Monday, December 31, 2007

Happy New Year

The holidays were fun. I shall not get any more such holidays for a long time, and I had a grand time. Half the day would be spent sleeping, and the other half was devoted to the TV and eating. It was as hot as the inside of a sauna (some people tell me winters are cold. I refuse to believe them.), but too cold to bathe. I didn’t really want to, but my mom would threaten to switch off the TV if I didn’t take a bath, (she said she enjoyed breathing- I wonder what she meant by that) so I missed 3 minutes of the 47th rerun of the Friends episode where Chandler and Monica try to get their engagement picture taken. This, my 21st winter, was abominably hot. I've never had a cold winter in my life.

I read Along Came a Spider, and First to Die, and discovered that I prefer the simplicity of the Queen of Crime. I wonder if it’s a coincidence that so many of my favourite authors are British. I blame Enid Blyton. And Burnett, and Nesbit, and Crompton, and Lewis, and Carroll, and oh, what the hell, Rowling. I haven't read many American books from that period (which is the pre-electricity period, in my head, because no one says "It's so hot, switch on the fan" in them), except for the Anne series, and that is Canadian. I thought Patterson convoluted the plto so much he forgot to tie up the loose ends.

Officially, we had only three days off for Christmas, and were supposed to report back on Thursday. The holidays were unofficially extended by us students, and we went back only today. I must admit that I missed my routine a little, but not so much so that I jumped out of bed eager to rush off to college.

Obstetrics stinks. The whole place does. The rest of the doctors decided that they had to do something about the smell, and built a separate hospital for the Ob-Gs. The Paediatricians couldn’t bear to stop fighting with the Obstetricians, and went along. Thus, we have a separate Mother & Baby hospital. It is a very cheerful place that greets you with the floral odour of amniotic fluid the second you set foot through the door. The total absence of windows in the buildings is in keeping with the pleasant atmosphere.

The Ob-G nightmare began in 4th semester, and it still makes me wake up screaming in the middle of the night. It is one of our least favourite subjects, and there are plenty of Ob-G jokes.
A patient was in the early stages of labour, and it was proceeding satisfactorily. The obstetrician decides to take a break, and asks the duty house surgeon to keep a watch on the perineum. The housie promptly takes off his wrist watch and places it on the patient’s perineum.

I have 3 more weeks left in Obstetrics, and sadly, it’s going to be a case of from the frying pan into the fire- I am to join the slave corps in the labour room for my last clinical posting this semester.

A new year brings new hope, yada yada yada. It’s OT day tomorrow, and I’m going to be looking at Caesarean sections. What can give more hope than babies? Speaking of babies, my cousin gave birth to twins last week- a girl and a boy!

Have a great 2008, all.

Monday, December 17, 2007

A Walk With The Park

No, I didn't get the title wrong.

The Park is a torture device that can cause the entire medico population to become whimpering imbeciles at the mere mention of the P-word. We were fooled into thinking that The Park is an ordinary textbook, but, as many of its victims can attest, it is much more dangerous than The Monster Book of Monsters. All those who tried to find out the exact nature of The Park have perished in the attempt. May their souls rest in peace.

The Park contains many unidentified toxins. The most potent of these has been identified a neurotoxin known as Somnifera 420. It has a unique mechanism of action- acting through the optic nerve to produce paralysis of the extra ocular muscles, which soon extends to the facial nerve, causing paralysis of the facial muscles, including the orbicularis oculi, leading to drooping of the eyelids. It stimulates the parasympathetic system, causing the patient to drool, which, combined with the facial nerve palsy, can cause to cause a casual observer to infer that the patient is asleep. Prolonged administration of The Park can cause extensive brain damage, resulting in coma. The importance of early detection of Park poisoning and prompt termination of exposure in preventing irreversible brain damage cannot be emphasised enough, as there is no known antidote to any of the toxins. In certain susceptible individuals, The Park has triggered a violent biochemical reaction by which the individual becomes a Parkist afterwards.

The Park commands a large army of Parkists. These sorry excuses for a doctor call themselves specialists in Community Medicine, but fervent anti-Parkists know them to be actual SPMs (Secret Parkist Militant). During the undergraduate years, the future Parkists are indistinguishable from ordinary human beings. The change is apparently triggered the PG entrance, during which their true Parkist nature is unmasked. There are a few innocents who succumb to Parkist pressure and decide to become Parkists, but they soon realise their mistake and quit. The Parkists are members of a cult similar to the Prieuré de Sion, but unlike the Priory, they do not worship The Park in secret. They often hold large public ceremonies with hordes of food, known by various names such as seminars and CMEs. This is actually a ploy to attract hungry medicos.

The Park also has questionable associations with an international militant organisation. No one knows who they are, and who heads them, and therefore, it is known as The WHO. Some believe that The WHO uses rock music to lull the world into Parkism. The WHO is supposedly based in Geneva, and have been openly involved in many international crimes such as the eradication of smallpox, and the plan to do the same with poliomyelitis.

The Park ruined my weekend. My fortnightly SPM exams are very taxing, and the preparations for the last one, which was postponed to GOK when, are driving me crazy. half the class decided to bunk the exam- it was obvious they didn't intended for any of us to pass. Health programs in India, for God's sake. I absolutely refuse to memorise the date of launching of the National Rural Mission and the date when they decided that the name National Malaria Eradication Programs was stupid. I chose Science because I hated History, and now look at what the Parkists are doing to me.

I'm done with the Surgery casualty. The last day I bothered to attend, I nearly collapsed on the patient. I had been working the ambu bag (the patient had been intubated) for nearly half an hour, and I was drained of the little energy I had. I never rely on my instant impression of people, since I don't like sentencing someone without evidence. But I realised that day that I was correct in assuming her selfish- she was standing behind me while I was blacking out, and she didn't offer help. I'm willing to consider that she may have had her reasons for doing that. But it was downright inhuman of her to refuse to help me when I asked- she said she didn't "feel like putting on gloves". I would have throttled her if I had the energy. I gave her The Look, and she hurried off to get the gloves. Now, for some dumb reason, all the gloves in the box were lefts. You can put on a left handed glove on your right hand without much difficulty. That idiot of a female took off the glove on her left hand when she found out the other glove was a left, and left. I thought she would never come back, but she did. twin, who had been busy with another patient till then, caught me before I fell. Please don't get the impression that I was being selfless and dedicated. I wasn't. The PG on duty needed someone to work the ambu while he tried to stitch the patient back into something that resembled a human being, and caught me while I was trying to escape the stink. There was another patient with a gangrenous foot in the room, and the smell was unbearable. Anyway, I struck Selfish off my friends list. And well, at the risk of sounding overly dramatic, I can never forgive her giving precedence to her inconvenience than to the patient's life. Why do people with absolutely no concern for the patient want to become doctors? Or am I being too idealistic? The patient wouldn't have died if I'd stopped for a minute, but it was my responsibility to see to his ventilation, and that was the only reason I stood my ground.

I have started my next posting- Obstetrics. I'll be looking at pregnant women all month long. I loved Orthopaedics, though I sucked at it, but I hate the subject I'm good at. Ironic, like Alanis Morissette sang. Everything I learnt about Obs, more than a year ago, came back to me.

I am a strict political atheist. I cannot understand why people take their political stands so seriously. We have staunch Commies at war with the new Radicals. The Commies brought goondas into the campus, the Radicals disturb my beauty sleep by sending text messages in the middle of the night, as part of their campaigning. I'm not sure which one I should not give my vote to. My sleep is very valuable, but I don't like thugs littering my campus either. Decisions, decisions...

I shall leave you to ruminate on a favourite quote from The Park.
“Tuberculosis is a social disease with medical aspects.”

Saturday, December 8, 2007


The only disease I’ve escaped so far is asthma. Thanks to the work I'm putting in on my project, this issue is being addressed seriously. We need to do a research project on a topic of our choosing, and the department of SPM will give us brownie points. We (Arch, Lotus, and I) are doing a records based study (which is supposed to be easier than studies involving interviewing patients). I now spend my morning battling dust mites in the records library, searching for case records of patients with infections complicating diabetes (the infamous ‘diabetic foot’).

I was in the middle of a violent sneezing fit when I heard my cell phone announcing the arrival of a text message. Anticipating another one of those incredibly sappy messages my friends shoot me with, I snighed as I took out my phone to read it.

“The college day functions will begin at 4.30 PM today.”

Considering the fact that the preparations for the college day start well in advance, I can’t help but admire the organisers from the hiding this fact from more than a thousand students.

The announcement couldn’t have had a worse timing. I knocked over a pile of case sheets, escalating the sneezes to a full blown attack of asthma and had to be nebulised. (I didn’t, but, as any soap opera writer knows, everyone luurves drama.)

Oh, we also received our mark lists. So I now know my marks in each subject. Like I expected, it was Pharmacology that stole my distinction. (I was off by about 30 marks, but I need to blame someone, and I can’t be the scapegoat, obviously.) At least I managed to floor that sour faced examiner who was some sort of mutant vampire who thrived on the blood of us examinating students. She wanted me to name the non-antibiotic uses of Erythromycin. WTF?
SFE: What are the Ophthalmologic uses of Atropine?

