Wednesday 28 January 2015

INDO-US Relations fortify the spirit of INDUSWORLD : "Integrated Network for Developing United Solutions for the WORLD"

From the Desk Of
Sagar Galwankar, MD

President Obama has departed to USA after a fruitful visit to the worlds largest democratic free nation of India.

The visit which many consider as "just symbolic" in my view was the most important development for INDO-US Relations in this century.

The presence of the Leader of the Free World at India's Military and Cultural Parade indicates the importance given to building international security to foster peace.

The meeting with the Business Leaders across the two nations aiming to facilitate a expedited process to enhance trade and cross continental business indicates the bilateral commitment to envision and establish sustainable interdependence, investor confidence and growth.

The address by President Obama to the students of India sent a strong message to the Youth of India about the opportunities for Education in India as well as USA.

The joint radio address to the nation by President Obama and Prime Minister Modi signifies "A FIRST" in the books of history. It was a casual chat where both leaders spoke their hearts out.

The mere friendship between the two leaders was very palpable and positively visible. It was not practiced and not planned....It was all natural !

It signifies a firm resolve of the leaders and the administration to build a new world.

India has always been a Country which advocates and practices peace. Since time and again its not known that India invaded any nation. Infact India was always invaded.

Our Population, Its Diversity, Its complexities poses enough work at hand for our leaders to not allow our country to indulge in solving others problems.

"Being Good at Home and Great with our own people" is what India and its leaders have practiced for centuries way back from the medieval to historic to now the democratic era.

United States has always believed in playing an instrumental role in resolving challenges across the world. This stems from the fact that historically United States is made up of citizens who originated from the whole world.

History always plays a role in the Present.

The coming together of the two leaders signifies the unity between the two nations to expedite the process of progress and peace.

President Obama and Prime Minister Modi resolved that HealthCare is an area of need where both nations can play a major role.

I feel these are great times for Medicine and Health in India and the United States.

Collaborations between Institutions, Agencies and Individuals in United States and India in the fields of Clinical Medicine, Bench side Research, Health Technology,  and Population Sciences under the auspices of Education, Innovation and Patient Care initiatives will be game changers for this multi billion dollar industry.

It has been recognized by many in both the administrations that INDO-US Partnership in healthcare is crucial to Smart Diplomacy.

"When Brains Meet-Bodies Build" : I advocate this vehemently.

Health Security is a major challenge to all nations. Ebola continues to be a looming threat and Microbial Invasion is something which can wipe out a whole nation and its economy within a short span.

India has a large population  and a larger challenge to contain diseases and foster health. United States has the resources, the technology and the experience to work with India to find solutions to the challenges thus benefitting the world at large.

Continuous Immigration of Indian Technocrats, Researchers, Innovators, Administrators and Physicians to the United States provides a major talent resource which has to be kept flowing. This can only happen in a vibrant India. USA has recognized this fact and India has understood the same extremely well.

HealthCare in India needs the technical inputs from United States to create processes for accrediting quality benchmarks for patient care, instituting strong public health education infrastructures, building the NanoBiotech Innovations Corridor, strengthening and modifying the Health Education system towards making it more patient centric and personalized.

Its is very defined that definitely the United States can do all of the above.

In return India can provide the much needed constant supply of talent and work force to the United States who will push trade and development by and between the two nations.

The areas of progress are below:

1. Technology Development, manufacturing instruments and medicines are key areas where the cost of healthcare can be reduced and "Make in India" campaign can be progressed.

2. Creating Schools of Public Health attached to major Universities can increase the Public Health Workforce in India.

3. Modifying the Medical Education Model to make it more focused on Personalized Medicine and Quality Care can change the perspective of patient safety in India.

4. Bridging Information Technology to build the Electronic Health Records System which enhance the tracking of diseases and monitor the effect of interventions to better the health of Indians.

