In the preceding snippet, mention was made of the 'mhedical rip-presentatives' (MRPs) who were seen as the nuevo de facto providers of continuing 'mhedical' education for many doutors in amchem Goyam and (possibly) elsewhere. A dinner party here, some fully funded conference-trips there and some cheap pens and 'samples' thrown in between was part of the ambience (for want of a better word). Some doutors believed that they were the 'phavourites' of the MRPs. They even felt emboldened to ask for sponsorships and gifts. And, based on the commercial value of the doutors, the MRPs obliged. What the doutors were probably unaware is that the MRPs had the ability to keep tabs on the 'receitas' written by the doutors.
Zé Antonio was a physician who was working overseas aka foren. Based of the children's vacations (which coincided with the monsoons in Goyam), he and his family would visit "Gaum" (or the bairro to be more accurate) once every three years. On one such visit, upon arrival, Zé noted a bunch of syringes and needles placed on a piece of gauze resting on the dining table. There also were some vials each a containing fluid of a different color. The vial with the bright red color was most striking. Zé asked his dad what that was all about. By this time the little kiddies were milling round the table quite curious (perhaps apprehensive) about the needles. Dad told Zé that Mum probably had the flu and that he had called the nearest doutor. The doutor popped into the dining room and was quite surprised to see Zé who he probably knew (or had seen) in Ponnje. "They also called you?" was the doutor's first reaction. Seeing the rather amused countenance on Zé and the kiddies milling around, the doutor remarked: "aanh, your maather or vot?", 'in that case, I wont give these injections'. I later found out from the doutor that these colourful injections are very useful in the village. If one does not give them, the patient is very disappointed and finds another doutor who will give the injections. There also was (probably still is) a thing called 'Calx' - Calcium Gluconate given intravenously. A number of doutors advised me that there was 'lot of Calshium defishensee' in Goa and that is why so much Calx was being given to the doentes in Goa. Who told the doutors about this 'Calshium defishensee'? You guessed right! But there was another point: The doentes told the doutors that the Calx worked. It also gave them a 'warm feeling' once given. Not that it relieves the doutor of his responsibility to do the right thing, but IF the doutor's practice had to survive in the villages, he apparently had to practice medicine according to the "manual written" by MRPs and the doentes! A couple of weeks later, Zé s dad requested him to see a sick child in the neighbourhood. Zé wasn't particularly keen on the 'home visit'. They are notorious (especially when fukott) for the doentes not accepting the advice proffered. (Possibly why bank managers do not make home visits in order to loan money). But Dad had sacrificed so much for Zé. It was not possible for Zé to refuse such a request. Besides, Zé thought of the "Kishore" principle. So, Zé (who was registered to see doentes in Goyam) went to see the child. The child apparently had fever, cough, shortness of breath and a green stuff nasal discharge for about a week. The family was giving her a codeine containing cough medicine and some vitamin syrup (because she was weak). No doutor had seen the child for this illness, so it is possible that the mother had just walked up to the farmacia and asked for some antibiotic pills. I doubt that they were being used as recommended by the manufacturers as the package was only one-third utilised. In any event, Zé examined the child and determined that the child had a pneumonia. He advised the family that she needed to be in the hospital where they would be able to give her intravenous antibiotics. After explaining what the condition was all about and stressing the need for this child to be in hospital Zé returned to his parent's home. Later that evening, the child was taken to the Hospicio and admitted. Zé heard that they "made XRay" , diagnosed pueumonia and started the child on treatment. Zé also heard criticism (passed on through his Dad): that the family wanted to go for a party that evening but instead had to go to the hospital with the little girl. If only Zé had given the child some injections, they could have gone to the party that evening and to the hospital on the next day! The positive point: The child eventually recovered fully To be continued..... Next time ....the "Kishore" principle jc
