December 3, 2015
October 19, 2015
Veritas Curat
That happens to be on the JIPMER emblem. Translated, it means "Truth Heals". I did and do believe in the saying and have always been truthful to the patients. I believe that there is no harm in undiluted, unvarnished truth and human mind will accept anything after sometime, even if it is unpleasant, and totally negative.This has a great bearing on the future.
Families must be told the truth to plan their future and the patient must be told the truth to accept it.
Otherwise the patients will do reckless things and suffer. (A cardiac patient with a heart attack, if not told the truth, will carelessly do hard work or climb stairs etc. and collapse.)
I have had 2 patients die in the bathroom. They had massive heart attacks and were admitted under my care. I told them that the protocol declares that they be confined to bed at least for 3 days, not getting up even to go to the bathroom. They will have to use a bedpan. They did not understand the gravity, in spite of being told that they may collapse (like Nehru or Zakir Hussain) in the bathroom. But they felt that a bedpan was undignified, pushed aside the relatives and went to the bathroom and collapsed. When things are explained, people are like this, not willing to believe, as they feel apparently alright. If not warned, I shudder to imagine what they may do.
By God's grace, they were the only 2 who did that.
There was another gentleman, who was a terrific smoker (a chain smoker as they were called). He came to me with an Infarction and was in the ICCU. He continued to smoke, even in ICCU. Firstly, I was dead against smoking in the hospital. ( Even Dr. Sankara Sastry and Dr. Seshagiri Rao - friends of ours- never did it in the hospital.). Remembering my futile struggles with my brother, I felt that mere words achieve nothing. So, I told him that he was having a bad heart attack and if he continues to smoke, I refuse to treat him. I went up for my lunch and the staff came running behind me saying that the gentleman walked out. I ran behind him and caught up with him near the end of the street and asked him what he thought he was doing. He said" I can not keep off smoking and since you said I have to stop it, I am discharging myself and the rest is in HIS hands." I asked him to comeback but he refused to and went away. I was terribly worried about him but God, in His infinite wisdom, was kind. That man lived for another 2 years, used to greet me whenever we met, but never approached me for treatment and SMOKED his life away.
Should I have talked to these guys more patiently, convinced them about the risks and then may be they would have lived longer? That is why, I take time to talk and talk and try to persuade people from that time on wards.
There was a case of Cerebral haemorrhage in another hospital and I was called in for consultation. I saw that the situation was hopeless, called the sons aside and told them that the patient will survive a maximum of 2 days. I asked them to call anybody who wanted to be by the bedside and to check and see the documents, LIC policies etc. to see how the name is spelled, so that they can take a properly spelled death certificate. Otherwise, they will have a lot of trouble in getting the money and transferring property. Gopal who came with me, out of curiosity, for the nocturnal visit was aghast. He asked me " how can you be so direct with such news?" I said that my job is to treat and the power of life is not in my hands. I know the patient will die soon and so the best I can do for the family (my next target) is to prepare them.
Was I right or heartless and uninvolved? What do you think?
A lady, a longstanding diabetic with poor heart function came to me with complete heart block. The entire family works in shops as clerks etc and still there is a gap between both the ends (the ends do not meet). She needed a pacemaker, costing rs 10,000+hospital expenses. They said that they could not raise the money. I sent them to JIPMER. The cardiologist agreed to do it but as the pacemaker was not available, they had to buy it. As she was an old lady, I asked them to consider their finances also. Without treatment, she may survive 2 or 3 years and with treatment may be 5 years. She has to be guarded all the time in either case. They elected to get her treated and raised a loan of rs. 15000. Meanwhile, she was admitted under our care. We had gone out for a social visit one evening. She had a cardiac arrest. Our efficient staff of Kotaiah and Mumtaz revived her and by the time we got back, she was alright. She underwent pacemaker implantation, came back and was convalescing. She had a sudden cardiac arrest again 2 months post-op and died before she could be revived, as she was at home. The family sold whatever they had, repaid the debt and left town. All the male members became daily laborers and females were doing whatever they can at home. The entire family was ruined with nothing left.
Now, here is the tricky question. Was I right or wrong in asking them not to go ahead with pacemaker implantation? I ask for your opinions.
Families must be told the truth to plan their future and the patient must be told the truth to accept it.
Otherwise the patients will do reckless things and suffer. (A cardiac patient with a heart attack, if not told the truth, will carelessly do hard work or climb stairs etc. and collapse.)
I have had 2 patients die in the bathroom. They had massive heart attacks and were admitted under my care. I told them that the protocol declares that they be confined to bed at least for 3 days, not getting up even to go to the bathroom. They will have to use a bedpan. They did not understand the gravity, in spite of being told that they may collapse (like Nehru or Zakir Hussain) in the bathroom. But they felt that a bedpan was undignified, pushed aside the relatives and went to the bathroom and collapsed. When things are explained, people are like this, not willing to believe, as they feel apparently alright. If not warned, I shudder to imagine what they may do.
By God's grace, they were the only 2 who did that.
There was another gentleman, who was a terrific smoker (a chain smoker as they were called). He came to me with an Infarction and was in the ICCU. He continued to smoke, even in ICCU. Firstly, I was dead against smoking in the hospital. ( Even Dr. Sankara Sastry and Dr. Seshagiri Rao - friends of ours- never did it in the hospital.). Remembering my futile struggles with my brother, I felt that mere words achieve nothing. So, I told him that he was having a bad heart attack and if he continues to smoke, I refuse to treat him. I went up for my lunch and the staff came running behind me saying that the gentleman walked out. I ran behind him and caught up with him near the end of the street and asked him what he thought he was doing. He said" I can not keep off smoking and since you said I have to stop it, I am discharging myself and the rest is in HIS hands." I asked him to comeback but he refused to and went away. I was terribly worried about him but God, in His infinite wisdom, was kind. That man lived for another 2 years, used to greet me whenever we met, but never approached me for treatment and SMOKED his life away.
Should I have talked to these guys more patiently, convinced them about the risks and then may be they would have lived longer? That is why, I take time to talk and talk and try to persuade people from that time on wards.
