Pot and cocaine

Methylphenidate, the drug I take to contain my ADHD, is supposed to be similar to cocaine. Overdosing on Methylphenidate, I’m told, produces the same effects on the mind that snorting cocaine would, because of which it is a tightly controlled drug. It is available only in two pharmacies in Bangalore, and they stamp your prescription with a “drugs issued” stamp before giving you the drugs.

Extrapolating, and referring to the model in my post on pot and ADHD, snorting cocaine increases the probability that two consecutive thoughts are connected, and that there is more coherence in your thought. However, going back to the same post, which was written in a pot-induced state of mind, pot actually pushes you in the other direction, and makes your thoughts less connected.

So essentially, pot and cocaine are extremely dissimilar drugs in the sense that they act in opposite directions! One increases the connectedness in your train of thought, while the other decreases it!

I’ve never imbibed cocaine, so this is not first-hand info, but I’ve noticed that alcohol when taken in heavy doses (which I never reach since I’m the designated driver most of the time) acts in the same direction of cocaine/methylphenidate – it increases the coherence in your thoughts. Now you know why junkies in your college would claim that the kind of “high” that pot gives is very different from the kind of high that alcohol gives.

Hospital Issues

There is one thing that I haven’t managed to understand about Indian hospitals – it is the dependence on patients’ attendants. Every patient is required to have an attendant next to him/her all the time. In case the attendant is going out, he/she has  to literally take permission from the nurses. Full time, it is the attendant’s job to monitor the patient and alert hte doctors/nurses in case something goes wrong. And the main job of the attendant is to bring medicines.

Yeah, you heard that right. Most hospitals here have attached pharmacies, and the usual practice is for the doctor/nurse to scribble down a prescription which the attendant has to fulfil from the hospital’s own pharmacy. I find this practice weird and ridiculous, and wonder why the hospital cannot short-circuit the attendant’s role and then finally bill the medicines to the patient along with the rest of the bill.

Over the last couple of weeks when my mother has been in ho0spital, I’ve found myself being woken up at all times – including 1 am and 5am to go get stuff from the pharmacy. Sometimes it’s been as trivial as a syringe. Usually it’s a much longer list. Such a long list that given the crowd at the pharmacy, it’s impossible to check if the pharmacist has given you everything he’s billed you for. And in the wee hours of Tuesday morning when there was an emergency and my mother had to be shifted to intensive care, the first thing the people there did was to give me an extra-long list of stuff to get from the pharmacy. This was at 3am.

I wonder why this practice came about, and why it still exists. Is it to facilitate easy transfer pricing for the hospital? Is it t give some sort of transparency to the patient about the medicines being given to him? If the latter, can’t the patient just sign on the prescription authorizing the hospital to procure the stuff from the pharmacy? And given the monopoly power that the hospital’s pharmacy has, service is usually slow and inefficient, thus leading to long queues. And in such scenarios, it’s not easy to actually check if you’ve received everything you’ve paid for. And on top of this, you have the hospital giving multiple prescriptions for the same non-consumable thing, maybe just hoping you don’t notice.

And then there is this thing about the attendants. Thankfully we have enough extended family here in Bangalore that it isn’t hard to find volunteers to do vigil at  the hospital when I’m away at work or other things. But what if we were in a place with no relatives around? Or if the patient were living alone in the particular city? How would the hospital handle this? Would they make the patient himself run around to get medicines?

Whenever I think about these things I tend to get extremely pissed off. The hospital has been otherwise good. The nursing staff are all very nice and never crib. The hospital is maintained extremely well and is clean in most places. There are enough duty doctors at all times. And then they expect an attendant to be with the patient. And the expect the attendant to run around all the time to fetch stuff from the hospital’s own pharmacy.