Me: As a mydriatic and a cycloplegic.
SFE: Do I have to stand inside your mouth to hear your answers?
Me: M-m-mydriatic a-and…
SFE starts looking at me like I was a ketchup stain on her new white sari.

Me: M-m-ma’am…. Cyc-l-lo-p-ple-g-gic…
SFE: Tell me one indication for using it as a mydriatic.
Me: F-f-f-f-fu- *deep breath* fundoscopy.
SFE looks sceptical.
: Ph-ph-enyl-e-e-phrine is p-p-pre-f-f-erred.
SFE: Hmmm… When do you want both mydriasis and cycloplegia?

Me: Re-re-f-f-f-fraction t-t-testing.
SFE: (now looks like exactly like Umbridge spoting Hagrid with Buckbeak) Is it used for infections?
Me: Y-yes, M-ma’am.

SFE: (She was actually smiling. And not in a good way.) Oh, really?
Me: C-corneal ulcer.
SFE: (clearly diappointed) Oh, good. You can go now.

I went home to get ready for the fun after collecting the certificate, and that was when the horrible truth hit me. I didn’t have a thing to wear! Yes, ladies, thank you for your sympathy. Gentlemen, that does not mean I went in my birthday suit. After ringing up various girl friends (“wear the mustard yellow one”, “wear the sunflower yellow one” “wear the sunshine yellow one”), my mind still looked like my bed. Unmade. That was when my cousin (who is an unimaginative member of the male species) rang me up. I informed him that my style crisis was much more important than the death of his beloved dog he’s had for the last 10 years and that wet shoulders weren’t quite the look I was trying for, he asked if I wanted to be a show stealer. On salivating in the affirmative, he instructed me to wear a bikini and hung up. Men are idiots.

I finally settled on green, and then came other issues like hair, make-up, etc. I’m noted for the smooth way in which I handle stressful situations like those (Ammmm-mmmaaaaaaaa!), and I was ready to take on the world by about 6 PM. Those of you who know my college will know that I was too early.

The inaugural speeches were ending when I arrived, but Twin had sat through the entire ceremony, and now bore more than a striking resemblance to a moth eaten corpse. And as luck would have it, something important came up and her dad came to pick her up as soon as the last speech ended.

The lights dimmed, and the curtains did not go up. Instead, I saw my friend N standing in front of the curtain and singing ‘Dil de di-ya-a-a-a hain… Jaan tumhe de-e-e-e-nge…” He wasn’t excellent, but he could carry a tune, unlike some of the other fillers. The show kicked off with a group dance by Small, G and some of the girls in 3rd year. I fell in love with Small all over again. She is the best dancer I’ve seen in my entire life. Except perhaps Shobhana, but I’ve watched her only on TV, and she doesn’t really count. And Pavlova died a long time ago.

Some professional dance troupe danced to the theme song from Don. The lead guy looked like a badly shaved cockroach, but he sure could move.

All performances by students from the junior-most batch are accompanied by the vocal participation of the audience. I accepted A as my guru, and I can now boo in 3 different ways- from the back of my throat (will get hoarse after more than 5 seconds), from the front of my throat (painless, loud, and high-pitched) and without using the throat at all (after extensive laryngeal damage). After watching some particularly clumsy females attempt to shake it like Shakira, my throat completely gave out, and had to comfort myself with occasional croaks. I dance better than all of them put together, and that’s saying something about their total lack of grace and talent. They totally changed my opinion about Shamur.

The more inebriated male members of the senior and junior batches provided an alternate form of entertainment- action songs! Wrestler sang an old Malayalam melody (Alliyambal kadavu, no less, fellow mallus), and we had a lot of people rowing imaginary boats while drinking karikkin vellam (tender coconut water, like P. T. Usha wants us all to), and others pushing them into the imaginary water, after which the wet victim would roar with rage at the display of disrespect and attempt to crush the perpetrator’s ribs, and both of them would end up holding hands and slow dancing to “innum kalamayille ente kai pidicheedan”. This group rose to prominence when Shaan came on stage. Not that Shaan (I had the same reaction when his name was announced, and Tanha Dil started playing in my head). This guy is a Malayalam music director, and could be cast in the role of Luttappi (the little devil from our beloved Mayavi) without much makeup. Come to think of it, I know a lot of people like that.

R and I shed tears of happiness when Shaan asked us all to wave our lighted cell phones, us being the only cool girls in the area where we were sitting in who understood its implications. We rushed to get out phones out of our bags, when A told us we weren’t qualified, he had specifically asked for non-singles. Bastard! We eventually had our revenge when we noticed that he seemed to be avoiding looking at the (predominantly) girls’ sections of the audience/spectators/whatever while serenading the guy’ side with love songs and we concluded that he was probably gay.

While we were lulled into complacency by music, the terrible junior girls got on-stage to dance, again! My poor larynx needed lots of TLC to start functioning after that murderous assault.

Observe the blurred photo* on the right. No, it’s not an ad for some hotel. Neither is it a fly impaled on a spider web. It is an actual human being from a troupe of contortionists, and managed to do everything but hang himself by his neck from the rope (look closely, there’s a rope hung from the centre of the stage). He was preceded by two no less marvellous guys who could jump over each other’s heads. Wow!

4 of my batch mates have this rock/metal band known as the Ruff Rekord, and they drilled holes in our eardrums with their music. I have quite a lot of things to say about them, but I shall make do with one- the band would have only a drummer if D quit. I don't know how many actually enjoyed them, it looked like most couldn't wait for them to exit.

Small (she is plain awesome!) and Co. returned to huge applause, and theirs was the last performance we watched, after which the inmates of the Ladies’ Hostel were asked to return. R and I were spending the night at the hostel, our respective ancestors glad to have an excuse to get us out of the house for a few hours. We continued our daily night time ritual of staying up half the night to chat, the only difference being that Airtel did not in any way benefit from our conversation.

*It was taken on my phone, I'll put up better ones when I get them.

Saturday, December 1, 2007


I bunked classes the entire week. And the reason is Nunu.

I could probably find a lot of things to talk about if I put my mind to it, but my brain can come up with only ingugungu koochy vava chunju njunju tutty puchy.

If you look closer, you can see a rash over her face. It's called erythema toxicum, and is not as scary as it sounds. It's very common in newborns, and should clear up in a day or two.

Odd, that she keeps her parents awake all night, and mine try to mix sedatives in my dinner so they can get some shut-eye. I'm thinking she can't wait to grow up to be like her cool Aunt AP.

Saturday, November 24, 2007

Sir Jerry

Surgery casualty was one of the postings I was looking forward to. I find Emergency Medicine (which is not available here) very interesting. Put it down to watching too much ER. Damn you, Noah Wyle. And traumatology is the main branch of the subject. In our hospital, trauma care comes under the departments of Surgery (for people who get coshed on the head, stabbed in the chest, and then have their breakfast disagree with them), Orthopaedics (for boyfriends whose limbs get broken by The Dad), OMFS (for those endearing personalities who pick fights in bars and pretty their faces) and ENT (for heavy metal fans who play their music REALLY loud). All of these can be achieved by simply getting drunk and then driving the next vehicle in sight.

We work in 3 shifts- 8AM to 11AM, 4PM to 8PM, and 8PM to 8AM. We are given these times so that we can watch TV at home with a guilty conscience during those hours.

The very first case I saw was depressing. An unconscious old man was brought to the surgery casualty- his wife said he had fallen and hit his head. The housie on duty tried to get the history of head injury (the usual projectile vomiting-convulsions routine), while the patient’s wife wailed in the background. She (the housie, not the wife) checked his pupils and breathing, and I noticed that the guy had blood tinged saliva coming out of his mouth. Then the duty MO took one look at him and yelled, 'MI, Medicine casualty stat!' We rushed him to the resuscitation room, and the Medicine PG immediately intubated him and gave him CPR. Shit, that was scary. Half the instruments wouldn’t work, the nurse couldn’t find any veins, and the PG was pumping away at his chest yelling instructions to the nurses. And then, for the first time in my life, I saw them using the defibrillator. ‘Stand back, we have to zap him.’ It was all done in a hurry, and I saw the paddles sparking. They tried it twice, but he was already gone.

I wish they would start a proper department for Emergency Medicine. It’s awful how patients need to be shuttled from one department to another because their illness encompasses many specialities.

I put 3 stitches. I hadn’t done it in more than a year, but the how started coming back once I started to stitch up a kid’s forehead. I’d forgotten how thick the scalp was, and how difficult it is to get the needle through. But I managed to finish it, and felt very satisfied. I hadn’t wanted to stitch up the wound, because the kid had vomited, and had bits of it sticking to his mouth.

Vomit and I have a very strained relationship. I can never look at it without wanting to add to it. I can resist the temptation until the smell hits me. Another repulsive body fluid is sputum. The revolting mallu habit of spitting on the roads has given me plenty of opportunity to get grossed out while crossing the road. This disgust does not a good doctor make.

Our SPM ‘study’ tour is coming up. After the heroic effort it took to convince my parents that we are going to Delhi strictly for ‘educational’ purposes, it got cancelled. We haven’t given up hope yet, though.

