Monday, January 27, 2014

The Third Year Syndrome



It's the stuff for punchlines and Adele songs. When the bully becomes the laughing stock. When the fingers are pointing the opposite way; when the tables are turned.

Introducing you to its small-scale medical version: the third year syndrome (aka second year syndrome, intern's syndrome and even medical students' disease, because different people open their textbooks at different points in their lives, apparently), which is when the incubating physicians and surgeons grow paranoid about their own health and of those around them, thanks to their unripe, scattered knowledge of ailments and cures.

On a serious note, it is interesting to see the phenomenon unravel in front of, and inside, you. Perhaps, a keenness to apply what little you know without risking getting sued for it. Your roommate no longer has a simple bout of cough - she's a suspect for Pulmonary Tuberculosis. You're willing to give every member of your family a free diagnosis for their minor-but-could-be-deadly symptoms. Even an excuse of a headache can raise alarm about anything from migraine to brain tumors.

Hence, I used to think the most irritating thing would be for your classmates to doctor you around - be it theory or practicals.
Was I wrong.
It's worse when you're suffering from the third year syndrome and everybody else seems to know it.

My experience with it started at the beginning of the semester. Third year in our college meant three hours of postings where the previous year we'd spent only two. I'd started postings full steam in second year, but ran out of fuel mid-way. So, frankly, I wasn't too thrilled spending an extra hour in our wards, watching the exchange of words between Kannada interviewer and interviewee, like a Tennis match. I loved getting my hands on the patient and even talking to them soothingly, but more often, my mixed up grammar and misunderstood words put them in more distress than before, that I - as ashamed as I am to admit it - just stopped trying. Thus I lunged halfheartedly into my first postings, Ophthalmology.

A week into it, I had a fainting spell in the Outpatient Dept. Attributing it to my habit of skipping breakfast, I didn't think much of it. Till I had a rerun less than a week later. And again the subsequent week. And months.

As I was more regular about my food habits by then, I knew it couldn't be hypoglycemia. Considering the possibility of extreme sweating, I even kept gulping water throughout the morning session, but to no avail.
 Remembering the concept of peripheral pooling of blood, I thought I should just keep contracting my calf muscles to reroute blood back to my brain. Shortly I was the restless kid in the unit, shifting from one leg to another in the desperate hope of keeping myself conscious. But nothing seemed to be working.

Soon, a half hour into the posting, I'd just stop listening to the class and be on the lookout for stomach cramps, glare, palpitations or any other warning signal that I'd be flat in minutes. That only made things worse.

It was extremely mortifying to be giddy when juniors fresh into the schedule would stay back to learn more, all caution thrown to the wind. Everybody else seemed to be fine. After initially trying to talk me out of it ("Why don't you just get used to standing?", "Just stop thinking about it", "Be strong!") my unit-mates started making way for me to lean, sit or lie down, even if I'd raised my hand just to rub my eye.

By then my humiliation and frustration transformed into genuine concern. What was wrong with me? Was I anemic? Was I doing it for attention? Perhaps I was suffering from orthostatic hypotension?

Of course I had no such problems - definitely not the first and third. I consulted two wonderful doctors in our hospital and even got my blood tested, and they all had the same thing to say - I was perfectly healthy. They also suggested eating well, keeping hydrated and pumping up my legs to restore circulation to my head!

After drawing a complete blank, I realized there was a long way to go. It wasn't my body that needed strengthening, but the insides of my head. I kept doing the same old rituals in our wards, to ward off all thoughts of dizziness. I got off my seat to get some real exercise and build some much-needed stamina. But the magic truly was just a tranquil mind - be it through slow music, deep breathing or yoga. Because it takes a sound mind to sculpt out a healthy body. (Like it takes a rocket scientist to figure that one out.) 
I was no longer going to be the girl in the white coat asking a patient to make way for her to rest and so far so good.


Prevention being better than cure, you would think being sensitive to the slightest changes in your physiology could screen out more complicated prospects. On the contrary, looks like we shouldn't sweat the small stuff and let nature handle the rest. 

The funny lesson from all that was not just to stop freaking out about your own health but, as a medical student, not to belittle anybody's problems; what may be trivial medically could be giving them sleepless nights, or in my case, too much of 'sleep', each with their own trail of problems.
And that's something you'll probably miss out in most textbooks.