EXPERIENCE AS AN INTERN

EXPERIENCE AS AN INTERN

 

 

Being a child, I was always afraid of doctors. They always seemed like a demon with a sword ready to pierce me through. But the reality would be just a simple man, wearing a bright white coat and standing right in front of me with a 2cc syringe. I never thought of them as a demon because of their deeds but the fact that they had a needle in their handmade my imagination go crazy. After all, I was just a normal kid waiting in the queue to get my routine vaccines and also watching every kid come out of the doctor’s cabin crying their lungs out, made my heart skip a beat. Those were the days when I had sworn to never get close to a doctor and here I am today, standing in a bright white coat, with a Littmann around my neck, entering my OPD for the very first time as an INTERN!

 

Every senior doctor will tell you that these twelve months of your life will help you decide your future course and with no surprise, it did help me understand what I really wanted in life.

 

So I started my internship with the department of community medicine. Little did I know that this would be the time when I would learn the most. Yes, it was this period of two months that taught me the most valuable lesson of my life – humanity. I can still remember my first day and my very first patient. She was a 70years old granny, a known diabetic as well as a hypertensive for the past 20years, came for her routine checkup. Her name was Mrs. Lakshmi. I clearly remember her peculiar voice and her interest in her medicines. She was an active woman with all the knowledge about her drugs as well as her doctors. She very well knew about the system of our department. She was aware that every two months the PHC would have a new batch of doctors, which is why she made sure her new doctor thoroughly went through her history and did n’t mess up with her medicines. This was something rare for an uneducated lady to do and also the reason why I remembered her so well. She made me nervous, as I was a beginner. I did not want to fail in any circumstances. Later, after reading her records, I handed her the prescription with my name and initials signed on it. She smiled with gratitude, with a blessing in return. That was the moment which made me realize that my journey had now begun. I spent two months traveling to various villages, set out camps, provided health education, distributed free drugs to those who need it. And that’s when I learnt that there are endless people who need medical help and also people who are unaware of their illnesses needed  education and our duty is not just to sit within four walls and sign off prescriptions, our duty includes to stretch a hand of humanity towards those who are suffering and bring them to a better world and at least try to give them a better life to live . I learned, we doctors, are the ray of hope they were in search of.

 

After completing a posting filled with mixed emotions, I entered the world of surgeons. General surgery was my next department, where I saw myself turning into the imaginary demon I was once afraid of as a kid. Every procedure I did, every step I took, involved my patient under a scalpel. My hands were shaking as I assisted my professor for my first surgery. I was all decked up and a tad bit excited to read my name on the surgeon’s walls for the scheduled surgery. But, the first time I had to bury my gloved hands into someone’s wound made me obnoxious. I felt miserable for the patient. Had just one question throughout my surgery, “God, why must a human suffer so much ?” I could barely concentrate on what was going on. I had a sigh of relief once we closed up. Happy for the patient who had made it, but still a thought in the back of my mind – what if he wouldn’t have?

 

As days passed, my hands stopped shaking and my thoughts started diminishing. I started emphasizing learning how to save a life. There were no options apart from reading those huge books which would weigh more than a sack of rice and to practice the art of butchering. While I was a student, I would often hear doctors being referred to as a butcher. I used to get offended. But today, while I stand wrapped in my gown, with my patient completely sedated, lying down with his fate in my hands, I don’t feel less like a butcher. The only difference is we save lives.

 

Weeks after weeks, I started feeling strong and confident in what I did. The feeling of helping people cure their illnesses started growing on me. It was a magical land where drugs would do the magic and a surgery would cut the illness totally where and when required. I shifted from general surgery to orthopedics, and then kept moving to other departments as in the routine, and I could feel the magic of a scalpel until I entered the department of obstetrics and gynecology. Being in gynecology didn’t make me feel any different from being in any other surgical department. But what changed my complete mindset was the department of obstetrics.

 

My first few hours in obstetrics gave me a panic attack. I was in shock to see patients screaming in pain. I took a minute to see all around the department and realized this is something beyond the magic of a scalpel. I can’t help the ones crying for help. I just can not sedate them and cut them open to cure them. I felt very helpless. All I could do was console each and every mother and wait with them for the birth of their precious ones. I could see them struggling for hours together. And their struggle taught me to tranquilize my temper and be patient. After all, it was I, who could cheer them up and regain their confidence in the process they were going through. I could not wait to deliver a baby, but at the same time, I could not rush at any given cost.