5. Increasing Capital Investments in Building Hospitals, Consolidating working hospitals, starting disruptive innovative solutions like dialysis centers, short stay hospitals can provide the needed care for a ever increasing population.

6. Working to create Accreditation and Regulatory Processes to synchronize the education, research and patient care systems can enhance the coordination of flow of talent between India and the United States.

7. Encourage partnerships in Education, Research and Patient Care between Individuals, Agencies and Institutions with a clear focus on Health Development.

8. Expedite the process to allow investors and innovators across the countries to work swiftly and deliver quickly.

9. Conduct Talent Hunt Marathons to foster Talent across the two nations which can be used by the two nations collectively to grow both the nations as a whole.

10. Provide the needed financial and governmental support to make all the above happen consistently.

Now I will state history:

12 Years ago INDUSEM ( was born when many like me envisioned that INDIA and United States should work together to do the things which are being chalked out today.

INDUSEM started off with a focus on developing Academic Emergency Medicine and Trauma Sciences in India with technical inputs from the United States.

Today INDUSEM has established partnerships in all the areas of HealthCare namely basic Sciences, Clinical Medicine and Public Health.

INDUSEM has fostered collaborations between individuals, institutions and agencies in India and United States to progress Education, Research and Patient Care.

 INDUSEM is a major force in INDO-US Health Advocacy, Policy Development, Health Prevention, Developmental Leadership and Translational Medicine.

INDUSEM has created Networks for bringing existing leaders and discovered human talent to work together to progress India and the United States.

INDUSEM Leaders and Institutions meet regularly, do research together, build policy as partners and advance India and United States as one family.

Leaders across Agencies in India and United States have agreed that INDUSEM is one of the most successful collaborations in history of INDIA-USA partnerships.

"When the Worlds Largest and the Oldest Democracies Work Together the World Progresses as One"

This is the Magic Mantra of INDUSEM which is now a accepted Reality by both the nations !

Tuesday 20 January 2015

Students of Emergency Medicine in a Transitional Academic Environment: Each One Teach One!

From the Desk of: Sagar Galwankar, MD

“Change is always challenging. When you want to bring the Change, You have to convert the challenge into opportunity and that Opportunity is the Real Change”: I have learnt this dictum from my Father who learnt it from his father (My Grand Father).  My Two preceding Physician generations had spent their entire life transforming Rural Health Care in India. Coming from a Family who will soon complete a Centenary in Patient Care- Transforming HealthCare is our DNA which can’t be altered.

Transitional Academic Environments of Emergency Medicine are vibrant places for discovery. These are places where History is being written and future is being chiseled.

These Departments have teachers who are new to the specialty. There are the HealthCare system administrators who have accepted to transform and transition towards better healthcare and there are students who have accepted this new specialty. These students have embarked on an exciting journey to master the unknown.

These Students of Emergency Medicine will spearhead the Future of HealthCare. How they learn and how the grow will shape how the nation will proceed. Nurturing their ideas and Fostering their talent is crucial to this growth story.

This task becomes very challenging when the Academic Fraternity is in the Neonatal Stage itself.

How do these students learn, How do they transform, How do they become competent, how do they become confident and how do they change?

The answer is simple: Teaching can facilitate learning but until learner wants to learn nothing can happen, hence effort is always by an individual, only now the effort increases exponentially. Innovative strategies have to be deployed to learn so that complete knowledge can be effectively mastered.

Emergency Medicine is Dynamic Process. There are nations which have progressed and are progressing fast, there are nations who are now starting to progress and there are nations where there is no Emergency Medicine. Every Health System goes through transition.

Today media, internet and technology has brought the knowledge of Progress closer to those who want to progress.

The Students of Emergency Medicine in Transitional Academic Environments have to understand that they have to learn on their own and what they learn will change the future of the country.