This is my last lax posting, and I have plenty of free time to catch up with my studies. So I spend most of my time on the Internet drooling over shoes. Strappy sandals are my best friends. We met when I was about 4, and their heels developed when I was 14. Take a look at this pair. I would cheerfully cut off my arm for them. And my other arm for these. And dear God in heaven, just look at them beauties. But I only have two arms, and they don't accept them as payment. My feet hurt from just looking at them, and my purse quit. I overheard my mom telling my dad that the internet connection wasn't such a good idea because I spend too much time on the net looking at shoes and crying. I hate my life. I think I’ll go jump from the roof or something. I’ll end up in the casualty anyway.

I am so unhappy. :(

Saturday, November 17, 2007

Bones of Contention

For every patient who makes you get a little too involved, there’s always another one who will want wo convince you that patients are assholes.

We had this polytrauma case in the Orthopaedics casualty (my last one, by the way), a guy in his late teens who had the incredible luck to get hit by a bus. I think he didn’t break his little toe on his right foot, the rest of his limbs were a mangled mass of injuries. He had no head injury, so he was conscious and oriented throughout. His left leg was a sight to behold. I'm not sure how much skin he had left on it, and pieces of bone were surveying the world through numerous bleeding wounds. He had had massive haemorrhage, and we requested the blood bank to send 3 units of blood, stat. He was going into shock, and my friend and I were asked to check his BP. He was lying on a trolley, so we need two people to check blood pressure- one to hold the apparatus, and another to do the actual measuring. I held the manometer, and my friend tied the cuff round his arm. He was having fluid infused into him through every vein on his arms, so I was turning off the fluid supply so that inflating the cuff wouldn’t send blood into the fluid bag. And then my friend screamed and ran out.

Everyone stared at her, and asked her what happened, but she smiled (which looked like it was pasted on her face) and shrugged. The guy’s arm was stretched put of the trolley, and he had a leer on his bloody lips. It took me a moment to figure it out. The fucking bastard had tried to grope her. There he was, guaranteed to die without medical attention, with a good chance of becoming handicapped for life even with the best of care. No one wants his bloody gratitude, why can't he just let us do our job if he didn't want to lie in a ditch and die?

Am I supposed to feel happy about the fact that he may never walk again? Should I be ecstatic his arm will never regain complete function? Upset because he didn’t have a head injury to complicate his condition? Miserable because there was no blunt trauma to the abdomen to cause more haemorrhage? Would it make me any less a doctor if I felt any of this, or less of a woman if I did not?

I suppose I have to hold a farewell party for my humanity soon. I went to comfort my friend only after I finished checking the bastard's blood pressure. And satisfied when it started rising to near normal levels.

Sunday, November 11, 2007

Resultant Happiness

I paaaaaaaassed!
That made me feel like Mushu the ‘dragon’. Anyway, the 3rd year results are out. All of us have done pretty well. I feel like an idiot now, agonising over mere Pathology and Pharmacology.

This is my last week in Orthopaedics. I am the first (and only) girl in my batch to have set a fracture. Not one of those Amazons, but ol’ pencil arm. (Certain congenital idiots reach for my arms when they get pieces of chicken stuck between their teeth, but they are always ignored. Corpulent jackasses.) Reducing a Colles fracture is not a one-man job, you need one person to give traction, another for counter-traction, and a third one corrects the displacement. I pulled the patient’s hand (traction), and there was this sound like what is produced when you crack your knuckles. That was the bone fragments aligning themselves. It was a very rewarding experience. Which was why I kept grinning like an imbecile throughout.

I can read X ray films now. The picture on the right shows a beautiful supracondylar fracture of the humerus in a 12-year-old boy. It's a fracture that has to be reduced as soon as possible, because it goes in for dangerous complications. The major artery of the arm passes in front of the elbow, and the fractured fragment can injure it. *sigh* If only Anatomy had been taught by clinicians.

I do crazy stuff these days, like going to college on holidays. The casualty sure is addictive. I wish they offered a PG course in Emergency Medicine in India. I know what I'd sign up for. It's the only reason I'm contemplating taking the USMLE. Remind me to change the channel the next time E.R. comes on.

Today is the last day of the Intermedicos, our annual excuse to fight with the other medical colleges in the state. I’ve never attended a single one. Damn.
The first one was held in my own college. But my dad decided against my going, and had a heart attack. He always had a flair for the dramatic.
The second one was at Kottayam. I was all set to break some Achayan hearts, but they got wind of my coming, and cancelled it.
The third one. This year. Dammit. I was not given permission to go. I didn’t want to risk my dad’s heart falling to pieces, so here I am.
The last I heard, we were 30 points behind. I knew I should have gone over and intimidated become friendly with the judges. I sing, you know. Now I may have to disown my college.

My cat fooled me into thinking she had kittens. Close inspection made me think she was right, but on palpation, they were revealed to be the evil progeny of Satan and Dracula. I don’t think tetanus shots are any good against warding off evil spirits. Maybe if the constituting fluid used was garlic dissolved in Holy normal saline.

Arch wanted to watch horror movies over the weekend, and turned to us for suggestions. My scotophobia and hyperactive nocturnal imagination prevent me from watching anything scarier than the Hindu mythology serials on Doordarshan, so I couldn't help much, until horrible memories of watching the last scenes of a movie where an evil toy comes to life, resurfaced. I just couldn't remember the name of the movie, and turned to the guy sitting behind me for help. He couldn't recall the name either, and he asked his friend.
1st guy: Da, what's that name of that movie in which one boy's toy comes alive and tries to kill him?
2nd guy: Ayyo, I know that.
1st guy: I do too. Something like..
2nd guy: Got it. Playboy!

Got yet another test this week. Those SPM people seem to have nothing better to do than correct answer papers and chase mosquitoes to find out whether they are Aedes or Culex. If anyone is building a new toilet, make sure it slopes 45 degrees. That is the kind of useful stuff we learn in SPM. Clumps of my hair will be available for sale as soon as I finish reading the anti-insomniac-cum-hallucinogen known as Park’s textbook of Preventive and Social Medicine. The money will go towards the treatment and rehabilitation of former medical students suffering from delusions of being persecuted by the Department of Community Medicine. Bidding begins now! Loosen those purse strings, generous people! It's all for a good cause. And my hair is very nice- long, black (appears dark brown in bright sunlight) and wavy. So place your bid NOW!!!

Sunday, November 4, 2007

The Healer of the Abyss

I am still in shock. I came out of the coma yesterday, but I haven’t yet recovered fully. Skoda is still out, with a GCS score of 4. We were the only witnesses, and I don’t think either of us could relive the experience. *shudder*

In a moment of misguided enthusiasm, we decided that we would go to the casualty after classes, on our admission day, to have a Live! experience of how patients are treated in an emergency setting. Arch and Hope, and Skoda and I trotted off to the Orthopaedics casualty. The guys in my unit are bats. Skoda and I are deer.

Our first impression on entering the Orthopaedics casualty was that we had somehow entered a men’s club by mistake. 6 of the members stared at us like we were extra terrestrials, complete with green skin, antennae, and white coats. Then they recognised us as 4th year students, smiled and invited us in. My, what a lot of teeth you have, Grandma.

Dramatis personae
1 duty medical officer- a doctor employed by the medical college in the Department of Orthopaedics, known as Sir
4 PG students- MBBS graduates who have crossed the post graduate entrance hurdle, doing their residency in orthopaedics, known as PG Chettan
1 house surgeon- a glorified manual labourer who has passed his final year, and is allowed to be addressed as doctor to satisfy his ego, but has not yet received his MBBS degree, known as HS Chettan
2 undergraduate students- 2 sacrificial lambs who had no idea what was in store for them, known as AP and Skoda
Patients- I don’t know why they are called that, impatients would have been a better term for most of them. After a while, a few became inpatients.

Boy, was it crowded. All the old people in the area seemed to be using the bathroom only to slip and fall, while the younger ones were getting drunk and having accidents. The children, in the absence of adult supervision, climbed trees and fell from them. This is the Ortho casualty in a nutshell. Full of nuts. Not counting me, of course.

Things became really hectic, and Skoda and I got drafted. I held arms and legs while PG Chettans bandaged them. My new dress and I, both of us got covered in plaster of Paris. But we didn’t mind, because it did feel a little like we were helping, almost like we were real doctors.

It was some time before we noticed the byplays. At first we took it for some sort of tribal ritual. It then dawned on us that we were the first females to observe males in the wild, on their territory. I refuse to elaborate on the details, suffice to say that I have been scarred for life. Some might call it insights into the psychological profile of males, but it felt more like a lesson on the habits of Wild Animals, that goes by the innocuous sounding name of male bonding. Testosterone is poison.

I have informed my parents of my decision to marry a blue wildebeest called Ramu. He is an absolute darling, who occasionally has trouble controlling his temper. Nothing I can’t handle with some alfalfa and TLC.

I can say that my already considerable respect for Orthopaedics has gone up several notches. You can’t help but admire their sturdiness and perseverance. Who would have guessed that all those apparently bird boned PG Chettans had so much strength? Why is it so hot around here all of a sudden? And who on earth is Ramu?

