Curtain Falls

It has finally happened!! My ICMR Project report is out, and it says -

Wait for it!

APPROVED!!!!!!!!


 I'm so relieved!! I have had so much trouble with this whole project idea this year, I can't actually believe my eyes which read that "Approved". Yes, everyone around me told me that it was a good topic, that Diabetes is a subject that no researcher can ignore, that the effort I had taken was for real and that the authorities would see that, that I deserved to get the approval.....but, my whole experience was one big roller-coaster....I never believed that I would touch solid ground, until I did for real. Yes, I have finally touched solid ground.
From the complications that arose from our Symposium Competition and the submission of the Research proposal clashing....to the missing of the date for the Ethics Committee Meeting...to the decision of almost giving up this project, irrespective of whether the ICMR allowed me to do it or not....to that provisional certificate that was given and then revoked (after I'd completed my study)....to having been called to present my topic before the Ethics Committee (something that has never happened with ICMR projects before)....to running around behind the new Head of the Ethics Committee to give me my approval letter....to having to buy the Lipid Profile Kit for my project....to having to make the numerous trips to the lab to get things moving...to having gotten my mom to college to collect the blood of my first two patients....to getting so nauseous out of worry that I did not eat for two whole days...to coming everyday to college compulsorily to get two (and any more being called 'bonus') patients of Diabetes everyday....to having trouble with the Statistics of the project....to waiting till the last minute (after my Prelims got over) to create a report out of whatever I'd managed to find....to that final horror of a day when things got unruly at home, and I still managed to send the whole report to ICMR.....yeah, it has been quite a journey.
I made mistakes along the way, I hated my life along the way too....I made life hell for all the people close to me, friends and family included. It was tough, but it was an experience...something that I shall never forget for the rest of my life. I know what it's like to conduct research, I know the pains people take to do something that can get them something more than just plain knowledge (the feeling of having done something great, found something new)....I understand why people fall in love with their papers and hate it when they get rejected from Journals they are sent to for publication. I landed at the other end of the scale...instead of falling in love, I hated it....I thought I could've come up with something grand, and I did not. Which hurt, yes it did. But, I think it is grand now. Out of the 1000s in the country who applied for this Short-Term Studentship, they selected around 200, and out of those 200, they approved my whole research. Yes, this is a good positive feeling.
Looking back, I probably don't want to miss the Ethics Committee meeting date. That is pretty much it. I wouldn't change a thing about my experience while doing this project. I met some really good patients...I was told many good things by a lot of patients....my 70 patients, who shared a part of their life with me deserve a big thank you. I learnt a lot about talking to you, being kind, appreciating the problem you have, trying to make things better for you...as I said in the assessment of my experience, I grew as a doctor, I learnt to be a doctor and a human being. I might not be very gentle during my internship, but I do know that I have a responsibility to treat every human as human, give importance to everything the patient has to say, and always be kind, no matter what. Yes, that was my biggest lesson.
It would've been such a bummer to not have got this approval...I'd have probably been chanting all sorts of negative thoughts, hating those 4 months, wanting to have followed my heart and not wasted time in my project. But, God has been there, and been there in style :-) Thank you so much Dear God. You have no idea how much this means to me!!
So overall, yes, I hated the year. I took on a lot of things apart from plain studying-
1. The Symposium on Islet Cell Transplantation
2. The ICMR Project
3. The Seminar on Hospital-Acquired Infections
4. The Paediatrics Quiz
5. The TB Quiz
6. The Medicine Quiz
7. The Asthma Quiz
8. The load of my Final Year studies
Phew. I think I've done decently well then.
Oh yes, the reason for that 'decently well'-
My Final Year results are out....I've gotten 72.33% :-)
No distinctions though...missed the one in Paediatrics by one mark :-p
I'm 4th in College. Which is sort of cool :-)...a let-down on last year (73%, Rank 2), but after looking at that list above, I think I've done better than I thought I would have.
Results were declared on 28th February. Since I was doing that BLS and ACLS course, I'd decided not to check my result. The tentative date was always 28th Feb, so that day, I was on tenterhooks all day long. You can imagine my delight when I got a text from a friend saying that they were not going to be declared on that day, but maybe the next day. I was on Cloud 9. I've been ranting about how I don't want this result, haven't I? It was an answer to all my prayers.
I was so happy about passing my BLS examination, I updated my FB status to "I can save lives now." Turns out people took that as my status response to the results having been declared. Oops. A few phone calls down the line, I had to delete my happiness over my BLS course from FB. Weird thing is, the moment I deleted it, I got another text saying, "Results declared." Now, you would obviously think there was still some confusion over my just-deleted status. Which is what I thought and replied also. Fate had decided t play a trick on my me and my jolly mood though. Results did get declared. Hmm.
I thought I'd just check out the college list to see whether I'd passed or failed. Seeing that "PASS" against my name gave me a sigh of relief. At least there was no further exam to take 6 months down the line. Again to soothe my nerves down a bit, I called up my school friend, talked for half an hour, then decided to check my marks.
There they were- 651/900. Was I happy? Umm. Was I sad? Umm. I was actually empty on emotion. I had now gotten the tag of Dr. to my name, and I was still feeling empty. That was strange. I didn't really care about anything. I knew I hadn't topped but that did not matter...I knew I hadn't come 2nd, but somehow that did not hurt or matter either. These marks just proved that I was done. Done with this jam-packed final year forever. That gave me a calm, a serenity that did not budge for a long time (now it has, because the thought of internship scares the hell out of me). It has been that way about my results this year. I don't care. As long as I pass, that is all that matters. I feel more satisfied about my Project and my Course. Maybe that sounds strange....but it sounds good to me. And it has put my mind in a state that has come to terms with these marks much faster than ever before.
Done...now I can only look upward from here. No going back. 

