Shouldn’t You Know That ?

 

One unintended consequence of becoming a doctor is now apparent–everyone assumes you should know everything there is to know about the human body, from head to toe. Hell, the last Iattended a biochemistry class was more than a decade ago and I had to defend my right not to know an answer to a question from my badminton mate:

Mate: Why are you supposed to work out in the morning?
Me (bullshitting): Hmm. Maybe because your glycogen levels are high in the early morning, so your body will be forced to use its fat reserves first?
Mate: Really? Because I would think that…
Me: Okay, okay, I have no idea.
Mate: Shouldn’t you know that? Aren’t you a doctor?
Me: I don’t know! I’m not a dietician!

But I’m guilty of it, too. I’ve said the exact same thing to my dad (an Orthopaedician) on numerous occasions.

Me (pubescent teenager): Dad, why does it hurt when I go like this?
Dad: I don’t know. Don’t go like that.
Me (scathing, bratty, “God, my parents are so dumb”): Shouldn’t you know that? Aren’t you a doctor?

So now the tables are turned. But the thing is, I kinda feel like, “Yeah, I should know that,” although I don’t understand many things well enough yet to integrate all my knowledge. I mean, yeah, I guess I’m supposed to know everything, but… everything? That’s… kind of a lot isn’t it …..?? 

A night that day

The ultrasonic black and white images of the living foetus flashed in front of Ali’s eyes on his laptop screen. Nothing made sense to him but Ali had been here once before and he knew in a few days these images would be transformed to life. Inspite of this, being his second time coming he was tense and restless…

Ali is a NRI based in  Dubai and works for one of the leading banks  in the region. Global economic recession had hit the bank very hard and he knew taking leave to be with his wife would put his job at great risk. Ali really wanted to be with his wife and daughter at that special moment. The risk was taken and as all Gulf malayalees say- ‘hop skip n jump and you reach your backyard !! ‘, Ali reached his hometown, a place where he thought the MTV culture and the gizmos of the modern world had not yet polluted the system. Ali was soon to be mistaken.

Ali was brought up in a traditional joint family with conservative Muslim ideologies. Although his  wife Shehana had fuelled doubts about this ‘joint family’ system , the birth of their daughter Tasneem 2 years ago laid all fears to rest. Now Ali was part of a big happy family all waiting for the new arrival.

Sept 7^th was given as the due date by some sort of ‘magical’ calculation which had worked for the family the last time around. Promptly 2 days before that day Ali and his ‘big happy ‘ family found themselves waiting for Dr Shiny Jacob outside her OP room. A quick examination following which a smiling Dr Shiny instructed Shehana to get admitted and once she gets the labour pains she would be taken to the Labour Room. As the previous delivery was nomal she informed them that the chances are high for the same this time around too.

The very next day immediately after breakfast Shehana developed labour pains and she was shifted to the Labour Room. Ali and his family walked beside the stretcher giving comforting words to the mother. As they reached the Labour Room Ali lifted Tasneem and the child lunged forward towards her mother and gave her a kiss on her cheek. Ali held her back. The double doors of the Labour Room opened and Tasneem’s mother was rolled into the dakness of the Labour Room

Sitting on the cold metallic benches outside the Labour Room Ali thought the wait would never end. Ali looked at Tasneem who was holding on to her teddy bear. The child asked her Father “ Papa were you more tensed than now when I was inside Mummy’s tummy? “. Ali smiled at her and was thankfully saved of the embaressment of having to answer the question when the double doors flew open and a Nurse came out holding the new born baby!!

The family rejoiced at the birth of a baby girl. Dr Shiny confirmed that Shehana had a full term normal delivery. Tasneem now had a little 'vava' (children are fondly referred as vava in Malayalam) to play with her, and her teddy bear. Both Mother and baby was later shifted to Room No 212 where they were advised 2 days rest before they could get discharged.  The next 2 days were filled with well wishers .. both near n dear ones who came to see the mother and child. For Ali this was uncomfortable as he knew Shehana too would not be pleased to keep smiling at the never ending crowd. The same answers to the same questions. Ali even thought of giving a Press Release ….and handing it out to their relatives !!  So, Dr Shiny telling them on the 2^nd post delivery day that they could go home later that evening  , was of great relief to the couple.

