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

Pranamam

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.
Me
: 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

Neonatology

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.