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. 

My most important post ever

So, I've finally done it. I managed to get past the nightmare of my practicals, a true test of my knowledge, according to the people who really know.
It was different, this experience. For one, I realised what it os like to get really tense before an exam; so tense that I think I spoilt my own chances of answering well in there. This was before Surgery. The problem with that subject is, I love it so much, I get nervous knowing I may not do well enough, and obviously, when such thoughts haunt your mind, you don't end up doing all that well. A vicious cycle. I hate it. But, I haven't able to solve the mystery behind my love and fear for this subject. Looking back,  I know that my nervousness and fear that I didn't know anything only held me back, on what could have been a good viva. What more can you ask for? The residents conducting the exam are helping you; they stop just short of giving your viva for you (just partly, because they stand behind the examiner and mouth the answers they know). The examiners are really in no mood to fail you, unless you decide to do that yourself. And you pretty much know the cases, instruments, xrays, specimens beforehand. Despite all this, when I wasn't happy with my own answers, I knew I had only myself to blame. I did enough to pass, yes, but, this is a subject I love, and passing here was just NOT enough.
It has been that sort of a relationship with Surgery. The Love-Fear quotient is like a 50-50, and that really really sucks. But, I did learn a lesson, and decided I wouldn't panic so much for my next practical.
Medicine- that was that next practical. Now, the thing about Medicine is, I think I know, I know I know, but when it comes to using my head, I always go off on a tangent. And, I can't examine patients the right way, to save my own life! There's always something incomplete in my method. If that isn't the case, the fact that I'm not applying enough strength, always gets me few marks less. So, yeah, there are a few areas to be worried about, in medicine. But, by God's grace, I ended up getting Alcoholic Liver Disease cases as short and long cases. Oh man, by the end of the practical, my pleximeter had turned into a mass of aching skin and bones (thanks to all that percussing- this despite cutting my nail so short, it hurt there too). In fact, at the end, I couldn't understand whether it was the patient's percussion tenderness or my own finger groaning and saying it had had enough.
Medicine was ok. I say ok, because, if you end up getting the same topic on all your three cases, you should ideally ace your exam. Problem was, my first case was a disaster. The examiner was an internal one, and she is considered to be a little scary. I wasn't given a warning that the exam had started or anything. She just came up and asked, "Are you 49089?" "Yes, Ma'am" "Start your case. And keep that paper away." WHAT?! No bloody warning!! And how the hell was I supposed to remember the details. This woman has her own set of rules, so you have to remind yourself of each and every one of them, before you speak. Like, do not say "Cynosis" in a p/a case, because it doesn't have any significance. Caught by her out of nowhere, I went into panic mode, and next thing I know, I'm rattling off Cyanosis to her with loads of 'ahhhh' interrupting words and sentences. I couldn't wait to finish with that viva, and I guess she couldn't either. Bad start. Had I been in her position, I wouldn't have given myself anything more than a 50%. Maybe she did. Will only know in February. The other internal examiner was my Project guide. I was worried, because I hadn't gotten back to him regarding the project. But, both his vivas were good. He took my long case and although it started off well, they (internal and external examiners) were a little disappointed that I missed out on Spider Naevi in my patient. What is worse is that, I hadn't missed it, had checked loads of times, and had concluded that it WASN'T Spider Naevi. Talk about difference of opinion. But, the table viva made up for it, I hope. There was nothing that I didn't know about whatever they asked me. We parted with a smile (a wide one, by the way) and I kept praying, they'd consider my awesome table viva and give a me a few more marks for that long case. The xray and charts were taken by my scary internal, and obviously, I was still scared of her. It was ok upto the point of recognising the problem. Thereafter, it enough to say, I don't think I use my head much when it comes to differential diagnosis.
Paediatrics was easily the best practical. My table and short case Viva was good. It was full of questions that were first-timers (like, disadvantages of breast milk, reason why you use Ca gluconate in hyperkalemia and some others that I don't remember), and I answered to the best of my ability, which was quite a lot. My long case was Cerebral Palsy. How I hated my luck that morning. After praying and praying and praying some more (that I don't get Cerebral Palsy), I got that case. Lucky for me, I was the last person to get done with my viva, and he only asked me read my case and asked 2 questions after that. So although it felt incomplete and weird, at least it wasn't a disaster, thanks to the case.
Obs-Gynae was a story itself. The HoD was the internal examiner, and he got really angry when he found people with their books near the cases. He found my book in my friend's bag, and that got me included among the people he was going to punish. Punishment meant that our vivas were going to be held last. So throughout the day, I just had one thought in my head, "Will I pass?" It'll be so humiliating to have the topper of 2nd year and 3rd year to fail in final year because of something like this. But, he did take our vivas. He didn't ask any question though. The external examiner sitting with him was asking everything. And, overall, it turned out to be decent enough. I obviously wish the incident hadn't happened, but I guess it was all for the best. When our HoD was asking questions, he was asking tough ones,  making students feel like crap. But, when he was sitting quietly, things were better :-)
So, I'm done. For the first 2 days, it didn't seem real. I kept thinking I have to go back to studying in a few days. But, now, I'm getting used to the fact that I don't have to study for a month at least. Not that I'll be sitting idle. I have to decide my future, I have to catch up with old friends, I have to get my garden in order, I have to start preparing my brother for his exams....in all a lot.
Currently, I'm stationed at my grandmom's house, trying really hard to make up for all the time I didn't have to spend with my gradnparents in the past 4.5 years. I'll be leaving for Hyderabad tomorrow. Its the AIOS-2013 conference and I'll probably attend a day or two. My chief purpose is split between taking a tour of the LVP institute there, meeting up with friends, and enjoying the awesomeness of the Ophthalmology conference :-)
Bon voyage!!
   