Alas, it was time to conduct my first delivery. It was something I had to do without a scalpel. My hands had to be steady but tender. This time I was not about to cut an odious part of her body, but bring out the little one who has been growing in her womb for the past 9 months. This journey of mine continued for days together. I shared a very strong bond with each and every mother I came across. Each one was special. The joy of bringing another life into this world was incomparable to any other feeling I had ever felt. But as we all know, life is not a bed of roses. They always have thorns in it. And this time I was pricked by a thorn when I was informed I have to hold a scalpel in my hand once again. It was time for my first cesarean. Something I knew I would come across, but hoped I would never have to. Because unlike other surgeries, this one had another life struggling between my patient and my scalpel. I had to help protect a life unseen. As we painted and draped the patient, we prayed for the betterment of the little one who is yet to see the world. As we cut open in search of the juvenile soul, I could once again feel the pressure and fear which I had felt on the day of my very first surgery. This time the pressure had turned more intense and I had a sudden adrenaline rush to see the angel face safe. This was not something which was growing on me. Unlike my previous postings, this time I was not getting stronger with time, but I was definitely getting better with my skill. The task to get the mother and child safe from the surgery had become easier, but the worry I had before each every incision never reduced. I still pray before I start operating on a mother. I still feel the responsibility of keeping the mother and her offspring safe. There were sleepless nights, which I never regretted. Continuous duties which never stopped me. My journey in this department was like a roller coaster ride, where I  had numerous state of excitement which always encouraged me to move forward. I just wanted to stay back in the department, because for the very first time I felt like this is where I belonged.

 

It was my last day in the department as well as my last day as an intern. I had no emotions to express as I was going through my last few hours. That day we all sat together, recalled memories of our entire internship. All I could think of was how badly would I miss this department. As my seniors always used to say, this is when I would realize what my future holds for me, I agree with them, because  I have realized what I want my future to be.

 

Twelve months of the internship was nothing less than those twelve years of school life. We gradually learn as we grow. And that’s exactly what happened with me. It was the most difficult ‘goodbye’ of my life. Tears rolled then as they roll now while I conclude sharing my EXPERIENCE AS AN INTERN.

 

 

EXPERIENCE OF A DOCTOR

EXPERIENCE OF A DOCTOR

The hustle bustle, the chaos of the daily life, splattered blood on the floor and big blobs of Potassium Permanganate scattered all around –Yes this is the Emergency Room or fondly called the ER. The daily commotion of the ER and its speed of treating patients is what makes it the most critical yet exciting area of the hospital. It must sound preposterous to some, to call a Department or award with critically ill patients as ‘exciting’, but a Doctor’s point of view says much different. The thrill of cut and the joy of recovery – both are felt by the doctor at the same time, Blissful as I may call it. In the ER, you must work then and there –provide the patient with the first and foremost help required and as said by the book of Love and Bailey – ‘The Golden Period decides the quintessential treatment required by the patient  ’.  But is it really all that rosy and sparkly as it seems?  Every cloud might have a silver lining- but every cloud has a time when it bursts too. Same could be said with a doctor – A little delay of the seconds, a little inappropriately the body reacts and whoop- the case becomes critical than ever. How the doctor deals with the patient at that time, how he puts his extreme hard work of medical studies into actual treatment and how he manages to save the patients life is the real ball game. Unconscious, yet aware subconsciously how much pain the patient is going through – the doctors know it all. They might not be emotionally involved with everyone but yet the patient’s pain is their pain and the patient’s anguish is their anguish. And theoretically, everything is laid down on the books – which Medicine is first, which injection is second, when to push your chest for CPR and when to call time of death. And amongst all these battles with life – only one thing remains out of control of the patient –a deterration from the normal and even the abnormal. What if a patient reacts a way not mentioned in any Medicine books? What if the patient shows a symptom or sign never seen before –then what? Do we blatantly blame the doctor or feed our superstitious belief that God has planned so. Patients maybe mum at the time of crisis but the ones who love him/her are the real sufferers here. They want to do so much- and yet are helpless there. And there at that moment all their hopes, dreams, wishes lie on the doctor- and he is wilfully made the God. But also with that, lies the blame, the resentment, and the accusations – and if nature takes a call where the Doctor is unable to do anything even though he tried everything to his best of abilities –he is made a demon.
The ER has a million stories every day, millions of hopes and hues and cries of hurting people. It shows how the doctor rushes to the patients help, it shows what medicines are given during emergencies, it should how a person who has ingested poison can be saved – what it doesn’t show is the Pressure of the doctor,what it doesn’t show is the extreme burden of putting his treatment to use in a way that it shows results,the burden of handling a living human life in hand and most of all,the burden of letting down the patient and  above all –himself.
A doctor isn’t merely a white coat human with a stethoscope. A doctors experience is way more than words can explain. He wakes up early in the morning or possibly after only 2 hours of sleep after a night shift, then gets ready and on his toes for the next 10-12 hours. Crying, mourning and pain is what he sees every day. He doesn’t have a sunlight showing him joyous things all day long.  He doesn’t have flowers and butterflies and wall pictures. What he has is a solution- to heal people’s wounds. To make the best of his potential and treat that ulcer, and cure that chest pain. He works and works till the removes the word PAIN from patients’ dictionaries. He doesn’t mean harm – he only means well and truth. And the truth lies in the very basic fact that – LIFE AND DEATH ARE CONTROLLED BY SOME EXTERNAL FORCE THAT CANT BE ELUCIDATED and a doctor can trade his own life for the life of his patient but that’s all he can do. He can work and work and work harder to heal the pain, the sufferings the torture and turmoil born by the patient and his family – what he can’t do is compete against the undeciphered External Force of Nature and have a victory over it.
Lastly would like to quote – “The highest form of knowledge is empathy, for it requires us to suspend our egos and live in another world. It requires profound purpose, larger than the self-kind of understanding.”
-Bill Bullard.
What People in India think about Doctors !!

