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Sunday, November 27, 2016

in the company of juvenile diabetics

During my internship days in Kilpauk medical college in Madras in 1982..83 i was posted in internal medicine in the unit of Kisaar Ahmed a pioneer in Diabetology. In those dark days endocrinology as a superspeciality was yet to be born. Kisaar sir had then itself started the Diabetic Research cell in KMCH. His focus was on Juvenile Diabetes the rare ill fated children and adolescents and young men fated to depend on external insulin as thier bodies never produced them or if they did it didnt work.
Before discovery of insulin juvnile diabetics just died.
it was for Banting a young doctor and Best a medical student of Toronto university to discover the magic of insulin from the extracts of the pancreas of a dog later a cow. Though the Nobel price of medicine went to Banting he had to share it with Mclelod a physiologist in Toronto university who gave space to Banting and Best to conduct the research. Banting was furious and felt it was Best and not Mcleold who deserved a share of the prize and donated half his prize money to Best later the Nobel Committee agreed that it should have gone to Best too.
Lets not divert
Coming back to Kisaar sir he loved those juvenile diabetics like his own.
Many had been abandoned some were from very poor families who could ill afford daily insulin
so many stayed in the hospital itself
The younger ones even went to school the olders went for work.
Back in the evening they would go to thier spots in the corridor the older men would help us with collection of samples
I still remember one lanky young man who was my perpetual assistant trailing me with a litany of syringes test tubes as I went about the ardous task of collecting blood samples from the hundred or more patients in the ward some on beds some between beds on the floor for Government hospitals which were crowded beyond belief.
The nurses actually were supposed to do the job but Government nurses were dictators and poor interns just listened to them.
This guy i remember would spell urine as unir
saar unir samples collect paniten saar ...he would say
Kisaar saar knew each juvenile duabetic by name and would often enquire as some just disappeared for few days most were brought back in hyperglycemic keto acedotic states to be nurtured back by a considerate sir who would later give them a piece of his mind too.
another problem was hypoglycemia .when you had insulin you need to have food some youngsters did not on and off or insulin dose was bit high so they landed up in hypoglycemic attacks which are emergenciies body cannot last long without glucose
Most in the ward knew the drill as soon as they see slightly woozy strange behaviour of thier friends they would give jaggery water or sweets or sugar but if less conscious would yell for nurse.
.nursamma rashid hypo...
.then we would rush load our fifty ml .glass syringes with glucose trying to get a vein out of a thrashjng foaming super powerful hypoglycemic patient.
As the glucose flowed in the throes would subside calm would settle and he would sleep with a beatific smile like a baby would.
Next day in rounds an angry Kisaar. Sir would tick him off.
Can never forget those guys

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