Hunting for Clinical Examination

So, over the past few weeks I've been hunting for videos of Clinical Examination of various systems and joints and all, to help me gain some confidence with my own skills. Found a great blog called http://imedrxtv.blogspot.in...it has the MacCleod's Examination videos and also the Dr. Ghanshyam Vaidya clinics. Any one who needs either of them, can definitely have a look.
Today, I watch a youtube video of the Knee Examination. Thought I'd put it in here. its a big help to all those people like who have had to manage Ortho all by themselves, and need some help with the practical part.

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 Break

Did I take a break? Not really. So, after the exams, I had to complete and send my research project to the ICMR, clean up my room, clean up  the house, get some decent sleep, just get away from studying for a few days. Unfortunately, that did not exactly happen. I couldn't do everything and when time came to get away to Mahabaleshwar for the weekend, I had spent an entire night trying to get my project done and was carrying all my work with me.
It is such a pain the ass to do something like that. I haven't been to Mahabaleshwar in a decade. I was really excited about roaming around there. Having the incomplete project hovering about in my thoughts did help much. Mahabaleshwar was wonderful....cool, windy and very friendly. On Saturday, we enjoyed our hotel completely. We were staying at Evershine Keys. Nice hotel :-) lovely food :-) Yesterday, we visited all the "Points" in Mahabaleshwar. My favourite had to be Kate's Point. It overlooked a river...the water was crystal blue, and it reminded of the Pacific Ocean for some reason. The scenery all over Mahabaleshwar is so pretty!! I simply love to places like that, so I've been one happy person over the weekend. Knowing that I have to start studying from today males me cringe, especially after reliving all those wonderful memories of the weekend.
The market in Mahabaleshwar was so inviting!! There were shops after shops of footwear of all kinds, purses, handbags, hats, artificial jewellery and the pride of Mahabaleshwar - Strawberry with Cream :-)) Mom and I went crazy with all that footwear...we bought so many!! Over all, I had a wonderful time.
What makes me relaxed even more today, is that I managed to finish writing my report yesterday night and sent to the ICMR. I was worried that there may be a lotof load on the site (after all, today is the last day of submission). But, sending a report at 2 am in the morning always eases the load a little :-p
My experince with this project has been enriching. It wasn't enjoyable. I remember that initial period. It was all new, the hunting for patients, talking to them, convincing them to take the required tests, interactions with the lab personnel, getting the statistics done, getting my ethics certificate...and the most difficult of the lot, trying to get my Guide to talk to me for a few minutes. Getting into the groove and setting a time table that I could follow was a task. Juggling my studies, exams with the time that went into this was an even bigger ask. I've already given up hope that I'll match my own standards of the last two years. I just want to do well enough to be proud of myself and this year...
Lets see how everything pans out. I hope they accept my report. The four months have been tough and I don't want any more trouble related to this project. Best of luck to me for the next one month :-)

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.

Angry

I am so ANGRY rite now. Angry to the extent that my concentration is being intercepted by all sorts of childish thoughts about what I would like to do to the person concerned. That led to me writing. Nothing frees my mind more than putting down in words how exactly I feel.

About two years back, we were celebrating the fact that Paediatrics does not include a journal. We did not know then, about a notebook that you have to prepare. This notebook is supposed to have 30 cases. Ok, so I came to know that this year. I spent two whole days and the night in between them, writing this notebook and managed to get that load off my head before the term end examination was done. Unluckily for me, by the time I went to the respective teachers, they weren’t in a mood to sign.

Today, I got the signature from my second CR pretty easily. She was sweet enough to just sign in the index and told us to put ticks inside ourselves. No, it the other CR who’s the nidus of my anger.

