medicated Nepal

The paradox Schrödinger’s cat was first known to me via the sitcom The Big Bang Theory. Its an interesting puzzle, and right now, I use it in Health practice from Nepal

My mother was ill last week. Three days of mild to moderate fever temperature (maximum of 102 F) every evening. Continuous, with no chills and rigor. Chest infection, with productive cough (normal color) with her all time favorite maxillary sinusitis flaring up. The first two days were supportive treatment, but when the fever was not down, we decided to get her checked at a hospital with all the necessary tests.

Because I am a junior doctor, my parents do not believe me. It’s the same with my sister too. We may advice and prescribe medicine to all the others, except our family. Family still takes few years to believe in our qualification. This and the reason that my mother was an excellent nurse for the 12 years that she was in health professional.

We none the less, advised her to get a chest x-ray. My father took her to the nearest hospital, and then came back in an hour or so, with a dose of azithromycin (PO x OD x 500mg) and a mixture tablet of codeine phosphate along with acetaminophen. No investigation done. Upon our inquiry on why no investigation was done, our good parents told their doctors word

– “start with the medication, and if it doesn’t improve in five days time, we will do some investigation – – chest x-ray and blood test”

A paradox in Nepal, whether to start medication on hunch or do all the test and spend some money before one can confirm the problem. But a sound explanation that a macrolide was given for atypical chest infection in age range of 50+  is a good decision. Not satisfied with the result however, we wanted a second opinion. We went to my fathers’ cardiologist.

He prescribed my mother cetirizine tablets, calling it a an allergic infection. he gave her the free MR copy of the medicine in his drawer. He charged us no money.

Multiple things are wrong with this. One, we should definitely not have gone for second opinion. But its health, and even if I am a doctor, I have not been practicing for few months now. Second, we should not have gone to a cardiologist for a a problem related to chest infection. Third, the cardiologist, should not have given us a free medicine, from his cabinet which was given to him by one of the pharmaceuticals as a sample copy. He gave a medicine that is, by all means not so much valid (at least that’s what I think) for chest infection, on a patient already in azithromycin, codeine phosphate and paracetamol.

strange world. Smile