From my experience of learning Emergency Medicine since the last 14 years , I have a Ten Step Ladder for my “Students of Change”:

1.    Students of Change have to take extra efforts to master the theoretical body of knowledge. Choose one textbook and master it from First Page to the last page. Line by Line Page by page. I often hear that students see a case in the ED and then go and read about it. That is a good strategy but a Complete Strategy is to read from First Page to Last Page. In the three years of Training a students should read the whole textbook three times. Stick to one Textbook-Divide it into 12 Sections to be read over 12 Month-Divide the monthly reading into 30 parts and then read those number of pages daily-religiously.

2.    Try to practice history taking and clinical examination on every patient, you will see that as you go along your history and clinical exam skills will speed up.

3.    Learning procedural skills is considered very crucial by many students of Emergency Medicine. “A Fool with Tools and Techniques is still a Fool”. Learn the knowledge behind it. Try to go to the Operating Rooms early morning and learn Controlled Intubation. Try to attend Central Line Workshops on Cadavers and attend IV Line sessions in pediatrics. Chest Tube, Foley Catheterization and NG Tube placement can be learnt in a similar manner. Attend Orthopedic Calls and learn splinting and reduction of joints and attend cardiology lectures to learn EKG. There are less than 40 Rhythms one has to master as an Emergency Physician. Ultrasound can be learnt by attending workshops which are held across the country. Online Videos and Posts are available in ample to help a student learn the skills.

4.    Read the various Journals focused on Emergency Medicine. Learn what is new, what is happening. Stick to Three Journals and read the articles religiously every month.

5.    Try to work with other departments when they attend the ED Calls. Try to discuss with them based on the knowledge given in your text book – The Textbook of Emergency Medicine. Example: Admitting Chest Pain Patients: This is a situation of immense debate across the world and an area of conflict between EM and Cardiology. Use your knowledge to debate this subject and learn about ACS. Remember whatever the cardiology perspective maybe it is your Textbook which is always right for you. No need to fight just stand by the principles in your book.

6.    Master your Resuscitation Algorithms. ATLS, ACLS, PALS, NALS should be on the fingertips of students and should be practiced naturally. No Deviation from the algorithm should be entertained.

7.    Chest Pain, Shortness of Breath, Focal Weakness, Altered Metal Status, Abdominal Pain, Bleeding from Orifices, Fever, Airway Management and Procedural Sedation should all have protocols clearly mentioned. If you don’t have such protocols in your department then work to create them. If this warrants engaging the other departments then engage the other departments. In a Transitional Academic Set Up Get Other Departments to commit to one protocol whatever it may be. Remember the patient should be cared for and that has to be FAST because it’s Care in the Emergency Department. So protocols should focus on this principle.

8.    Students may have teachers who claim to be Emergency Experts, there may be enthusiasts who believe that they are educators , there may be teachers who have accepted Emergency Medicine as a career option and there many genuine teachers who really want to be educators in emergency medicine. Students should try and learn the positive points from all the different genera of Educators available. Again how will a student know what is right and what is not right? The student will only know this when he has mastered the Textbook of Emergency Medicine.

If your educator is from a Surgical background the try to learn surgical skills like suturing central line chest tube from the surgeon. Try to master the examination of Hernia, Torsion testis and all surgical emergencies. Knowledge is everywhere, students should be ready to absorb it. What to absorb can only be learnt if a student knows exactly what to absorb! A student will know this only when he/she has read the whole textbook.

9.    Attending Seminars, Symposia and Conferences is helpful but that is not training in Emergency Medicine. Real Knowledge is gained in the residency program where all the action is. Focus on Learning is important. Attending a conference to present research papers, or participate in academic competitions is helpful when the student is a religious reader and a vibrant learner. You can’t learn EM by attending a conference. There is a lifetime to attend conferences.

10.  Remember that there are only 1000 Days to Learn in a 3 Year Residency. The mistakes can be forgiven in these 1000 days. After that you are on your own.

A Nation where students believe that they need a Degree to Learn is a nation where the growth of quality healthcare is nothing but a distant dream. The students who believe the above have a difficult path ahead and are misleading no one but themselves.

