When Doctors Act Like Patients

One would think that the years of study we put in to become Doctors would make us better prepared to face any health situation that confronts us. Since the pathophysiology, the symptomology, the complications, the investigations done and the treatment needed have been encrypted into our minds, we would in fact be the most resilient and calm patients or patients' relatives. Yeah, that is just a myth. We are humans. And we have every right to create a scene and fear the worst, when our own health is concerned.

As an occupational hazard in our profession, we are capable of being exposed to anything and everything. It is our  responsibility to protect ourselves against the worst of  scenarios. The most common is, of course, the needle pricks. It has been 4 months of Internship now, and I've managed to get two already. Both experiences contributed to my post today. I feel more confident about handling such situations now, but in the spur of the moment, I acted like any non-medic person would. That is scary. That spur of the moment action or inaction.
We are taught to maintain basic precautions - gloves, covered shoes, masks, glasses, lab coats, etc. We are also told that there are certain norms to be followed to protect ourselves. One is, never recap a used needle. NEVER. More than half of the needle-pricks occur when we try to use our own heads and recap needles. Two, always push the used needle into the plastic cover on the bed. That keeps everybody out of danger. Three, wear gloves. Yeah, that's what I wrote first, but that is just so important!
I want to record my second experience here, because I learnt more from this one. I was posted in Skin (I don't know what it is, there isn't much love lost between me and the subject) and had to put an iv cath for a patient. I'd previously taken a sample of his for HIV testing, so I was wearing double gloves, a mask and doing everything I was supposed to do. While taking the cath to throw it, I felt it pierce my gloves. On removal of the gloves, I looked for any kind of injury on the skin of my palm. There was none - no blood, no inflammation, nothing. I washed my hand, there wasn't any burning either. I thought I'd caught the needle just in time.
That was a mistake - Never think there is no prick. Go to the Medicine guy responsible, immediately.
I didn't think about it too much until next morning, I saw an  inflamed spot. At 4 am in the morning. And then everything got twisted. I started  panicking. I wanted to cry and scream....I wanted to call up my resident and ask her about the patient's HIV status. Having seen the patient, I kept thinking, there was a possibility that he could be positive. And I hadn't taken that PEP dose immediately. My sleep disturbed, my mind shaken, I  spent my morning trying to decide what to do. Ultimately, it was decided, that I should go and do that patient's Tri-Dot test any way, instead of waiting for his report. Before doing that, I took the first PEP dose. That moment, when I was waiting for the lines to form on the strip, was most frightening. I could imagine more than one lines on that strip. I had prepared myself for the worst, because I was so sure that was going to be the case. When only the control line came up, the surge of relief that went through me, filled me with a new life, really. Next day, the patient's report also came as negative. Phew. Close call.
This whole episode made me think. I've learnt about HIV and HbsAg since I was in second year. I've learnt that the chances of contracting diseases like this are pretty slim, that once you take all the necessary measures, you don't need to think much. I've learnt all about the pathophysiology, the spectrum, everything there is to learn, at UG level. This is enough  to know that what I was faced with, did not put me in danger at all, especially after that Kit test. Yet, I panicked. Yet, I feared the worst. Yet, I traumatised myself and my parents and my two bestest friends. I told myself, it couldn't happen to me and yet, it was happening. What was the use of all that knowledge then? It didn't matter that I was a doctor. I could easily have been an engineer or an archeologist or a parent. My reaction was a purely human reaction - a scared person, faced with the possibility of a different life. It is like facing a tiger in the middle of a forest - in those initial seconds, it doesn't matter whether you've been researching tigers all your life or whether you're thrown in front of him by mistake. This fear, this panic....it's a part of the innate response of our body. Innate - present since birth. However trained and educated we get, this response always gets the better of us when faced with danger or death.
And at such times, doctors end up acting like patients....

The Day Before

I can't believe I'm being like this. Although, I actually believe it. yes, that blasted day is just round the corner and all I can think of and wish for is Jan 12th to return back.....ahhh...those wonderful first few days after exams got over....so relaxed, so carefree, so alive and so real....I can't bring them back, but I keep wishing for it.

I have no expectations this year, that I have to stay true to. The Rank 2 from last year managed to get that demon off my chest. Of course, I won't be terrified the moment I know the result is out (like last year. I freaked myself out. I swear I have a dual personality disorder. One is as cool as a cucumber, the other as Type A a personality as can be.). I know I probably did all I could for those exams. I was just glad to see them through and know, just know that I had managed to do enough to see the back of them. It isn't the same as last year. It is different. Yet, the fear of the result does not go away. Thanks to my awesome 2nd year result, I now have expectations that are so sky high, I simply know I haven't done that much hard work to do justice to them. I want to do so well. I want that No. 1 and that hurts.....it is no use asking for that No. 1 when you haven't put in the same amount of effort. When I haven't done enough, why should I want it? 

That is the question that plants the fear of tomorrow in my head. The passionate desire and the practical common sense clash, and that irrational desire always gets the upper hand. Whoever said that practicality is always victorious. I know exactly how I'll be feeling minutes before I open that page:

"Please please please God, let me pass (with really awesome marks, I'm not going to lie to you).

No God, just let me pass, I don't care about those 'awesome' marks (but I do!!).

NO God, let me pass....and let me get what I truly deserve (maybe a teeny weeny bit more?)

NO ABSOLUTELY NOT. I know there are many others who have done much more than me, so you know, just give me what I deserve and get it over with. Nobody is going to ask me about this 10 years down the line (oh but they will, because more marks, stronger CV, better chances. Logic, girl.)