 Tasneem though was liking the crowd. Her Uncles and Aunties took turns in playing with her. They even took her many a times around the hospital. Tasneem loved going to the hospital canteen and sitting on the metallic chairs with her teddybear beside her. Buboo the teddybear was Tasneem’s companion. Wherever Tasneem went Buboo would be taken along.

Ali after clearing the hospital bills came to the room to find Shehana still talking to his parents and his in- laws. Ali raised his voice marginally and told them to get the mother ready and finish packing all their stuff.  The ‘experienced’ mothers held on to the ‘new’ mother and walked her down the stairs . Shehana’s sister was holding the baby. Tasneem walked down the stairs and when she was passing the canteen she suddenly remembered Buboo wasn’t with her. She looked around to see if any of her grand parents were holding Buboo. She wriggled her small fingers slowly out of her Aunty’s  grip and stood still. If only her Aunty had realized what the little girl was going to do….

 Two cars were waiting for the family… parked in the car porch of the hospital. The doors were opened and the family with all the mothers got in . Ali’s phone rang. It was his childhood friend and the now local MLA of that constituency  Mr Abdul Majid.  Although Ali’s NRI status had drifted them apart now the birth of his daughter , was a reason for the school mates to come together  that evening to celebrate. The engines were started and the cars sped of leaving Tasneem and Buboo behind in the hospital ..!!!

The girl had found her missing teddybear sitting on a canteen chair. The change over of the staff was 5 mins before. Tasneem could not recognize any faces there. She slowly got out the canteen and started going up to Room 212. Night shift had just started and the staff were busy with the hand-over of duties. No one noticed the small girl walking alone through the hospital corridors..

Tasneem reached 212. She was familiar with the hospital by now. She opened the door, expecting her mother and the rest of the family. But she found different people in her mother’s room.  She was a little surprised but thought they could stay in the room  till her mother comes back. All the eyes in the room were on Tasneem now. The pregnant lady who had just got admitted had the same big belly as her own mother. 

She went close to her and said, “ My mom also had the same belly like yours. Don’t worry, the doctor aunty will come and get the vava  out of your belly and give it to you.” All of them laughed good heartedly, instantly liking the little kid’s innocence.

Then Tasneem said, “ You can stay here till my mother comes. I’ll go and get her.” People in the room did not give so much importance to the fact that a little girl was alone in the hospital, unattended. They just believed her mother and family were in the next room.

Tasneem left the room and started wandering around the hospital, looking for her mother…

A big white SUV was parked outside Ali’s house. The childhood friends embraced each other. The warmness of the reception was interrupted by Shehana’s scream. The family had just discovered Tasneem was missing.

Back in the hospital Tasneem had got herself seated in the metallic chairs outside the Labour Room. Bubbo was sitting on her lap. The little one was waiting for her mother while a family next to her was expecting their ‘new’ little one. Soon the double doors opened and Tasneem saw the Nurse coming out holding a ‘vava’. The family rushed towards the double doors and surrounded the Nurse and the ‘vava’. Tasneem wriggled through their legs and reached the Nurse.She looked up and instantly realized it wasn’t her ‘vava’. Disappointed, yet not ready to give in she slowly slid in between the double doors and the Nurse and Tasneem had now entered the Labour Room .

The Telephone Operator at the Hospital was quickly loosing her patience trying to explain to the parents that she had no idea about the missing child. Angered by this lukewarm response Abdul Majid told the parents to get into the car and quickly reach the hospital. The politician got into his SUV and told his driver to follow Ali’s car. Abdul Majid was a shrewd politician and he knew how to play his cards well. He had over a short duration quickly climbed up the power  ladder of the Communist Party with cleverly planned tactical moves. The Comrade scrolled down the contact list of his mobile phone and dialed Dr Basheer  who was the owner of the Hospital. What started as an exchange of pleasantries soon got a bit rough when Abdul Majid reminded the Doctor of the donation to the Party Fund which the Doctor had blantantly refused many a times before. Abdul Majid’s tone changed and he warned the Doctor of the consequences of not paying up and also informed the Doctor of the ‘missing child’ episode at his hospital. The Doctor hung up on the Politician. The shrewd politician followed this up with several anonymous calls to the local newspaper and TV stations – the message loud yet simple- ‘ A child goes missing at a local hospital and preliminary doubt being the 3 year old girl might have fallen into some uncovered drainage hole in the hospital premises. Search is still goin on … !!!!! ’

