A Medicine Disaster Story

Me - At the BEGINNING of the Medicine  Posting

Me - MID-WAY through the Posting

Me - 2-3 days BEFORE the Term End  Examination

I write today, having emerged from a vicious battle; a battle that left me feeling thwarted and scarred; a battle which made me question the very reason I was put in there; a battle which gave me sniff of victory early on, only to take it far far away at the end.

Good evening, dear Readers, welcome to the post-term end report of the Medicine Term-end.

The past week has put forth shocks at the speed of, well, not light...at the speed of sound. It all started on Monday. I decided to go for the OPD after 2 whole weeks of staying out of it. I am a pretty sincere student, so I was feeling really guilty for not having attended it, in the previous two weeks. I reached the OPD and there came 

Shock No. 1 :Our not-so-down-to-earth Chief Resident had LOST HIS VOICE!! Ok, so a few words about this guy. He loves to talk. In fact, there isn't a second when he won't talk. He is a mountain of knowledge, but doesn't    complement that with much humility. He teaches really well, too, but wastes time in between. And - what irritates me most- he loves to be on great terms with the teachers, usually at the students' expense. I simply hate it when these residents make it their job to trash students. We're supposed to be little children. Treat us with care and love, will you!

So, this guy had lost his voice. It didn't stop him talking, but yeah, the load had reduced. It was funny and sad. Funny, because his voice was really gone, and it was nice to see him helpless for once :-p Sad, because, he wouldn't really be able to teach, and because, I pity every single person who gets a sore throat.

Shock No. 2 : He knew my NAME and RANK STATUS in my class!! I know I've done well in the past, but that simply doesn't put me on the map, right? Here I was, standing in the OPD, regretting every single moment for coming, and enjoying every single moment for hearing that funny voice. Out of nowhere, when I answer wrong, he says. " Why are you answering like that? Aren't you the topper??" Wow. The guy gets his information and how! I was pleased, yes ( I agree I don't have a lot of humility inside of me), but I was flabbergasted at the same time. How in the world did that happen?? And on top of that, he took my NAME.  Oh my God! Now he knew me. Any chance of being unnoticed went out of that OPD door.

Shock No. 3 : I know no ECGs. ECGs have evoked that Phobia system in my brain. Due to the miraculously perfect functioning of this system, I get Phobias of things very very easily. Stuff like the darkness (unless I can see the dark sky studded with its diamond stars), lizards, heights, certain chapters in Maths, Physics, FMT, Biostats and the newest addition - ECGs, freaks me out immensely. The fact that nobody really taught us ECG properly put together with another fact that almost everyone in class and in my batch could read ECGs pretty well, just multiplied that problem. Our tutor did teach us ECGs, but fact is that the patterns shown in books are never really seen in practice thanks to the machine-related errors. ECG- reading also requires practice, which I do not do, because I am so phobic about the whole thing. As the week went by, I started having panic attacks. I did not have the time to read the book and practice reading 100 ECGs and the ECG was worth 5 whole marks. Knowing me, you know how particular I am about each and every mark.

Shock No. 4 : I develop a sore throat and severe Sinusitis with GI symptoms too...Swine Flu?? This was the biggest scare of them all. The lingering thought in my mind that any day, I could end up in the hospital, ate up a lot of the tension related to my term-end, but brought on newer and bigger problems. I had taken the vaccine, you know. I have also gotten sick a lot of time since then. However, this time, the clinical features of Swine Flu have changed and it is now associated with GI symptoms. Also, I have spent a lot of time in SGH, with no mask and the place has loads of suspects. So I couldn't think of anything else. It turned out to be baseless and stupid any way. The GI symptoms went off in a day. I am healthy as a pony (I won't say horse, because I am on the thinner and smaller side) right now. Scary, though.