Getting a Qualification is Important but more than that the training and the knowledge gained is more important. These are human lives that are at stake…. And Seconds Count!





Friday 16 January 2015

EM Teacher-Student Matrix of Multi-Tasking in a Transitional Academic Enviornment

From the Desk of
Sagar Galwankar, MD

Earlier in my blog I had discussed what the challenges are as regards education in an Environment in Transition.

Today I want to address what my thoughts are regarding the Teacher-Student Matrix of MULTITASKING in an Transitional Academic Environment.

Emergency Medicine is an unique field where there are defined algorithms and pathways for taking care of a large number of patients with different pathologies. I agree that every patient is different but over and above that there are fixed guidelines and approaches which are advocated. Core Measures, Clinical Pathways, Standard Operating Protocols and Critical Actions are some of the multiple processes which help in operating an efficient and vibrantly progressive Emergency Health System.

Creating Teaching opportunities and sustaining an knowledge imparting environment  in such  a system where the situations change by the second is a great challenge. That is the reason Emergency Medicine Education is different and very important. Its all about Timing and all about the skill to MULTITASK.

Educators who commit to teaching EM are not only educators of subject matter but also experts at Multi Tasking. There can be a time in the ED when you could have 10 beds with ten different patients with 10 different pathologies with different clinical presentations with a Nurse to Bed ratio of 1:3 that means one nurse for three beds with only you covering the 10 beds. That is when the systems and algorithms come into action.

A routine ED shift is 8-12 hours and how you manage your time and try to wrap up your patients with minimum Sign Out to your Next Shift colleague is a part of an art called Multitasking. You still have to not keep patients unseen for a long time in your shift time.

Now this skill has to be nurtured and developed in students and again this has to be displayed and taught LIVE by Teachers.

In an Vibrant Milieu like EM teaching Multi Tasking and learning multitasking is a two way commitment based on the Foundation of Correct and Current Knowledge.

The child Learns what the child is taught, a sibling picks up habits from the other sibling, students learn from their fellow students- these are known fundamentals of learning behavior.

The commitment to teach multi tasking is a daunting task for educators because educators have to be consistent and equivocal to all their students.

Being Efficient in Episodes is not going to impart the skill to the students who know little or nothing and are in transition towards gaining skills and knowledge. 

Example's like Complete Clinical Examination of a Patient in Emergency Department includes examination of the skin. Getting the patient to undress and do a complete clinical examination and see the whole body is a crucial part of the EM Examination because abuse, violence, rashes, ulcers, injuries and reactions are all demonstrated by skin examination and can alter the treatment pathways. WHOLE SKIN EXAMINATION IS CRUCIAL.

In an Academic Environment the educator has to demonstrate that by doing the complete clinical examination all the time and every time so the students learn its importance from the teacher. Theoretical Preaching and Practical Learning have different impacts on a learners skill development. It may be annoying and tiring for the educator to do a complete clinical examination for a small laceration of a stubbed toe but when the educator does that examination what the student is learning is that Complete Clinical Exam includes complete SKIN EXAMINATION and that this fact is important. Imagine if this was not taught to the student , how would be practice of the student when he/ she became a licensed EM Physician. 

In an academic environment in transition where EM is newly developing the responsibilities for the new teachers and the students are exponentially more because both have to develop their skills simultaneously. Being committed to learning with an open mind and teaching and sharing the knowledge are important to both, the teacher and the student.

Having the knowledge, gaining more knowledge and sharing that knowledge consistently is the duty of the teacher. The knowledge has to demonstrated by action and behavior in ACADEMIC THEATER called Emergency Department where Humans Lives are at Stake and seconds count. The student at the same time has to consistently study and improve on his/her skills as to increase the speed and precision in the quest to be efficient thus becoming well trained, safe multitasking Emergency Medicine Expert Care Providers.