Since, in second year we did not know about this journal thing, we didn’t bother to really approach any body. Now 2 years down the line, we have genuine cases in our notebooks, but no CR to get them checked from. The current CRs are playing handball with us (we being that poor ball). First, the CR started checking my journal, but then he got bored and shooed us off saying that he’d never seen our faces, that we weren’t posted under him, so he couldn’t give us his signature. We had to go to the other CR, who told us we had to get permission from the lecturer so that the CR would be eligible to check our journals. All this, despite telling her (and him) that they’d given signatures to the rest of my batch.

 Finally, after pleading to him and given him his supposed due share of respect, he said he’ll check our journals at 7:30 pm. I was not in the mood to go all the way to college, 10 kms away (100 bucks by rick one way) for a signature I wasn’t sure of getting. I gave my journal to my hostelite friend and told her to get it signed for me. But, I should’ve realised that this CR is a jackass through and through. He expects people to come all the way from home to get his darling signatures. And, when they don’t arrive, he simply says, “ No. Tell her to come herself.”

I don’t understand what problem these residents have. It may be called human nature to reap the benefits of attention showered on you once in a while, but, seriously, do you do that when you’re dealing with 9^th semester students, who will be appearing for the Final MBBS exams in 2 months time?? Are you that cold-hearted? What does he know about the trouble of coming all the way from home to college. After all, he isn’t a localite, right?

Jerk, absolute jerk. Ultimately, we have to go to him any way. Because, our appearing or not appearing for the practical exam depends on that signature of his in the index, doesn’t it?

Jerk. I hope he fails in his exam. Or at least, if not that extreme, I hope he falls down after I’ve gotten his signature and fractures his hand so that he can’t sign any more. That’ll save quite some time and energy of people wanting to study.

I am also pissed off at the people from my batch. Yesterday, a few of them went and got his signature. One of those was a girl who used to keep telling me to tell her when I would be going to the department to get those signatures. There are some really mean people in college. Selfish enough to not even inform. Nice. Its been that kind of a day, you know. You’re just angry at the whole world and the whole world actually does things to get you even angrier!

By the way, that workshop in Delhi got postponed. I don’t think I’ll be attending it now. My prelims last from 24^th Sep-9^th Oct. The final date of submission for ICMR is 15^th Oct. So I don’t have much time to do anything, let alone travel. Well, now I’ll celebrate my birthday in Pune. I don’t like that. I was really looking forward to this Delhi trip and spending my birthday there. I guess I haven’t realsied how much this project is jinxed. 

Exam Forms

Yes, the day is finally here. That dreaded day when I submit my Examination form. Yesterday, we had to run around a lot for a lot of things that need to be done.
1. The Challan - You get that challan in the Students' Section in college and then after having filled in the details, you go to the bank in college to fill your exam fees. I don't why and how it happened, but when I went to fill in my challan, there were just 2 people ahead of me. For the past three years, I've had to wait in that damned sun and then in a stuffy room (called the bank branch) to pay that money. Yesterday, however, luck smiled upon me a little. I could even go for my Gynaecology lecture, I was so sure I was going to miss!

2. The No-Dues Certificates- There are two such certificates for people living at home (god knows how many for those using the Hostel). One is from the Hostel saying we have no dues there, and another from the College saying that we've paid our fees and we have no dues here either. I was smart and lucky enough to pay my fees on Thursday itself. This fees business is really annoying. I started telling myself that I had to pay the fees way back in March. Obviously, I never did it. I realised that last week and since then, its been a task to remind myself every single night. Somehow, I did that on Wednesday night. I was so lucky, because when I came to college yesterday, there was a HUGE line of students waiting to pay their fees; a line that did not get shorter until the guy collecting the money declared "lunchtime". Phew!! The great part about paying your fees close to the exam form filling time is that you have those Receipts ready at hand. In  my first year, I had to waste a few days looking for those receipts (we'd paid the whole money at the start of the year itself) :-P

3. The Certificates from ObGy and Anaesthesia Departments -  This is new. This is NOT nice. When your examination form have to be submitted the very next day, and that ObGy Department decides to act mean because they have a three-day workshop to conduct, it hits your nerves at all the wrong spots. It definitely made me want to spit all kinds of stuff at my Professors and maybe even the HoD, if he'd turned up. But, I wasn't alone so I was restrained by my friends big time. They did give us the stamps that we required. After all, a whole batch failing because they refused to co-operate will be much bigger news than some stupid workshop that went the chaos-way.
The thing about these certificates is that it is plain useless work. We have to stick our photos on the certificate page of our Journals. Then, we have to catch hold of a Lecturer, and only a Lecturer of the concerned Department to get it attested ( which consists of his/her signature and the stamp of their designation). So, you may have the best of acquaintance with a person at a higher designation, it will be of no use.
Choosing these two departments only, and not the others fails to spark any light inside my considerably intelligent head. The only reason I can think of, is that its their last way of troubling us. Anaesthetists are never outside the OT. So, you roam about carrying your OT material and get inside every OT possible to catch hold of those people. The Department itself is also located just outside the OT. So, you may be told to wear your OT slippers at least, to enter it.
ObGy has the most number of OPDs that a stream can have. Our timetable in ObGy is like a superfast busy Deccan Queen. Every day there's something different. There's Antenatal OPD, Gynaecology OPD, MTP OPD, Labour Room Day, Wards Day and OT Day. 6 out of 6. Nothing repeats. So, getting hold of lecturers is pretty tough. You shall only have one lecturer in the ward on one day, or you simply run around to the other places, located on a completely different floor!