There was a case of Cerebral haemorrhage in another hospital and I was called in for consultation. I saw that the situation was hopeless, called the sons aside and told them that the patient will survive a maximum of 2 days. I asked them to call anybody who wanted to be by the bedside and to check and see the documents, LIC policies etc. to see how the name is spelled, so that they can take a properly spelled death certificate. Otherwise, they will have a lot of trouble in getting the money and transferring property. Gopal who came with me, out of curiosity, for the nocturnal visit was aghast. He asked me " how can you be so direct with such news?" I said that my job is to treat and the power of life is not in my hands. I know the patient will die soon and so the best I can do for the family (my next target) is to prepare them.
Was I right or heartless and uninvolved? What do you think?
A lady, a longstanding diabetic with poor heart function came to me with complete heart block. The entire family works in shops as clerks etc and still there is a gap between both the ends (the ends do not meet). She needed a pacemaker, costing rs 10,000+hospital expenses. They said that they could not raise the money. I sent them to JIPMER. The cardiologist agreed to do it but as the pacemaker was not available, they had to buy it. As she was an old lady, I asked them to consider their finances also. Without treatment, she may survive 2 or 3 years and with treatment may be 5 years. She has to be guarded all the time in either case. They elected to get her treated and raised a loan of rs. 15000. Meanwhile, she was admitted under our care. We had gone out for a social visit one evening. She had a cardiac arrest. Our efficient staff of Kotaiah and Mumtaz revived her and by the time we got back, she was alright. She underwent pacemaker implantation, came back and was convalescing. She had a sudden cardiac arrest again 2 months post-op and died before she could be revived, as she was at home. The family sold whatever they had, repaid the debt and left town. All the male members became daily laborers and females were doing whatever they can at home. The entire family was ruined with nothing left.
Now, here is the tricky question. Was I right or wrong in asking them not to go ahead with pacemaker implantation? I ask for your opinions.
October 4, 2015
My First Mistake (and so soon)
Gowri says that I am a fantastic listener (Opigga Suthi veyinchukuntavu) and Sarada says that I am a patient persuader/negotiator. I cultivated both these things after committing a grand, cardinal mistake on my very first duty day. Thank GOD, it was not fatal. I made myself a promise to listen patiently, elicit history diligently and explain properly, patiently in spite of interruptions from the patient.
This was how it went.
I was on duty as a house surgeon in Medicine. Our day (on OP days) starts at 7.00 am with ward rounds, after which we have to go to OPD. We have to be in our seats by 8.00 am for our boss will peep in at 8.02 and note absentees. Then OP will go on till 12.00 and/or past that till the last patient leaves. (usually by 2.00 pm). Meanwhile the house surgeon on duty will go to the hostel for lunch at 12.30 and be back by 1.30 pm. All cases admitted on that day in OPD belong to that unit and all emergencies that come to Casualty (Emergency dept) as well as all the case that are treated there after OP hours belong to that unit. The duty of the house surgeon is to be on call and attend casualty, examine the patient and prescribe what is needed and send him away or admit him depending upon the need. Seniors are always available on call for advice and will even come down if called. (Remember about me calling my registrar 4 times in the night and getting banged for making silly calls.)
After the patient (non emergency) is admitted or after the preliminary treatment of the emegency case is done, comes the drudgery.
A detailed history is to be taken and a case sheet needs to be written with following headings--Presenting complaint, history of the Presenting complaint, Past history of such complaints or past episodes, past history of any other illness, Any drug treatment given previously and current medication, personal history like bowel bladder and food habits, places visited recently, family history of illnesses etc. Then the examination findings are to be recorded, a prelimianry diagnosis is made, routine lab tests (blood, urine, sputum if indicated) are to be done by the house surgeon and he should be ready with all data for rounds by chief and assistant at 7.00pm. Imagine all this to be done for 7 or 8 cases between 2.00 pm and 5.00 pm because evening OP will be there between 5.00 pm and 7.00 pm.
This will be interspersed with calls from casualty.
I forgot the underlined part in my nervousness, cockiness (I know all that is there to know--I am the best outgoing student in Medicine, am I not?) and pressure of treating a patient on my own for the very first time. (of course I can call on my senior, but if I keep calling for everything, what am I there for?)
That was the mindset with which I tackled my first emergency.
He was a 50 year old gentleman complaining of breathlessness. I examined him straightaway and found that he had a diseased Mitral valve and was in heart failure. The heart was dilated and there was some water in the lungs. So confidently, I said " sister! 1 ampoule of Digoxin (1mg) and 2 ampoules of Lasix (40 mg) IV please". These were the loading doses and more will be given later if necessary.
It was given and then I sat down to write the case sheet.
His brother who came in just then brought some presciptions which were given to the patient by a doctor in their place. He was on Digoxin 0.25 mg daily (maintenance dose) and lasix 1 tab. per day.
That meant he was already loaded and was now on maintenance. I had gone and added 4 times the maintenace dose in one shot and I had not given Potassium Chloride yet. Low Potassium will increase Digoxin toxicity.
Did I kill him?- was my thought. I got panicky and went and examined the patient again. To my consternation, his heart was going fast and irregularly ( Atrial Fibrillation).
I was nearly in tears and called my registrar, who was 3 years my senior.
He came in, saw the patient and confirmed that it indeed was Mitral Valve disease, enlarged heart, Congestive heart failure and Atrial fibrillation.
I told him about my mistake-no, blunder-of giving 1mg. Digoxin IV. He just said h'm and called the patient's wife and asked her about the medication being taken by the patient.
She said that he had stopped taking drugs for the last week as he was vexed with swallowing tablets.
All the Digoxin had gone out of his body and he did need the loading dose and more digoxin after 6 hours. We gave him 15 ml. of Potassium chloride and put him in ICU. By god's grace, what I did was correct but I escaped a catastrophe by a whisker. If he was a good patient and was regular, then we would have been hard put to get him of Digoxin poisoning.
My registrar said "see! now you know the importance of diligent history taking. If you elicited the drug history, you would not have rushed in with Digoxin. And--if you talked to the wife as part of current medication history, you would not have yanked me from my house at 7.30 pm on an emergency call and would have done just what you did at 7.00 pm because you were right. Let all the tension you underwent be a lesson not to be forgotten and be a good doctor. An intelligent doctor is not a great doctor but, a caring, diligent doctor is a great doctor." He then ordered coffee for me, the CMO and for himself and after the coffe he went home. Procedures are devised with a view to run things like clockwork. We ignore them or use shortcuts to our detriment.
That is a lesson that has stayed with me till today. The persuasion part will come later.
This is about the listening part.
This was how it went.