What People in India think about Doctors !!

Well you may be wondering that this article may highlight the glorious history of Indian medicine and how people in India should appreciate  that. But well lets just say thats not the scenario presently. Lets just say it is one of the most respected career options available in India. People are trying hard to crack the entrance exams to be in this. But the weird thing is that very parent who is actually criticising the doctors admits his/her child in the best coaching institute so that entering into that very profession becomes easy. So you can say a lot of bad things but at the end of the day you unknowingly admit that they are still the saviours of the society. That means people do not actually think that way but they are made to believe certain things by some group of people. now lets think about the so called “Group of People” who are spreading a poison in our profession.

Is it the biased media who considers themselves greater than any doctor and apparently end up channeling an artery?

or is it the fake doctors who are practicing in reputed institutions 

Or is it the local goons who just waits for a moment to take out their frustration on Doctors maybe because he was unable to save an 80 yr old chronic alcoholic with liver cirrhosis . ?

Or is it our very own system who actually makes a doctor work for 10-20 hours continuously ?

Well,

All these poisons have actually misguided people about us. We still do work as hard as possible. We sacrifice our own lives for the betterment of society. So lets hope for a day when people will again start admitting that they do respect us and more importantly they need us when their mind will be free from all the influences . Then will be a time when you actually wont be hearing people mumbling behind our backs…you wont actually feel the need for greater security during a night duty…..you will finally be happy after seeing “That Smile” in the innocent face of a child who will actually admire you after you had treated him .

Lets hope for a better future…

Experience in first year MBBS final Anatomy practical exam

Experience in first year MBBS final Anatomy practical exam

A knowledge in anatomy is like a dead weight if we do not know how to apply the knowledge with successful skill. My experience in first year MBBS is quite good.Anatomy is really a hard subject for first year students because you never read about it like two other subjects like Physiology and Biochemistry. Our school teacher used to tell us that you have entered into a sea when we were in class eleven, But we are now really understanding what actually a sea is. The sea we were used to think are now like a small pond. Every wise person said that Practical part of the anatomy is more important than theory. I am sharing my experience in first year mbbs anatomy practical examination.

“I will turn human anatomy into roses and stars and sea. I will dissect the beloveds body in metaphor.” – Siri Hustvedt in The Summer Without Men

I know syllabus of human anatomy is like counting number of stars and amount of water in sea but if you love it like you love the beauty and smell of a  living rose – you are going to be a genius. I am writing another quotes which sounds funny.

“No man should marry until he has studied anatomy and dissected at least one woman.” – Honoré de Balzac

He had told like this to express that it is impossible to understand a woman. But if he really tried to learn anatomy- ever read the Grey’s anatomy, he would not said like this. If People have to study anatomy in order to get married – then – I like to hear your comment in this regard. It’s really a long debate.

So, I had the Anatomy practical exam. There was one day gap between two practical exam. Anatomy was next to Physiology practical exam. So, I had to focus on important chapters of anatomy and obviously my most favorite Atlas of anatomy utilizing most of the day. It was a amazing experience in first year mbbs anatomy practical examination.