We did get the stamps and the certificates. At the end of the day though, my legs had given in to that accumulated lactic acid. They did not want to walk, neither did they want to move. So did my mind actually. I slept pretty early. But, thanks to that wonderful ghost that haunts me this year (''YOU DO NOT KNOW A THING") I got up early to study.
Exam Forms shall be submitted on Monday ( hopefully, I shall get my No-Dues Certificate from the hostel. It is such a pain in the ass to wait for days on the end for just a formality! I don't even use the hostel, and I weren't forced to pick up books from my hostelite friends, I wouldn't even know where it was! However, I still wait. Wait for the same amount of time as my hostel colleagues. That's the fairness of this world, isn't it?  

P.S. I am officially certified to write my exam now :-D The college thinks so. Do I??

Death

Death has always intrigued me. I wonder what it is like to go on the other of life…but more importantly, it cuts through my heart to see the people that you leave behind…the crying and all can be managed…but the hidden feelings, the pain, the unhappiness felt can’t even be measured.

I have seen relatives crying aloud in groups in the corridors of Sassoon. Initially it was unsettling. But, soon I got used to it. There are things you can’t do anything about. And death is one of them. Yesterday, however, I went back to being unsettled again.

I have wondered for a long time, what I would go through if I lose a patient. A patient under your care surrenders his life to you. That is a huge responsibility. Losing that life would make me so guilty…in fact, a lot of times, I’ve decided on not taking up braches that involve life and death…I don’t think I would be able to live with the thought of not being able to prevent death. Yesterday, the event unfolding before me and my emotions during that time, proved to me that I still haven’t strengthened my mind to face serious situations in the future.

On Friday, a friend and I were examining a patient of Alcoholic Liver Disease. On the bed next to him, was a young patient. He was asleep when his father started to wake him up. He did not wake up…his father slapped his face a few times, but when there wasn’t any response, he went and called the doctor in-charge. They managed to get the patient to wake up. I was a little scared that they might lose the patient, but he was breathing the whole time, so I was sure he was hanging on. Yesterday when the same events repeated, there was no respiratory movement and know response…the patient got an infarction in front of our eyes and the doctors couldn’t do anything to save him. They tried CPR but couldn’t do much…he expired…

The whole time, his father was standing at the side, expressionless. When he was told that his son hadn’t made it, he tried making a few calls. His face looked a bag full of suppressed emotions as he tried to deal with the problem of range for his cellphone. Looking at the way he was walking around and trying to remain calm, I wished he’d had one more person to manage him. After taking the help of the people around him, he managed to let his relatives know, I guess...That done, he sat on his son’s bed. And he just stared at that face. Then, he took his son’s head in his lap and brushed his fingers through his son’s hair. A lot of times.

That was when it happened. There was a change of expression…a glimpse of the actual pain he was going through. He kept staring at that pale face, kept running his fingers through those hair…with speed that showed his intent at wanting to get his son back. It was so painful to watch him like that. Helpless, broken, lost. I wanted to go and give him a hug. I wanted to tell him it was ok to cry and that he should. But, all I could do was stand at a distance.

It hurts so much to think of some person you know, as dead…a friend of mine expired in an accident 4 years back. She wasn’t a very close friend, but the shock and pain I had felt at that time, makes me uncomfortable even today. I still care and still wish she was around with us. If that is what acquaintances feel about the dead, how would the relatives feel? How would parents feel holding their children’s bodies in their hands; the same hands that had held those children when they were born, the same hands that had held their children’s hands as they took their first steps…the dreams, the beautiful pictures painted suddenly come crashing down and all you stare at is that white face. You want to do anything to bring them back, even sacrifice yourself if it would bring them back. But, you just sit there, crying to yourself…trying to move on, but not being able to get rid of those memories.

And this is where I think, should I, as a doctor, be so sentimental about death? This wasn’t even my patient, or a patient I’d talked to. But, I still felt it. Wouldn’t it be worse if a patient under my care lost his battle? Apart from feeling guilty, I would keep thinking about the effects of that death on the rest of his family. This will only increase my own guilt. In my sensitive side’s defence though, I can only say : It takes time to get used to something, or to find a way to get used to it. And where Medicine is concerned, failures are more serious than failures anywhere else.

Food for thought, I guess… 

Iceberg

The iceberg has some wonderful peculiarities. The most important one is obviously its shape. What you see is the tip and there is a whole huge world of ice underneath. Final year is that world of ice. It all starts way back in first year when you are a starry-eyed kid, fresh out of junior college. You arrive at the gates of this strange place. You have lots of exciting hopes and dreams. More importantly, you have some really, really exciting preconceived ideas about how your new life is going to be. A week into college however, those ideas changes pretty dramatically.