I was on duty as a house surgeon in Medicine. Our day (on OP days) starts at 7.00 am with ward rounds, after which we have to go to OPD. We have to be in our seats by 8.00 am for our boss will peep in at 8.02 and note absentees. Then OP will go on till 12.00 and/or past that till the last patient leaves. (usually by 2.00 pm). Meanwhile the house surgeon on duty will go to the hostel for lunch at 12.30 and be back by 1.30 pm. All cases admitted on that day in OPD belong to that unit and all emergencies that come to Casualty (Emergency dept) as well as all the case that are treated there after OP hours belong to that unit. The duty of the house surgeon is to be on call and attend casualty, examine the patient and prescribe what is needed and send him away or admit him depending upon the need. Seniors are always available on call for advice and will even come down if called. (Remember about me calling my registrar 4 times in the night and getting banged for making silly calls.)
After the patient (non emergency) is admitted or after the preliminary treatment of the emegency case is done, comes the drudgery.
A detailed history is to be taken and a case sheet needs to be written with following headings--Presenting complaint, history of the Presenting complaint, Past history of such complaints or past episodes, past history of any other illness, Any drug treatment given previously and current medication, personal history like bowel bladder and food habits, places visited recently, family history of illnesses etc. Then the examination findings are to be recorded, a prelimianry diagnosis is made, routine lab tests (blood, urine, sputum if indicated) are to be done by the house surgeon and he should be ready with all data for rounds by chief and assistant at 7.00pm. Imagine all this to be done for 7 or 8 cases between 2.00 pm and 5.00 pm because evening OP will be there between 5.00 pm and 7.00 pm.
This will be interspersed with calls from casualty.
I forgot the underlined part in my nervousness, cockiness (I know all that is there to know--I am the best outgoing student in Medicine, am I not?) and pressure of treating a patient on my own for the very first time. (of course I can call on my senior, but if I keep calling for everything, what am I there for?)
That was the mindset with which I tackled my first emergency.
He was a 50 year old gentleman complaining of breathlessness. I examined him straightaway and found that he had a diseased Mitral valve and was in heart failure. The heart was dilated and there was some water in the lungs. So confidently, I said " sister! 1 ampoule of Digoxin (1mg) and 2 ampoules of Lasix (40 mg) IV please". These were the loading doses and more will be given later if necessary.
It was given and then I sat down to write the case sheet.
His brother who came in just then brought some presciptions which were given to the patient by a doctor in their place. He was on Digoxin 0.25 mg daily (maintenance dose) and lasix 1 tab. per day.
That meant he was already loaded and was now on maintenance. I had gone and added 4 times the maintenace dose in one shot and I had not given Potassium Chloride yet. Low Potassium will increase Digoxin toxicity.
Did I kill him?- was my thought. I got panicky and went and examined the patient again. To my consternation, his heart was going fast and irregularly ( Atrial Fibrillation).
I was nearly in tears and called my registrar, who was 3 years my senior.
He came in, saw the patient and confirmed that it indeed was Mitral Valve disease, enlarged heart, Congestive heart failure and Atrial fibrillation.
I told him about my mistake-no, blunder-of giving 1mg. Digoxin IV. He just said h'm and called the patient's wife and asked her about the medication being taken by the patient.
She said that he had stopped taking drugs for the last week as he was vexed with swallowing tablets.
All the Digoxin had gone out of his body and he did need the loading dose and more digoxin after 6 hours. We gave him 15 ml. of Potassium chloride and put him in ICU. By god's grace, what I did was correct but I escaped a catastrophe by a whisker. If he was a good patient and was regular, then we would have been hard put to get him of Digoxin poisoning.
My registrar said "see! now you know the importance of diligent history taking. If you elicited the drug history, you would not have rushed in with Digoxin. And--if you talked to the wife as part of current medication history, you would not have yanked me from my house at 7.30 pm on an emergency call and would have done just what you did at 7.00 pm because you were right. Let all the tension you underwent be a lesson not to be forgotten and be a good doctor. An intelligent doctor is not a great doctor but, a caring, diligent doctor is a great doctor." He then ordered coffee for me, the CMO and for himself and after the coffe he went home. Procedures are devised with a view to run things like clockwork. We ignore them or use shortcuts to our detriment.
That is a lesson that has stayed with me till today. The persuasion part will come later.
This is about the listening part.
September 30, 2015
Vemana/Sumati Satkam Poems in Engish by SBD
Mrs. Bhargavi Devi translates Vemana and Sumati satakam poems into English, hoping to inspire other Telugu/English pundits in the family.
1
The joy of a father
is felt the moment a son is born
But when he is praised by all that gather
Great is the pleasure the father does adorn
2
A dog seated on a golden throne
never loses the traits of its own
No one will benefit
if power is given to the unfit
3
Piety gained with a clean heart
may be little but is a start
The Banyan tree so tall
rises from a seed so small
4
The unintelligent blabbers a lot
unlike the wise who speaks so soft
Bronze does boom when tolled
Will it be the same with gold?
More to follow!
1
The joy of a father
is felt the moment a son is born
But when he is praised by all that gather
Great is the pleasure the father does adorn
2
A dog seated on a golden throne
never loses the traits of its own
No one will benefit
if power is given to the unfit
3
Piety gained with a clean heart
may be little but is a start
The Banyan tree so tall
rises from a seed so small
4
The unintelligent blabbers a lot
unlike the wise who speaks so soft
Bronze does boom when tolled
Will it be the same with gold?
More to follow!
September 29, 2015
What was that?
After reading Gouri's comment, I had a doubt.
Those who practice "CRIMINAL MEDICINE"--are they Criminals?
of course, nowadays with litigation mounting, doctors are being dragged to court and are being charged with criminal cases.
So, why are "criminal lawyers" not prosecuted when you arrest and charge "criminal gangs" and "criminal tribes"? And some of them are known as " leading criminal lawyers" too.
Is a "Child Psychologist" a prodigy?
(we saw it on a signboard in Kavali)-- "child specialist"--should we not congratulate the parents for such a precocious child. BTW, what kind of a specialist was he?
In a book dedicated to a great man of Kavali--someone wrote anecdotally--"he served his community well"--really? Of course, he meant the community.
Have you met any "Pichi doctor"?
I invite contribution of such gems.
Those who practice "CRIMINAL MEDICINE"--are they Criminals?
of course, nowadays with litigation mounting, doctors are being dragged to court and are being charged with criminal cases.