Tasneem peeped into the Labour suite. She saw a lady lying on a table with her legs spread out in front of her and various ladies wearing green caps and masks busy doing something which the little girl didn’t understand. She walked down the passage and entered the next room which was bigger but empty. She went in and sat down leaning against a table and soon dozed of. Little did the girl realize this is where operations are conducted – The Operation Theatre.

The crowd outside the hospital was growing. The search continued. The mother was wailing in front of the camera crew of a local TV station. The Administrative Officer had given a statement to the effect that the Hospital authorities were doing all to search for the child. The crowd was getting restless.  The local police force made their presence felt in the hospital. Sections of the crowd were getting verbal with the police force as they tried to get into the Hospital. It was just a matter of time before the legal machinery would break down. The sound of the window panes breaking with someone throwing a stone was the signal for the mob to barge into the hospital. The crowd was running amok. They stormed into the patients room shouting abuses, throwing the patients belongings , pushing the relatives and in some cases causing harm to the patients itself. The hospital furniture in the lobby was completely disfigured. Complete chaos prevailed…. Patients started running out of their rooms in fear, the hospital staff fled, the Doctors ran for their safety.  The legal machinery had failed miserably and the hospital was being taken down minute by minute…. !!! Pictures of this assault were being aired on a few local cable channels.

In the middle of all this everyone forgot about Tasneem. Most of them never even knew whom they were looking for let alone did they know how the girl looked like…yet they continued to bring down the hospital.

Tasneem woke up from her sleep and she realised Buboo wasn’t with her. She got up made her way out of the OT, walked down the passage to the double doors and came out of the Labour Room. Bubbo was lying on the floor next to the metallic chairs. Tasneem picked up Buboo went towards the stairs and climbed down. There was commotion all over the place. In all this turmoil the little kid was unperturbed and she ran towards Room No 212. Shehana her mother was standing there outside the room. People were running all over the place .The mother ran towards the child and hugged her. She picked her up and with Tasneem holding onto Bubbo they all fled down. Ali saw them coming and ran towards them and shouted at them to run towards their car. They started the car when Ali’s phone rang .Abdul Majid had called to enquire if Tasneem was fine and also told Ali to leave for home while he would take care of the mess here. A relieved family drove home.

Abdul Majid went to his dialed list and dialed Dr Basheer. He spoke with a heavy tone.

“ I now need triple the amount I had asked you earlier and don’t worry about the news being leaked to the media. I will make sure no media network will bring out this news tomorrow. You just make sure the money reaches me before midnight.”

The Doctor’s feeble voice replied” Abdul Majid  Sir, please message me your account number………”

A story from the land with the maximum number of per capita hospital mob attacks in the world   !!!!

A glimpse into our Anatomy Dissection Hall

Let laughter flee

  Let conversation cease

  This is the place where

  The dead delights in helping the living 

A day in my life when i was a third year medical student...

6:30am

Wake up and lie awake in bed.

6:31

Realise you spent Rs 300 on last night's dinner, means no eating for the next 6 days.

6:32

Hit snooze button. Go back to sleep.

7:00

Wake up suddenly with heart in mouth when you realize you didn't hit the snooze button--you turned it off.

7:01

Fall asleep again.

7:44

Wake up with heart in mouth again.

7:45

Ready to go to Hospital, will shave tommorrow, will eat early brunch at  Suresh Anna’s canteen

8:03

Arrive at Hospital
Realize your Professor arrived earlier today, must have got more work done.

8:04

Pass by HOD’s office, chat with his Secretary to find out if he is coming in today. He is, darn. Need to start work on the presentation  due this afternoon.

