Sunday, January 31, 2016

Clinical Records.



I have a bad habit of keeping clinical records of all the patients treated by me. They say that it is a good habit to keep records. May be. But it is bad when it shows a failed case or a missed diagnosis. The patient sitting in the chair would have forgotten what his complaint was when he had visited me four or six years back or that the tooth about which he presently has a complaint had actually been treated by me earlier. It would be very nice to consider it as a new case without bothering about the inconvenient history. But for the record, I would not remember the case, the patient’s memory would be worse and I would treat it as a new case. I may even get to blame the previous dentist (Gleefully. Who doesn’t like other’s mistakes?) for messing up the case and charge a little more for setting things right and doing the patient a favour! But my record does not allow such pleasures. It places my blunder in front of my eyes in black and white. Painful. That is why I sometimes feel that I would be better off without my records.

But it has its uses. Once in a way I get a patient in whose mouth I find some really good job done. I mention it to the patient and he/she says “Oh, that was long back doctor, I do not know who did it”. It would be extremely gratifying when the record shows that it has been done by me. People get different teeth treated by different dentists as per convenience and never remember who treated which tooth, let alone where and when. Sometimes they will have totally forgotten visiting any dentist in their life at all. “No doctor, I swear that I have never been to a dentist before. This is my first visit ever.” I place the card in front of them and hear an excited “Oh, you still have my card! That was when I was in sixth standard. I never had any trouble later and have entirely forgotten about it” and it impresses them a lot.


 Some cards bear cautionary signals like “Very apprehensive patient”, “Never keeps appointments”, “Bargains. Quote more”, “Collect fee in advance” etc etc which are very useful in running a practice.

The popular belief among my patients is that winter is bad time for dental treatment. For that matter, dental treatment is considered bad in any season but worse during winter. Hence the attendance in the clinic is quite low during winter. Yesterday was one such day with just two patients.  I removed few teeth for one of them. Since that was to be followed by making an artificial set, the patient said that she would pay for everything together and walked away. No collection for the day.  Not even the milk and vegetable money.

I was about to close when the second patient walked in. It was quarter past eight. He just wanted an appointment for a filling. An appointment was fixed but I can not charge someone for just fixing an appointment. I am not that bad yet. And they wouldn’t pay even if I do. So pockets remained empty. When he was about to leave, the patient mentioned that he had visited me years back for some fillings and I took out his card just to check. He was right. I had done some filings for him but he had not paid me! That was ten years back and he owed me five hundred. I mentioned it and said that he may pay me when he came for his fillings. “Oh I am so sorry doctor” he said “No, No, I will pay  right now.”  He sheepishly took out the cash from his purse, paid me and left putting me in the black for the day!

Of all the benefits of maintaining records, I feel this is best!

Thursday, January 14, 2016

Urban wild Life - Sand Boa




Last night when I stopped the car in front of our house, the head lights picked up a long sluggish creature crawling on the road. I knew that it was a snake but was surprised at the slow movement. Snakes do not come out for a leisurely walk. I went closer. It was a snake alright but a Sand Boa. Since I am much more evolved now as a naturalist than what I was decades back, I did not pick up a stick to beat it’s life out of it but took out my mobile phone to get some pictures.  I hope that I will evolve further and when I find the next snake, will be able to suppress the urge to take pictures, switch off the head lights and leave the snake in peace.

This is how it looked right in the glare of head lights. More shadow, less Sand Boa.  
 
I  changed the angulation and a helpful passer by focused the light from his mobile on it's head while goading me to go closer assuring me that the snake is harmless. Good intentions but bad results.
This time however I got some pictures while a passerby focused the light from his mobile phone on the snake. while I was dancing around the snake, my wife ran inside to get the camera, did not find it, shouted from the balcony, got my reply, ran down the stairs without tripping and breaking her bones, found the camera in the clinic and brought it. By then the Sand Boa had crossed the road, moved along the border of my neighbour’s compound and was just about to get into a hole. Still, I did get most of it in my camera and so you are able to see how it looked without the shadow play.

Somewhat better picture after the snake moved away from the glare of head lights. 
 
This is how it really looks. It is headless but since the head and tail look alike in a Sand Boa, you did not miss much.
I do not know if you have a seen a Sand Boa live. It actually looks and behaves like an overgrown earth worm. I understand that it lives by eating rodents, lizards and other snakes. I also understand that coming under the wheels is a major cause of It's death. I fail to understand how it manages to catch a rat or a lizard unless they have suicidal tendencies. But obviously, nature has provided. And till date this Boa has been lucky to cross roads without getting under a wheel. Luck be with you Sand Boa!



 

Saturday, January 9, 2016

Second Childhood


“Go, get a haircut”

That was my wife ordering me. She was not happy with the look of my hair and was insisting that I have a haircut. I am not against haircuts.  I usually go for one on my own accord every two months or so. But it was just about three weeks since my last cut and she was ordering another one. I did not like it.  