One of the patients was a very old man; he reminded me very strongly of my grandfather. He was disoriented (Alzheimer's?) and had a fractured hip. I had to hold his legs while they drilled his bone to insert a pin for the skeletal traction. He kept calling his son, whose name just happened to be the same as my uncle’s. I rarely have trouble keeping myself detached, but he got to me. Dammit, he looked Achachan. Why can’t my heart just pump blood when I’m in the hospital?

Objectivity is an invaluable asset. How else can a neonatologist not resuscitate a child born with anencephaly (clicking on the link is strongly discouraged if your last meal was less than 6 hours ago) struggling to breathe? The parents could not afford a scan, and the developmental anomaly was detected only at birth. You can’t take pity on the mother and help her child live a little longer, the child will not survive, and you’ll only be prolonging its miserable existence. Maybe euthanasia should be legalised.

I heart the casualty, at any rate. I'm definitely going back next week, but this time they are in for a surprise. Oestrogen pills cunningly dissolved in coffee. I'm going to have a great time.

Wednesday, October 24, 2007

Sword Swallower

I tend to be suspicious of hype. I was totally prepared to be unimpressed. But I didn't expect it to cater to my kitschy tastes. And the result? I fell in love. There you have it. Straight from the horse's mouth, although I am not a horse, and will kick anyone who calls me a mare. I'm talking about Om Shanti Om. It's very unlike me to like a song because I enjoyed the video, but KK's voice has a peculiar way of frying my brain. And, like I said, I'm drawn towards kitsch. I can offer no other explanation. Go watch it.

I'm trying to delay the inevitable, but I can't think of anything else right now. Oh wait, there's this. Very impressive.

By the way, I passed the ENT end posting. I wasn't expecting to.

Do you still want to read about my boring life? Come on, there are millions of better things to do. Like picking your nose. Um, you still want to know about me? Although it beats me how anyone could be interested in the dreary event that is my existence. OK, here goes. *gulp* I have a confession to make- I love Orthopaedics. Who would have expected it to be so fascinating? Mind-blowing, utterly bewitching, yada yada yada. No, this sudden change of heart has nothing to do with the cute PG student in my unit.

First day. We entered the ward, and scanned it for the presence of white-coated figures. There was one. Bandaging somebody's leg. The figure straightened, and we went up and introduced ourselves as the new batch of students posted in Ortho. He said he was a PG student, and told us to go meet the unit chief. Suddenly, a child with CTEV handed him a toy, and he turned and smiled at her. I immediately went into ventricular fibrillation. Oh. My. God. That kind of smile should be made illegal. No wonder the sex ratio in the state is plummeting.

I was so disoriented that I agreed to present the case. That too on the first day, when no one knows what to do. Needless to say, it turned out to be a joke.

A little boy brought with a painful, swollen knee. I had to bribe him with chocolates before he allowed me to examine him. That brought back horrible memories of a child with Tetralogy of Fallot in Paediatrics. The case sheet (which we aren't supposed to refer, so we never fail to do that) said he had septic arthritis, and I was in no state to disagree. As luck would have it, the child turned out to have pyogenic osteomyelitis. Fortunately I'd mentioned it as a differential diagnosis. Seems it's really hard to distinguish between the two clinically, unless you do some special scans. That was forgiven. The rest was not. The skin overlying the swelling was not red, as I had stated (gundadi, roughly translated as bluffing, is my birthright), in order to give added weight to the diagnosis of an inflammatory condition. I'd forgotten that the kid was coloured like coal. I also managed to knock over the X ray lobby, after which I got so flustered I held the X ray upside down. I don't know how to read an X ray, stop asking me to do that. Anything other than a chest X ray, that is.

The next day, a PG, who had been present during my joke presentation, took a class on fracture neck of femur. Dammit, he didn't have to tease me about the red skin. Like we needed a reason to laugh. My unit mates are notorious for giggling at inappropriate moments.

Our teachers are having a lot of trouble digesting the fact that we had a month's posting last semester. They also cannot believe that we have, in fact, passed our Anatomy exams. I was forcibly reminded of the existence of structures like the rotator cuff and bicipital aponeurosis. If teachers ask unnecessary questions, they should be prepared for our answers. We also teach them new things, like, the nerve supply of the supraspinatus muscle is the axillary nerve.

I'm rambling, am I not? Blame the PG for scrambling my brain. I'm not the only one, by the way. Skoda had diligently read up fracture neck of femur when she came the next day. I can tell you everything about the Gustilo and Anderson classification of open fractures in my sleep. Arch is an expert on the different types of sequestra. I would have topped every single exam if all the departments could boast of at least one specimen of such magnificence.

Dear lord, how time flies. I have to go read chondrosarcoma now. The PG said he'll ask us questions tomorrow. Skoda and Arch stand no chance against me. Hah!

Friday, October 19, 2007

The ENTing

I'm done with ENT. Yay!

The end posting exam was an unpleasant experience I would definitely not care to repeat. The highest point of the exercise was when the examiner gave me a clue to the answer (pilot) and asked me to name the person who flies in the sky. Unfortunately, I grew up on a diet of comic books, and still need a fix every time I feel down. Nothing like people wearing underwear over their clothes to cheer you up. Things went downhill from there. Technically, I did give a correct answer, but the examiner misconstrued my enthusiasm for the man of steel as impudence, and soon, I found myself being bodily ejected from the room. I hope she gave me a pass mark for correctly identifying the radiograph as an X ray of the chest, with a neck attached to its upper end.

The ENT department would have been a nonentity without that St Clair Thomson guy, which, if you ask me, is a very silly name for a man. Every other instrument seems to be named after him. It could be 2 people, St Clair and Thomson, the bestest of friends since Thomson and Thompson. But I still maintain that a man named St Clair would have been regarded with contempt by his peers, but not Thomson, who would have had forceps stuck up various orifices had he expressed his disdain. So we have St Clair Thomson quinsy draining forceps, St Clair Thomson adenoid curette, St Clair Thomson long blade nasal speculum, St Clair Thomson post nasal mirror, etc. By the time the surgeon finishes asking for a St Clair Thomson adenoid curette without guard of a different size, the patient would have half bled to death. But wait a minute an hour. Here comes Mollison's blunt tonsillar dissector and anterior pillar retractor to assess the damage. Hold that bleeding point with the Waugh's long dissecting forceps with tooth, while I get some gauze to stuff up the area using my hands. ENT is a weird subject.

I'm afraid all this rejoicing is useless, since I have Orthopaedics next. As if I haven't had enough of nailing and hammering with all the work being done at my neighbour's place. If any male wants to make a sexist remark like 'Orthopaedics is a man's work, you had better stick to Ob-G', please give yourself a castration. No, you won't need any surgical skill or anaesthetic. I promise you, it will be painless. I do not want to look back when I'm 70, and think, I think I spent a total of 3 years probing somebody's vagina.

I wish we could have all those kutti/chhottu/tiny 2 week postings again. Except for the Family Planning one, naturally. I do not want to watch an abortion being performed again. The sight of those tiny feet lying in the dustbin were more than what I could handle. There are genuine cases, when the pregnancy has to be terminated, but most of the women attending the FP OPD wanted to get rid of an unwanted baby. Why the **** don't they use contraceptives if they don't want more kids? I don't blame the FP guys for forcing contraceptives on those murderers. Doctors aren't hired killers.

Dental posting was fun. Every single day was spent at home. I think it was my favourite posting ever. I enjoyed Psychiatry until they took us to the Mental Hospital, where the incurably ill patients were. I still have nightmares about that place. Don't get me wrong, the patients aren't mistreated there. I only discovered that insanity is no laughing matter.

I loved my 2 weeks in Radiotherapy. Not out of any particular interest in the subject, but none of us girls missed a single class. *sigh*

Oh, and how can I forget Respiratory Medicine? It was like going on a picnic everyday. The Resp department is on the top of a hill, about 15 minutes from the college, and the view was awesome. We once bunked class to climb up the terrace, from where we could see for miles. It was Omigosh's class, so we weren't missing out on anything, unless you count our first hand knowledge of the deplorable state of medical education in the state as being insufficient. We know we're a bunch of incompetent idiots, thank you.

The kutti postings were also a a great excuse to catch up on gossip. I think it was during our ROME (Re-Oreintation of Medical Education, or the posting to which all the corridors lead) posting that we took turns measuring each others' shoulder breadth, height, and um, certain circumferences. Mid-arm, O corrupt souls.

I loved chairing the verandah committees, heading the restaurant inspections, organising the pilgrimages to the beach, being initiated as shopping Guru's disciple... Kutti postings. Those were the days...

Wait a minute. I believe this post had something to do with my delight at the conclusion of my month long ENT posting. I knew I was in deep trouble earwax the day I heard a professor say, 'Wax removal is an art.'

Wishing you all a Happy Vijaya Dashami. It's not a very happy occasion for me, in spite of having gotten rid of my textbooks for a while. I don't like the herbivore that has taken over my body.

Sunday, October 14, 2007

Medicine 101

It has come to my knowledge that people have strange ideas about the medical profession, and in particular, about medical students. Like, we are always found buried under piles of textbooks. I have been authorised to abort these misconceptions. By whom, you might ask. Authoriser, authorisee, author, all me. We do not believe in outsourcing.