Shock No. 5 : We find our new CR ( not the one from Shock No. 1) taking our term end instead of Kadam Sir. WTH!!
The tradition is that if Dr. Kadam is present, he takes the Vivas of the first and the last groups. We were the first. It was known and expected by all that we would have to face him. In fact, the three of us were waiting for that moment. We have had the experience of his Viva last year. To say it in one word - SATISFACTION. Agreed, he asks his own set of questions. They make you think, and they follow a logical pattern. More importantly, he leads you on. There aren't hints as such, but he puts you on the right track. You learn too. Ultimately, even if you haven't been able to rattle off all that you know, you are satisfied because you have managed to wriggle yourself out of his Viva in a good way. That feeling can only be felt. No words will describe that feeling.
Having been there once, we knew we were in a good, if not, better position to face him. Disappointment showed on all our faces when that CR walked up to us. If he had been nice, it may not have mattered. What can you do, when every answer of yours is shot down with a big "NO", before you even complete it? And who can calm you down when you say something you know is correct and the reaction is , "Are you writing a new chapter of CNS?! Hahahahaha!!! You know nothing!" This misnomer of a Viva continued for half an hour. It ended with all of three of us telling him we did not like Medicine and we were NOT interested in doing it. The look on his face was worth it. We had taken such a wonderful case and he ruined our moment of pride. There is no way I am even going to look at him again, let alone, talk to him. The end result was that, we didn't really warm up for the Univ exams, we didn't get to know questions that we may face later on, we did not learn anything new, our old knowledge was laughed upon and our morale related to CNS and Medicine wasn't just broken; it was ground into microscopic little pieces that we can't even put together. Oh, and yes, it made me decide I shall not take up Medicine. I would take it up if my life depended on it, but then I know I am strong enough not to be faced with such a choice.

Me - AFTER the Term-End examination
"I will not rest until I have had my stomach's fill."

This disaster wasn't foreseen, especially after a nice table Viva in which I could identify and read the ECG and the X-Rays and even talk about the instruments and drugs. I hope I don't face such an episode any time in the future. I am not made of wood, and a repeat of that term-end will not leave me stronger than before. It will just add to the misery.

Over the weekend, I have healed my wounds. I start afresh today. We have Orthopaedics Posting now and I aim to finish reading the book once at least. I completed two chapters today so I know I am going to manage this.

Subconscious Priorities

When you start dreaming about your college life, it helps you put things into perspective. On the surface, there are a million things to think of; a million things to do and a million things trying to get your attention at the same time. Dreams really just line them all up, starting from the most important to the least important.

Over the past few days, I’ve been dreaming. The important point to note is that, I’ve dreamt about stuff that I have never acknowledged as stuff that has troubled me or made me uneasy when I thought of it. However, I guess I was wrong. It has affected me more than I thought it did, or should I say, more than I wanted it to.

Let’s start with the first.

A dark background all around me…I’m assuming it is night. I’m outside an unknown cabin - a wooden one like in those Cowboy movies. I’m sure I’m alone yet there are a few people with me. I have my cell phone with me, but I don’t feel like calling anybody as of now. Out of nowhere, there come a group of people – no wait, there appear to be two groups of people. I seem to recongise some faces…hell, yeah! These are my Medicine and Surgery Residents. What are they doing here?? They see me. They are shocked to say the least. The very next second, they’re holding my arms. The Medicine group gets to me first. I know I am being kidnapped but can’t really do anything about it.

The Residents start bombarding me with questions -Medicine-related questions. I can answer a few, and at the one question I can’t answer, I’m being dragged off with that group. When this happens, the other group jumps up to my rescue. Not rescue exactly, because, the moment there is a question I can't answer from their list, I'm just dragged off there! And then, I get a phone call. Again, from a surgery resident. He seems to want to tell me something, but just keeps beating about the bush. I'm scared. I can't tell him where I am. I keep wondering whether he is involved in this very operation or not. Ultimately, he doesn't end up doing much to help me. 
I did not get up with a jerk or anything. I got up with an uneasy mind and a tough day to look forward to. I know I haven't been on top of my timetable. But, such dreams are definitely going to push me onto Insomnia big time!
Moving on to the second:
Let me first give a brief background to this one. I've had two such dreams. They are both related to the ICMR project I was intent on doing a few months back. At this moment, in April, I know for a fact that I will not be able to do everything possible, and giving my time to the ICMR project is just going to spoil my chances of doing well in Final year.
The first dream basically had my to-be Guide shouting his head off at me, when I go to tell him that I don't want to do the project. This was obviously related to an incident from day before, when he told our batch off for making too much noise in an evening clinic. It was the first time I had seen him lose his head, and I think, I was a little traumatised by that experience. Hence, the dream. I just stand helpless, waiting for the dream to end, by the way.
The second dream came yesterday. After cajoling myself to at least take a look at the list of selected projects, I found that my project had been selected. So now, my dream had me walking about in college, trying to make up my mind whether to meet my Guide now or not. Out of nowhere, lots of people start coming and wishing me congratulations for having been selected. It appears on Facebook and I seem to be caught in this big trap. I want to say no, but I can't seem to say it. And nobody even wants to listen to what I have to say. Scary.
These two dreams bring me to the main worry I have. Do I want to do the project? I have a stack of points for not doing the project:
1. There is way too much to study in Final year. I know I'm not that strong. So whatever time I get to waste, I want to be able to waste it and not spend in more work.
2. My aim in doing the project was to improve my CV when it came to applying to universities abroad. I am now leaning more towards doing my PG in India, in which case it won't really matter. Also, it isn't necessary to have a project under your belt. I have my academic record and lots of certificates to which I shall add many more in the coming few months.
3. My Ethics certificate hasn't come, in which case, I shall have to wait till June. That is when my Terminals would begin. Not a great time.
4. I'm just not in the mood any more to run around looking for patients.