Damn your 'logic'. You know better than myself what I've managed to do and not do. I know you'll be just, because you have many people to care about, and frankly, all of them are asking you for the same thing as I am. So, thank you for some wonderful results in the past 2 years. Hope it is the same this year, at least enough for this year."

Yes, that will be the conversation in my head....between that Desire and that Practicality. Ultimately, the Practicality will get strong enough to drown that Desire's voice, but my Desire isn't one to back down so easy....it'll continue screaming...at a really low volume yes, but it shall continue. I hate myself for being like this (for being human actually....who doesn't aspire things out of their reach, eh?)...I'm not one of those self-centred people who think they are so important for the world to survive, so I do feel wrong when I pray the way my Desire just prayed. But, it is a trait I haven't been able to get rid of. All thanks to identifying my true potential after the disasterous first year. This does not just include the exam performance. It includes all those small post-end examinations that managed to make me believe I was good at Medicine.

Any way, I've enrolled for a Basic Life Support and Advanced Cardiovascular Life Support (BLS & ACLS), conducted under the aegis of Symbiosis Institute of Health Sciences in association with the American Heart Association. It starts tomorrow. I shall try and concentrate on the course and not answer any calls/messages or communication of any kind that says, "Results are out." Lets hope this has the same effect as taking a journey to a destination unknown.....to try calm my nerves down a little. I do have a strange feeling that that isn't going to happen....and that this course is not going to be as great as I'd initially thought it was going to be. I'm not much of a hands-on person...and that is exactly what this course requires. But, it is essential in my endeavour to be eligible for Universities abroad, so need to do it. Sigh.

Help me, Dear God....calm me down, let tomorrow be a happy day, and let this year come to a decent end :-)

Crazy Worry

February has begun, and now that dreaded countdown begins. As I sit and think now, I realize that it is worse to wait for the result than to wait for the examination that gives rise to that result. As much as I live for exams, with the passage of time, I have only become weaker and weaker in handling the stress of that result. Is that a part of growing up? Or is it my B12 defc acting up? Or is this simply me finally shedding my cool-as-a-cucumber image and going the Type A personality way? No idea.

When I look back over the past 4 years and my reactions to my result, they have been interesting in a way. First year, I had no clue. Absolutely no clue. I was out choosing tiles for our new home (yeah, imagine all my colour-coordination and artistic thoughts being sqashed by “YOUR RESULTS HAVE ARRIVED”). It was a shock, but since I wasn’t going anywhere near a computer for the next 2 hours at least, I was able to be myself when I finally laid my hands on the computer. Phew. That was my scariest result, because there was a danger I was going to fail Anatomy. I did not. Yay!!

Second year, I was at home, down with an upset stomach, watching my favourite event- ICC Cricket World Cup, 2011. It was my favourite match – Aus Vs Nz. It was a nice day, Aus was doing so well, they’d gotten NZ out for an under 200 score (I think around 161). When I watch cricket, I’m usually far away from my cellphone, which was precisely the case at that time too. Messages went unnoticed,  phone calls too. I still don’t know what made me go and check my cellphone to have my friends calling and telling me my big news- that I’d topped. I’m not going into the details of that day. I was unprepared and that helped me keep my cool a little.

Third Minor year was when I lost it. I did. It was the pressure of that second year result, and I lost it. Today, looking back, I don’t know what else I could have done to get more marks, but I wasn’t happy about my result and that day does not stand as one of my happy days. When I started studying after that, I thought that the pressure to top was off me, now that I’d relinquished that throne. In fact, during my I-don’t-care-a-damn moments, I don’t have that pressure at all. But, ever since February started, those nice moments have been few.

I end up thinking about all the things that went wrong in all those practicals, all the ways I could have managed to cram up my timetable more than I managed, all the luck I could have had in the world if I’d just tried harder (Have I mentioned that I believe in the philosophy “God Helps Those Who Help Themselves”? I think I have mentioned it before in one of my posts). It hurts. This feeling of inadequacy hurts. I know I could not possibly have done any more than I managed. I know that my efforts are good enough to get me my MBBS degree. I also happen to know that my parents are going to me incredibly proud of me for finishing this course in a sane manner.

And I also know a few things about myself:

1.       I’ve become greedy. You’ve shown me that coveted Rank 1 once. Now I keep wanting it again. Even when I know, I don’t deserve it.

2.       I may say that marks don’t matter, but damn you, they DO. A lot.

3.       I don’t really care about other people’s marks, but then I do care about them any way. Especially a few ‘special’ people.

4.       I just know that my marksheet is never going to live up to my expectations. The only reason for that anomaly is that my expectations are tall mountains the height of Everest, and the effort I put it, just about scales the local hill in my city.

5.       Even 10 years down the line, I’ll always look back on these undergraduate years and decide which year was best according to the marks I scored in that examination. So, first year is the worst, 2^nd the best and the two parts of final year still have to decide their places. I won’t look at all the things I managed to do, all the fun I had, all the friends I made, all the gossip I shared, all the quarrels I had. No, it’ll be those marks and that marks-covered glass through which I will view these 4.5 years.

I’m shit nervous right now. And this nervousness will only increase. The tentative date currently is 28^th Feb. Lucky me, I have my Basic Life Support training course on that day. It is going to last for 8 whole hours. So, I shall not be very close to my cell phone. In fact, I think I’ll change a few settings on my phone, so that I can only answer my family phone calls and messages. The rest of the world will be blocked, until I am ready to show my face to that world. You know, they say you’re whole life flashes before your eyes when you die. My whole undergraduate course flashes before my eyes, when I look at those marksheets; also, some decent memories from before my BJ years. All my achievements flash before my eyes. And that is good enough to make me look at that marksheet and be depressed for the rest of the day.

Dear God, give me strength. 