1. All medical students (and doctors) are brilliant.

That one's true. Except for that hag in Physiology who flunked me in first year. And that snot-nosed guy who keeps sending me love poems. See for yourself.
Patient presenting with head injury after falling from a tree. Medico takes the history.
Medico: How did this happen?
Patient: I fell from a coconut tree.
Medico: Do you have a family history of any relatives falling from coconut trees?

2. Medical students spend all their free time studying.

Of course not. We engage in a number of activities that do not involve books. Like examining each others' tympanic membranes, scouring the wards for patients with heart murmurs, listening to professors bragging talking about their surgical skills, helping our dearest professors de-stress by having them shout at around us, honing our assmosis skills, etc. After these extra curricular activities, we unwind at the on-campus, free, air-conditioned dormitory known as the Library. A few of the pillows we used last year are are shown on the left.

3. Medical students are arrogant jerks.

I was very shocked to hear this one. We are not arrogant. Filthy Muggles! How dare you speak of us that way? *points knee hammer* "Avada kedavra!"

4. Medical students do not have a sense of humour.

First of all, I doubt that sentence is grammatically correct. Shouldn't it be senses of humour? And it is absolutely untrue. It may be a warped sense of humour, but it exists.
Me: What does a patient with diplopia say when he sees a bee?
R: Two bee or not two bee?
Me: Yeah, muscae volitantes (a condition that is also known as 'swarm of bees').
Both: Hahahahahaha!

5. Medical students (and doctors) do not fall ill. Ever.

Yeah, we gave up our humanity when we chose this profession. And the initiation ceremony involves a bone marrow transplant from Wolverine.
I think there was one person in my class who did not get measles during the outbreak last year. Me. Because I was at home recovering from chicken pox.

6. Medical students start minting money as soon as they graduate.

This one doesn't even merit an answer.

7. Medical students are the ones performing surgical procedures in the medical colleges.

I have done 4 thyroidectomies, 3 laparotomies, 6 hysterectomies, 2 hernioplasties, 8 tonsillectomies, 5 CABGs, 2 hip replacements, 4 face reconstructions, and 7 appedicectomies. Jeez! I haven't even seen a CABG. I have given a blood transfusion once. Meaning I hung the bag of blood on the stand. I can draw blood from veins, but so can a lab technician, and they do it better.

8. Medical students are interested only in Medicine.

I have no idea how this one started. Is it because we are called medical students? This bears no semblance to the truth. We are also interested in Surgery, Obstetrics & Gynaecology, Paediatrics, Orthopaedics, Anaesthesia, Ophthalmology, ENT, and in sub-specialities of the above, although individual preferences will vary.

9. Doctors make easy money for a simple job.

36 hour shifts are all in a day-and-a-half's work to a doctor. Occasionally getting beaten up by drunk patients is part of the fun. Physical exertion is definitely not a problem, especially to those who perform an average of 4-6 CPRs a day. Not if you're built like a pre-bite Peter Parker. Oh, and a starting salary of 4 figures unquestionably falls into the 'easy money' category.

10. Medical students are hard-working.

There are some of us ruining our reputations this way, but most of us would be insulted if we were called hard working. Our brilliance lets us make do with all-nighters before the exam. Oh, and most times, it doesn't feel like work. :)

That should do away with a lot of myths. OT tomorrow. I have an adenoidectomy to perform. Good night.

Tuesday, October 9, 2007


What happens when a hypochondriac starts learning Medicine?

My mom is convinced that I am one. (I'm not.) She reminds me of the time I 'pretended' to have appendicitis to get out of school. She says I got the idea from Roald Dahl. I had fever, I vomited, and the paediatrician hurt me when he palpated my abdomen, so I winced. He told me it was appendicitis. Reading 'Boy' the week before had nothing to do with it. Come on, how could an eleven-year-old know where the McBurney's point is? But my mom insists that my getting well in a week, without surgery, had something to do with me faking illness. *indignant*

I'm not a hypochondriac, but I do tend to think "Hey! That's my symptom." when I read my books. Who hasn't felt that way? But that doesn't make me a you-know-what.

We were told to auscultate our own hearts as homework, during our Medicine posting, to know what a normal heart sounds like. I swear I wouldn't have done that unless they'd told us to. The time when I got my new stethoscope doesn't count. I had even auscultated my cat. So, the homework. I looked at my Littmann. Littmann stared back at me. I gently put the ear piece in my ears (duh!), and lightly tap the diaphragm. Whoa! That was loud. I place it on my mitral area. Lub-dub. Lub-dub. Lub-click-dub. Lub-dub. Lub-dub. Wait a second. Was that a mid-systolic click? Lub-click-dub. Lub-click-dub. Yes. It is. *thunder and lightning* (for effect)

Mitral Valve Prolapse. It's not as scary as the name. It is usually asymptomatic, non-progressive, and benign. The only disability is that patients can't travel to the Moon. Or got to outer space. Some of my cousins have MVP, and so does my brother. That's a positive family history. Marfanoid features is another indicator. Um, yeah, that too. Some.

I looked up MVP on the net. I was all "Oh boy! Oh boy!" while reading it. To quote, "The typical profile is a slender (yeah, baby!) young (yeah, baby!) female (yeah, baby!) with long, tapering fingers (yeah, baby!) and a model’s figure (Oh, boy! Oh, Boy!)." Can you blame me for thinking have MVP? Also, people with MVP are high strung, prone to anxiety attacks, and have a hypersensitive startle reflex. All me. It doesn't require any treatment, so I haven't gotten it confirmed. I'm sticking to the 3rd rock.

That doesn't make me a hypochondriac. Meet a true hypochondriac (I checked, it doesn't have any synonyms.), my friend Fat (name chosen for obvious reasons). It was summer, and she wasn't drinking as much water as she should have been (given the state of the toilets in the common room). Her pituitary compensated by increasing its ADH production.
Fat (after a trip to the toilet): Nothing.
Me: Oh.
Fat: Could it be renal failure? Like that patient we saw today?
Me (checks pulse): Looks normal. No oedema. Um, doesn't look like renal failure.
Fat: But there's definite oliguria. In fact, I might even say anuria.
Me: Anything else?
Fat: Very irregular. Only once or twice a day. It's dark.
Me: And you think it's renal failure? Seriously?
Fat: It isn't?
Me: If you'd use that brain of yours, assuming you have one, you'd know.
Fat: Oh, yeah. Man, can't believe I missed it. Enlarged prostate!
Me: (I didn't say anything, but you can imagine the expression on my face.)
Fat: Oh. You were saying?
Me: Drink more water.

My brother told me about the 3rd year syndrome, a condition that affects medical students who have started their clinical postings. He looked forward to my claiming that I had hydrocoele*, because he considers me a You-Know-What. Fat's enlarged prostate certainly gives her Voldemort status.

To use a dreadfully clichéd expression, on the other side of the coin, there are many genuinely ill people who pretend they are perfectly well. One of the guys in my class (let's call him Leg) came to the Orthopaedics OPD, with muscle weakness. He'd been shifting rooms, and Sir laughed and said it was due to the strain, and prescribed a pain killer. But something in his gait warned Sir, and he called Leg back. He asked him to squat on the ground, and get up without using his arms for support. He couldn't. Proximal muscle weakness. Leg insisted he was fine, but he was forcibly referred to Neurology, where he was diagnosed with Guillain-Barré syndrome and was hospitalised. (He recovered completely, in case you were wondering.)

One of the things I do have is migraine. I've had it since I was 8, with all the classical symptoms. It doesn't come on very often, once in a few years or so, but when it does, it's hell. I need a dark, soundproofed room to rest in until the attack passes, with a toilet close by so I can go puke my guts out every 2 hours, and loads of painkillers that don't do any good. Since it's the classical type, I can prevent an attack as soon as I start seeing shimmery lights. The last episode was 4 years ago, and I can't tell you how happy I am about it.

Ordinary headache is one of my pet miseries, there's never a time when I don't have even a twinge. Sometimes, it gets really bad, with severe pain in my eye, like a red hot poker inside my skull is trying to gouge my eye out. I've consulted plenty of doctors, they would give me Paracetamol, and that was it. But it never did much good.

Imagine my horror when I heard one of my teachers saying 'severe pain in the eye, usually unilateral, throbbing in character, is typical of migraine. If not preceded by any aura, it's common migraine.' I have both kinds of migraine? Oh. My. God.

I had an atypical migraine headache yesterday. I'm supposed to start long term drug therapy if I get another one soon. I'm hopelessly forgetful when it comes to taking any sort of medicines on a regular basis, but something tells me I won't forget it this time.

*Seemed like a good opportunity to reminisce about a hydrocoele surgery I saw. It was a huge one, and it splashed all over my mask when they were cutting it open. Ewwww! moment.

Saturday, October 6, 2007

Not Again

I got this SMS yesterday.
"The SPM exam to be held on 11th has been preponed* to the 9th."
That's when I knew an exam had been scheduled for the 11th.

SPM stands for Sleep Producing Medicine, known in some places as PSM, Pain of Studying Medicine. Because of these flattering expansions, the Social and Preventive Medicine people have changed their name to Department of Community Medicine. We, the tortured, continue to call it SPM, of course.