For doing the project, there are a few points too:
1. It has been selected. That means it is good enough and there are going to be some results which would really help the future of Medicine.
2. It will add to my CV any way, whether I like it or not.
3. I won't get another chance.


Add on, the fear of facing my to-be guide, yeah, I'm pretty screwed. I just hope he takes it nicely and helps me put my mind at ease. 


I'm doing the Inter-Disciplinary Seminar this time. The topic is 'Hospital-Acquired Infections' and I shall be dealing with the Surgery aspect of it. The reason I am so proud of this is that, I was chosen on the basis of my performance at the University Examination. Initially, there was going to be an elimination round. The Academic Committee, finally decided to just go with the Univ marks.
I'd had a conversation with a friend about our marks after the results came out. He said, it didn't really matter because nobody was going to bother about these marks later. I, on the other hand, was a big supporter of the rank system and was delighted about what all I had achieved. The selection of participants for this time's IDS, simply added weight to my argument. I feel that whatever I get, on the basis of my marks at Univ exams, I thoroughly deserve. That's 'cause I work my ass off for these exams. Thus, I am extremely proud of my selection. I wanted Surgery and I got it too. So I am pretty happy right now.
Our Medicine term-end comes up on Friday the 13th. I hope to do well there. It is going to be a busy week up ahead. Let's hope it shall start well and end well.  

There's always a way out :-)

There's always something worth it over that blessed rainbow :-)

Questions

Our HoU has a smart way of training us into doctors. He has allotted each of us undergraduate students a bed in our Ward. We have to go talk to our patients, ask them for their histories, examine them, and follow them up throughout the time that they are admitted. The moment they get discharged, a new patient gets admitted and the same routine continues.

In the past one month, I’ve only had two patients on the bed allotted to me. Initially, we did not take this allotment that seriously, so I didn’t really talk to the first patient. The few times that I did, I just got a superficial history, nothing more. No, it is the second patient that has made me speculate about the seriousness of becoming a doctor.

To cut things short, this patient has Pneumonia and is a known case of Acute Kidney Injury. The first time I met him, he looked pretty bad. A 60 yr old, coughing incessantly, with a Central line and other tubings put, doesn’t cut a very bright picture. I had a long conversation with his son, who was giving me the history. It included a lot of questions from my side regarding the case, and a lot of questions from his side, regarding the overall prognosis and the future implications.

I have to say, it made me think a great deal. Here was this 40 yr old man asking me, if his father would survive and how long. I, who for all practical purposes, myself, did not know how severe the disease was, had to answer the most important question that a patient can ask a doctor. Such a situation only makes me wonder how brave we have to be, to take up such a responsibility.

I’ve just heard that, ultimately, doctors deal with living beings, so the job is tough. But, we are humans too. How in the world can we just take up the responsibility of deciding how long another of the same kind will live? Patients believe in us. The internet and sophisticated instruments may have made patients more aware, but ultimately they trust us. How strong do we need to be mentally to be able to return that trust?

I told that man pretty nicely that his father would live long in the right precautions were taken. However, when I was going back, I kept asking myself, how was I to know that there was even a need for those precautions? What if that patient was already way past gone? What if I was just giving his son a false ray of hope? Who was I to even pass a small judgment on another fellow?

For such a question, is there even an answer? Even studying all the books on a particular disease will not be able to give me enough power to believe in what I’m saying. If I can’t believe what I’m telling the patient, how can I expect him to believe it? When the patient does believe it, I want to simply shout out to him that I’m not good enough, and he shouldn’t take my word for it.

Such thoughts are scary. Today, I have people above me. Tomorrow, there won’t be any. At such a time, I will need to raise myself up to a level, where I shall get a good night sleep and not worry about whether I have given the right advice to my patients. Self-belief is the toughest to get. When it is a person like me, the task simply gets worse.

The questions that torment me, today, are going to torment me for sometime. After all, I’m not a genius at Medicine. I just hope to strive hard towards being able to answer them. In doing so, I know I shall be able to be what I want to be.

A GOOD DOCTOR.