So, why are "criminal lawyers" not prosecuted when you arrest and charge "criminal gangs" and "criminal tribes"? And some of them are known as " leading criminal lawyers" too.
Is a "Child Psychologist" a prodigy?
(we saw it on a signboard in Kavali)-- "child specialist"--should we not congratulate the parents for such a precocious child. BTW, what kind of a specialist was he?
In a book dedicated to a great man of Kavali--someone wrote anecdotally--"he served his community well"--really? Of course, he meant the community.
Have you met any "Pichi doctor"?
I invite contribution of such gems.
September 28, 2015
Examiners!
The day I realised, that the Examiners were not the devils I(and many more students, even today) thought them to be, was the Medicine Practicals and Orals day of the FINAL year exam.
I did my short cases well, I did the long case very well and was happy and went for lunch in a happy mood. My good friend Anky had not done well and was depressed. So, in a sombre mood, we returned from lunch and lighted up ( I was a terrible smoker those days--upto 30 cigarettes per day).
We did not see the examiners pass by.
It was 3 pm by the time I was called and it was time for the examiners' tea. So, I sat in the room waiting while they had tea and biscuits. That over, Two of them lit cigarettes. There were 6 of them sitting in pairs. The first pair were non smokers.
As soon as I sat down, one of the asked me-out of the blue so to speak-"do you smoke?"
I never lie if it is not absolutely essential for preserving my life.
So, I said " yes sir! I do."
He said " not bad. At least you are honest. Now tell me the hazards of smoking".
I started with the mouth and recited a list of about 20 conditions.
He asked "you know all that and you still smoke?"
I had no reply but had a convenient defense at hand. I just looked at the two examiners smoking and back at my examiner.
He laughed and said " Oh! you mean they are smoking. But remember, what your guru does is not always for you to mimic."
Then he plunged into the questions and I answered well and he passed me on to the next pair.
So I knew they also have a sense of humour and are not absolute terrors. They are HUMAN.
As a bonus I got a high 58% (50% being the pass mark.) There was only one first class in the university (60%).
So. now, whenever I hear the students in the family complain about the heartless, cruel examiners, I just smile to myself.
I did my short cases well, I did the long case very well and was happy and went for lunch in a happy mood. My good friend Anky had not done well and was depressed. So, in a sombre mood, we returned from lunch and lighted up ( I was a terrible smoker those days--upto 30 cigarettes per day).
We did not see the examiners pass by.
It was 3 pm by the time I was called and it was time for the examiners' tea. So, I sat in the room waiting while they had tea and biscuits. That over, Two of them lit cigarettes. There were 6 of them sitting in pairs. The first pair were non smokers.
As soon as I sat down, one of the asked me-out of the blue so to speak-"do you smoke?"
I never lie if it is not absolutely essential for preserving my life.
So, I said " yes sir! I do."
He said " not bad. At least you are honest. Now tell me the hazards of smoking".
I started with the mouth and recited a list of about 20 conditions.
He asked "you know all that and you still smoke?"
I had no reply but had a convenient defense at hand. I just looked at the two examiners smoking and back at my examiner.
He laughed and said " Oh! you mean they are smoking. But remember, what your guru does is not always for you to mimic."
Then he plunged into the questions and I answered well and he passed me on to the next pair.
So I knew they also have a sense of humour and are not absolute terrors. They are HUMAN.
As a bonus I got a high 58% (50% being the pass mark.) There was only one first class in the university (60%).
So. now, whenever I hear the students in the family complain about the heartless, cruel examiners, I just smile to myself.
September 15, 2015
Never Give Up
Exam time was always fun filled and tension ridden.
When it came to II MBBS (Anatomy, Physiology and Biochemistry) we had to go to
Madras for Practicals and Orals. Since students from all 6 Medical colleges
were jumbled and allotted to 2 centers, it was always a mix of students and we
JIPMERites had an advantage. Since we were the "cream of students from all
over the country", we stood out in the batch of 20 students.
But we were scared of the "woman power".
The talk was that the girls would cry and get sympathy from the examiners while
boys could not be so lucky. There were only 3 boys in our batch, all from
JIPMER--Lakshmi Narasimhan, Leons Joseph Rajendran and Lingeswaran. All the
rest were Lathas and Lakshmis.
The Examiners were a tough lot. There were some
dreaded names--John Suneetha, SeethaRamaRao etc. They (according to legend)
take the greatest pleasure in failing a student for the trivialest reason.
So, scared about the double handicap (woman power and
tough examiners), we went to Chennai and stayed at a lodge in Broadway (Ambi's
cafe--since demolished) because it was close to both MMC and Stanley. It was an
old house converted I think, and was a building straight out of a horror movie
like "House of Wax." That added more to the tension.
My dissection practical was "the Lateral
Ligament of Knee" and around me were 3 girls dissecting away. The examiner
approached us within 40 mts. and asked the girl next to me "what is your
dissection?" She said "Cubital fossa, Sir!” That is the front of the
Elbow. He took out a tailor's tape and measured the dissected area. It was
4.5" long. He just smirked and said “young lady! What is the length of the
incision according to Cunningham?” She replied -quakingly-"4 inches
sir!" ”So!" was the drawn out comment. Silence, dreaded silence for
15 seconds. “Just because it is a dead body, you cannot cut as you like. If it
was a living person, do you think he will accept this unnecessary butchery?
Please go back, practice some more and come back in April". Fate decided.
Imagine my feelings when he approached me. Luckily, I got away with my mistakes
(I am sure there were some) and passed.
When the results came out, we were not surprised.
University pass % was 50 and JIPMER's 95. That was a record and I think it
still stands. That gave our batch a big reputation as a bunch of intelligent
blokes. Class of 1966 is just great.
But when it came to Path and Bacteriology
(Microbiology, Parasitology and Virology), it was a different story.
We had a combined paper for Path and Microbiology.
Part A (Path) and Part B (Microbiology) with 2 essay questions and the third
one with 4 short answer questions. Each essay was for 17 marks and each
short note was for 4 marks. If you left even 1 short note question (4 marks)
the result was a FAIL. Because, as they were fond of saying "you cannot
leave a question in choice, because tomorrow you have to leave the treatment to
choice and the patient to God."
The pattern in Microbiology was one essay from
Bacteria (TB, Typhoid, and Diphtheria etc.), one essay question from Parasites
(worms), 2 short note questions from Bacteria, one from Parasites and ONE short
note from viruses.