The ENT people are away at some conference, and there are no classes for a couple of days. I have plenty of time to drown in the Park (that's our SPM textbook), but somehow, I can't do it. Exemplifies my innate laziness perfectly.

This SMS did the rounds a few months back.
Life of an MBBS student:
Kapde hai, Pressed nahi
Wallet hai, Paise nahi
Lecture hai, Attendance nahi
Mobile hai, balance nahi
Friends hai, Girlfriend nahi
Exam hai, Tension nahi
Padhna hai, Mood nahi.
For the Hindi challenged, the rough translation looks something like this:
We’ve got plenty of clothes, but they aren’t ironed
We have wallets, but they have no money in them
We have lectures, but not enough attendance
We have mobile phones, but there’s no balance
We have friends, but no girlfriend
We have exams, but we aren’t tensed
We have lots to study, but we aren’t in the mood to.
This also illustrates the simplicity of Hindi, but that's beside the point.

I have to go study mug up the subject (understanding it is beyond my capabilities) now. I hope all the dust on the book won't make me snore.

*I know there is no such word, but hey, this is India. We speak our own brand of English.

Saturday, September 29, 2007

Resting in Pieces

Slowly, slowly. Yeah, like that. No sudden movements, please. There. Thanks. I'll be here for a while, you go ahead and take some time off. I'll yell if I need anything. Thanks for carrying me around.

My muscles are on strike. Including that tiny muscle with the weird long name. What is it? Levator palpebrae superioris alaeque nasi? I'm not sure. The fever's left me more or less paralysed. And the ENT people aren't helping at all. They insist on our arriving at 8.30 AM sharp and then refuse to let us leave before 12 PM. And we do. They use a sneaky underhand method for achieving this level of obedience. Attendance! Also, in order to build character, humility, endurance, and hatred for the department, they don't allow us to sit down at any point of time between 8.30 and 12.00. They sit in their OPD, they often perform the surgery sitting down, they lie down in between 2 procedures, but undergrads sitting down? A glare is unleashed every time someone rests against the window sill.

Since I can't protest against the ******* department, my muscles have shown their displeasure by refusing to support my weight beyond 12 o'clock. My weary unit mates can be seen carrying out a limp body everyday after class. They put it inside an auto rickshaw and instruct the driver to take it home. He calls the body's parents after he reaches the destination, and the body's parents, giving anguished cries like "Ayyo ente moley.... Tumhe kya hua?" (Ayyo my daughter, what happened to you?) et al, carry it inside and attempt to feed it. The thing gives a few croaks after a while, signifying the end of the meal, and is then put on a bed. Meanwhile, the auto driver, who had been waiting for his fare to be paid all this time, barges in and demands his money. The body's father sadly parts with his cash and starts weeping. After a few hours of immobilty, the body suddenly sits up and starts talking, and the entire family gathers around it. "I am hungry. I want food. I am hungry. I want food." Amazed by the quick recovery, they soon ply it with food, after which it goes back to its former states, and gets up for food later. It is again fed, and everyone goes to sleep, because by then it's bedtime. The body wakes up fresh and relaxed the next day, and goes off for ENT posting. There it is again tortured, and the sad cycle repeats itself.

I would have done anything had the subject been interesting. I've thrown in 14 hours a night during my Medicine (and Surgery) postings, staying nights and all, rushing around the ward, pockets bulging with needles, syringes, tourniquets, cotton, with the satisfaction of actually doing something, and going home the next morning bursting with energy. This 'zimbly standing' business is getting on my nerves. There is nothing we can do to help, and we don't want to, either. ENT sucks. I haven't hated a subject more, unless it's Orthopaedics. And maybe Ob-G. But Obs was at least interesting, if not fun, although Gynaec more than made up for any interest we may have felt for the subject, with the Family Planning posting reinforcing our decision to stay away from Ob-G as a whole.

I must be the only person who actually looks forward to final year, because it means I can go back to Medicine. It will be hectic, exhausting, taxing, worrying, and a lot of other things, but it will be Medicine.

Here come the pall bearers. Back to bed now.

Tuesday, September 25, 2007


The ENT postings have started. Ear, Nose, & Throat, or Otorhinolaryngology, in more complicated words. There are only 3 units, and I'm in E3, which, for some obscure reason is called E2A. A unit is like the functional unit (pun not intended) of a clinical department. The General Medicine, General Surgery, and Ob-Gyn departments have 6 each, Paediatrics has 5, Orthopaedics has 4, ENT has 3, and so on. The number of units depends on the size of the department. Each unit is headed by a chief, other teachers, and some PG students. It has its own admission day, theatre day, blah day, and blah blah day. So when we undergrads are posted in a department, we're put in different units. So I said goodbye to Twin and A and Small and joined Skoda to venture into the unknown realms of the ENT OT. That's right, Operation Theatre. I get to wear the green dress and all. The 'all' consists of a cap, a mask and a pair of bathroom chappals. The gown and chappals are our own, and the chappals are never worn outside the theatre. The cap and mask are kept outside our changing rooms, and are disposable.

There are 10 of us in a unit, and only 4 of us were present. Pretty good turnout, actually, only 1 girl and all of the guys absent. So Skoda, Arch, Hope and I rushed into the OT bursting with excitement to see the procedures. Yeah, right. We sat around in the changing room discussing Skoda's new shoes, what Irritant (that's the most irritating guy in the Universe) had said to Small the other day, how I looked like a zombie interrupted from my eternal sleep (good description, 8-30 is an unearthly hour to show up at college) and how Hope hadn't eaten any of the crap passed off as food at the hostel and other matters of international importance. After a while, we decided the OT needed to be inspected and ranked on our coolness meter, and went in.

It was a very uncool theatre. Now the surgery OT is cool. 2 tables per room, those lights we see in the movies, lots of people rushing about, and most importantly, the air conditioning actually works. This one is just one room and 3 tables, with small lights worn by the operating surgeon on his headband (let's face it, an ear surgery does not need as much light as an abdominal one) in a tropical forest.

We decided to watch an frontal osteoma being removed, since none of us could figure what the ENT people are doing removing osteomas, which is a bone tumour. I thought it was done by orthopaedic surgeons or general surgeons. It was done under local anaesthesia, and the patient was conscious and talking to us throughout. I was ecstatic to note that when they reached the periosteum, I recognised it as the periosteum. Yay for me! I'm improving. Uusually, when I watch a surgery being done, I recognise only 2 things, blood, and some-tissue-or-the-other. After about an hour of standing in the same spot, I started losing concentration and began leaning on Skoda. I soon realised it was not concentration I was losing, it was consciousness, and had Skoda take me out and put me on a bed in the doctor's room. Anyone who makes stupid jokes about this will be made to walk the plank after being shot through the heart with a shotgun at close range. I've never fainted in the theatre before. I have a good stomach. Let's see you assessing the damaged area in a patient who's left leg got ripped away by a train without a single wince. I'm not a squeamish wimp.

I believe the attack of no-blood-to-the-brain (latest evidence has confirmed that I do have one) had something to do with a patient on the other table who was taking a hell of a long time to come out of anaesthesia. I thought she was dead, and I think I empathised with her at some point. Contrary to popular belief, death during an operation is very uncommon. I've never seen a single death happen on the operating table. I guess the sight of that girl's eyes rolling about in her head while the anaesthesiologist kept telling her to breathe deeply freaked me out. She was perfectly OK, but this voice in my head kept screaming "She's dead. Oh My ******* G0d She's DEAD. SHE'S DEAD. OH MY ******* GOD SHE'S ******* DEAD." over and over at increasingly higher frequencies until my brain imploded.

I lay on the bed for a while, holding Skoda's hand. I think the combined effect of standing still for an hour, the patient on the other table, and my fever (I had a slight throat infection) plus the lack of breakfast was what did it. I never lost consciousness, by the way. Soon Arch brought in Hope and deposited her next to me. I had company. Hope has some problems with venous return, and she can't stand in one place for more than an hour without blacking out. Hope and I lay next to each other and talked for a while, when we heard voices outside. The guys had arrived! All 5 of them! An unprecedented event. Stubble (the guy never shaves), Irritant, Lotus, Wrestler (he looks like Hulk Hogan) and a nondescript individual I shall call Brown. That brought the turnout to 90%! The M2 would have been proud of us. Only Eli was missing, and she had rang me up to say she was attending a wedding and would not be coming.

The osteoma excision finished, the surgeon came out and we got a class on tonsillectomy, where I displayed my usual prowess at gundadi. Gundadi is a traditional art form, practised by medicos all over the world, when asked a question. The classic example of gundadi deals with a student who was asked where his anatomical snuff box was. He replied that he had forgotten it at home, and would bring it the next day without fail. Gundu keeps me alive, and is not be frowned upon. I am known by various names, Gundu Queen being one of them. Gundu is pronounced like mundu, not gund-ooh, which means 'plump person'.

My mom had a fit when she heard I fainted, and kept me at home the next day. My throat infection is now a full blown gale force cough and upper respiratory infection. I'm on antibiotics. I'm sick of politely laughing to the 'Doctors fall ill too? Hahahahaha' lame joke. I warn you, I have a bazooka.