If anywhere is this matrix the links of Consistency, Commitment and Current Correct Knowledge are weak then the matrix would break and the outcomes would be bad.

We definitely don't hope bad for our patients that too in a specialty like EM which is newly developing because Bad Outcome in EM is death or damage. I believe a D/D to a EM patient because of a weak matrix demonstrates a system which has to learn to care. In an Academic Environment the teacher and the students are the major stake holders of the system ! 

Sunday 11 January 2015

Nurturing a New Specialty: Challenges from Communities and Cultures in Transition ! My Thoughts on Educating New Specialists !

From the Desk of
Sagar Galwankar, MD

Developing Emergency Medicine in a nation which never had this specialty is one of the biggest changes a nation can ever witness.

Transforming existing Emergency Infrastructures or developing new emergency medicine departments is something which is challenging and demands a lot of patience and tenacity.

I have always believed that Academic Medical Colleges are the ideal locations to develop any new specialty because Education is the key to sustainable growth of trained specialists.

Many practicing physicians see the importance of emergency medicine and want to develop the department and the services at their facilities. They often unite and establish forums societies and networks to increase awareness and advocate the need for this specialty with the regulatory bodies.

Well these are important points similar to any revolutionary movement in any nation BUT the core challenges lie after the specialty is recognized and gains momentum.

Important Questions facing any new specialty are:
1. Sustainable Growth
2. Economic Advantage
3. Research Development
4. Educational Innovation
5. Policy Development

Today I will address the Importance of Education and its role in growth:

Education and Training are not simple and trivial  issues. Mentoring is an integral part of training but Training does not mean Mentoring alone. 
As regards to EM , when we have to develop the specialty from scratch , the trainers will be transitioned from Anesthesia, Medicine, Surgery etc. This is because EM does not have a parent discipline and Emergencies happen in every specialty. Emergency Medicine involves training on knowledge about managing every emergency from any specialty. In early years when diverse Faculty adopt and adapt to be trainers they come from different specialties. Its not astounding that their backgrounds will play a major role on the training imparted to the new residents in EM. The maiden teachers should realize that they have adopted the new specialty and they have to commit to it. They are expected to be aware of the body of knowledge and train the residents as well train themselves in the new specialty.

For Example: In Emergency Medicine the trainers may be from a background In surgery. It is imperative that the New Surgeon-Emergency Medicine Educator learns to manage Medical , Pediatric Emergencies,  toxicology and gains the competency over the next few years and continues to train the new residents in EM. 

Academic Commitment demands that residents get the correct education which makes them competent and in turn develops the specialty at large.

There are instances when enthusiasm  can go overboard in the quest to establish the new specialty. Advocacy by health leaders can create residency programs in jet speed. The challenge here is who will impart the training and are there enough educators ?

Academic Training has to be Continuous and Persistent to create a sustainable process leading to the manufacture of a constnat supply of competent specialists.

Modeling and Process Management with Continuous Quality Improvement based on generated Evidence and Innovation are core fundamentals of Academic Education and Training.

When importance of Education is Undermined the sustainability of quality driven growth is compromised in exponential ratio.

It is important that New Specialty Trainers from diverse disciplines adopt and adapt to the new specialty and train the residents honestly thus growing themselves simultaneously.
It is Important that advocates realize that sustainable growth comes via Quality Training and not enthusiasm alone.
It is important that we realize that establishing a specialty is easy, growing it and Nurturing a Positive Growth is more challenging !

Education and Commitment to Education is an Important pillar to this castle of growth.
All Educators are Enthusiasts that is why they do what they do, 
But not all Enthusiasts can be Educators !

Tuesday 6 January 2015

Accomplishing Core Measures in Crowded Emergency Departments: A Race Against Time !

From the Desk of
Sagar Galwankar, MD

As I walked into my shift I saw the busy waiting area of my emergency department and remembered my days as a medical student when patients waited for the one single doctor who did triage based on observing the patient and calling the speciality he felt was appropriate to examine the patient. 