AIDS was not known till 1981, Ebola was discovered in
1976 and hepatitis viruses were no big deal. We knew other viruses were out
there and were pathogenic but they were only minor nuisances like Coryza virus
(common cold).
So, nobody studied virology in detail--only just
general characteristics of viruses which used to appear now and then as a 4
marks short note question.
But our batch got lucky--One essay and 3 short notes
were from virology and the other essay and short note questions were from
Parasites present in Africa. In effect, the knowledge of most (99%) of the
students was Zero. Me, I am a guy who never takes a chance. I did study all the
viruses also once, just for completion sake and so I did give about 75% of the
answer. So, I was confident of passing and was a hero amidst devastated
classmates.
My roommate Papanna Sastry just gave a blank paper
for Part B. So, he was ready to go home after the exams not waiting for the
practicals as the result is a foregone conclusion.
I told him that all the students of all 6 colleges
will be in the same position and they cannot (can they?) fail everyone. He countered
by saying that the final year pass last year was 14%.
Still I said “NEVER GIVE UP, as a doctor, you should
never give up. Even if it appears bleak, you have to fight on. Even if ONE life
is saved out of 50 because of this, it is not 2%--It is a life and a family is
saved. Let us go to Madras and see what happens”.
He refused, I
argued, wore him down and finally we went to Madras and stayed at Ambi's cafe (where
else?). We had a haunt- a chai kadai in Walltax road where all these birds of
same feather from 6 colleges gathered to compare notes.
To my gratification, I discovered (and Papanna felt
happy to know) that blank papers for part B were very much in fashion and
nearly 40% did not write down anything except their number on the answer sheet.
Encouraged by this we went for practicals next day.
He did the staining procedures well, identified all the specimens and drew
the slides neatly. With restored confidence and palpitating heart, he went for
the orals. The Devils or Deities who were presiding there looked at him and the
blank paper in front of them. (No spot valuations those days--they used to
correct the theory paper during orals and while 5 examiners were questioning
the student, the 6th will correct his question and pass it on to another.
So, the paper is valued in front of you and your idiocies will be brought to
your face then and there.)
They asked him why he had given a blank paper. He
said that he did not prepare for Virology as it carried only 4 marks till then
and he used all the time for the rest. One examiner said “as if you are
thorough with the rest. We will give you one chance as an exception. Impress
us. Tell us about Mycobacteria (TB, Leprosy etc.) Papanna was a good student
and he had the ability get a book by heart in a week. So, off he went on a
spree and they were impressed. “So, tell us about Diphtheria”, they said and he
told them. Lastly, tell us about flukes--of course he flew in a flow. They were
really impressed and said “ok! don't make a habit of skipping things. Read everything
at least once. Go happily." I got a B plus and he got an A plus. So in the
end he outshone me.
So, my advice to anyone and everyone is "NEVER GIVE UP." If you give up you have
failed already, so, try and see if you can win.
September 7, 2015
Dead Men Do Tell Tales (or) Why Irreverent Medicos are useless
We were the first Entrance batch in JIPMER and were an all-india batch in nature. We started off with Premedical (I MBBS)—Physics, chemistry, Botany, Zoology and English for 1 Year.
That will be dealt with later.
We entered the II year—Anatomy (1 year and 6 months), Physiology (1 year and 6 months)and Biochemistry (1 year and 6 months)with Biophysics (1 year). WE started our Anatomy dissection with great glee. We were cutting up a real body (though dead) like real doctors and learn what is there inside. We were paired in twos and my partner was T. Krishna Moorthy AKA Tikky ( who now is a plastic surgeon in Trichy.) We took possession of the Right leg and another two took up the left leg. 4 of our seniors were doing the dissection on the upper limbs. So there were 8 of us crowding round the table and jabbering away while jabbing and cutting away, supposedly as per the instructions in the dissecting manual. Most of the time we did, but occasionally we were too fast because it was a race to see who were the fastest.
On the first day, some of us were scared and touched the body gingerly. By the third day, it was familiar. By the end of the week, we were propping up the books by the body’s flanks and we used to lean over the body to talk to guys and gals on the other side, casually resting our hands on the chest or abdomen of the body.
We had Osteology classes taught by a Lady Medical Officer (only MBBS) working as a demonstrator. She got the job because she was the wife of our Radiology Associate Professor. She was from somewhere in the North East and had poor English Language skills. These Two things made her an object for ridicule and we had a field day in her class.
She: why you late?
Student: me not late. Mess is late. Mess is Dosa and Dosa is late.
She: don’t care. Not late in future. Student : no mam! Only on dosa days.
Student: madam, I am feeling giddy. I want to go to casualty.
She: why?
Student: because head is turning.
She: go.
He leaves the class amid titters. We all know he is going to lie down in his room.
Another student: madam! He is giddy. He may fall on the way. I shall go with him.
She: (glowering) ok go.
A small pause. The second student returns.
Student: madam! He has fainted. I want 4 people to carry him.
An exodus starts without waiting for permission.
She: (angrily) you will all suffer in the exam.
We were all confident, because we depended on ourselves and text books. All the students in six medical colleges (MMC, Stanley, Kilpauk –all 3 from Chennai, Chengalpat Medical college, CMC Vellore and JIPMER) were pooled together and divided between 2 exam centers in MMC and Stanley. None of our professors were examiners as they were in CGHS and were taking a transfer to North India within 2 or 3 yrs.
In Physiology lab., the demonstrator was introducing us to the various pieces of lab equipment. Suddenly a boy in the last row fell down faint. Ether was kept in the lab for cleaning the glassware stained with blood. He wanted an experience of “ether kick”.
But in Biochemistry we were more careful as our Lecturer with his phenomenal memory (He will figure later in my story) asked us for personal details and wrote them down. From next class, he used to call all the 65 by name. We had to sit alphabetically in his class.
Thus we were well on the way to earning the name of a mischievous batch.
Back to Anatomy dissection then.
We (Self and Tikky) finished the dissection fast and first. We separated the limb from the body, after disarticulation at the hip. We held it aloft like a trophy and crowed “we are the first.” All hell broke loose wiuth everybody yelling something. In the next second, there was a deathly hush.
Our Professor, Dr. Charnalia had stepped into the Dissection hall. We all received a dressing down and we were singled out for most of it (deservedly). He concluded by saying ” I know what is happening in the Osteology class, I know what is happening in Histology lab (that was directed at me) and they tell me you are exhibiting the same behavior in other classes. Remember that you are a nothing now, just a student and an irreverent one at that. You have no respect for your teachers and elders. You have no respect for what you are doing.