Theory Examination Over

Over the past 2 weeks, I’ve realized the following:

1.       I hate exams. I thought I lived for them, but I don’t.

2.       If Final year is supposed to be hard, it doesn’t even compare to the stress you go through during the exam. Looking back, I don’t know how I made it through in one piece.

3.       Papers always turn out differently this year. They are all expected questions, yes, but you don’t feel like you’ve written expected answers (or this might just be me talking).

4.       The age old superstition : the lesser you’ve done something, higher the chance of it actually ending up in the paper. It sucks through your brain. Oh, it SO does! And probably, that’s why you end up staying awake the whole night.

5.       Everybody but you, seems to be less concerned about the examination. It’s almost as if, you’re in one boat and everybody else in the other. It actually isn’t like that, but that’s how the world looks to you.

6.       The MUHS does NOT care about us students. They prepare papers full of spelling mistakes, repeat short notes in the same question (which is: Answer any three out of five. So that effectively reduces us to answering 3 out of 4. Or taking that bold step of writing the same answer twice hoping you’ll get 3 marks two times over.

7.       Surgery still freaks me out. I did it almost twice. Almost, because, there were a few chapters I did not do twice. Yet the day before both my papers, I was freaking out. And I was almost wishing I hadn’t taken up this course of Medicine.

8.       I always fall sick before my exams. Thing is, the week before my immune system decides to take a holiday, and I suffer. Surprisingly, this time, I got better like 2 days before the exam began, to reach my designated centre and end up with the flu AGAIN. Seriously, there was a time during the paper I had to allot to clearing my blocked sinuses!!

9.       I am exhausted. I don’t want any more testing, I don’t want any more theory answers to be written. I’m so tired of taking all this stress, it’s reduced my weight to more than is normal during a preparation leave.

10.   And, did I mention, I’m still hating Final year? Oh yeah, I’m still hating it, and I simply can’t wait enough for 13 Jan to come.

So how were these exams? The same exams I was so worried about, the exams on which nothing depended, my parents had absolutely no expectations from, I had no expectations from, the exams for which I literally turned the entire household’s lives upside down….yeah they were ok….all of my papers were more or less the same…I didn’t find any paper extremely easy, but no paper was pathetic either….I liked my Obstetrics paper best, because I drew a lot of diagrams, and they didn’t ask the questions I’d dreaded. I think I like my Paediatrics paper least, but that’s just because I couldn’t give the finishing touches I’m so used to giving all my papers. And it sucks to end your undergraduate examination on that note.

It’s what I’ve been through in these past 2 weeks, that’s so important. I suck at managing stress. Oh man, I really suck. My mind plays all sorts of games with me, and it’s so freaky. My usual method of calming myself down went to the dogs this year. When I told myself, “Shut up, stupid little girl, you’ve prepared well!!”, another louder voice used to come up behind me slowly and say, “Oh yes, little girl, you’ve prepared well. Tell me, do you know that you can’t remember the treatment charts? Or diagrams? Oh and by the way, you’ve not even touched contraception yet….and what about Skin….and you have even done your usual dose of MCQs this year.” It’s so hard to get rid of that voice once it starts.

This past month has been dreadful. I don’t think I’ve ever suffered so much in any preparation leave. It has been a combination of low confidence, sucky memory and a vast portion that refuses to even come close to the finishing line. The result : a complete wreck of a person, worried parents, indecision about the future and an ardent desire to just let go. They say Medicine is tough, so this is just the beginning. I’m really worried about my brain and its tolerance capacity. So, yes, there are some tough decisions to make in the coming month- regarding my future, what I want to do, how I want to do it, and the best way to keep my brain stable. I almost resorted to some anti-depressants and I don’t want to go down that road ever again. That’s why this decision will be so important to me.

Right now, I’m already worried sick about my practicals. The worry doesn’t make it any easier to start studying again, but it does affect the general day. I wish I had some confidence in myself. I really do. I hate this low self-esteem I have about my case-taking and practical skills. Of course, I have good enough reasons to feel this way, but I also have good reasons NOT to feel this way. Our timetable isn’t out yet. All we know is that, practicals in our college will be held from 1^st to 12^th of Jan, 2013. Nothing more. I want to know the exact details as fast as possible…that way, once I have a deadline to get to, it’ll make it easier to manage my study timetable.

God bless me and my case-taking skills. One ordeal over, another to start very soon. Oh I hate Final Year!  

