Search here

Translate

Follow by Email

Monday, April 28, 2014

O! What has happened of Men!

(This article features in GOSUMAG 2013)

      If you call the 2nd year MBBS a honeymoon, call the final year a hell. The final MBBS exam, especially, is a living hell – an apt punishment for all our karmas – past, present and even the future! The dying declaration is considered to be the most truthful and as I write suffering these insufferable sulphurous fires of hell, what I say is nothing but the truth.
      Look back, just five years ago, how happy we were! Young, vibrant and enthusiastic! We were still ‘humans’, with social lives that could be measured on a Richter scale. Five years hence, we are now ‘zombies’! No pain, no emotion, no exhaustion! No sleep, no hunger, and more importantly, no joy. Generalized anhedonia now defines us.
      Is it so difficult, passing an exam? Aren’t we the cream of the intellects? Having cleared exam after exam, fortnight after fortnight, with an effort no more than required to slice a knife through a piece of butter, seasoned campaigners hardened by the toils of war. Innumerable times we’ve heard, “If you can clear this exam, you can clear any other!” However, at this time it seems more of a taunt and less of a consolation.
We have read, we have learned, we have understood, we have practiced and even rotted and mugged, but since the past few days the mind only draws a blank. All that has been constructed has just disappeared. Even when we read our revision notes, it seems something new. There is no déjà vu! It is said that one should sleep well before the exams so that one is relaxed and the mind can work at its optimum. But we’re just maniacs now, sans the excitement and the happiness that is.

Every morning we look in the mirror, and feel just that bit more ashamed. Somewhere, in another parallel universe, is another version of us, who is better, who has continued to travel on the upward trajectory, a path from which we have long deviated and fallen.
Once in school, a teacher gave me a mark less and I cried. Today they say – I will pass you because the examiner who will take your exam six months later will not!
Is this good? No. Because, we deserve better. The world deserves better. We do injustice to our capabilities, to our talents, to our capacities, the hopes that people – parents, friends and teachers – place in us. Usually, when greats retire, the fans feel saddened and it appears that the void will never fill. None of these accolades will ever come our way, though. We are way past our greatness!
Yet, we no longer feel disgraced. It hurts, but not that much. The more you think, the more immune you become. It is the oxygen in our lungs, the blood in our veins and the bile in our tummy. A Professor calls it shamelessness, I prefer the term complacency. As bad as it may sound, it is the antidote to our stresses, a necessary evil.
O! What has happened of men!

Saturday, April 19, 2014

Ek Bottle Khun Ka, Kaam Mera Roj Ka!

"Kitna khun nikaloge ?" They ask.
In the earlier days of my internship, I would explain then, how much and for what. But in the due course, I realized, that not all good intentions are always reciprocated. That time and trolley, waits for no intern! That the Registrar is not interested in whether you were counselling the patient. That the patient's well being is decided by timely blood reports and not by whether you answered all his queries.

Then again, it is the human body. It comes with its daily quota of physical and emotional and mental stamina. And all that can't be drained off within the first 2 hours of the day. So, we all mature with time.

"Kitna khun nikaloge?" they ask.
"Roj nikalenge!" I answer, the soldier hardened by a year of war. This is a good answer. It keeps most of them quiet for the entirety of their ward stay. It's diplomatic as well. Man, am I good diplomat! You sort of don't answer the question, but still give a satisfactory answer.

Then again, there are those days, when your mechanisms fail. Those are called the post-emerge days. Post-emerge, post-emergency for those of you who may be interested in knowing the full forms of our medical lingo, is the day that comes once or twice in a week, when you have an emergency the previous day. An emergency is defined as a day, when you manage actual medical emergencies, and not those that your acquaintances call you up in the middle of the night for, like cough, cold and its cousins.

The beauty of a post-emerge is that, most of the times you would not have slept for about 20-22 hours at a stretch, some lucky sons of guns go on for 40-44 hours and then its day dawn for your post-emerge. So maybe, about 5-8 more hours before you can fall dead. You basically work at a spinal level as most of your higher facilities start shutting shop and dissociating from each other.

"Kitna khun nikaloge?" they ask.
"Aadha aaj nikalenge aur aadha kal!" a post-emerge me answers.
My friend (who's hooked on to weed) and I were once discussing life in general. He said he did weed, because it sent him to another world. I described to him my feelings post-emerge. He said, if only he could get such a kick! Sleep deprivation causes dis-inhibition, to be short and sweet.

In my disinhibited state, I loose my diplomacy, and as is the fervor this election season, say something detrimental, but it won't get me any votes. Definitely, if someone told me that he would take away half of my blood today and the remaining half the next day, I would run away. But sometimes, things become such a daily routine for you that you forget that they mean drastically different for others.