This cadaver is so much better than you. It is trying to teach you something useful, so that you become useful to the society. And you are shamelessly insulting its dignity. God help you all.
I expect better from you now on.”
We were chastened and never did we do silly things in class after that and from that day I made it a policy not to disrespect an elder.
Dead men do tell tales and teach us many things.
We entered the II year—Anatomy (1 year and 6 months), Physiology (1 year and 6 months)and Biochemistry (1 year and 6 months)with Biophysics (1 year). WE started our Anatomy dissection with great glee. We were cutting up a real body (though dead) like real doctors and learn what is there inside. We were paired in twos and my partner was T. Krishna Moorthy AKA Tikky ( who now is a plastic surgeon in Trichy.) We took possession of the Right leg and another two took up the left leg. 4 of our seniors were doing the dissection on the upper limbs. So there were 8 of us crowding round the table and jabbering away while jabbing and cutting away, supposedly as per the instructions in the dissecting manual. Most of the time we did, but occasionally we were too fast because it was a race to see who were the fastest.
On the first day, some of us were scared and touched the body gingerly. By the third day, it was familiar. By the end of the week, we were propping up the books by the body’s flanks and we used to lean over the body to talk to guys and gals on the other side, casually resting our hands on the chest or abdomen of the body.
We had Osteology classes taught by a Lady Medical Officer (only MBBS) working as a demonstrator. She got the job because she was the wife of our Radiology Associate Professor. She was from somewhere in the North East and had poor English Language skills. These Two things made her an object for ridicule and we had a field day in her class.
She: why you late?
Student: me not late. Mess is late. Mess is Dosa and Dosa is late.
She: don’t care. Not late in future. Student : no mam! Only on dosa days.
Student: madam, I am feeling giddy. I want to go to casualty.
She: why?
Student: because head is turning.
She: go.
He leaves the class amid titters. We all know he is going to lie down in his room.
Another student: madam! He is giddy. He may fall on the way. I shall go with him.
She: (glowering) ok go.
A small pause. The second student returns.
Student: madam! He has fainted. I want 4 people to carry him.
An exodus starts without waiting for permission.
She: (angrily) you will all suffer in the exam.
We were all confident, because we depended on ourselves and text books. All the students in six medical colleges (MMC, Stanley, Kilpauk –all 3 from Chennai, Chengalpat Medical college, CMC Vellore and JIPMER) were pooled together and divided between 2 exam centers in MMC and Stanley. None of our professors were examiners as they were in CGHS and were taking a transfer to North India within 2 or 3 yrs.
In Physiology lab., the demonstrator was introducing us to the various pieces of lab equipment. Suddenly a boy in the last row fell down faint. Ether was kept in the lab for cleaning the glassware stained with blood. He wanted an experience of “ether kick”.
But in Biochemistry we were more careful as our Lecturer with his phenomenal memory (He will figure later in my story) asked us for personal details and wrote them down. From next class, he used to call all the 65 by name. We had to sit alphabetically in his class.
Thus we were well on the way to earning the name of a mischievous batch.
Back to Anatomy dissection then.
We (Self and Tikky) finished the dissection fast and first. We separated the limb from the body, after disarticulation at the hip. We held it aloft like a trophy and crowed “we are the first.” All hell broke loose wiuth everybody yelling something. In the next second, there was a deathly hush.
Our Professor, Dr. Charnalia had stepped into the Dissection hall. We all received a dressing down and we were singled out for most of it (deservedly). He concluded by saying ” I know what is happening in the Osteology class, I know what is happening in Histology lab (that was directed at me) and they tell me you are exhibiting the same behavior in other classes. Remember that you are a nothing now, just a student and an irreverent one at that. You have no respect for your teachers and elders. You have no respect for what you are doing.
This cadaver is so much better than you. It is trying to teach you something useful, so that you become useful to the society. And you are shamelessly insulting its dignity. God help you all.
I expect better from you now on.”
We were chastened and never did we do silly things in class after that and from that day I made it a policy not to disrespect an elder.
Dead men do tell tales and teach us many things.
September 5, 2015
What of My Future?
I was not a model student by any chance and was a bit of short tempered and a stubborn person too. (Gouri! Are you Happy?), I was beaten by the headmaster in the VI form in ZPMP School, Kavali for leading a strike and boycott of classes in protest against the attitude of our Tyrannical Sanskrit teacher. Of course, later we were called to the HM’s chamber and were pacified and made to agree to attend classes. It was a moral victory of sorts, as our Sanskrit teacher stopped beating us—which was the cause of the uprising. Luckily, it did not reach home or I would have gotten a second coating from my father.
When I was doing my PUC in Andhra Loyola College, Vijayawada, I was expelled from the college for indiscipline (read going home to write my Hindi exam from DBHPS before the quarterly exams, after I was specifically denied permission to do so. The Vice Principal felt that as it was a crossroads time, Even a quarterly exam was more important than any silly other exam.) On returning, I was called for a one-on-one with the VP Fr. Thikkamore and was told in no uncertain manner that this kind of behavior was intolerable and I had to bring my father for a discussion about my future. I had to go back and explain to my father why he has to accompany me to Vijayawada—which was a nightmare for me—but surprisingly, he took it in his stride and only later have I realized how well he sympathized with my position at that point of time and refrained from saying anything. By the time we returned, I was struck off the rolls and my father had to give an undertaking about my future good behavior and pay a hefty readmission fee before I was allowed to attend classes. My father, the great man he was, merely said “careful! Do not be annoying the powers to be” and left for Kavali. I did not even accompany him to the bus stand, as I had classes to attend to.
When I was doing my I yr B.Sc. (MPC) in Jawahar Bharathi, Kavali-we had a strike in January (no big deal in JB, as it is a quarterly occurrence and dissent is given its due respect and place in the ideology of Visvodaya which runs the college). I was not THE leader this time (as it was a collective effort), but one of them. It was against the hastily announced half yearly exam schedule. We won the right to take only assignments and were given stationery from the collge—8 full sheets per each paper (40 in all).
We returned the assignments with the written papers numbering from 0-40 according to the students’ ability.
