Saturdays and Sundays are invariably busier than weekdays for the nursing staff in our children’s ward. These two cases perfectly illustrate the weekend rhythm of our hospital.
As the apex hospital of East Coast Railways, we are expected to deliver quality healthcare 24/7 across all broad disciplines—Medicine, Surgery, Gynecology, Pediatrics, Anesthesia, Orthopedics, Ophthalmology, and ENT. However, each of these departments is manned by only a single doctor. In Pediatrics, this creates a unique set of challenges—a problem that seems exclusive to the landscape of Bhubaneswar.
Case 1: Sunday, April 12, 5:00 AM
A 16-month-old child was brought to the casualty department with severe diarrhea. Dr. Acharya, who was on duty, promptly admitted the child and started IV fluids and necessary injectables. I was kept updated on the child’s status over the phone throughout the early morning.
By the time I reached the hospital at 10:00 AM, the mother and grandmother had already accosted the duty sister 14 times, demanding to know why the bowel movements hadn’t stopped. Despite three sisters from adjacent wards explaining six different times that recovery takes time, the relatives refused to understand. They were likely fishing for a referral.
I examined the child and noted in the case sheet: “Loose motions continuing; fluids administered; no signs of dehydration. Explained to the mother that the purging will not stop before Wednesday, April 15th, by any means.”
Yet, that evening, the relatives created such a scene that Dr. Acharya felt pressured to add Loperamide to the treatment. We generally avoid Loperamide in one-year-olds as it can lead to inconsolable crying or more serious complications; luckily, that didn’t happen here. The stool frequency did decrease.
By Monday morning, however, the distraught mother suddenly changed her tune. She meekly asked, “Can we go home now?” After spending all of Sunday shouting at the staff, they were suddenly unwilling to stay a moment longer. It makes one wonder: can any serious condition truly be “cured” in 24 hours? Yet, this is the Sunday cycle in our ward.
Case 2: Sunday, March 29, 1:00 AM
An 8-year-old was admitted at 1:00 AM with a high-grade fever and an angry-looking subconjunctival hemorrhage in the left eye. By 10:00 AM, the parents were already shouting at the duty sister, complaining of “inaction.”
“Why hasn’t a doctor seen our child yet? What kind of hospital is this?” they demanded. In reality, the casualty doctor had seen the child three times in that short window, consulted the eye specialist, and even shared a photo of the eye via WhatsApp to receive a prescription.
Unsatisfied, the father called a union representative, who then began pestering our ophthalmologist, Dr. Gopi, at home. When I arrived at the ward at 10:00 AM, the child wasn’t even in his bed—he had been taken to the eye clinic for an immediate exam. The prescription remained exactly the same as the one sent via WhatsApp, but only then was the father satisfied.
Upon my examination, it was clear: typical seasonal viral fever with a unilateral red eye—very common during the spring. By this time, an officer from the father’s department had joined the crowd. Once both the pediatrician and the eye specialist provided reassurances, the father’s mission shifted instantly: he began chasing me for a discharge because the child had an exam on Monday.
Summary & Observations
Both children were admitted in the early hours of Sunday. Both families leveled the same allegation: that no doctors are available in railway hospitals on Sunday mornings—ignoring the fact that they had been attended to multiple times by casualty doctors.
In my 16 years of service, I’ve noticed several common threads in these “odd-hour” weekend admissions:
1. They almost always arrive between 1:00 AM and 5:00 AM on Sunday.
2. By Monday morning, they are desperate for discharge.
3. Most have been seeing a private doctor earlier in the week.
Conclusion
There is a distinct trend here in Bhubaneswar. Most private pediatricians close their clinics on Saturday evenings and Sundays. When a patient they’ve seen during the week calls with concerns over the weekend, these practitioners often spin “imaginary complications” and advise urgent hospitalization at their facility.
Since our patients are railway beneficiaries, they land in our hospital instead, keeping our weekend wards overflowing. The same patient who waits patiently for hours in the OPD on a Tuesday becomes abusive and impatient on a Sunday morning. Once their fear is addressed and they feel safe, the urgency vanishes, and they want to go home immediately.
Every Sunday is a busy day in the children’s ward; it’s a pattern I’ve watched repeat for 16 years.
Dr Ramakanta's Ideas 