You already fall behind your said timetable…the textbooks become hard to understand…the teachers and their English even harder…you wonder why there are so many new words you have to learn…and at some point of time, you ask yourself why you wanted this. Of course, the answer usually revolves around some ancient childhood dream (yours or your parents’), or the fact that you love Biology or (in my case) the fact that you know you couldn’t have gone through with the other option (Engg).

The problems that hit you the hardest don’t come in your first year. They aren’t even related to your first year subjects. And they involve people concerned with the administration of your college (especially if it’s a Government one), and people who are senior to you (beyond undergraduates). These problems are concerned with some subjects that nag you from the start of college to the end of college, namely PSM, Medicine, Surgery, ObGy, Paediatrics. And there is just one word that describes these problems completely.

JOURNALS

Yes, Journals. Nobody tells you in your first year that you should complete your PSM journal at that time or they are going to trouble you in Third year. No. You make that mistake and pay for it for half of you Third Minor. Similarly, there are 4 postings of each of the next 4 subjects I’ve mentioned above. Nobody bothers to tell you to write cases in that journal when you go for your first ever posting. In fact, if its Surgery in our college, you convince your Unit that a termend  examination is not necessary. You manage to live happily until reality strikes you in your final year.

Now instead of studying hard, you get down to completing journals. Journals of three previous terms. Then you get down to hunting the concerned people down. But, oops. Its been three years you know. The Chief Resident has started his own private consulting and is no longer concerned with your college. The Lecturer of that time has done his required duty and moved onto better things. And the Junior Resident (who you’d called an idiot and many other things for marking you absent on some ancient day) is now the Chief Resident. Yikes. It is going to be difficult to explain how you’ve managed to get so late :-p

We’ve been lucky enough to get Units who either pushed us into completing our journals in the concerned posting itself, or have at least decent people who don’t create a ruckus when it comes to signing journals for 2 years ago. But, there are certain people who do create some problems. Like our first Surgery Unit. They took a term-end examination before giving us signs on our journals for our 2^nd year posting.

Well, Medicine is tough. The day you enter that Medical College with those twinkling eyes, your training starts. And Journals and their completion are the best tools to teach perseverance, determination and patience. You also end up learning the origin of the famous proverbs “Try Try till you Succeed” and “Try Try, Don’t Cry” . Yup, definitely Med School!!  

Outside My Comfort Zone

A moment of personal victory for me was to receive an E-mail from the Moving Academy of Medicine and Biomedicine telling me that I had been selected among the 40 people from all over India to attend a Foundation Workshop of Clinical and Laboratory Medicine Research. When I initially sent my ICMR proposal to them, I did not expect to get through. It was a wonderful feeling to see that e-mail and know that I had a marvelous experience coming up in the next month. My only regret is that I won't be able to spend my birthday with the people closest to me. However, the way I'll spend my birthday this year sounds pretty great too :-))
On Saturday (4th August), members of Medical and Educational Perspective, a non-profit organisation looking to come up with low-cost innovative equipment to better the health situation in India and other developing countries, visited BJ. We interacted with them and what struck me most was that they were so seriously concerned with wanting to do something to improve Medical Science and Healthcare. There were medical students, MD students, PhD students and Bio-Medical Engineering students too...all with a common goal. It made me ask myself why I, as a budding doctor in India, should not be as concerned about the situation here and strive to do something about it.
Talking to them, I realised how differently we are brought up by the educational system in India. You are moulded to run in a particular direction. Yes, at times you may deviate a little and do something outstanding. But, ultimately, you are pushed onto that straight path with a pre-decided goal. These guys, instead, are forced to think differently and originally. They are forced to use their heads, heart and creativity and imagination. They are forced to take that path which deviates outside of normal and stay there...it is so refreshing!! I was delighted that I managed to interact with them. I was disappointed at the same time, because due to our poor timing (what with it being Final year and prelims coming up), I won't be able to really be a part of the project that they want to undertake here in India..ah well, maybe soon enough...
My Ethics Committee saga may come to an end...I'm not sure yet. I'll need an entire post to describe it. I'm just going to say that if there were ever a bunch of idiots with egos as huge as Jupiter, they were all hand-picked from the various parts of the world they lived in, and placed in BJ Medical College as the Ethics Committee.    

Down with Flu

My life has been plagued with viruses that seem to get attracted to me, like flies to honey. I guess I’m an excellent host. Viruses get all that they need for their subsistence and more when they colonise my Upper Respiratory Tract.

Initially, I used fall ill once a year. This was usually around February. The moment that cold winter and spring decided to clash, I knew I was going to be visited by the ‘Virus-Fairy’. This continued all throughout my school life. It was only when I entered Med School that the fairy decided to favour me and visit me more often.

I think it was related to the hectic schedule. I am the first to admit, I’m not the strongest of people, physically. A little less sleep or a little more running around than normal, and my immune system decides to go on holiday. At times, just emotional stress is enough to allow that immune system to file in its leave application. Med School is pretty demanding. It provides the perfect setting for viruses to surround me and my immune system to want its designated holiday.

Throughout first year, I fell ill twice I think. But, it wasn’t all that bad. Having parents as doctors makes you exempt from doctor’s visits every time you have slight cough or cold. You straightaway start with symptomatic treatment and stay at home for a day or two. Soon, you’re back to normal. So getting the flu wasn’t a cake walk, yes, but it wasn’t a matter of national importance.