I was in IIT for 10 days—a theory week followed by a workshop week which was tiring—so after 3 days of metallurgy and a day of carpentry, I turned my tired feet and body home to Kavali (bunked Friday and Saturday and added Sunday) to have a 3 day vacation after 11 days of study. I do not know what would have happened for that because on return, I attended JIPMER interview and came to IIT campus for my TC only on Wednesday and vacated by Wednesday evening.
Thus with this illustrious career behind me, I joined JIPMER as a I year. I wondered what lay in store for me. So, there I was, In June 1966.
August 31, 2015
The Beginning
It started almost 50 years ago. 49 years and 2 months to be more precise. In June 1966, I took the first steps on the path of medical profession.
I was alone when I got down in JIPMER and went to the office to report. I had come bag and baggage from Chennai, as I was in IIT at that time and I vacated the hostel (Ganga) and got on the bus for Pondy.
After getting admission in the office, I was told by Purushothaman (a nice Malayalee who was the student clerk—remember him for he will figure later in my memoirs)) to go to the hostel and get a room allotted.
Students were allotted single rooms in Harvey house. But as it was full, Ist years were given accommodation in the 4th floor of Lister house, above the Senior House surgeons and Registrars.
I, my good friend George Kurian (currently a retired gastroenterologist from CMC, Vellore and a good blogger active on the face book) and a Sardarji - Inderjit Singh Rana were the three Ist years who reported the day after the announcement of selection. All the others had gone home to bring their baggage and were to report in 3 days time.
So, the seniors had a field day ragging only 3 of us. Due to lack of victims, they had to resort to group ragging-sometimes as many as 15 or 20 seniors at a time. Since they all were asking questions simultaneously and ordering us to do different things at the same time, we managed to do nothing and say nothing, looking confused all the time.
As part of the ragging ritual, I was sent to the ladies hostel to deliver a letter to Miss Leena (was a mythical person, I came to know afterwards). When I expressed my apprehension that I may be beaten black and blue for doing such a thing, I was told that I will be beaten black and blue if I did not.
It was a revelation. I was scared to look at those ogresses in their lair in the leisure time. Many a made up beautiful face seen outside, looked like something the cat dragged in. I was promptly told to get lost and equally promptly sent back by the seniors. The watchman whose job it was to prevent boys coming into the girl’s hostel was laughing and staying away. After 3 rounds, an angel in human shape took pity on me and told me that my best efforts will be in vain as there was no such person. When I went back and told the same to my seniors, they brayed like donkeys (laughter) and sent me away.
Thus a 3 day period was passed and since my face was familiar to everyone, from the 4th day onwards, I was excused and was given the job of recruiting (bringing my newly arrived classmates to the seniors.)
They were casting envious glances at my good fortune to be roaming the hostels freely while they had to sneak around to escape the attention of the seniors.
Being early I got a single room (416) while the last to arrive had to settle for double rooms with a roommate.
Thus began the career and an eventful first week passed.
August 24, 2015
August 23, 2015
The Answer
August 22, 2015
The Doctor Who Disappointed The Village (Part III)
August 20, 2015
Back to Mary.
"Singampallis, , forgive me , for I do not know what I was doing.". I know. I was staying away from the blog. I am back (though it seems you people did'nt miss me much. ha ha )
August 18, 2015
The Doctor Who Disappointed The Village (Part II)
I had resigned my post of senior house surgeoncy to take up this job and had no place to stay. So, I stayed in my friend Ranga’s room in JIPMER for a while- a week or so and moved to the Doctor’s quarters here. They were nearly decrepit, in need of repairs and I pestered the State PWD to carry them out and to repair the other quarters too. I was busy organizing work here, getting to know the ropes, the territory and the staff. I was visiting DMS office, PWD office and medical stores depot for drugs etc. In the night I was busy making Ranga read and help him with Pharmacology. In fact I was BUSY. Meanwhile, I was commuting between Pondy-JIPMER Hostels and Katterikuppam.
The commute was also an adventure.
The road from the bus stand to the PHC was a mud track and if it drizzled even a little bit, we had to perform feats of balance, just to stay vertical, while walking to the bus stand. We had 2 options—
1. walk with your shoes on and wash them at the “boring pump” in the bus stand but this comes with a need for great skill in balancing as the shoes are more likely to slide and slip.
2. Walk barefoot (for better grip on the ground) and carry your shoes in hand----wash your feet at the boring pump.
The road was lined with coconut trees on either side and at a turn in the middle, there was a big mound inhabited by snakes.
In fact a typical village of India in the 1970s with minimal facilities and a tough life.
After getting the quarters repaired, I moved in. It was a 2BHK bungalow without attached baths.
I insisted on repairs to staff quarters and they promised to get cracking “soon.”
The jeep attached to the PHC was donated by UNICEF and was doing duty in DMS office. I quarreled, insisted, cajoled and got it back to the PHC with a driver. There was an unmarried nurse posted there, who came to live on campus. Her quarters were next to mine with a gap of about 10 ft. with the road to the garage intervening. There was a ward boy on night duty (permanently as his lungs were destroyed by TB and he could not perform any active duty in the daytime.)
In the night the nurse and the ward boy slept in the hospital and I slept in the quarters alone to the accompaniment dogs barking and foxes screeching.
August 13, 2015
The Doctor Who Disappointed The Village (Part I)
It was mid October 1973 and I was going in the bus with a
bit of trepidation. I had finished my MBBS,
did my House Surgeoncy, did a Short stint in Dermatology and Thoracic
Surgery and was a fully qualified
Medical practitioner with a Registration with the Tamilnadu Medical Council. I had a bit of trouble with my
college Administration and so did not see my chances of getting a PG seat as
bright. So, I thought of putting in a 2 Yr rural service and get back to PG
with admission under service quota. I was selected by UPSC for Pondicherry
Medical Service and was on the way to take charge at PHC Katterikuppam as
Medical Officer –in- Charge.
Why the trepidation? Till then I was confident of support
from my seniors and could call on them at anytime if I had a problem. Of
course, as a house surgeon in JIPMER, I sat in the Out Patient wing twice a
week disposing of patients. I saw them, advised the necessary investigations
and after getting the results made a diagnosis and prescribed treatment—the
tablets to be obtained from the JIPMER pharmacy.
If a case was difficult or confusing, I call my Registrar or
Professor and get their advice. If a case deserved admission, I took the
patient to the Registrar for the needful. He was the de facto head of the
ward—with 2 to 6 yrs of experience and was looked up to as a guide. The
professor, of course was GOD himself, to be approached only in emergencies or
for big problems—he was busy with teaching, making grand rounds, doing surgeries
or medical procedures, conducting bed side clinics and administrative matters.