The Effects of an Illness

Ok, so as a part of growing up, you have to deal with illnesses. Some are small, the flu kind...they make you lie in bed for a few days, give you a headache, a sore throat, fever...u take analgesics, anti-pyretics, anti-histaminics and within a week, you get back to work. Then there are some other illnesses that lurk around inside your body for years before you come to know they existed. There are a few others that tend to show themselves now and then. We just fail to identify the symptoms.
I seem to have the third category. In past few months, there has been a lot of buzz about Vitamin B12 deficiency in my family. My very first patient correctly diagnosed was my mom. She had complains of burning patches over her toes. They used to just come and go. I asked her to get her B12 profile done and it did turn out to be B12 deficiency. A few injections down the line, she said she had never felt better! Her Physician pointed out a lot of other signs of B12 deficiency that she had. So, it had been around for quite some time. My grandmom has had problems with haemorrhagic patches over her skin. A little trauma and the next thing you know, there is a sizeable reddish purple patch over her arm. When my mom told her to get her profile done, she was diagnosed with B12 deficiency too. She can't tolerate the injections, but she takes them once a month to just feel better.
I did not think I was going to end up with it too. But, over the past year, I've been feeling that I'm having memory issues. I don't remember my friends' birthdays, can't remember people favourite foods, toys, cars, etc...and most bugging, can't remember things I've read like hours before. I could feel the contrast between Me of 2nd year and Me of third year. We got my profile done, and it was really really really low. I had a 137 where the normal lower limit is 211. I was put on injections immediately. The funny little patient I am, I can't tolerate pain much. I had some fainting episodes after the third and fourth injections. My parents decided no more injections for me. I was to stay of medication only.
Funny thing about oral medication is, you never know how much is exactly going into your body. So I even started with all the milk eggs and stuff. I couldn't feel much of difference really. I still had episodes of tingling and still felt my memory wasn't back to normal. But, yes, it did improve a bit.
It was only in this last week in my PL, that I have really started to think I might have gotten back to my really low levels of B12. B 12 deficiency is characterised by a lot of things. Among them, there is a point about mood swings. I don't have mood swings, but over the past week, I had started getting worried about my exams, worried about finishing my portion, missing my friends like crazy (to the extent that I messaged sentimentally to a few), missing my family when they'd go out for work. I kept thinking about the future and how it was all going to wrong for me. And these episodes would just turn up spontaneously. Next thing I knew, I'd have tears in my eyes and I'd be crying like there wasn't an end. It freaked me out. Because, I am not like this. I don't think about results and study. I just study. I don't think about the future. I live in the present. And, yes, I do miss my childhood like crazy and get sentimental, but I do NOT cry in this manner.
When I broke down in front of my parents, it was the last straw. Because I didn't even know what I was crying about. I was nervous and tense. About everything. Anything specific? I had no answer to that. We all knew I was ruining everything- my health, my mental capacity, and my chances of seeing these exams through. It was very frightening. Was this year so bad, that I'd turned into a mass of nervous wreck?
When I calmed down a little, I thought back to the time this had first happened (before my Surgery Paper during the prelims). I'd broken down at that time without any warning too. Then when I had my B12 tablet, I'd felt a little better, more in control of my emotions and senses. Then I thought about all the mornings nowadays, when I take that tablet. I'm not very tense at that time. The time I freak out is 5 am in the morning when I get up because of that fear. And, in the evenings. The period around 9 am -12 noon is a calm serene one. That got me thinking that I should start with the injections. Maybe not every day, but at least once a week. I am not the kind of a person thwarted by exams. I kinda live for them. SO there had to be another reason for my erratic behaviour.
And you know what, it has actually helped! I took an injection on Monday, and since then, I haven't felt any of that fear of destruction and that insane need to cry. I'm still a little concerned about staying alone at home, in case I go back my last-week self, but I managed to stay alone at home today afternoon and I'm just fine. So, yes, it has been my B12 acting up again. I'm actually a little shocked, because I sudden;y feel like a patient. A patient who was totally utterly lost and defeated and now, one shot of the medication has given him a new life. I think I'm going to take the injection monthly for the rest of my life. If I could get so tense about a stupid exam that I just need to pass, imagine what sort of hell I shall put myself through later on, when there are bigger and scarier things to deal with (patients' lives, for example).
Mom says I shouldn't take weekly injections right now. But, I so don't want all this to repeat again in my PL, I'll try convincing her to give me one more a week before my exams or something. Till then, its oral medication and being my normal self.
Phew!! Scary, freaky experience. For a moment I thought I'd have to go get myself a psychiatrist's consultation with a few prescribed medications. Let's hope it doesn't get down to that.         

The Prelims Over :-)

Looking at the few results that have come out, its not been the happiest of times, but its not like I expected to rock my exams.

These 3 weeks have been nerve-wracking. First, it was back to back papers. That pretty much left you with no time to really brood over the previous paper or the next one. My acid-test was the Surgery paper. My relationship with Surgery hasn’t been smooth. I like the subject. I love it. Its amazing how that is possible. Surgery is Anatomy clinicalised, if there is such a word. I used to HATE Anatomy. I couldn’t visualize anything in there. But, here I am, 3 years down the line, liking the subject that is the advanced course of the subject I hated.

Any way, so as much as I love the subject, I’m not very confident about it. So, when it comes to an exam or a practical I get so paranoid. The day before my Surgery paper, I was at my wits’ end. It is all thanks to my dad who somehow got me through that paper, with all his discussions the day before. Before my Surgery 2 paper, we did the same, but it wasn’t as successful. My paper wasn’t the dream that I wished I’d had. It was a cross-over between a normal dream and reality.

The rest of the subjects have been ok. I know my Obstetrics paper wasn’t as great as my Gynaec paper and the difference in the marks showed it. I know that my Med 1 paper was 100 times better than my Med 2 paper. Yes, those marks showed that too. My practicals were pretty fine. The Gynae pracs were especially better than expected. I got decent marks too. My internal assessment marks for my pracs are more than those for theory, so that does say something. The med practical was supposed to  be fine, but my marks didn’t show it. I was pretty disappointed with that.

At the start of this prelim exam, I just prayed that I get through it somehow, any how. I did. THAT is an achievement. For a month back, I was totally unprepared. Totally, completely, fully. I didn’t know how things were going to fall in place. They did. Not perfectly, but they did. To me, that is all that matters. A friend of mine says I’m overly competitive. I don’t believe that is true. I know the kind of answers I write or give in Vivas. After having taken exams for the past 20 years, I can say I’m an expert at it. There was a time when my papers were held up in front of the class to demonstrate how a paper should be written. Even now, in medicine, there is always something that I like to incorporate in my answers to make them better than the person before me. After all, the checking of papers is relative, isn’t it? All students study the same amount. All students write the same amount. They write the same things too (biology of the body won’t change with each paper, will it?). The difference between a 67/80 and a 40/80 is the method of presentation. It is your answer that shows your ability to succeed. And, I know I have to keep doing that to score more.