"Par kal bhi to liya tha. Aur isko khun kitna kaam hai!" The mother adds in. "Khun banta hi nahi iske sharir me."
"Haath seedha karo aur muthhi tight karo. Hilna mat, ek baar me nikalne ka hai, aur bahoot nikalne ka hai" say I with a smile, as I flash him a 20cc syringe, made famous by those funny scenes in the yesteryears' bollywood movies as "Haathi ka Injection". I think it may be the shock of such a huge thing penetrating their bodies or something, but they don't say anything after that. Except for the one occasion, of course, when the mother actually pulled me away when I barely had collected 5 cc screaming "Bas karo!"

"Aur isko khun kitna kaam hai!" The mother adds in. "Khun banta hi nahi iske sharir me."
"Khun chadhana hai" I answer, "is liye tapas bhej rahe hai."
"Roj ka 5-5 bottle khun nikaal nikkal ke khun khatam kar diya, abhi ek bottle chadhyenge!"
"Khun chadhana hai ki nahi?" I ask. The basic tenet of medicine is that the patient decides his course of treatment. I leave the choice to them, therefore.

My friend had an interesting encounter once, on her post-emerge day. The relative proclaimed, " I know there is syndicate here. You collect all our blood everyday ....... And sell it to the blood bank. Then you tell us to go and get a bottle of blood from them! I am going to complain to Aamir Khan."

Aamir Khan, is the de-facto highest medical authority in India, btw!

"No, I am hungry and blood is tasty and I drink all of it! " She said, in her intoxicated state.

"Khun chadhana hai ki nahi?" I ask.
"Par kal bhi chadhaya tha. "
"Kal ka report aaj nahi chalta. Khun chadhane ke liye, blood group check karna padta hai."
"To kya blood group change ho jaata hai?'
Valid question. But, there are safety mechanisms and legalities. I would have loved to explain in details to her, but for the lack of time.
She continued," Aap bolo unko, khun kam hai, aise hi dusra bottle de do."
"I don't want to go to jail. There are rules!"
"Aise kaise rules banate ho aap log?"
"Khun chadhana hai ki nahi?" I ask. The silence that follows, is an implied consent.

"Yaa Allah! Ye kya marj hai!" she shouted, as I pricked her.
"Chachi, aap ki liver pe sujaan aa gayi hai."
"Wo mujhe pata hai" she said, " Tumhe kya marj hai? Aise suiyaan chubhate rehte ho."
"Aap ke liye hi kar rahe hai." I couldn't think of anything else.

Monday, 21st April, 2014, will be the last day of my internship. For all the foreseeable future, blood collections (majority of them) will be someone else's responsibility. That poor soul will be my intern! And O! Shall I grin, from ear to ear!

What is it, that makes such an innocuous procedure seem such a hardship to the patients?
Is it fear? Fear psychosis..... Internship has been of 365 days, and it has been 365 faces of fear psychosis! Some of them our own faces, majority those of the patients.

There were days when our hands trembled, for we feared, we may hurt the patients...... There were times, our hands trembled for the fear we may hurt ourselves. There were times we dreaded contracting a deadly disease from a patient, there are times when we think and only think about the uncertainty of the future.

Why does it occur?
Is it because, we are afraid of what we do not know?

All-in-all, anxiety and uncertainty and immature psychological defense mechanism of transference makes life hell for us. Knowledge can be empowering...... but not always! Knowledge can be dissipated, but not always. There are prejudices, beliefs and misunderstandings that, do us all in.

We all face them, though, in whatever way we can. Arguing with an intern, perhaps, because somewhere in a dark corner of your mind, the brain has equated a blood collection with a disease, which has affected you, of which you are suffering, of which you know little, which has changed your priorities....... and of course, you do not know, if it will take you to the grave.

 My friend (who's hooked on to weed) and I were once discussing life in general. And he said, he did weed, cause it helped him think about things in a way, he wouldn't have otherwise.

Medicine, has made me think about things in a way, I wouldn't have otherwise.

There is a diabetic admitted in my ward. We want his fasting blood sugar levels, but he always eats something before I come.
"Monday morning komai nahi aaunga tab tak kuch mat khilana!" I instructed as I prepared to leave.
"Par Sir, ye bahut weak hai! 2 din bhookha kaise rahega?"

At some point in the future, I do see myself becoming a resident medical officer. More responsibilities, more complex procedures and definitely more food for.... sorry weed for thought!

Thank you, my dear patients for a small trailer of the bigger picture to come.

Another friend of mine, did a blood collection, and handed over the bottle to the husband saying, " Isko hilao!"
She blinked, and the fellow had uncapped the bottle and was just about to feed the sample to his wife.
"Array! Ye kya kar rahe ho?" She exclaimed, in shock and surprise.
"Aap hi ne t bola, Isko PILAO!"