The Day of Exam (experience in first year mbbs) 

Journey from Hostel room to Anatomy Hall – some unexpected moments 

Moments in the morning The day was luckily unlucky – Sometimes my luck favored but mostly luck was not with me. I was forced to wake up at 6:35 AM in the morning by me though alarm was set for 7 AM. And after some unorganized last minute view of Histology slides, I got ready and prepared my bag with with few  books, color pencils, pen etc. Then I see my white apron was staring at me curiously hanging from a overpopulated rope. I thanked myself for remembering that as I am a experienced and expert in forgetting.

Crisis in the road – It was 9:15 and I hurried for auto, taking a cake from canteen as usually I do. I was in hurry and there was auto but fully loaded there was no space for a single poor man. After few minutes a auto came and there was a space. But around ten people were struggling for  the single seat without showing any sympathy with this fighter. Waited for another 10 min with red face with anger in every cell like the Angry Bird and finally, I managed to get a seat and now I was the winner of the battle, feeling proud for myself. I traveled the 3/4th of the road very smoothly but suddenly paused but time was not paused. It’s cost was only 5 min, I had to pay. I started running, reached the college at 9:45. My heart was beating very fast as it wanted to come out from by body. I was feeling my apex beat like a novice drummer practicing with a hammer inside my chest.

The incidents that took place inside the anatomy hall – usual or unusual 

At last I entered the anatomy hall with gathering some confidence with in me. I was trying to charge mind but past experience was haunting my mind in the staircase. Head of the Department mam had already scolded me for the same reason.  It was my good luck for that day.

Histology exam experience – Histology exam started at 10:30 am, Histology notebooks were taken. I am telling seriously that I had some type of allergy in Histology notebook.  In Histology exam you have to identify 5 slides with two points and a special slide which you have to  draw only. Viva will be asked from the special slide . There was no problem in identifying the five slides and also the special slide. I was happy and did not hear any mishap from my fellow batch mates though 2 or 3 people mis-identified and later corrected with HOD’s solid snub.

Other six exam tables – After Histology, you have the freedom to choose any one of the following tables- Identification, Radiology & Surface Marking, Bones, Viscera and dissection window. Histology exam is conducted by fully internal team of Anatomy department but now it is the time for facing external.

My first choice Window – There was two cadavers one in supine and one in prone position. You have to give exam for one window. Normally you have to pick one card by lottery. The name of the window is written in the card. If you are lucky enough you get the chance to play with your luck again if the sir or mam conducting the lottery has some sympathy for you.

Luck didn’t favor this time – But actually what happened, the lottery was conducted by a really good and sympathetic mam. I was in a small queue behind two. They did no lottery just told what they want and mam gave the same card to them. My mind and heart was bouncing like a spring to get my most wanted, most practiced, most studied  Femoral triangle.  But, when my turn came another mam came to assist her. I told mam my choice. But mam was completely changed. The mam came like a negative inducer and I was ordered to choose from the bunch of cards. I choose a card and it was not for me, I have not done this before I told. The second mam started her mouth which I denied to hear and requested for another choice. First mam gave me the chance warning that it was my last chance. I did and and yes I got “Cubital fossa” a hot thing.

On spot preparation – I went for the cubital fossa there was no one for it. External sir was taking exam of a other fortunate who were first in the queue. I got the time as I required to prepare myself extra time to discuss with others who got the same.

We both enjoyed the Cubital Fossa – My turn came, Sir asked me to show roof, floor, boundaries, nerves, vessels everything and some clinical questions that I answered properly. I was happy to make sir happy but happiness came to anger when I came to know that sir gave 6.5 for good answers and 6 for moderate to bad answers. Actually they gave average number for experience in first year mbbs.

Identification, not a problem – Then I preferred to go for identification and waited for my turn sir pointed his forceps to  vessels, nerves, structures, viscera’s, muscles. I identified and answered carefully. Very good experience in first year mbbs practical exam.

Radiology and surface marking was my next choice I got a token of a line and a point frontal air sinus and 9th costal cartilage respectively. Examiner asked me few questions from occipito-mental view of skull.

V for Viscera – I gave the Viscera exam confidently. Brian, lung, tongue, cerebellum etc was given to me and I tried my best to satisfy the teacher. My total experience in first year mbbs dissection classes for viscera works fine.

Studying bones proved useless – The examination of bone was my last exam and the examiner’s too. We were three left for the exam. So as a team of three got confidence but he picked up the section of a bone. Giving half of the sectioned bone asked some definitions. He wanted us to tell “The exact definition written in the book” we failed to satisfy him. No anatomical position, no bony features, no attachment – studying these all things proved truly useless for the exam – a nice experience in first year mbbs.

It was my experience in first year mbbs and It was truly my last exam for anatomy, I successfully passed the first year and now trying to study the anatomy of second year that is Pharmacology.

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