Do these scores matter anywhere? Not really. But, they do stand to give me a shot of confidence. So, I know that next time I write a Gynaecology paper, I shall be sure of myself when I’m writing it. The Obstetrics paper, on the other hand, will require some more effort on my part. When I know that I’m managed to score among the top brass of my batch, I know that I’m up there knowledge-wise.

These upcoming preparation leave days are going to make all the difference. I know that. It is going to be one tough month of studying. But, having gone through my prelims, I know I need to work extra-hard to stop myself from losing it before or during the paper. Our practical dates have also been declared and they are a month away from the theory exams. So, the upcoming 3 months are going to be the make or break of my Medicine journey. In this last leg, I can’t give up or be loose. I’m going to make each and every day, each and every second count.

Finish at the Start

The terminals got over. Four days of disaster. And weeks of disaster before that. After things get done, I can't believe that I actually went through it all when I look back.
A week back, I was telling myself, "One week from now and you shall be done!! You'll then be able to let the demons of exam stress rest a bit." Then the realisation that time doesn't go at lightning speed dawned on me. I knew I had to get through the whole week, being aware of each and every moment and what I did at each single time. The whole process has been exhausting. This should seem unfair because last year, at this time of the year, we were taking exams in Medicine, Surgery, Obs-Gynae, Paediatrics, Ophthalmology, ENT and PSM with practicals in 4 of those subjects. That was supposed to be the exhausting one. It lasted two whole weeks and seemed like a lifetime. At the end of it, I was happy that I got through it, almost unhurt :-)
This year, however, these 4 days have been torturous. Since the time May dawned, I have realised that I do take stress. And that eats into my sleep. Big time. I may go to sleep around 11, but I shall always get up between 3:30 and 4:30 pm. I don't even need an alarm. It just happens. And these few days during the exams, I have had to deal with just that. By the time my last paper came (Paediatrics), I wasn't even in the mood to study during the time I was awake, let alone get up early. I managed it, however. Telling myself that this was the last paper played a huge role in this endeavour. When those last three hours came, I couldn't write fast enough to get it all over with. When it actually did, realisation of the end swept into me. I had lots of things to look forward to. All my cousins, uncle and aunt are in India, and now, in their last week of stay, I finally have time to spend with them. My eldest cousin left for the US yesterday, so once the paper got over, I spent the evening catching up with him. Everyone appreciated how I still had the energy to have a kick in my step and bounce around everywhere when I came back home.
A few hours later though, the consequences of my escapades of the past few days started creeping in. I was tired. And now I felt it. My dinner was as good as not eaten and I just wanted to get into bed and sleep. Maybe hibernate for a few days. When we came back home from the restuarant, I couldn't even get my self to change. It felt like now that I had the time to just sit and not think, my mind decided to react to the pain and injury inflicted by the tedious examination timetable. When you get a swollen knee or something, as long as you ignore it, it doesn't affect you. The moment your attention wanders towards it, it gives you that first stab of pain and then follows the saga of injury. I went through the same thing.
Even today, 2 days after the exams have gotten over, I'm feeling the stress and the exhaustion. I had lots of things planned. I have to meet up with my friends, get my room cleaned, make a timetable for the next three months, start with my project work, spend some quality time with my grandparents, write my diary (haven't written in months). But, I can only sit in one place and stare (mostly into the TV). I don't feel like getting up and taking a bath either. It is the one thing I have to push myself in every way and do.
Talking about my To-Do list reminds me, my project just doesn't stop giving me problems. Three days before my examination began, I had to present my topic before the Ethics Committee of our College. I was sorely pissed. I was way behind my timetable and I did not have a minute to spare. They expected me to spare 2 whole hours for that stupid meeting. And then, they had so many comments to make, and so many changes to suggest, I felt like I had been asked to come there to provide them with some academic entertainment. At that time, the result was the least of my worries. I just wanted to go and study. Yesterday, I had to go to college to get my brother's Admission brochure. I thought I'd go and ask about the status of my certificate. They told me I should get the changes done to get it certified with the committee. I told that Professor that it wasn't possible for me to do that. It had been selected for the ICMR just the way that it was, and I had to it that way itself. And, since I had already got a provisional certificate from the committee, I had already begun the work. I just had to get it all done in the way I had presented it. She told me that I had to go and talk to the Head of the Committee.
I can't believe how 'lucky' I am. Since the very start of this project, I have had nothing but problems. It is amazing how much trouble you can have with a 2 month research project in your own college. You end up wondering if it all is even worth it! And, if the ICMR selected this project out of the many entries they got from all over the country, I'm sure they thought it was worth whatever I had written. That body is way more deeply into research than an Ethics Committee in any college. If they didn't have a problem, why should these people? I guess Monday will tell now. Lets hope I get a solution out of this whole mess..    

Holy Crap

As the month of June creeps closer and closer, the nervousness regarding my forthcoming examinations and the frustration over unfinished work is reaching new heights.

I haven’t been in the best of moods. The sudden realization that:

1.       I am very far from my target of 50 cases for the ICMR project.

2.       Residents vary in their desire to help me get on with my project work.

3.       I am very far from finishing my Surgery portion as I wanted to.

4.       I haven’t even started with the other subjects yet.

5.       I am not able to get whole days to myself when I can just study from start to end.

6.       I don’t really remember everything after doing it just once.

7.       College is just a big waste of time.

8.       Journals keep piling up – first to write, then to get the signatures.

Has made me melancholic. I haven’t yet reached the stage where I start thinking negative about my situation. I may be on the way though. I know for a fact that I have been taking about 8-10 cases over the past 3 weeks I think. I should have 30 cases, right? I am stuck at 24 and 25. The imminent arrival of my Guide on 27^th is also making me a little uncomfortable. I have to show him my cases…it will be very disappointing if he points out mistakes. Please, please let him not.