8:15

Read Bombay Times

8:20

Crumple up the paper. Throw it into the waste basket. Imagine you are Michael Jordan while throwing it. Alas … it falls out……..
Hate your self.
Depression: When will I become a Page 3 celebrity….??????

9:00

For jumpstart: go to coffee machine.

9:05

Kick coffee machine; promise yourself to call up the company and ask for your money back. Plan of sueing the company.Wonder why they would believe you. Enjoy the black coffee. Paisa vasool …..

9:33    Go to Library

9 37     Take the smallest textbook of the Surgery section and start reading.

9:41

Early morning stupefaction. Mutter racist comments to yourself about your studious colleague sitting next to you who is seriously reading the Davidson.

9:43

Curse your colleague in a low tone he would not comprehend. Feel good about him not grasping English well.

9:58    Ask your colleague a doubt about cystic hygroma in such a way that he          

           feels I am doing some research on that. ( I found that word by looking   

          through the  index of the textbook…..Thank God for the index ..!!!!!! )

  

10:19  Feel proud of my achievements in making him tensed. He closes his Davidson and goes to the Surgery section and takes a Bailey and goes to another place far away from me. Mission accomplished ..                    

10:31 Feel sleepy, should not have stayed late playing tetris last night.

momentary panic attack!!!!!!!!!!!! Presentation ……!!!!!! HOD needs a draft by afternoon.

10:32

          Tachycardia

10 33

           Sinus rhythm

10:59

Drop in at HOD’s office and borrow something you don't need and kinda make him aware you are working hard on your presentation

11:05

Perverted daydreams

11:11

Go to Suresh  Anna ‘s canteen and have a cutting chai.
Mid-morning yawn time

11:34

Go to Surgery  Department Library and start writing notes with a Bailey in front of you to pretend you are working hard as your HOD  passes by from outside.

11:35

Scratch out what you have written , tear the page in digust .Realise you have just 3 more blank pages in your notebook.(No money to buy a new notebook so stop tearing George….)

11:41

Flirt with the new secretary in the department.

11:45

Print out some slides for afternoon's draft + presentation.

11:47

Print them again, you forgot to change the date from last presentation.

11:49

Print another copy in case this one gets lost.

11:51

Completely forget about suing the coffee-machine company.

12:15

Hunger pangs:

12:20

3 vada paavs and a cutting chai…. Plenty of water .Lunch over.

1:00  

            Group Meeting with HOD

1:14

Sudden awareness of one's shallowness, resentment towards your behaviour towards your colleague in the library. Get reminded by your HOD that you need to do some more work for your literature review.

1:51

HOD hands you the reddened copy of your draft for corrections.

1:51:02

The 49 second urge to murder HOD begins!!

1:51:52

Realize that he controls your internals which will affect your University exams which will affect your life.

1:52:53

Thank him.

1:52:54

Thank yourself for not saying something stupid to and/or killing your HOD.

1:53:00

Splitting headache #1

1:59

Go to canteen. Check India Pakistan cricket match. India wins toss. Elects to bat.

2:06

More cutting chai

2:17

Oh No, it is my turn to cook tonight :-(

2:30

Sit through the afternoon lecture on Ca Testes.

2:39

Look outside the window make unrealistic plans to quit this degree  and take up a job. Wonder why Sindhi girls are so pretty.???

2:48

More perverted day-dreams. Pathology of Ca Testes is being taught.

3:06

Worry about never graduating.
Time to write a letter to Papa and Mummy….. No ..no time for that.

Wonder what must be going on with the match..

3:43

Watch the clock.
Make plans to do a all-nighter tonight. Vow to watch only Last 10 overs of both sides.

3:55   

          Sudden commotion in the class. Realise lecture is over. Give roll call. Give      proxies for friends..

3:58:01

Sudden sense of freedom.
Go home .Quickly check the score. Promise to see just one over. Land up seeing entire Indian innings.( IND : 245 /4)

6:00 pm

             Start reading Ca Testes from Bailey.

