30th of January

Khushbu arranged for me to spend a day at the hospital she works in, Escorts Heart Institute and Research Centre. This is a private hospital with a chunk of its patients coming from overseas for the so called medical tourism.

Khushbu took me to see the head of Anaesthetics and Critical Care who the previous day had invited me to spend today observing the anaesthetic side of things in the hospital. In fact he actually arranged for me to spend the day with one of the ICU consultants. Which was fantastic as this is where I would like to end up practising, probably more through physcians training than anaesthetics but that's neither here nor there.

The ICU had equipment about as advanced as they do at RPAH with staff that had the training to use them. The difference between Escorts and IGMC is unbelievable. The doctors and nursing staff actually seem to care about the patients and want them to get better.

In the 6 hours that I was at the hospital I received more teaching than I had during the entire time at IGMC. It was wonderful.

21st of December

Today we started in the general theatres in the hospital. If I thought the other cardiothoracic vascular theatre was a bit disturbing the general are far far worse. They look like they are from a MASH scene. White drapes, halothane, no ventilators, blood everywhere. In one theatre the only monitoring they had was ECG, the sats probe was broken and the BP cuff wasn't connected. They do possess some advanced equipment, like a laparoscopic stack, but currently it's broken.

Unlike the cardio theatres, there didn't seem to be a disaster associated with each operation. The operation of choice is a cholecystectomy; I've put this down to the Indian diet of eating things doused in ghee,

Indian food is fantastic, wherever you walk there are dhabas; shops that sell all sorts of delicious food, usually deep fried. But it isn't ordinary deep fried western food, because that would be disgusting and unhealthy. This is deep fried indian food, which is delicious and unhealthy. We've been having samosas, paranthas, bread. Just to clarify the middle one isn't strictly deep fried, but it is cooked in a puddle of ghee. When I say bread, I do mean bread, plain ordinary bread dipped in batter.

15th of December

We arrived at the hospital and after waiting for 40 minutes or so in the principle’s secretary’s office we were finally ushered into the inner sanctum (actually down the hall). Dr Kashyap then admitted receiving one fax and one postal letter from us, despite his previous insistence that no communication from Australia was ever received. We then spent about 20 minutes going over what we wanted to do, when, for how long and why. It should be noted that each question was answered very quickly, it was the continuous repetition of the questions and the same answers that actually occupied the 20 minutes.


We were told that the head of aneas was not available and we should go across to the cardiothoracic vascular theatres for the mean time. Arriving at the theatres we had to put on scrubs that looked like they predated the monolithic period, so washed and stained were they. They were also sized to fit someone from the said period with an ideal stature of 140 cm, which meant they ended mid calf on me. Now I want you to consider that if you were to walk in to an operating theatre what kind of foot wear you’d like to put on; covered and water impermeable would be high on the list of answers. Wrong, the correct answer in India is rubber sandals, no toe coverage and certainly not very effective at preventing blood from coming in contact with an enclosed foot. However, that said entering the theatre was very comforting in many ways. There was advanced monitoring, everything you’d expect in a first word theatre. Certainly the ventilator wasn’t quite as advanced as what we have at RPA but it was close. It just didn’t support the advanced ventilation modes we have back at home.

After watching the start of the operation we bailed with excuses of a need to do shopping, which wasn’t that far from the truth. Before we left we were invited to see a surgery tomorrow, being Saturday we were a bit surprised but we were assured theatres in India ran on Saturday.