Talking about studies itself is frustrating. The subjects this year were supposed to be interesting. Somehow, my interest in them has vanished. I don’t feel the desire to go on and on with my studying. Instead, I’m just waiting for those little breaks, which eventually span out into larger breaks than they are supposed to be.

Maybe it is the idea of me running around for that project, while seeing my friends study, which is eating me from inside. Maybe it is the idea of me studying that is eating me from inside. In all, final year is testing a lot of me. I also get the feeling that this is just the beginning. There is a lot more to come. We’ll see…I look back to that one week…to those two days when I had totally lost hope…those two days when I had to deal with one shock after another…I got through that. There is no reason why I can’t get through the studying then J

Reality

I just have to write. I have my Paediatrics term end tomorrow, so ideally, I should be studying. However, out of curiosity, I went through my last post and the urge to write erupted through me. The past two-three weeks have been such huge reality checks. I think I have almost hit rock-bottom, but somehow, managed to wriggle out with something to cherish.
I remember writing a month back that my ICMR Selection list was out, and that my project had been selected. I wrote a lot of reasons why I decided I would not do the project. However, a little coaxing from my mother ( she showed the wonderful things I would get if I had this project under my belt.) and I decided that I would do the project. The more-than-just-happy approval from my Guide gave me all the more reason to go ahead with it. Neither of them told me what I was in for, though.
Everyone says the first few days of any project are hard. You are somehow just getting into the rhythm, trying to work out some kind of schedule, arranging and rearranging your work, meeting the concerned people. Lots of things just tend to happen together. You end up hating those first few days. I went through just more than hating them. Being a student at a Government Medical College, I should have realised this a long time back - You can never walk straight in here. You just HAVE to take turns to reach something that can resemble a destination. My Guide told me that doing the Lipid Profiles of patients would be a very easy thing to do. That has ended up being the most dreadful thing to do. It takes quite an effort to coax patients into talking to you. An even bigger effort is required to bring these very people to you the next morning to take the blood samples. Add to that, the fact that Lipid Profiles are NOT done regularly in our hospital, got me freaked out majorly. I now also had to provide the kit to do the test. Still, it was ok. I went to the Diabetic OPD on Day 1 of my project, and managed to take some cases. Next, I had to go and tell the Lab Director that the kit would arrive there soon. When I told him that, he dropped the next bombshell - " I don't have the manpower to do the tests. You'll have to do them yourself. I'll teach you." That was it! I have my term exams coming up in June, and now I have to perform Lipid profile testing of patients!
I am going to take a few words here to talk about my temperament. I'm cool. I get nervous before an exam or a Viva. I just talk to myself at that time, say stuff like, "You're being stupid! You've studied. It is going to go great. Come on, be yourself!", and go back to being cool again. I don't freak out. I don't stop eating or lose sleep or dream of scary scenarios related to anything. I'm just not that kind of a person. I switch on and off pretty easily.
Those two days, I did exactly the opposite of what I've written above. I kept thinking about the project, the time that was going to be wasted, the patients whose blood I would have to take, the ignorance of my Guide for having put me through all this (although the Lipids may have been the reason why the project got selected in the first place), the sadistic happiness that the Director was getting (again, although, he might have been telling me the truth), my term end exams, my univ exams (yes, I went to the extent of planning out my schedule for the repeat year). I stopped eating, I couldn't sleep. I became an insomniac within a day!
Being who I am, I couldn't share this with anybody. My Mom, bless her soul, saw right through me, and gave me a boost up the next morning. The fact that two patients came that day, and I could finally say that I had started my project, made me a little settled.
Since then, however, I've been trying to find the right rhythm. The insomnia has sort of remained. I still get up  at 5 in the morning and manage to study a little. Going to the Diabetic OPD is something I have come to dread. The compliance of patients is 50%, so now, I've decided not to go there at all. I'll just hunt down patients in the wards. That way, the irritating bug (Wednesday Diabetic OPD awaits you. HAHAHA!!!!) that keeps haunting me all through the week, will disappear. I am trying to just divide my day into parts. 8-9:30 am will be dedicated to looking for cases. Thereafter, posting. The afternoon onward will be my study time. Exams are coming up next month, and I need to score. That means I need to study, HARD.
I do panic. There are loads of moments. But, I'm trying to manage. Journals have added to the tension. The to-do list never seems to reduce! My brother (in the 12th grade now) had his entrance exams. My Mom had gotten really nervous. I sat with her throughout the day for company. During that time, I finished writing two journals. The trick is always multi-tasking. I have never been good at it. I've chosen an awful time to learn it, but I can give it a shot, right?
Right now, everything else in on the back burner. I had had the idea of applying to a few universities abroad for some courses after my Univ exams. I've decided to chuck those plans. There is no way I can do everything and succeed in it all. I got past the IDS, that is enough. Now I'm just going to concentrate on my studies and the project. I can't wait for the Surgery posting to begin. I can almost feel the fresh rejuvenation already :-)
Life sucks. A lot. Having to deal with so many people now, I've realised that. It isn't all rosy, this growing up. When you are a medical student in the GMC, the word doesn't even fit into your dictionary of life. I have gotten really low over the past few weeks. There were times, when I thought I should to take some medication to shut out the many thoughts swimming around at Olympic-record time in my head, so that I could concentrate on a single one. But, I got past all that, and am still standing ok. Yeah, I lost weight, and the radiance of my face (according to my Mom). Point is, I got through it. I still dread going to hunt for cases, but I still manage to end up doing it all. I'm far back in my studies, but i know and hope I can do it in time. I'm shit scared and nervous about the next month, but I can still smile and crack jokes right now.
This is reality- not easy, but easy enough to give you a chance to make it so :-)
Best of luck for Paeds, Jill!! Do well :-)      