Today things have changed and EM has come a long way. 

Around the world there are evidence based algorithms for traige and standardized protocols for acute care. 

The Monitoring of the overall care of patients is done by  looking at indicators called as "Core Measures". These are actions which are mandatory and are benchmarks of efficient patient care in emergency departments.

Individual Emergency Departments do emphasize on many actions and indicators and monitor many benchmarks as they strictly evaluate the quality of care. 

Pain is an Important part of the symptom presentations in the emergency department. Pain anywhere is Still PAIN. It can be Headache/Chest Pain/Abdominal Pain/Back Pain or pain in extremities or GU area. Fever / Bleeding / Rash / Loss of Function (LOF) are some common presentations in the Emergency Departments.

Pain/ Fever / Rash / Bleeding and LOF are what I call the Major5 of EM Care. Treating the Major5 is the Fundamental of these core measures.

Getting Complete Set of Vitals : T/P/R/BP/Pox is the first step in this regard.  Additional data on GCS / Pain Score and Bedside Sugar will be the next few steps to be accomplished.

In the past few years Traige EKG has gained immense importance. Two sets of 12 Lead EKG in traige with one done at traige and one of recent past pulled from the records is printed and it
is expected that the Emergency Physician reads the same in 5 minutes and comments on it. If its ACS/MI or unstable Arrythmia the patient is brought to the emergency bed immidiately.

Diziness/ Uneasiness/ Weakness/ Syncope/ Chest Pain/ Abdominal Pain/ Back pain/ Shortness of Breath/ Palpitations can all be signs of a Cardiac Event and in Busy Emergency Departments missing ACS/MI can be avoided by this measure.

Administering Pain Medications and Anti-Pyretic Medications is paramount core measure in ED's Around the world.

Giving Aspirin in Chest Pain with Nitro is another crucial core measure.

If Patient has a Fever with Signs of Sepsis namely Tachycardia / Hypotension/ SOB/ Fever etc then Giving Antipyretics IV Lines Fluids and First dose antibiotics are important components of the sepsis core measures.

Bleeding patients (Orifices or from skin) need immediate control of bleeding, vitals check, Airway-Breathing-Circulation Check and IV Lines and Fluids administered.

Patients with Stroke need CT done Stat and then TPA administered if the findings and presentation meets the Stroke Algorithm.

Door to Triage, Door to Physician, Bed to Physician, Door to Ballon and Door to TPA times are extremly important as Emergency Care evolves further pushing towards levels of maximal efficiency.

As I sit and pen my thoughts I realize how Dynamic and Complex has Emergency Care Become. 

Developed Nations are at the forefront of monitoring newer and increasing number of indicators and inserting a longer list of core measures. Nations where EM is developing are yet struggling to establish Emergency Medicine. 

Getting the nations in transition and thier Emergency Departments to the level of monitoring these complex indicators is a task for the future, which I hope is not far.

Core Measure are Monitors for Quality and Efficiency and they are important as they give the physicians and the whole Emergency Health System a direction focussed on  progress towards better efficiency and patient safety.

What ever we do OR Whatever we should do , Must always be focussed on the best cinical care for our patients.
It is these Patients in ours ED who define our mere existence &  without them there is no Emergency Medicine !

Saturday 3 January 2015

Does Cost of HealthCare reflect Quality HealthCare ?

I have often wondered about the state of Medical Care across the world. We are surrounded by scientific data which emphasizes Evidence Based Medicine, Patient Safety, Best Practices, Current Norms etc.

I have attended conferences and meetings where we talk about what is best for  our patients.

Developed nations like United States, United Kingdom, Australia, Japan etc. are the major powerhouses of research and manufacturing of evidence based medicine  norms.

They work in a Paper Less Hospital Settings where Electronic Systems try to minimize the risks and maximize the speed and efficiency of patient care with uniformity in the practice of evidence based medical care.