It was only in second year (during my first terminal examination) that the flu hit me hard. At that time, I thought it had a lot to do with the long nights I spent studying, before the examination. Now, I think it was just a precipitating factor, rather than the actual cause. I fell ill after two papers, wrote the third battling high grade fever and hardly studied for the fourth. If the examination had ended here, I might’ve recovered faster. But, it didn’t. There were practicals to come. That is where I was hit REAL HARD.

I have a pattern. I guess it might be the same as everybody else, I don’t know. Flu starts with a unilateral sore throat and earache. There is a little bodyache but not something that instantly catches your attention. Soon the unilateral sore throat becomes bilateral. Next, runny nose sets in. Watering of eyes begins soon enough. This goes on for a few days. The sinuses start paining to add to the general discomfort, and there is a slight voice change. Ears get blocked to give you a compressive feeling. On day 3 or 4, the voice change is more apparent than ever. You start coughing a bit (but not expectorant, mind you. No use of those gargles, if you think they’re going to stop that expectoration from coming.). The nose gets blocked quite continuously, and watering eyes give you more problems than ever. Thereafter, that cough becomes expectorant (yes, the bacteria have decided to add to the colours of the ravishing part inside my respiratory tract :-P ) and fever sets in. The nasal discharge gets its purulent nature. Add on, there is a peculiar smell that comes. This smell to me, suggests that I need to start antibiotics immediately. Now, the voice totally goes. Problems arise in getting even a few words out. The fever makes a few visits here and there. With the effect of the antibiotics, the discharge stops, the cold decreases, the fever reduces. What stays is that cough and the voice change. I have been told that I quack like a duck. My dad has said that I sound like a broken gramophone record. This continues for 2-3 weeks. Gradually, the cough decreases, the sputum also reduces. The voice gets closer to normal. I strongly feel that the voice never really returns to normal. It just comes pretty close to it.

Going back to my second year problem, I had to give my practicals in that horrid voice. I couldn’t get words out. It was so bad that my mom finally took me to a doctor. She suggested that I immediately continue with the antibiotics and not talk at all. I had to spend a week at home, I think. I thought the degree of severity was related to my habit of saying things aloud while studying. I immediately decided to change my style of studying. I would say things in my mind or write down a few points. It took me months, but I managed to succeed in finally retaining what I had read and learnt without uttering a word.

Since then, I’ve fallen prey to the flu about twice a year. I usually start with antibiotics after 2-3- days. There is no use of giving prophylactic antibiotics in such a case. This time, maybe the trip to Kolhapur  was the precipitating factor. A day of travelling with the addition of a punctured tyre shook my immune system a bit. The Sunday following the trip, my aunts came to meet us. The preparations involved a lot of work. So there wasn’t any rest as such.

I’m in the initial phase of the secondary bacterial infection. I started with antibiotics yesterday. I don’t mind the flu. I’m pretty used to it by now. I mind the interruption of my studies and my project. I was feeling the urge to study. But, I’ll have to push that urge to Monday now. There is no way I can concentrate with the blocked sinuses and the on-off fever.

By the way, the reason for the trip to Kolhapur was that my brother got admission into the Government Medical College there. It was a shock to us, because the College usually is allotted to those whose ranks are between 700-800. My brother’s rank is 660 so we thought he would be going to Government Medical College, Solapur or Miraj. But, having made the trip to Kolhapur and seen the beautiful campus there, my brother decided that it was an awesome thing that he got this particular college. Since he is used to city life and its attractions, Kolhapur is a much better place for him than the other two cities. I wish all GMCs were like this one. It would make the first year of college very joyful and sweet J    