Prelims: the Finish-line

Time to celebrate a bit :-)

2.5 weeks, and the ordeal is OVER! In the past two weeks, I've suffered and learnt real meanings of words like "Patience", "Frustration", "Insomnia", "Acidity" and most importantly, the mantra that "good things never always happen to good people", and that at times you never get what you really deserve.
The marks don't count- not when it comes to the satisfaction I've derived from every question I've answered. And at the same time, they really do count. If I end up getting less than I expect, I'm going to feel betrayed and again ascertain that this is one unfair world. If I more than I expect, I'm only going to put it down as my amazing luck. Please note, nowhere do I blame myself for the results. Typical student attitude. We just don't ever want to say, "We just din't study enough." Fact is, it isn't easy to do all the studying, and frankly, I can't bear to even think of how I've spent the last 2.5 weeks. I wish I could predict when I'm going to learn that doing my entire portion the night before the exam, is sheer foolishness! Yet, I can answer a part of that. It is only when I feel confident enough ( that is, after having done my portion at least three times over), that I can entertain such a thought. Currently, all I want to do is, take a few days ( hours out of days actually)off, and just relax. I want to do things that are going to make me want to get back to studying with enthusiasm, not with the resigning attitude that I so feel I am going develop soon.
So, how were my exams? Pretty ok. The papers were good. Except for a disaster that Micro 2 might turn out to be, and a catastrophe that Forensic is going to be ( I will eat a boiled eggplant if that doesn't turn out to be true!), the rest was definitely on the verge of good. My patience and the ability to stay hungry for 5 hours was tested big time during the Pathology practicals. I am not very good at staying hungry. During exams, no way. The tension and the atmosphere of the practical hall make a lethal combination. The moment my stomach gets a little empty, the brain starts to talk about putting in some HCl in there, and I suffer from vague symptoms of hypoglycemia and acidity. Patho was the height of it all. I was the 2nd last person to go for the viva, and finished at 5:30 pm. And I had had lunch at 11:45am.
Forensic (FMT) was another tester. This time, completely testing our ability to patiently wait....wait....wait...wait...wait...wait......and wait. I was there for the practical from 10 am in the morning to 5 pm in the evening. Had that 2nd viva not turned out to be awesome, I would've been ready to send a body in there for a post-mortem!!( kidding....I woud've just chucked the thoughts of FMT aside any way!!)
What have I learnt from my prelims? Firstly, I totally understand why a senior of mine, gave a post-exam party after her prelims had gotten over last year. The feeling CANNOT be described! You fly in the air, as high as you can go, feel the breeze blast past you and yet not hurt a single cell....suddenly swoop down and catch hold of all those small and special things you wanted to do for so long......and have a great night's sleep without worrying about those alarms that have been dissolving dreams within seconds, for the past 2 weeks.
And, I learnt that doing things on instinct does work to your advantage, making your paper go much better than it might have gone otherwise. I also learnt that everything has to end finally, so it is obviously going to a much better finish-line, if you stop losing your head and health over small things. :-)            

Prelims : The Forecast

10 days left for the Prelims to start, and I am having panic-attacks and the absolute urge to throw away my books, in cycles. It is hard to keep so many things inside a small head, as many mnemonics that one may want to come up with. To top this, I have, once again, fallen prey to my delicate health, which seems to wait and wait and wait for that right moment (two weeks before the exam) and then collapses like a sand castle against the ocean waves. I was fine through out the past two months; Hell, I’ve never been better health-wise. People around me fell ill, every day…..every day a new virus made its existence clear around me. But, exams are the food that these organisms need when I’m concerned.

I might be able to complete my portion, but, there’s no way I can even tell myself that I’m ready for the Prelims. It’s so simple. I can start months before, or days before. I still won’t be able to believe that I know everything!! I’m just hoping I can get past this barrier ok. Then there is a two month preparation leave, when I hope I can do things more systematically and less hurriedly…..

It’s my birthday on the 14^th!! Of course, I’m studying throughout the day, and there are not going to be any surprises like last year. But, it’s my birthday!! And I have reason to rejoice for those 24 hours!!!!

Best of luck to me for the horror that awaits. 20^th September, here we come!!!!!! 

Examinations - The Chapter

I've tried my level best to try and describe Exam Time in a Medical College....And failed....MISERABLY. Mostly because I didn't have the time to write all that I felt. So I thought, I'd try right now....only a little differently. Through chunks out of my Diary which would describe what I went through them.

* Dates to remember:

26th May, 2009 - Anatomy paper 1

27th May, 2009 - Anatomy paper 2

29th May, 2009 - Physiology paper 1

30th May, 2009 - Physiology paper 2

1st June, 2009 - Biochemistry paper 1

2nd June, 2009 - Biochemistry paper 2

30th June, 2009 - Anatomy Practical

2nd July, 2009 - Physiology Practical

5th July, 2009 - Biochemistry Practical

Excerpts from my Diary:

8/5/2009:

" Well, things aren't going all that well. I just CAN'T seem to FINISH!! I was supposed to end a 1st revision on Sunday. And its just not happening! I'm gonna push to Tuesday and hope I can still manage 3 revisions. But, you know me, Jili. So it all looks a little bleak."

