Saturday, June 23, 2012

In you we trust

(This short story is entirely a work of fiction.)

"Welcome to Charaka!", Dr. Suketu Jha said as he offered a handshake to Prakash. Prakash beamed as he took the doctor's hand and excitedly said, "Thank you sir!"

Dr. Jha's search had ended. Ever since the senior most technician of the dialysis unit of Bangalore's swanky and famous Charaka Hospital, Ramesh, had resigned to join one of the new standalone dialysis chains coming up in the city, the operations of the dialysis unit had suffered. What could two junior technicians do, after all? The number of patients also kept growing as Dr. Jha was a skilled and empathetic doctor, a rarity these days. Months of newspaper ads, checking with contacts, even unabashedly calling techs himself, yielded little success.

Then finally, almost out of nowhere, Dr. Jha saw an email in his inbox one evening after his usual rounds. The subject read, "Applicn. for Sr. Dialysis Tech. - 8 yrs exp". Dr. Jha chuckled as he took in the abbreviations. But 8 years experience looked tempting. He went over the resume. It was a typical technician's resume. Bad formatting, spelling mistakes, a pompous objective. One thing struck him however. 8 years in only 2 jobs. That was rare in this industry! Dr. Jha called Anu, his secretary, and asked her to schedule an interview.

It was almost 8 in the evening when he could finally leave his room. On the way out, he stopped by at the dialysis unit as usual. Four cases were going on. The two junior technicians were managing the unit. There were two nurses helping out. But Dr. Jha was never sure. He dreaded every call from the unit fearing the worst.  He checked with the staff if everything was ok. One patient's BP had dropped a bit. Dr. Jha advised that they reduce the ultrafiltration volume. One of the techs proudly said that they had already done that. Dr. Jha smiled and said, "Good!" Under his breath he muttered, "Wasn't it obvious?!" But he realized that he needed to handle these rookies with kid gloves.

As he made his way to the car park, Dr. Jha thought about how easily he had set up the unit about a year back. He had found a team of technicians who were available as a dialysis unit about six kilometers from where Charaka was located had closed down. Ramesh had been very good, very efficient and took complete responsibility leaving only the medical management to Dr. Jha. But when he was given an offer by the standalone chain that was being started at almost double the salary he was currently getting, Dr. Jha could do little to convince him to stay. He did not even make an effort to talk to the management of Charaka because he knew what they would say. Ever since Ramesh had left, his problems started. The junior fellows did not know even basic inventory management, patient scheduling and other book keeping. Dr. Jha had to spend a lot of time in the unit fixing things and guiding them.

"Let's hope this new guy is some good," he thought to himself as he got into his Honda City and headed home.

That evening as he opened his MacBook Pro to look for some information on uptodate.com about a particularly difficult post-transplant case where an IgA Nephropathy case had shown an increase in renal parameters, he saw an alert in his Google Reader page that was headlined, "The Lufkin Davita Bleach Murder Case: Opening Salvos". He opened the link and read with horror the accusations against a dialysis nurse in Texas state in the US of injecting bleach into some dialysis patients at a Davita dialysis center. Dr. Jha was appalled on reading the sequence of events. How could anyone do this? How could anyone betray the trust of a patient? There was some mention of a Davita conspiracy to implicate the nurse to cover up bad processes. Dr. Jha felt a shiver down his spine. What precautions do I have in place to prevent this kind of a thing from ever happening?

Was the nurse at fault? Was it the unit? Either scenario was scary. I should institute processes immediately to make sure the chlorine content of the RO water is checked every month. Why every month? Why not every week? This was a critical aspect of dialysis. In fact, I should have it done every day! What about the staff? How can I make sure that they do their job? One disgruntled staff member is enough to bring about disaster in our unit. Just one disgruntled staff member! 

Dr. Jha then took a Restyl 0.25 mg. He needed some sleep. Everything would be ok, he reassured himself. Indians never feel so strongly about any thing. An Indian would never kill a patient. The Restyl began to act. An Indian would never kill a patient. An Indian would never kill a patient. The Restyl took over completely.

1 comment:

Kartik said...

Very nice start Dr.Jha, oops, Dr.Shah! :)
Eagerly waiting for the next episode