until I found my footing and got a proper idea of what investigations to tell for which complaint, I needed help from our seniors. But in a short while it all fell into place and I could write prescriptions and talk to the patients with much more ease. Every alternate female would come with the complaint of either weakness, or joint pain and bodyache, or both. Fever, cough and cold were the next most common complaints. For the occasional case which is baffling, or beyond the scope of being treated by PHC and those patients then have to be referred to Nagpur. Ever so often we would encounter old ladies who would live all alone on their own, with no family to support them and I felt a pang of sympathy for them. But when we are so swamped and engrossed in being a doctor, we sadly often forget to be kind. We were busy as a bee the entire span of five hours as we saw nearly 70 patients that day.
One peculiarity of people of Saoner is their obsession with Saline and Injections. Very often the patients would request a bottle of saline on their own accord and absolutely refused to be satisfied with pills, much to our amusement. It was quite a task to convince them otherwise if they weren’t in need of it. The more seasoned and frequent patients of the PHC would often themselves dictate us the medications to write, and I would shake my head and smile to myself, and write it anyway. As I realised over a period of time that the patients came there with much expectation and full faith in us intern doctors, and with all the respect for us as a real doctor. It was our responsibility then to fulfil their expectations. Even if we have no idea what drug to prescribe, or what to diagnose from their complaints, the trick is to appear confident and knowledgeable and talk kindly to all the patients. Half the job is done right there.
While the female OPD was a bustling one, my second OPD was a very relaxed one, in Immunization and MCH (Maternal and Child Health) clinic, which as the name suggests was exclusively for immunization of infants and counselling and check up of pregnant females. It was essentially similar to its counterpart in GMC, where we had already worked a month ago. These two sets of patients are without a doubt right at the heart of Community Medicine.
As I have realised, Male OPD is slightly less busy than female OPD, and the patients there often present with itching, fungal infection, wounds, in addition to the all pervasive hypertension, diabetes, fever, cough cold and weakness. Occasionally there might also be some health camps or immunization drive in the town, when we Interns will have to go there.
OPD in Saoner thus might just be where Internship peaks – a change of scene, a quieter hospital, the scenic drive to and fro, fixed working hours and sedentary yet mentally stimulating and fulfilling duty. It is certainly the posting to keep looking forward to.