11/5/2009:

" Managed a fair bit of Central Nervous System ( Physiology) and I'm actually on top of the world!! Its funny, how small things just make me smile like anything!!! Things are a little tough, but I'm, well not enjoying, but keeping the humour intact. After all, ur spirits need to be up in the high sky to make it through all this, right?"

19/5/2009:

" Alright, I'm a little worked up here. I knew I'd said I'm not going to take tension, but, wen you are way behind a schedule you've had to change twice to make sure you manage stuff once at least, you are in murky waters there. And, can you believe it, its Physiology that's getting me worked up. Not 'coz, I haven't done it once. Its because, I haven't done it twice!! Anatomy, I have 5 days. I can move the heaven of Anat on earth if I have to. But Physio's getting unnerving here. Ok, girl, cool down. Deep breaths. Remember that weirdly dark sky that you have neen seeing at 2:30 and 3:00 in the morning for the last few days. And smile. They're all there to sail you through. You are gonna pass. I promise."

Well, I really did have it coming to me. Especially since I couldn't move the heaven of Anat on earth in those last five days. But, I guess that happens to everyone. The papers were much better than I thought they might be. And considering that I was pretty much on the verge of puking and fainting just before my Anat papers, I'm glad, I came out with a smile saying " Its over!!" At that time, I knew I'd done well, because I wrote everything that I could remember. Looking back, I'm not so sure. But, its Medicine and this stuff does happen. Physiology and Biochemistry were good too, although the last paper ( Bchem II) was definitely the worst of the five. Point is, you can't expect to have six smashing papers. In fact, we'd been warned that either paper I or paper II is tough. So, since the paper Is went well, there was always the fear that the paper IIs would be disasterous. So, I'm happy that my worst paper was the last, and I didn't even have the energy to ponder much on it.

Excerpt from my entry on 3/6/2009:

" Exam's reduced all the weight I put on. It has worn me down; mentally, physically, inevery way possible. All those 2-3 o'clock nights the week preceeding and all the 40hour sleeps in the past week.... But, its over!! And for the pracs, its not going to be like this. So, I'm dead pleased."

Practicals was a whole different ball game, as I managed to realise, a triffle late if I may be permitted to say. It included our journals ( to be learnt cover to cover) and the ENTIRE portion for the grand viva. So, I got worried sick about Anatomy again. And it was pretty bad too. We had revision practicals and they were definitely better than I thought they might go. But, its me, and I always seem to believe that I am the worst BJ can get, at Anat. Its not true, but its something that has stuck on, despite having decent practicals. So, I'm just relieved that its all over, and praying hard that I don't have to do it again. Physiology and Biochemistry practicals were good too. Biochemistry actually qualified for " Good", in the real sense of the word. They were not exciting, nothing out of the ordinary. Just simple, quiet practicals. It is another matter that we were all absolutely impatient to get over with it all and say " Finally, its OVER!"

So, I'm going to say: The last four months have been the toughest and I definitely do NOT want a re-run of them in the years to come. I've learnt my lesson and its time I start studying from day one....Not as seriously as " I've got exams tomorrow" , but serious enough to prevent blotchy entries in my diary saying " I've got exams tomorrow". We're told that first year is the toughest. I've just put a bit of it behind me. And wait for my results to make sure that all of it is behind me.

Till then, I've decided to catch up on sleep, books and 'time-pass' that I've sorely missed doing in the past few months. They have really shaped my life, and I find it hard to believe that I finally have free time!! So, I'm lazying around. And doing it well. Friends, family and books.....and a new " Learn to Drive A Car".....I've got almost nothing on my plate (compared to the past months)..... and am making the most out of it.

The New Year

I am terrified of the idea of writing my paper tomorrow. And when I say terrified, I mean it. I am going through the usual, pre-exam ritual of forgetting things, that I had learnt so well about a day back, so you see it geta a little tough. Still, I might manage somehow in Anatomy. Physiology is nowhere within my reach at the moment, and half a day is just not enough any way.
So obviously, my New Year's resolution is to study more, and more regularly. So that by the time I finish with my first year, things won't be in the state they are right now. How glad will I be when Jan 9th gets over!!
Its the first time I haven't stayed up till 12 to welcome the New Year. But I guess, things do change with time. And 2008 wasn't all that great. I got into BJ Medical ( something way beyond my dreams) , yeah. But the life after that hasn't exactly been a smooth sailing. So this was a mixed year. Regrets? Not many. I wasn't able to write my usual favorite year-end in my diary yesterday. That has been a hard one to swallow. It just won't be the same when I write it on the 9th.
Well, gotta get back to pushing things into my head now. Just really nervous. I want at least 30 so have to make that happen. I am gonna be happiest creature on earth when I finish with the terms.....And even happier ( and that is possible) if I pass all my subjects! I promise to study more and regularly, God! Just let me off this time and pass me in all three,PLZ!!!!

The Weekend Before The Exams

Its tough, trying to think of exams from next week, precisely, next Friday. And I'm not exactly completely prepared. So I'm in major soups of all sorts. I'm really worried about Physiology. But hopefully I'll manage somehow. What I really wanted to write about was the dissection we started this week. Its the Head and Neck, and we dissected the scalp and even the brain. AND I LOVED IT ALL!!!!!! Its like one of the biggest things in my life really! Me and liking dissection and even doing it. The brain looked amazing! It looks just like the way we draw it. The other body parts differ, but this looks exactly the same, as the diagrams we take mintues to master. Guess, that really took me by surprise. I was thinking of sitting in the library today. Unfortunately, the maintenance work had to come up today itself, so well, my experience of studying in the library has to wait a little longer. Maybe Monday. I'm thinking of trying to finish with Biochem this weekend. Hopefully I'll be successful in this attempt at least. I've put pictures of our brain dissection.....Its not as gross as it looks!