Psst. Anyone miss me? Exams, post exam revelry and an 18 hour workshop over the weekend, on 'Problem Solving for Better Health', kept me busy.

Monday, September 17, 2007

HP and the Pharmacologist's Mortar

"Ah, yes. Hadorable Pancreas. Our new- celebrity."

HP cringed in her seat. Sympathetic friends patted her arm, while some parasympathetics sniggered behind their hands.

"Pancreas!" said Nape suddenly. "What would I do if I wanted my patient to get dilated pupils for a fundus examination?"

"Dilated what for a what examination?"

HP glanced at A, who looked just as stumped as she was; Twin's hand had shot into the air.

"I don't know, Sir."

Nape's lips curled into a sneer.

"Tut, tut- clearly ignoring the textbook isn't everything. Thought you wouldn't open a book before coming, eh, Pancreas? Don't look at me as if you are cycloplegic. The answer is Atropine, which, apart from being a mydriatic, is also a potent cycloplegic. Well? Why aren't you all copying that down?"

HP hated her Potions classes. Her weapons against the enemy she'd sworn to fight was turning out to be her nemesis. There were times she felt like hurling her Goodman out the window, with Gillman thrown in for good measure.. ANS, CNS, CVS, GIT, PNS... Her life seemed to be composed of 3 letter words. ANS was definitely the worst. First of all, while looking for her notes, she was overheard saying "I can't find my ANS." (Say A-N-S out loud, and you have it.) Secondly, it was plain boring. Thirdly, it was vast. Fourthly, it was boring. Wait, I already said that. So these are 3 reasons why HP hated ANS. And Potions, because without Potions, there would be no ANS. Or CNS, or PNS, or CVS, or GOK what else.

And the potions themselves. HP could bottle saline, brew calamine lotion, even stopper fever, but these are all extincter-than-the-dinosaurs procedures. Any Muggle who needed a Potion could just walk into a store and buy it, ready made. Heck, even HP did it that way. But You-Know-Who decreed that the Potions exercises will enable the young wizards to appreciate the problems their ancestors (read Early Man) went through in the past, making potions, labelling and dispensing them (to dinosaurs). Monumental waste of time, HP thinks.

Nape was a pleasant surprise. Nape loved the students! Nape would go out of his way to help students who were having trouble with Potions, and the students loved him back.

But now, Nape has left Ogwarts Medical College, and is now being forced to teach Potions to the delinquents at Durmstrangs. HP would like nothing better than to have Nape back at Ogwarts during her OWLs, but You-Know-Who has different ideas.

Being a natural idiot at Potions, HP is left with just one thing to do. Study.


Tuesday, September 11, 2007

War Bulletin

Good evening.
The latest report on the 'Viva Wars', brought to you by Adorable Pancreas.

Although of the initial reports were of the of peace talks being successful, they were proved to be as false as a waltzing kangaroo when our war correspondent, AP, reached the front. The peace-loving soldiers were preparing for battle, holstering their hall tickets, and confirming that they had clean uniforms on. A spy from the enemy camp confirmed that the enemies favoured the weapon known as CLIP (clinical pathology). AP immediately urged the soldiers to tell her more about the CLIP, but was drawn into battle herself when she heard that it was actually a weapon of mass destruction involving urine and blood.

The Battle of Pathology was fought in the Pathology Laboratory, and our brave correspondent, AP, was one of the last soldiers to be called up. Sgt. AP, can you please tell us about your encounter with the WoMD called CLIP?

AP: I was mortally afraid when I heard of the CLIP. Soldiers such as Sgt. Twin tried to prepare me to deal with it, but I became aware of its power when I entered the battle and saw Sgt. A fighting a losing battle with a urinometer. I do not think I've ever been as scared as when I was called up for urine. I was made to chemically analyse the urine component of CLIP. I do not know how I managed to complete it. But somehow, I managed to that part of CLIP without too many injuries.

Good for you, Sgt. AP. What happened next?

AP: Little did I know that worse things were to follow the urine. I was made to make a peripheral smear from the blood kept in a penicillin bottle. My hands were shaking so much that my smear looked like a caterpillar. The enemy jeered at me, and I regret to say, I got mortally wounded.

We are so sorry to hear that, Sergeant. What did you do?

AP: I had to sworn to fight for the noble cause, that is, finishing off the *&%$#@ exams! Dragging my useless leg (that's where I got shot), I managed to reach the Blood Typing front. The enemy stationed there was not a local one, but his fame had travelled far and wide. He was supposed to be the greatest CLIP warrior ever!

Oh, my God! Do you mean General Anaesthesia?

AP: No, it was President CLIP Bush.

OH, MY GOD! AP! Are you still alive?

AP: Yeah. And I am proud to say that I floored President Bush. It cost me an arm and a leg, but I managed to escape without sustaining any major injuries. Other than the arm and the leg, that is.

Congratulations, Sergeant. So you finished Urine, Blood, and Blood Typing. That leaves only the... Oh, no.

AP: Yess.... The peripheral smear reporting.

I hate to ask you this, but our ratings are more important. What did you do?

AP: Your ratings are not more important. I cannot bring myself to relive the horror.

Yes, yes. Whatever.

AP: *sob*

You deserve a bravery award. Happy?

AP: Yes, I do, you know. *sob*

There, there. It's over now.

AP: It shall haunt me forever.

Err... Let's change the topic. What about the spotting?

AP: MOMMY! I want to see my Mommy. MOMMYYY....

Oh, forget the spotting. How was the Battle of the Viva I?

AP: Good. Bad. Ugly. Uterus.


AP: The 4th enemy was surrounded by glass jars containing uteri. By the use of extreme cunning, stealth, and intelligence, I've managed to obtain a photograph of one of the uteri.

I have serious doubts regarding the ability of our loyal audience to tolerate such gruesome sights. Don't send it.

AP: I already have.

That isn't so bad. Adenomyosis, isn't it?

AP: Yeah. *sigh*

Thank you, Sgt. AP. Moving onto our sports segment, we have the 20/20 match between West Indies and South Africa. Our special correspondent, AP, is on the scene right now. AP, who won the toss?

AP: What the *beep*? Cricket? Don't you barking morons know I have to bomb the Forensic Labs tomorrow? Jeez. Never worked for a more inefficient bunch before. I QUIT!

Err... Certain 'technical problems' force us to end this bulletin right now. We'll be back, with more reports-

AP: Don't count on it.

Friday, September 7, 2007

Identifcation Parade

Do you know what this is?

Neither do I.

Exams next week, peoples.

Friday, August 31, 2007

Phase I - Nonsense

This post is dedicated to R, for the shoulder to cry on , for the times she kicked me when I needed it, for being there for me, always.
You're the best, hon.

Statutory warning: Smoking is injurious to health.
Also, this is a very long post.

The Onam holidays are on now, and I have nothing to do but sit at home and study. Study, yeah, right. So I thought I’d do a series on medical education. Readers (R, that’s you. You know no one else reads my blog. You’ll get that biryani tomorrow.) expecting Albert Schweitzer’s experiences in medical school are requested leave before they are disappointed.

Our syllabus is divided into 3 phases. Phase I consists of non-clinical subjects, phase II of paraclinical subjects, and phase III of clinical subjects, taking 9 semesters, in the ratio 2:3:4. Then there is the rotating internship for a year, after which we graduate as full-fledged doctors with a licence to heal. That was cornier than a cornfield, but I couldn’t think of a better word. Alternatives are welcome. (R, that means you should leave a comment. You’ll get an ice cream after the biryani for that).

Those who fail to pass phases I and/or III will lose 6 months, and will become what is called an ‘additional’ batch. They will be 6 months behind the ones who passed, and 6 months a head of the junior batch.

Phase I, the first 2 semesters, is called (surprise!) first year. Phase II, that is semesters 3, 4 and 5, is called (surprise! No, really.) third year (see?). No one knows why. Medicos just do not have a second year. Legend has it that when Adam sent Cain and Abel to medical college, Cain failed his first year exam, and went into the additional batch. Since there were only 2 students in the college at the time, Cain was alone in his batch. The authorities felt sorry for Cain, because he cried, and said that first year will be made a year-and-a-half long, so that Abel would still be still be in first year. Abel did not like this very much, and insisted that he was a second year student, since a year was over. Abel promptly decided he too was a second year. Abel , who did not like this at all, gnashed his teeth and muttered under his breath. After all, Cain was his brother, and his only classmate. At the end of 6 months, they took the exam again, but Cain failed, again. Abel had passed, and he began to refer to himself as a third year student, since Cain was still in his second year. Cain, who did not like this at all, got very angry and killed Abel. The authorities saw that the whole problem was caused because Cain was still in the second year, and said, “Let there be no more second year for medicos. Amen.”

Phase III has 2 parts- part 1 (semesters 6 and 7) is called fourth year, and the final 2 semesters make up the final year.

I walked into class on my first day, and saw that I had 200 classmates. Yes, 200. No, actually, it’s 199, not counting me. Wait a minute. There were 199 students in total. But if you count the teacher, there are 200 people in a class. Oh, but attendance has never been higher than 90%, so… Aaahh!!! *tears out hair in frustration* There are 199 names in the register. *whew*

I knew about 4 or 5 people previously, the rest were all strangers. People from different places, different settings, different outlooks, with one very important thing in common- all of us had new white coats. Haha, I was kidding. Some used their old lab coats from school.

