Sunday, June 23, 2013

How's The Internship Going?

This question is the most obvious and the most commonly asked of me wherever I go. Today, I have the time to ponder on the perfect answer to it.
Hmm...so, how is this internship going? One thing is for sure: I'm enjoying this phase only because I have my friends with me (and by friends I mean, people I like, call friends and who also work as much as I do). Working in a hospital can be a lonely feeling....you are working with and under residents, who you can have no choice of. Right now, thanks to the delay in the Entrance examination results, we are short of Junior Residents. That means that our Senior Residents are quite frustrated with the amount of work left for them to do and, in turn, we, the Interns suffer, because we need to work more than usual and also do all the petty jobs there are. In such a scenario, if you don't have decent people to work with you, pour out your innermost emotions to, have a laugh with and remind each other of your plight, life sucks.  That's where, I have been lucky enough.
Of course, there are people called 'cutters' in our batch too. The word is used to describe an intern who wriggles out of the work assigned, usually to study. Such a person is usually more thick-skinned than the rest of us (as interns, you have to be thick-skinned to survive the mental ordeal in SGH), has absolutely no conscience to provide a haven for guilt and loads the rest of us with extra work. In my batch, we have about 3 such people. We've been able to distance ourselves from them, but time and again, fate just plays into their hands instead of ours. Currently, there are 4 of us, who've sort of decided to stick together, because we work well together. 3 of us were together in the Orthopaedics posting and we had a blast. The fourth girl joined us during our ENT Rotation and we managed very well. We decided to do day duty during our Csualty &Trauma rotation. We've left that place with the Chief Medical Officer saying that our team of four was one of the most sincere and hardworking lot he's seen in a few years. Such a nice compliment to hear!
So, going back to the question: I shall be biased now because of the Casualty rotation. Upto the start of Casualty, internship was fine. Paediatrics was over and done with (that itself is such a liberating feeling. I realise it now when I go to the building and there is no reason why I should need to enter it), Orthopaedics was fun and signed off, Otolarhingology (ENT) created a few issues regarding the Interns' rotation but we scraped through and Ophthalmology just proved to be my favourite yet again. So far, so good. Apart from the ENT completion signatures, I had all the others and things were good. I particularly enjoyed Ophthalmology. All that I ever did was measure the vision of patients and take labs, but I'm so completely in love with the subject, I enjoyed that bit too :-)
My hate for Casualty began during Orthopaedics. On our Emergency days, the intern had to sit in the Casualty and do the preliminary of the Ortho patients. Obviously, that was NOT my favourite job. The Casualty Interns posted at that time weren't more than acquaintances of mine. Seeing them run around here and there like freaking doctors, added to my negativity about the Casualty. I used to get this helplessness sort of a thing watching them. I used every opportunity to run away to the ward. There was lab work, blood issue calls, the HIV-HbsAg testing and trips to the OT to help out the residents a little. I did not sit at all, but I got that helpless feeling out. I felt better about myself. It worked for me.
This attitude carried into the start of my Casualty posting. On day one, I did not want to start the posting at all. I wanted to run away from the place and hide myself in some tiny little corner of the world where nobody would find me. But, by the end of the day, that thought itself was hiding in some deep dark corner of the world.
Looking back, this has been my best posting till date. A 12-hour day duty, managing more than 80 patients per day (all sorts - malingerers to psychotics, chest pain+breathlessness to assualt, alcoholics to RTAs, dog bites, cat bites, pig bites, monkey bites....everything) is not a joke. We did not get time to sit. My whole diet was ruined because my ages-old routine of 4 meals a day at fixed intervals was kicked out. There was a point when I almost collapsed there due to exhaustion. But, amidst all this, I loved every moment of this duty. My fear of putting an  intravenous catheter, a Ryle's Tube, a Foley's....everything was dealt with. I'm more confident of myself now...I managed to put my CPR skills to good use (finally, the BLS, ACLS workshop can be properly thanked :-) ). But, if there is one thing I enjoyed more than anything else in the world, it was the Minor OT. We dealt with all kind of wounds....my mattress and simple suturing has flourished during these 15 days. I love doing it all. Such a constructive way of getting rid of all the frustration and anger that boils inside you when you have to listen to 10 relatives per patient asking you 10 different questions. I had realised long back that I love surgical work. In these 15 days, I have also realised that when a patient comes with complaints of chest pain+breathlessness+hypertension, I lose interest. Its so obvious that Cardiaology is so not my thing. The area of the CMO dedicated to Surgery and Orthopaedics was my home, my go-to place when things got out of hand. I could calm myself down, doing the preliminaries of those patients, setting their wounds right, giving them hope that things would become better.
We had all sorts of patients - suicidal attempts (I and a friend sutured a wound in 3 layers - the only one in these 15 days :-) ), cases of castration, hit-&-run cases, accidental machinery injuries, self-poisoning for all sorts of reasons....I got a look into the kind of life people are forced to lead. That was disheartening because, when you have all the luxury in the world, some people don't even have 10 bucks to make a case paper. Old men with BPH complaints came from afar and refused to go back, because they had no fare. Aged women travelled for 2 days to come here and be told that they should have come 2 days before or after....that part of a direct view of reality made me depressed. I will do something for such patients in the future, because, they deserve every bit of it.
The casualty is an excellent place to learn. Medicine, Surgery and Orthopaedics residents are always there and they always managed to teach us a little something. Yes, this 15-day posting was wonderful. So much so that now it is over and I have this vacant feeling. My elective posting is Dermatology and it's back to being an intern doing all the menial jobs. I'm still in that mode of activity and multi-tasking. It is going to take a long time to get back to my usual job. Ha ha ha. Check this out. On day one, I had already hated every minute of that Casualty. Now I actually miss it. He he!!
So, how's the Internship going? It's going well. I'm enjoying it and I've learned quite a bit :-)

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