after finishing my internship there was a gap of six months before joining for a postgraduate course. influenced by the need to start earning since i was newly married, and that too against the wishes of my parents, without the hope of support from anyquarter- i settled on a small rural settlement called parkala 3 kms from manipal where i was based.the year was 1977, and i was the first doctor with an mbbs qualification to start practice there. there was one doctor with a gcim qualification, 2 ayurvedic practitioners &the usual leavening of quacks.

in those days a gp practice involved treatment of wounds, minor surgical procedures,d&cs and the occasional deliveries, mixed with a lot of house calls.after a gap of a month my practise suddenly picked up ,partly due to my being the only mbbs- and partly because being financially naive i had kept my charges very low.also being only 24 years old and addventurous i would respond to any call for a house visit , at anytime of the day and night.

one such house visit is still fresh in my memory even after 30 years. it was a july night-8 pm or so at the height of the south kanara monsoon when it not only rains straight down, it also seems to rain from the sides-anyone who has experienced the fury of the south kanara monsoon will know what i mean.

as i was about to close my clinic doors, an elderly gentleman who had come as a patient earlier rushed in wet and breathless and pleaded with me to pay a house visit to his house

to treat kamala who according to his description was severely breathless and not in a position to be brought to my clinic. i hesitated partly  because it was raining cats and dogs, mainly because his house was located in an island which was totally isolated-one had to drive about 5 kms to the edge of a cliff-stop the car, scramble down the cliff in a very undignified manner, and then cross to the island by a very rickety boat which was the

only mode of transportation. against all my gut feeling i agreed to go on the house visit, because i could not resist the pleading of the elderly gentleman.

we started off with an old rickety umbrella as the only protection, finally crossed the river only to start walking in the slush towards the distant dim glow of an oil lamp- the village was not yet electrified- and after walking for what seemed an eternity we reached the small thatched hut only for the gentleman to veer off to a small leanto behind the house where my breathless patient was stretched out- kamala the cow!  yet another instance which stays in my memory concerns a competitor of mine, a quack called nemu shetty, who without training in allopathy, ayurveda, unani or homeopathy had a reputation for healing wounds-most wounds heal by themselves,for treatment of snake bites-the majority of snake bites are nonpoisonous- for treatment of jaundice, most cases of viral hepatitis are self limiting.

he was also a braggart always putting people down.

one fine day at the busiest time of my practice, with about 20 patients crowding my small

waiting room, i heard a commotion outside. it was nemu shetty pushing everyone out of his way, frantic with worry, pleading for his life, because he had been bitten by a snake.

end of a quack. more later