 As I said, I am not against a haircut but I do not like to go to the barber often. The barber whom I patronise has a shop in the centre of the market. When I go there I will have to first worm my way through the market by lanes, find a place free from garbage to park my scooter,  carefully walk some distance avoiding stepping on heaps of cow dung deposited at strategic points, squeeze myself between a cart selling ‘limbu soda’ and another selling sugarcane juice, and enter the barber’s shop. The barber does not give prior appointments and his services are on first come first serve basis. He is almost always busy and I will have to wait for my turn. I hate to touch the old magazines leafed through by hundreds of licked fingers and can’t bear the bollywood music on the TV. Hence I avoid visiting him frequently.  Some may suggest that I change my barber but it is not easy to change your barber once you get used to him. (Like your dentist for that matter - a sentiment, of which I happen to be a beneficiary)

Now the trouble is, I try to avoid frequent visits to the barber but my hair grows quite fast. “There is lot of manure in the head” is an old joke but my friends stress that it is not a joke in my case. Well whatever it is, I feel very uncomfortable with overgrown hair falling over my ears and neck.  So, I requested my wife to cut it and she was aghast at the suggestion. I told her that it is the wives job in the US and she asked me to shift to US and marry a wife who is ready to cut my hair. I requested my son and he did it once. He made a big fuss over the bits of hair falling all over his clothes and small bits getting entangled with his body and pricking him throughout the day. He refused to cut it the second time saying that he is a dentist and not a barber. I reminded him that barbers were his professional ancestors but he was not prepared to appreciate the fact.  I had to fend for myself.  

I decided that “self help is the best help” and purchased a pair of scissors. Using them I could trim the hair on the right side of my head reasonably well, enough to ward off a visit to the barber by a week or two but the left side was tricky. I could not reach behind the ears and the back of my neck was worse. I did not give up. I persisted, tried to practice cutting with my left hand, nicked my ears, poked my neck, was frustrated and had to give up. (Have you ever tried trimming the hair behind your ears? Try it once- particularly the left side if you are a right hander. It is fun)

 
During my visits to the barber I had noticed that he used an electric trimmer to start with and then he continued with the scissors and comb. And he effortlessly removed tufts of hair with each swipe of the trimmer. It was so easy! During my last visit I stealthily noted down the make and the model number of his trimmer. I was overjoyed to find the trimmer available on Flipkart and ordered one.  Strangely my wife who had made a lot of noise over me cutting my hair with the scissors (and bits of hair over the wash basin and the floor around it) did not make any fuss and she resigned after saying “You better close down your clinic and start a barber shop”.

 
During the past two weeks I had practiced running the trimmer over the easily accessible parts of my head and it was time to go further. I got an opportunity recently. We had to attend a wedding reception in the evening and three weeks after the visit to the barber my hair was just right for a trim. Soon after my morning walk - before my wife woke up - I carried the trimmer and a hand mirror to our backyard and trimmed my hair in the peaceful surroundings.  No ‘give away’ bits of hair around the washbasin. I could trim not only the hair over my ears, but also the back of my head and my neck easily. I was ready for the reception.

In the afternoon, I was appreciating my work standing in front of the mirror when my wife exclaimed “What happened to your hair?”

“My hair? Nothing. What happened?”

“It looks moth eaten. Did you try to use the trimmer?”

“Me? No. You know that I am not capable of avoiding your eyes and ears.”

 “But you have done something. It looks like rats have been at it.”

I told her not to imagine things and said that my hair was fine.

“See here.”

 She held her mobile to my face. There it was. A moth eaten patch slightly above my neck on the right.  Not very much visible but visible to my wife. Photographic proof and no scope for further evasion. It was a mistake buying her a smart phone. Now she has photographic evidence for everything.  “See here” she holds it in front of my eyes - “You left your sandals on the door mat”, “you left the wardrobe door open”, “You did not close the jam bottle ” so on and so forth.  And now, it was my hair.  I told her that there is nothing wrong trying to be self reliant and mentioned that even Gandhi had tried cutting his hair himself. “Don’t dare trying everything that Gandhi did” she retorted and continued “Go, have a haircut, or else I will not be coming to that reception with you.”

I tried to tell her that nobody in the reception would be bothered about my hair but just then my phone rang. “Appa,” it was my son “Go have a hair cut”. I was surprised and uttered “Well.....” but he cut me short. “I saw the picture and I don’t want to hear anything. Go have a hair cut”. This lady had not only taken my picture but had ‘whatsapped’ it to my son and had enlisted support. It was another mistake teaching her to send the pictures of her sarees, bangles, handbags and sandals to her sister.

The last time I had heard that order was about fifty years back, in my childhood. When my mother could no more bear the look of my over grown and unkempt hair she would say “Look at you.  You look like a shabby sloth bear. Go have a hair cut” and she would press a rupee coin in my hand.

The SMS from HDFC bank said “Sir, we notice from our records that you will be sixty next week. Please contact the nearest branch for changing over to a senior citizen account and getting the senior citizen benefits”.

There is a saying in Kannada which means “Second child hood starts at sixty”.

My second child hood has started with the very familiar childhood order “GO HAVE A HAIR CUT” and me obeying it.