First year consists of 2 semesters, with 3 subjects- Anatomy, Physiology, and Biochemistry. Anatomy is one of the easiest subjects in the curriculum, and quite easy to pass. We just needed to memorise the names of all the structures in our body, their relative positions, their embryological origin, their blood supply, nerve supply and lymphatic drainage, and their histology. Oh, and osteology too. Like I said, ridiculously simple. It also helped that the teachers are saints. They never yell at us, they are all very even tempered, they never throw our books out the window, and liberally give us marks on our written tests. I believe (please prepare yourself for a nasty shock, R, even if you know what’s coming) 20 (don’t say I’m exaggerating, R. This is my blog.) people passed the first exam. About 50 passed the second one. Quite a few passed the final exam. Even I passed the final internal exam, that’s saying something. I managed to get a first class on the University (that’s 65% and above)!!! I was so shocked my tooth fell out. The dentist had pulled it out earlier that day, but who can say? I lost a tooth the same day my results came out, and it might be cause and effect, for all I know.

The first time I flunked an exam, I cried the whole night. Cut me some slack, people, (am I carrying the joke too far, R? Hey, that rhymed.) that was the first time ever. I got enough chances to get used to it, and eventually it got so bad that they would declare a holiday every time I passed, so I could throw a party. I laugh hysterically when people ask me if I get good marks at college.

Dissection sessions began on the first day itself. The first thing that hit me was the smell of formalin, which is used to preserve the bodies. No, the first thing that hit me was the door, which did not like being pushed open, and smacked into my nose. The second thing that hit me was the smell. My breakfast threatened to leave my system as fast as it could, but I managed to convince it that suicide is not the answer. I got used to it in a few days, but never learnt to perceive it as anything less than unpleasant. To me, it always seemed like spoilt curd, and put me off curd for a week. The next thing I saw was that all the cadavers were naked. There were 10 in all, and 20 students would be at the same table and share a body (R, please smile here).

I found out which table I was assigned to, got a stool, put it down next to the head, and sat down next to a hyperactive female who told everyone within hearing range (about a kilometre) to run for cover if she threw up. The cadaver was of a dead male, with a shrivelled up body. The skin all wrinkled and dark, no hair, peeling nails, a horrified “I-can’t-believe-I’m-dead-and-medicos-are-going-to-cut-me-up-what-did-I-do-to-deserve-this” expression on his face, mouth open, teeth rotten, no eyeballs, a tag on his toe identifying him as number 9. A couple of days later, we christened him Freddy, after the cadaver my friend’s dad dissected back when he was a first year. Many people name their cadavers; I think there was one called Urumees, from some movie where this guy keeps on saying “Athaanurumees.”

Our dissection manual is called Cunningham, and this is the only text allowed to enter the dissection hall. All textbooks not following this dictum will be sent outside the class through the window, so they stopped coming in. The Cunningham uses extremely simple descriptions, like, “the artery is found medial to the lateral border of the superior part of the humerus, posterior to the supraspinatus muscle, anterior to the inferior part of the pectoralis major.”

I remember my first day. All 20 of us were sitting at our table, in our brand new white coats, staring at Freddy (who didn’t have a name then), and they started the roll call. It seemed to go on forever. Finally, after about a century or so, it ended, and we were told to read the first 25 pages of our Cunninghams. That was when we discovered that the Cunningham had been written in Chinese, so we decided to check if any of our tablemates was from China, or spoke Chinese. We were all bonding and stuff, all senti about “Oh, we’ll be spending the next 5 years together, thank God you’re so nice and friendly, I’ll never forget you as long as you live. What was your name again?’ when the lecturer assigned to our table came up to us and said, “Read the Cunningham? You can start doing it now,” and left. Yes, people, she left.

She didn’t wait to see 20 horrified faces staring at her and went back to the staff table to discuss the latest gossip. Someone (no prizes for guessing who) went and opened the dissection set (a box full of gleaming metal instruments, and an old-fashioned shaving razor for GOK what), asked her, “Ma’am, what do we cut it with?” She laughed and came back, and showed us how to make incisions and reflect structures as flaps and other things. For the record, I did not faint. Off the record, I blacked out the second day, but that was because all the people crowding around Freddy to look at his brachial plexus interrupted my oxygen supply. Anyone who says otherwise will be beheaded.

Physiology was an interesting subject. The Physio lab was where we unleashed the sadomasochists in us. Take a sterile lancet, sterilise the fingertip, prick the finger, get a drop of blood, place it on a... Whoa! Prick the finger? Blood? Stop screaming. (R, I didn’t mean you. It was a joke. You know no one else reads this). Well, yeah, we use our own blood for most of the experiments. Those of us queasy about pricking their own fingers would get their neighbours to do it for them, who would readily comply. Some, like me, got their neighbours to donate some blood. We also did experiments on frogs, getting our white coats covered in soot in the process.

What do I say about Biochemistry? They were the guys who introduced us to urinanalysis. Don’t freak out, (again not aimed at you, R) it was not real urine. The subject was easy, and supposedly easy to pass, but I’ve never passed a Biochem internal exam in my entire life. The University was a breeze, and that’s all that counts, so no big deal.

Soon, everything fell into routine. Lecture classes from 8 to 10, then practicals for 2 hours, lunch break for an hour, and then 3 hours in the dissection hall, the routine occasionally interrupted by exams, fests, exams, batch tours, and exams. Oh, did I mention that we have exams? Because we do, you know. I may have forgotten to mention that earlier, so please note the point, we have exams.

We need to pass all the 3 subjects in both the theory and the practical exams for the University exams to be able to enter the next year. Otherwise we fall into the additional batch. No one wants to be an ‘addi’, so we are under a lot of pressure (the inside of a steam engine pales in comparison) to perform well.

I hated first year. The pressure, the backstabbing, the insane workload, generally a “what the hell am I doing here?” feeling, but I do have a lot of fun memories. Failing to recognise a gluteus maximus muscle pinned for the first spotting exam and writing pectoralis major, completing the records in theory classes, presenting “extra hepatic biliary system” before a baffled batch at breakneck speed, attending a Chinese, I mean cardiology CME because they needed people to fill the auditorium (but we never got any food), staging a dharna at the Principal’s office for some reason (again to give the illusion of number), chaya and vada at the canteen after class…

Explanation of some of the terms:

Backstabbing: I figured I’d get it out of my system, and tell people why I really hated first year. It took me a while to fall into the rhythm of learning stuff so that I'd retain at least 10% of what I'd studied, so I found the first exams really tough. Everyone assured me they had found it really tough too, that they would definitely flunk, flunking was no big deal, blah blah blah. Long story short, every one of my ‘friends’ passed with excellent marks, and they promptly cast me out of the group because I was the only one who hadn’t. The hypocrites. I was miserable for a good portion of my first year. It wasn't until the final sessionals that I fell into track. I had only V (does not understand what ‘read my blog or I’ll kill you’ means), but I saw her only in class; she being a hosteller and me a day scholar, our paths didn’t cross much, and neither of us had a cellphone back then. I still hate the day scholar common room. R (I love you for reading this), A (does not know what a blog is), Twin (will not accept bribes), Small (does not have a net connection) and the others became my friends only after first year. Horrendously lonely doesn’t begin to cover how I felt in first year. Learning things by heart was never my forte (refer my class 10 mark list for the social studies marks), and it's what first year is all about. So many names to memorise. God, how I hate Anatomy.

Spotting exams: These are a part of our practical exams, when a specimen is kept, and a structure is pinned. We have to identify the structure, and answer the questions kept on a piece of paper. There will be at least 10 such specimens, and we have about 2 minutes to answer each one, at the end of which a bell is rung, and we move to the next specimen. We have spotting exams in all the subjects, until final year. Instruments, case descriptions, drugs, gross (gross as in macroscopic, not as in ‘ewww gross’, even though some of them are) specimens, and histological specimens are the ones commonly kept.

CME: Stands for Continuing Medical Education. Seminar conducted for a group of specialists, sponsored by drug companies, where they meet up, eat a lot of good food, and fall asleep while someone drones on about the latest trends in the subject. They would often get the first years to fill up the auditorium, to fool the speaker into thinking he was addressing a large crowd. First years are the only ones to be found together at the same time, all the other batches have clinical postings in different parts of the hospital.

Presentation: This is the bane of my existence. It often involves charts and/or overhead projectors, and rarely, Powerpoint. The victim has to teach a topic to a group of batch mates, and 1 or 2 teachers who will grade the unlucky one. I started enjoying giving presentations only last year, with a Pharmacology one. Took me a while to get rid of stage fright. We have individual case presentations in the clinics, which are less taxing, probably because I love doing it.

Gluteus maximus is the largest muscle in the pelvic girdle, and the pectoralis major is the largest one in the pectoral girdle. Oh, who am I kidding? I mixed up the shoulder with the butt. I have “Number 1 Chump” written on my forehead.

Coming soon, Phase II - The Honeymoon. If and when I write it.