I deem this as an Ideal Scenario for best patient care across the world which is continuously improving with regulation, education and innovation playing a major role.

Is this possible across the world ?
The answer to this question is  a very complex one !

The whole practice of uniformity in patient care stems from uniformity in education and uniformity in skills training, uniformity in testing physicians for being qualified, uniformity in regulations, Uniformity in accountability and uniformity in economic stability to sustain such an uniform health care delivery system.

Transitional Economies where the rural and urban divide is still being bridged, industrialization is at its peak and population imbalance is a major concern with infections, cancer and trauma being major killers- the opportunity for the phenomenon of uniformity is an uphill task to accomplish.

Establishing Uniformity stems from sowing the seeds of change and simultaneously coaching change in the existing health systems. Building a model of health care which is sustainable and accountable where government and private sector work hand in hand and reach a zone where No patient is refused care and gets similar care if he/she visits any health care facility is an objective which needs to be achieved at a speedy pace if we have to provide quality care for all.

Today transitional economies are still operating under a divide of government supported healthcare for the less affording patients and private / corporate supported healthcare for the insured/affording/self paying patients. In this situation the perception is that "Expensive is better Quality" Similar to the Perception that "Expensive Hotel stands for Quality Hospitality and Safe Food". As we have star ratings for hostels we are now wooing for ratings for hospitals.

Do we want this for the psychology of a patient, who will now perceive that if he/she cant afford care then he/she has nowhere to go and he/she will have to be satisfied with what is available. This gives rise to an imbalance in the value system of a population and an generation.

Providing Quality HealthCare For All should be one of the top 5 priorities of any government with Education, Economy, Defense Development, Science & Technological Growth being the other four which form the Fist of Progress for any nation.

Health is the Wealth of a Nation. A Healthy Nation will always be an economically progressive Nation. Provision of Preventive and Curative Quality HealthCare for All is a major step on this ladder to Progress !

Sagar Galwankar, MD

BEEPERS goes Live!

Hello, readers!

We at Team BEEPERS hope that this seemingly simple blog is going to be treasure trove of stories from Emergency Rooms across the globe. Our team is still growing, and I hope you, our readers, help with that too. There are many stories to be told, and we aim to provide a platform for those.

You'll be amazed at the stories - both medical and more often than not, non-medical that you can find in any Emergency Room, anywhere. The atmosphere is always charged, medical/paramedical teams are up and about. There is always a story to be found, if you look close enough.

There are the tales of medical miracles, or practical perspectives into the daily lives of doctors, nurses, patients, and even relatives! There are wins and losses, celebrations and mourning. Anecdotes about funny misinterpretations, or stories that may warn and prevent you from making certain mistakes - they do say you don't live long enough to learn only from your own mistakes.

You may hear about a doctor, so tired at the end of his shift that he just wants to finish up the last few patients and rush home. But he gets another patient at the last minute. Now that's an awful feeling to have one more case just when you were about done for the day. But this doctor sees the patient, remembers why he's doing what he's doing, and goes on to help with warmth in his heart, shaking away the remnants of tiredness from his mind. He orders a few tests, begins treatment after assessing, and explains to the patient what he thinks might be the problem. Then the next doctor comes over, so it's time to say goodbye - to the department, to his patients, and his colleagues who've taken over manning the fort. He finds out the next day that the patient - that very last one, is in the ICU, but fortunately not critical. Not critical because he got assessed on time, and they caught an important positive finding in the tests that were ordered the night before. They results came in on time, because the patient was seen on time. The patient was seen on time because the tired doctor at the end of his shift did his duty. He saved a life.

There are many untold stories - some touching, some funny, some educational. We want to share them with you. And if you have stories - whether you're a doctor or patient, student or administrator, nurse or paramedic - we want to hear them. You can request to join in as an author, or we'll share them through our Team profile with due credit.

If nothing else, we hope to provide you with a good read.

Until next time,