FREAKS

My wish for a smooth journey regarding the Ethics Committee certificate has been anything but heard. This journey actually has put into perspective every single notion I had about "for every good that happens, there is equal amount of bad". Because here, there has been bad, worse and worst.
As you already know, it started 3 days before my exams. I had to present my topic in front of an Ethics Committee, and they had a lot to say about it. Particularly, it was on gentleman from PSM, whom I took an instant dislike to. He wanted newly diagnosed cases. He felt there was nothing that could come out my project. Yet another gentleman wanted me to decide the severity of the disease using Glycosylated haemoglobin. I had enough trouble getting a simple Lipid Profile done. Where could I manage the Glycosylated Haemoglobin? Another issue was that I had already taken my cases. And I was NOT going to take new ones. A nagging thought during all this process was, "Why have they asked me to present my project any way? They never do it for the ICMR!" At that time I decided that I'd just listen to whatever they said and go back and study.
Part 2 of this saga began on Friday (30th June) when I was told that I needed to make the changes or I wouldn't get the certificate. I talked to a teacher on the Committee, told her that my project had been selected as it was, and I had already done most of the work. She told me to meet the HoD (although I wasn't aware that this guy had become the HoD. The previous HoD had been transferred which I did not know). This new HoD was on Medical Leave. I decided to go and try on Tuesday. When I found out that even on Tuesday, he was still on Medical Leave, I decided to go and let my Guide know what all had happened. He told me to give him a copy of my proposal and told me he'd talk to the concerned people and let me know. I felt that things would get into motion now.
Part 3 of the saga occurred today. I got a call from the Pharmac Department office. On going there, I was told that I had been asked to call the new HoD. The lady told me that he and my Guide had talked to each other, and now I was supposed to talk to him. When I did talk to him, I was shocked and shattered. With anger, frustration, depression and unhappiness. He had the following things to say:
1. Why did you present your topic if it was an ICMR one?
Sir, I was told by the lady in your office that I had to. I told her that I hadn't heard of this happening to anybody before. She told me she had been told to ask me to, and she was just passing on the message.
2. You should've objected then.
How could I, Sir? You are all Professors. I thought the whole Committee had looked into my project and decided that I needed to present it. How I refuse or even object to it? Wouldn't that have been rude?
3. You have already started your work, it seems.
Yes Sir, I got a Provisional Certificate before. So I started.
4. You got a certificate before the meeting? That is not right. It is illegal to get a certificate before the meeting gets through.
Sir, I had missed the previous date of your meeting. So I asked my Guide and even in the office here, and they said I could get such a certificate. And the previous HoD went through my proposal and then issued a certificate.
5. How can one person issue such a certificate on behalf of the whole committee without even talking to them?
I do not know that, Sir. Since he said that there was no problem with getting such a certificate, I started with the work as soon as I got it.
He laughs...."This is not right. I don't understand what lengths you people go to. Look I don't have a problem with your project, but Dr. R--- does. I just don't like that provisional certificate."
What should I do then, Sir? What should I do with the project and my cases?
He laughs again...I'll talk to your Guide and let you know.

I just can't understand how unlucky this project is. Every single step that I've taken has been wrought with trouble and complications. It is so amazing that a person like me can get involved in so many issues. This HoD knows my parents, has taught them in fact. In my second year, I went to him to get some advice on how to study for the PG Entrance exams....at that time he talked as if I had already started classes with him. I didn't go back again. Is that why he's creating these problems? Did I hurt his ego? And seriously, if the previous Head gave me a certificate, big deal!! Why can't he just not let this newfound 'I'm-the HoD' ego not create problems for students? And for heavens sake, the ICMR selected this project. The INDIAN COUNCIL OF MEDICAL RESEARCH. A body that controls and encourages research from all over the COUNTRY. If they did not have a problem, what problem do these people have? May be this HoD was right. I shouldn't have presented my project only. I'd have invited their anger at the beginning only and not had to go through all this drama.
FREAKS. All of them. FREAKS. 

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..    

When A Patient Said...

Outside of all the frustrations involved in being a Medical student in a GMC, what I really like about this profession, is the respect that certain patients give Doctors. Yes, times have changed. Today, Doctors are no longer considered Gods. Thanks to Mr. Amir Khan and his celebrated coverage of this field, we have managed to unearth some of the evils that are present all around us. That does diminish the nobleness of this field.
Having said that though, the smile on a patient's face after having gotten cured, is the greatest gift a doctor can ever get. Any doctor will vouch for this. And any doctor will tell you, that he strives to attain this very prize.
Yesterday, I took the case of an 86-yr old man. He has undergone a Below-Knee amputation, is not very oriented to his surroundings at times, suffers from Diabetes, has lost quite a bit of weight and overall is very weak. Yet, the smile on his face was evident. The happiness he had got after having undergone that surgery to remove his gangrenous foot, was shining on his face immensely.

"If I can have a sip of water from your hand, my life will be blessed."

As I normally do for all patients, I asked him how he was feeling now. Initially he was a little disoriented. he thought I was one of his relatives. When his daughter told him that I was a doctor, he took hold of my hand and thanked me for having gotten rid of his pain. He said, " If  I can have just a sip of water from your hand, my life will be blessed." Imagine this. An 85-yr old bed-ridden man, older than my grandfather, telling me (young enough to be his granddaughter, or even great-granddaughter) that his life would be blessed if I gave him some water! It should've been the other way round.
It is moments like this that make me realise that I want to do this so much. Yes, final year is horrible, the college sucks quite a bit, the profession is demanding, it is a long obstacle-laden journey. But, during this wonderful journey, there are going to be such moments...when somebody says something...somebody does something...it leaves such an impact. I know that those words are going to echo in my life for a long time. Those words were not meant for me. They were meant for the doctors who actually treated him. But, in a way, they were meant for me, as a doctor. Over the past months, I've struggled to find reasons to want to do all this, to want to still be in this field after my Internship get over in 2014. I've struggled to find love among all my subjects, desire to excel in them and the determination to do the hard work required. I've questioned my intentions a lot of times. When I heard those words though, I knew exactly why I liked this field; why I had taken it up.
I may not recommend the field with 100% gusto. But, I do know that there is a reason why I got into it. When I get into that real world (with the Designation of 'Doctor'), I know exactly what I'm going to strive for. It is that smile and that hope that somewhere some patient of mine will be satisfied enough to say the same thing to another Medical student and show him the light to the path that he was looking for :-)