As a post-graduate resident physician in Pune in the late 1970s, Dr Nasli R Ichaporia was utilized to working long hours. Once, over a single night, he supplied treatment to around 200 clients who had actually taken in spurious alcohol. However, absolutely nothing prepared him for what took place one night at Sassoon General Hospital’s medication ward. It was not the laboured breathing and serious discomfort of a snake-bite client that shocked him, however a relative who had actually entered with the snake itself.
“There were small puncture wounds and the man was writhing in pain. But was it a venomous or non-venomous snake bite? I knew it would take at least 15 minutes to reach home where I had a book on reptiles. There was no internet, no functional computers or telemedicine facilities,” he says.
According to him, Pune city was then “localised” in between the Mula and Mutha rivers, and the Peth locations. (Photo: Dr Nasli Ichaporia)
Luckily, at the exact same time, a boy was attempting to set an uncommon record by remaining 72 hours with 72 poisonous snakes inside a glass enclosure at BJ Medical College ground in Pune. Neelim Kumar Khaire, who ultimately set a world record, was the very best bet to determine the snake, Dr Ichaporia felt. “The ground was just five minutes away from Sassoon Hospital. I kickstarted my Yezdi motorcycle, told the relative to hop on with the snake, went straight to the ground, knocked on the glass cabin, and asked Khaire to identify the snake. “‘This is a krait,’ he said,” remembers Dr Ichaporia.
“The patient eventually recovered and was sent home,” says the 67-year-old with a laugh, and including that he now prepares to tell the anecdote at the function which will be held this year to mark the 50th anniversary of the 1973 batch of BJ Medical College.
Today, Dr Ichaporia is the Director of Neurology at Sahyadri Superspeciality Hospital on Nagar Road. He has actually made a mark as a leader in thrombolysis for stroke in India, having actually done the very first such treatment and later on establishing the very first stroke system in the city. He is likewise popular as a speaker in the field of stroke and neurology, and has actually performed more than 300 public lectures and workshops. He resides in Pune with his better half.
“Things did change after the 1980s but at that point, private medical care was non-existent in the city,” Dr Ichaporia states. “The best equipment and teachers then were at Sassoon General Hospital. Along with Armed Forces Medical College, these were the two government-run healthcare facilities in Pune. Sassoon had the best ultrasound machine and amazing clinicians and teachers who were devoted to both patient care and mentoring students… The quality of clinicians was top class and I still remember, the best doctors would come to Sassoon and teach for an honorarium of Rs 100 or Rs 200.”
‘It was all a jungle then’
According to him, Pune city was then “localised” in between the Mula and Mutha rivers, and the Peth locations. Dr Ichaporia, who utilized to remain in Koregaon Park, keeps in mind how the “newspaper-wallah” and the milkman would be frightened to surpass the Ghorpuri train track. “It was a godforsaken place… Localities like Kothrud, Aundh, Kalyaninagar, Wanowrie and Nagar Road came up later but it was all a jungle then,” he says.
As for the medical college, “it was a tough grind and as resident doctors, we were on call 24×7. The little time we got for a night out was spent with other resident doctors at the West End cinema and getting a sada dosa all the way at Deccan’s Poonam Hotel. Latif’s and Kwality for continental and Punjabi food were a must.”
Not that it mattered, he says, due to the fact that he would not have actually had the ability to manage it. “We hardly earned anything and my first salary was Rs 225 when I was engaged in an internship at the Cantonment Hospital in 1978. I would spend Rs 50 on petrol and an occasional visit to the cinema hall or the famous food joints then.”
“There were no pagers or mobile phones. For instance, if doctors watching a movie were required at Sassoon, the stand-in doctor at the hospital would call the cinema hall and ask for a message to be flashed on the screen. More often than not, we were called,” he includes.
One occurrence that Dr Ichaporia recollects remained in 1978 when around 200 clients were given Sassoon Hospital in a severe condition after they had actually taken in spurious alcohol. “The ward had only one phone and 50 patients. Now, to alert the others meant getting through to the telephone operator who would then ask me to wait as the line was busy. That night was an unforgettable experience as the staff prepared floor beds. It was like a railway platform and the only treatment was to give them ethyl alcohol as that is an antidote for spurious liquor. The doctors ordered bottles of McDowell’s No.1 and treated them,” he discusses.
Equipment doing not have then, trust now
In those days, there were extremely couple of drugs and minimal scope of treatment, especially in the field of neurology, Dr Ichaporia explains. “There was very little knowledge then unlike today when the internet has changed the level of patient awareness. I went to study at NIMHANS (in Bengaluru) despite a few experts cautioning me that it was a dead field. There was no CT Scan, no nerve test. Sadly, a patient of stroke was referred to as a ‘verandah case’ and we were told to keep the person in the corridor of the hospital as there was not much we could do,” he remembers.
Today, Ichaporia says, such ‘verandah cases’ are dealt with in the emergency situation area and provided treatment to bring back blood circulation to impacted areas in the brain. “Alzheimer’s was not being picked up then… I am now seeing almost one every day and two patients with multiple sclerosis every week.”
There were extremely couple of ventilators at the healthcare facility. “Often the patient’s relative was educated on how to use an ambu bag – a self-inflating resuscitator. This is a handheld tool that helps deliver pressure ventilation to a patient with insufficient breathing. What is easily available now was a rarity in those days. There were no pre-packed saline bags and no disposable syringes, either,” he says.
What the veteran physician misses out on however is the “trust factor” in clients. “Then, the patients were a trusting lot and there was tremendous respect for the medical fraternity. There is so much anger today and people have become intolerant. Public expectations from senior doctors are sky-high and though we want to do our best every single time, it may not be possible every time. Breaking bad news to family members is always difficult but the truth must be said every single time, however bitter and painful. These were skills we learned on the job.”
According to him, star clients are typically hard to handle. “The best patients I love the most are the poor,” he says, keeping in mind how they would generate a sack of potatoes, broccoli and even garlic as a mark of their regard and love.
Dr Ichaporia says he has actually kept abreast with modern-day innovation and the latest advancements in the field of medication, and teaches thoroughly through Zoom as he feels there is no alternative to enthusiasm and effort. “Our intellectual abilities can be preserved till the late 70s,” says the veteran, who continues his practice.
The signboard at the physician’s center amounts everything up: “Good things happen to people who wait. So please do not jump your turn.”
First released on: 30-04-2023 at 09:00 IST