6:15 

               Dull aching sensation in groin region. Start wondering whether its Ca testes

6:31

The hard working grad student you are, you have to come to the hospital library late at night to "get the work done".

7 

            Go to canteen to check the score.(Pak 30/2 8.2 overs)

Suddenly realize you need references for presentation. Realize its too late today to go to the library. Sudden feeling of having wasted the day.No point in studying now. Continue watching the match

9:43

             India lost the match

             Sudden feeling of possibly having to waste the night. Decide to turn in    early and       come back very early tommorrow morning. Decide to play a Tetris on the Nokia to put yourself in a good mood.

10:05 

               Dinner at canteen. Tell Suresh Anna  to calculate total dues.(He has being doing that for past 2 weeks). Remind him also of the possibility that the dues will be cleared tomorrow.

10 18

           Reach home.

Play game after game after game to improve your score and get on the scoreboard. Realize that Kunal is still at number 6, two notches above you on the scoreboard.

11:20

Play until you beat  Kunal into the 7th place. A sense of achievement!! Yes, today was not wasted!! Find Kunal watching the highlights of the Ind- Pak match. Tell him about the "hard working grad student day you had". Discuss philosophy with roommate. Tell him what a waste of time it is to be watching cricket that too highlights of a match you know we lost.

00:09 

            Kunal tells me to mind my own business.

00:16 

            Think about becoming a philosopher Discuss with Kunal whether India                      should have actually fielded first .Discuss the role of the 5^th bowler.

00:49

Realize neither of you have bought milk today. Get reminded of the "too much milk problem".

1:04

 

Forget about getting up early.Set the mobile alarm clock to 6 am. Turn the mobile ringer off and go to sleep. Good night world …!!!!!!!

My white coat

I sometimes think what it is about the white coat, but whenever I put it on and go to see my patients it somehow brings out their innermost thoughts, emotions, fears, and desires. Patients are suddenly willing to share all of these personal aspects of their lives with me, a complete stranger to them in every sense of the word. If I was slightly less tired now (morning OP had close to 75 patients..!! ), had a bit more of those grey strands of ‘wisdom’ hair , I would probably have dealt with this topic on a more philosophical ground and emphasized on the importance of this cotton attire and how this forms an incredible  aspect of our health care industry. Instead, I'd like to share with you all an experience or let me use the word a ‘phenomenon’ that occurred in my life due to the presence of this white coat of mine. Being a not so enterprising medical student I would rarely be seen in the wards after college hours. Either a cute intern or an even cuter post graduate would have mostly been the reason for me to stray back to the wards during that evening. The Rajawadi Hospital, Ghatkopar  where I did my training from, wears a spooky and eerie look in the evenings, especially just before the Mausi’s (hindi word for aunty by which the ancillary staff of the hospital are fondly addressed by) switch on the ward lights. I entered the female medical ward wearing my almost brown white coat and walked in between the various rows of beds towards the nursing station. As most of the patients were getting ready to take a bath  (hot water was available only for an hour in the evenings) I could see a lot of empty beds. A couple of beds away from me I saw an an old lady getting up from her bed. I immediately sensed she was in some sort of distress. I was not sure of what was wrong with her and I quickened my pace of walking. As I reached her she was gasping for breath. In between her deep inspirations she was repeating ‘Hare Ram Hare Krishna’ continuously. I held on to her with one hand and with the other I started to feel her pulse. Her pulse was galloping and I knew with whatever little knowledge a 3^rd year  medical student had that the lady needed emergency medical intervention. I shouted for the staff. She held my hand which was feeling her galloping pulse and looked at me. I could see she was in severe respiratory distress and she was sweating profusely. She was collapsing …  and that too in my arms . I screamed for the staff to come for my help. We helped her onto the trolley and wheeled her into the ICU. Throughout the journey from the ward to the ICU she didn’t leave my hand and it was in the corridor between the ward and the ICU that I had this really awkward yet beautiful conversation with this lady. Two strangers having met for the first time…  What follows is the english translation of that hindi conversation, as close to verbatim as I can remember:
Old Lady: Thank you, Son for helping me. Hare Ram..(Gasping for air)                      
Me: Oh no problem just relax. You wil be fine.
Old Lady: Son, will you do me a favour.
Me : Uhh.. OK.
Me: [About to launch into a "You're doing great!" pep talk]
Old Lady: I know I am going to die soon Son…anyways, Hare Ram ..I have donated my body to your anatomy department and I wanted to meet one of you medical students while I was still alive.(Gasping for air)
Me: [mouth gaping]