On night duty, I can prescribe any drug as needed and the
nurses will see to it that the patient gets it. If the condition of the patient
is alarming, I can call on the registrar. In fact, on my first night duty
shift, I called my registrar, Dr. Sakunthala 3 times. On the 3rd
occasion, she enquired whether I would like my hand held or a lullaby sung
since I seem to be afraid to be in the duty room alone. That boosted my confidence
much. (She said that on all the 3 occasions my diagnoses and treatments were
correct and I needed only belief in my ability.)
From there, I handled independent charge of Cardiothoracic
wards (Later gave me the confidence for going on with Cardiac work).
But this was different. I was to be the sole responsible
person—Doctor, Administrator (new experience) and drawing and disbursing
officer and coordinator for state and centrally sponsored schemes. I had ten
villages and 3 subcentres under my control.
I was given pitying looks in the DMS office when I reported
and was directed to take charge at Katterikuppam. I was told that it was a
troublesome place with people petitioning the governor at the drop of a hat and
always causing problems for the govt. officers. In fact it was supposed to be
Punishment Post/ Newbie post as nobody else will go there. Since I fall in the
second category, I was posted there. This added to my anxiety. But I always had
a thing for the poor and village folk who do not get sufficient attention or
help anywhere. So, I thought of this as a chance to do my bit. So, there I was
going to my first posting –eager, scared and Exuberant.
August 9, 2015
WRITER'S CRAMP--MENTAL
How does one go about writing a short series?
Start from the beginning--proceed chronologically--and leave the end open!--for a Sequel.
or
Start in the middle--go for a flashback--come back and finish.
or
start in the middle--proceed to the end and write a prequel.
Which one is the better style?
opinions please.
At least 6 opinions needed before start.
Start from the beginning--proceed chronologically--and leave the end open!--for a Sequel.
or
Start in the middle--go for a flashback--come back and finish.
or
start in the middle--proceed to the end and write a prequel.
Which one is the better style?
opinions please.
At least 6 opinions needed before start.
August 3, 2015
July 31, 2015
July 30, 2015
July 28, 2015
Mother's recipes: Annamlo Podi
Here is the first of a series of recipes that mother is typing into the PC. We start simple, with Raghav's favorite food item.
Ingredients:
Chenadal- 100gms
Uraddal- 100gms
Toordal - 100gms
Moongdal- 100gms
Dry mirchies- 4 medium size [or take depending on your spice-level ]
Jeera- 1 tsp
Salt- roughly two levelled tsps.
Hing
Method:
Fry all the four dals separately till light brown colour or wheat colour. In half spoon oil fry the mirchies a little. Sprinkle some hing. Add raw jeera to the fried dals and powder all the ingredients in the mixer. Add salt.
Ingredients:
Chenadal- 100gms
Uraddal- 100gms
Toordal - 100gms
Moongdal- 100gms
Dry mirchies- 4 medium size [or take depending on your spice-level ]
Jeera- 1 tsp
Salt- roughly two levelled tsps.
Hing
Method:
Fry all the four dals separately till light brown colour or wheat colour. In half spoon oil fry the mirchies a little. Sprinkle some hing. Add raw jeera to the fried dals and powder all the ingredients in the mixer. Add salt.
July 4, 2015
Seat no 63
I had been to shirdi on 2nd July along with surekha w/o Ts.we had a great trip.enjoyed it thoroughly.way back we boarded bokaro express at vijayawada.I took my ticket out and S7 63 was my seat booked.when I went to the berth it was already occupied to my dismay.The occupant showed the ticket and he was right.People around ,all educated ,uneducated,compared both the tickets
And said the seat is booked twice
The railways are sloppy
They just do not care
Callous
They have put a woman to hardship.
Thank god it is a3hrs journey,
These computers!!!!!
The above were comments by copassengers.
The TTE came checked the ticket apologized and he made me sit in HIS seat.
He instructed a RPF constable to see that I get down at kavali comfortably
The train reached Bapatla
I just casually took my ticket out
That 63 is my AGE The seat number is 1
Still iam surprised how so many minds were influnced and so many eyes blinded by MY MISTAKE
And said the seat is booked twice
The railways are sloppy
They just do not care
Callous
They have put a woman to hardship.
Thank god it is a3hrs journey,
These computers!!!!!
The above were comments by copassengers.
The TTE came checked the ticket apologized and he made me sit in HIS seat.
He instructed a RPF constable to see that I get down at kavali comfortably
The train reached Bapatla
I just casually took my ticket out
That 63 is my AGE The seat number is 1
Still iam surprised how so many minds were influnced and so many eyes blinded by MY MISTAKE
May 6, 2015
Tirumala as it was----
Tirumala 60 yrs ago
Only a few in the family may know this and remember this.
Makes me nostalgic for "Beete huwe din"
Only a few in the family may know this and remember this.
Makes me nostalgic for "Beete huwe din"
May 3, 2015
Advance Birthday Celebrations in Hyderabad
March 23, 2015
hellow!happy wedding anniversaries coming days.first srn,kanakadurga: then sln,gouriranganayaki:and then again mruduls ,aneesh. and.now adavanced wishes to you all folks.and why such an eventful year for all.hope the same good luck continues forever and wish it.may lord venkateswara shower all his blessings on our family members.and for gouramma ,sarada,bavagaru swathi i wish lord sivas blessings and happy darshan
March 9, 2015
Happy Anniversary kuppakka and seenu bava
Wishing you many many many more happy returns of the day :)
February 23, 2015
HUH! What was that? a traveller's review of accommadation---
Good stay and enjoyed at ytd hotel. Clean and calm sea
shore.
Good food in all times and service also. All staff are help us specially thanks to reception staff.. always smile welcome and care of us.
Rooms are spacious and neat bedsheets and toilets.
Temple walkable distance. Sea shore area.
childrens play ground..
wife avail able for payment basis.
travel desk available.
Rooms was sunrise view in the main building of room no 109 and 110.
Good food in all times and service also. All staff are help us specially thanks to reception staff.. always smile welcome and care of us.
Rooms are spacious and neat bedsheets and toilets.
Temple walkable distance. Sea shore area.
childrens play ground..
wife avail able for payment basis.
travel desk available.
Rooms was sunrise view in the main building of room no 109 and 110.
Ps:emphasis mine.
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