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Casualty Department of a Government Hospital in Pakistan

Submitted by on August 28, 2012 – 12:55 AM

“We are about to reach don’t worry, it will all be okay” I tried to console my cousin on the way to the casualty department of a government hospital while he shifted restlessly because of cramping pain in abdomen after attending last night’s marriage ceremony.

Minutes later our car entered the boundaries of government hospital, I felt relieved for a while only to get worried again. There were some public vehicles parked in our way to the gate of casualty department. Few had drivers sitting in them and chewing pan, while other drivers were chatting around at a nearby shop. We continued to move slowly between the vehicles, obstructing the way of those who was going back to their homes after treatment from the casualty department.

Soon I realized that I should better step out of car and walk to the gate. Holding my cousin I moved to a corner searching for stretchers or wheel chairs. As we reached near them, I saw that most of them were broken; some of them had dust and remaining were blood or probably vomit stained. “Let’s move in brother, I can’t bear it anymore”, said my cousin while pulling me to gate of the casualty department of the hospital.

“Go there and make a receipt”, the gate keeper commanded us in heavy voice as we entered the gate. I looked around for some seat where I could make my patient sit. There were a bunch of chairs opposite to the receipt counter with stains of pan and wrappers of different stuff below them. Few men were sleeping on them and some others were sitting and chatting. Hardly I managed to find a clean and empty chair and made my cousin sit on it while I went to get the receipt.

“Patient’s name?” the bearded man asked while saving his gutka (a form of smokeless tobacco) from being spitted out. “MH s/o MA” (names changed for anonymity) I replied. “Son of?” he asked again, “Muhammad Ahmed” I mentioned in loud voice. “Age and address” he asked and I told him the complete details. “Take this receipt and go the doctor’s counter there” he said while giving me the paper and pointing ahead simultaneously.

I shouted in agony as I saw my cousin vomiting there. I rushed at him and rubbed his back to make him comfortable. The vomit spread on floor and smelled foul. “I should get it mopped” I thought and asked the nearby person for sweeper. He laughed and said “You will not get a sweeper here, better leave it and go in”. “Let’s go bro” H was getting agitated too. I had to leave it without getting it mopped and moved ahead to the doctor’s counter.

There were two doctors sitting on the counter with plenty of people surrounding them from all sides. “Sir, he is having serious diarrhea, vomiting and pain in abdomen.” I said loudly so that the doctor could hear. He looked at us and said “Make him lie on bed, I will see him there”. “Which bed?” I wondered to myself as I saw all of them filled with patients. I tried any way and finally found an empty bed where I made H lie down. Feeling victorious by managing to find an empty bed, I looked at the floor which was all dirty, had few open needles thrown on it, blood stains and much more. Having no other option I ignored all this, assuming that we are here for a while only and will leave after treatment.

There were no signs of doctor coming as I kept looking at the counter and my cousin’s condition was getting worse. I saw another person in a lab coat standing near a bed. I walked to him and said “Kindly examine my patient, he is in pain”. “What’s his problem?” asked the man while looking at some reports. “My cousin has vomiting, loose motion and…” Before I could finish, he said again “Go to the CMO”. “CMO? What’s that?” I felt confused. “What CMO sir?” I asked him again. “The doctor sitting on the counter, I am a Surgeon and your case is not to be seen by Me.” replied the doctor.

Amazed and irritated at the Surgeons reply I walked to the CMO (now I know it’s an acronym for casualty medical officer) and asked him to see my patient. He was still busy and asked me to wait a while. The reply increased my frustration. It’s been half an hour and still no body has attended him. “Will you see him or should I take him somewhere else?” I yelled. The doctor sensing my attitude got up his seat and said “Let’s go”.

As we walked to bed, twice he was interrupted by people accompanying different patients. Getting free of all of them he finally reached my cousin who was rolling on bed with pain. “What happened to you?” asked the doctor, “My abdomen hurts very much and I feel nauseated.” he replied in interrupted voice. He continued to ask more questions while writing prescription on the receipt. When finished he said “Go to the nurse’s counter and get these medications for him and he will be okay, don’t worry”. “Thank you Sir” I said in humble voice as he moved back to his seat.

I thought my problems were finished as doctor had seen my patient and prescribed medicines. Happily I moved toward the nurse counter. An old fat lady was sitting there busy in her cell phone, “I need these medications” I said while showing her the prescription. “Wait, let a nurse boy come here, and he will give you medicines” she said without taking her eyes off her cell phone. The rude answer hurt me badly but I still waited without saying anything further. With no signs of boy nurse coming I humbly requested her again for medicines. “Can’t you wait a while?” she replied in same tone. This time I could not bear it further and shouted “Why can’t you give medicines? My cousin in pain and you are busy here playing games”. She began to stare at me in anger and shouted the name of boy nurse, asking him to come here. “Give me the prescription and go to your bed” said the boy nurse as he arrived. Handing him over the paper I stayed there until he prepared the medicines and walked with me.

He set up an IV line in my cousin’s arm, connected injectable medicines with it and left saying “Inform me when the chamber ends”. Instead of saying him thanks I stayed silent and angry.

Amazed at my attitude that I have recently shown to doctor and nurse I looked around the whole ward. There were so many patients, in all type of problems. Every bed surrounded by attendants and people were moving here and there in confusion. There were doctors examining some patients while skipping others, probably because those were not for their specialty. The floor was all dirty and people continued to make it dirtier by every possible means.

Within ten minutes, H was in relief and now sleepy. I felt relieved too and waited patiently for the medicines chamber to end.

When done with all medicines I walked to the same doctor. “How does he feel now?” he asked “Better” I replied. “Alright, give him these medicines for five days and hopefully he will be fine” he said while writing some more medicines on paper. “Thank you sir and sorry for my attitude” I replied ashamed. “No problem, just take care of your cousin” he said smiling.

Outside the casualty gate, there were so many randomly parked vehicles. I searched for my car until I found my driver standing nearby waiting for us. He told that he parked the car far away from gate of the casualty department because there was no place here. “You stay here and I will get it for you” I suggested tomy cousin. “No, we will get stuck here in traffic, let’s walk to that place”. He replied trying to avoid the misery of waiting further in hospital premises.

Having guided my cousin comfortably in, I then sat beside him. Finally, the car began to move toward home and more importantly, away from the hospital. An old phrase that I heard in childhood continued to revolve in my head

“May even our enemies’ stay away from hospitals and courts.”

About the author:  Mudassir Hussain is a graduate from Dow Medical College, Karachi, Pakistan. After completing house job from Civil Hospital Karachi, Pakistan he is currently working as an emergency medical officer at Aman Foundation, Karachi, Pakistan. He aspires to become a competent general surgeon. He can be contacted at: [email protected]

About this article: This article is competing for the JPMS International Medical Writing Contest 2012

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