I felt her grip on my hand tightening.
Old Lady: Ya, I wanted to meet one of you while I was still alive and before you all cut me open and poked at my body when I'm a corpse. [Points to her noticeably frail and wrinkled body] My husband signed up for it too. So remember there was a nice old lady once before you all cut me up.

I was like…., what the hell am I supposed to say to that?

The double doors of the ICU flung open, her grip loosened and she was wheeled into the ICU…..

On an awkward scale of 1-10, with 1 being the least awkward (me proposing to a girl)and 10 being the most awkward (a girl proposing to me), I'd have to put this at least at a 6 or 7. It is almost necessary to spend considerable amount of time in first year of medical college forgetting that cadavers were once human beings, leave alone human beings that talked and that I'd ever meet, in order to do what we had to do to them. Basically, as she was speaking, I had images of my cadaver opening his eyes and trying to tell me where and how he had met me when he was alive . I realize this sounds really awful, but I guess this is something you can only understand after spending a year cutting open a dead body which was alive at one point of time.
Since I am no expert at these things anyways, never intend to be also…perhaps you'd like to fill in what you would have said in response to that old lady if you were me, and make a note of this in the comments section.

(The old lady died early next morning and I am still waiting to meet her in some medical college soon……)

Life in Medical College

There have been many challenges along my journey through medical college.

One major hiccup throughout the agenda at college was my very different perspective about being a doctor. There are a lot of stereotypes that still exist within the walls of our age old medical profession. This is also a challenging aspect of attending this institution.

One of the greatest challenges I have met throughout college was facing all the

stereotypes that still exist in peoples minds. For example, many students, teachers make

generalized comments that hit close to home i.e. involve people in my family, or about

my life experience. Through this though, I have learned that I can maybe help people

open up their minds a bit more to see beyond things and to realize that people and the

situations they are living in are not so black and white.

Throughout medical college, I have learned a lot about myself. I have learned that

I won’t compromise who I am and where I have come from to be like everybody else. I

think God has led me down this path and it has truly been a path of self-awareness

and self-growth.

One of the biggest surprises about medical college has been all the opportunities

and the doors that open before you. There are so many resources to access if you only

show an interest. My academic career in medicine has brought me all over the world!

For example, there are many conferences and educational opportunities available and

people are often willing to share their knowledge. I didn’t realize just how much of a life commitment this truly is and how it really becomes your lifestyle. This isn’t really a problem when it is your passion, but I do think it is important to share this knowledge with people who show an interest in medicine as a career.

There is one main reason why I chose to come to medical college and that is for

the people. For as long as I can remember, I have always wanted to help people. I

thought that if God gave the gift of knowledge and learning to me, then maybe I

should use those gifts to the benefit of others. There are a lot of people in the world who

people forget, push away, and many who get lost in the shuffle of life – these are the

people who I strive to work with and be a part of their life. Being a doctor is a special gift

– it allows you into people lives in a way that many people won’t ever experience.

My advice to students is that you can do anything you put your mind to – you just have to try and work at it. Another big thing is to reach out for support and information. There is a lot of information available, but sometimes it’s not right out in the open. Also, there are students who have gone before you and can help answer questions and also to be supportive in the journey. One other important thing is to be yourself and to always be honest.

This journey is sometimes a tiring and exhaustive trek, there are many obstacles, and you often feel like a fish out of water. However, it is also important for students to know that they are never alone in their endeavors. After all it takes a lot of ‘patience’ (patients) to make a good doctor.

I wish each and every one of you the very best in your journeys of life and welcome you all to my Medical Odyssey…….

Sunshines to all !!!   

Kochi (Queen of the Arabian Sea)

Jan 2010