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.

The History of a Med School Sophomore: The Three Messketeers

You know you're in charge of your mess, when:

- you find yourself often lost in thought, wondering what to serve for supper the next day.
- your day begins with the watchman screaming your room number, while the cooks ring you up at the crack of dawn.
- you'd rather hide in the kitchen cutting vegetables than face the seniors' wrath.

Last one, I swear:
- Nothing excites you more than the sight of a cooking gas cylinder, all filled up.

What was that all about? Allow me to drag you to the very beginning.

It was a dark and wintry night, a light breeze wafting through the hostel's quadrangle. Thirty of us were gathered there, waiting impatiently for our ex-Class Rep to come to the point of this unforeseen meeting.
"Being in second year, as you'd all know, we've to take charge of the mess, since we'd be the only batch not having exams in December; now, you can form groups of two or three and either volunteer to be the mess prefects for a certain month, or we'll draw chits to decide."
A unanimous murmur rang in favor of the latter - nobody wanted to be left with the months we'd have internal exams, or in my case, holidays.

Seeing how we'd be required to interact with the workers a lot, the Keralites all teamed up with Kannada speakers. I joined Hita and Charulata, informing them I was ready for any month but December, as my parents would be visiting then. Assuring me of her good fortune, Hita grabbed a random chit and opened it to see "December" scrawled in it. Awesome.

A mutual exchange with the February mess prefects had us being assigned the shortest month of the year (sadly, 2012's a leap year)
Come January 31st and we were all gearing up for a crazy 30 days, not sure what to expect, self-assured enough to believe we could pull it off as good as we want.
A cheesy heart-shaped card on the notice board declared our names and room numbers to everyone in a neat font, not very unlike a bull's eye to the archer.

The other two had gone to collect a check from our warden, while I rushed to the kitchen, ensuring they'd clean out the store room. With awkward pauses, I tried making small talk with the workers, introducing myself. Looked like a long and winding Feb this year.

Now you'd think getting two days less than the other prefects was a major bonus for us, but think again. We had exams stretching over the first two weeks.

The month began with a crisis - that of cooking gas shortage. Running on one cylinder per day, we needed them delivered every 5 or 10 days. The problem started when there was a strike among the truck drivers, with deliveries for the previous week stalled, the fate of our kitchens left in suspense. The gas agency rarely answered our persistent calls, and a visit to the warden to map out the chaos was met with indifference. We had to beg, borrow or steal from the men's hostel or simply declare the mess off.

All just about the normal load a mess prefect has to shoulder. But the proverbial straw was having to run all around the place on the eve of our exam, apologetically telling everyone dinner would be served late, all thoughts about our paper out the window, while our batchmates were sacrificing everything from sleep to showers for a third revision.

The three of us just as well gave up on our studies, more concerned about our role as 'Prefects'. While the title made us feel like V.I.P.s initially, we were never informed about the other duties we'd land ourselves in:
Nobody told us that one of the evening cooks let his emotions decide whether to come for work, often being absent with no notice (and by some miracle, still surviving without any sort of phone in this age, much to our ire) giving us the job of preparing tea and milk for 200 boarders. We had no idea we'd be cutting vegetables, rolling chapatis and puris, flitting to groceries every half hour, all in sync with the cooks' whims, ultimately to be reprimanded for 'spoiling the workers by doing their work for them'. Who'd have thought of all the mental strain in convincing these Masterchefs to cook what we want, instead of something normally fed to cattle? I've lost count of the number of days dinner would be over before a quarter of us even got to the table, while other days the cat would already be devouring our would-have-been meals. Not to mention the
'un-Messy' work of taking care of the building's plumbing, electricity and other requirements, which included tiling and painting the entire hostel. The petrol and telephone expenses burnt holes in our pockets. We only have to thank our stars there was no water shortage to add to our woes.

But what takes the cake are the 'feasts' - mini-feasts given every Sunday and a major 'Monthly feast' any weekday of our choice. Unlike the other days, when we'd have vegetables delivered daily after texting them our list, we'd to go out ourselves and fetch the items we had in mind, serve everyone a fixed amount of sweets, ice-cream, drinks etc. In fact, half the time we were roaming the city buying stuff - from eggs and bananas twice weekly, again to be personally delivered to each student to hunting for CFL bulbs for the study hall - despite having to pay a fortune for our daily rations to be brought to the hostel.
The big one had us all pushed to the edge, as this was our chance to redeem ourselves for a month of bad luck - to treat them within budget, on time, taking care not to let our dampened spirits show through. For we were the last of our batch to remain in the city after the exams, as the free 2nd year kids all returned home for a week-long break. Nonetheless, as we approached the last of the 29 days, we were like exhausted athletes simply looking to finish the race, rather than aiming for a win.
Having made quite a lavish combination of items for the monthly feast, surviving flying tempers, empty petrol tanks and a race against time, the ending fared far better than the ill-fated genesis, but we'd already stopped caring.

What started out as a chance to revolutionize the whole system ended up with us being tossed up and down - we were no better than what we started with. Hygiene was still non-existent, the mess fees sprang to far greater heights, the workers grew even more autonomous, and we still have no wi-fi, heck even a functional TV remote, both which our male counterparts can easily boast of.

Still, I admit, it was a learning experience, with lot to gain from. I witnessed the power of a soft-spoken word over a harsh tone, when dealing with the workers. It was nice getting to know them more, enquiring about their state of affairs, though the constant demand for their wages prematurely grew tiring. My language skills rocketed along with this gregariousness. And oddly enough, all that dirty work we had to do ended up being a gratifying narrative in retrospect.

But, no way am I gonna ask for a revision of that lesson.

The History of a Med School Sophomore: Vital Signs

Back in high school, when everyone was still debating career choices, I was not only solid on which direction to head, but what specifics to aim at – Medicine, Pediatrics, Psychiatry and beyond.

I believed I was too clumsy for Surgery, too coarse for Dentistry, too deaf for ENT;  the non-clinical ones never even figured in my scheme.

So, it was a pleasant surprise when I ended up loving Surgery, officially the first of my postings, so much that I wondered whether anything could top it off.Two months later, I was rather reluctant to move toward K.R. Hospital on the first day of my Medicine postings: Five days of rounds in the ward and one day in the out-Patient Department? Somebody take me back to the Operation theater.

But as it turned out, the 6 weeks' exposure had its own portion to teach. Every day was different, every case unique.

The initial days were spent getting familiar with the subject, particular to the Respiratory and Cardiovascular systems. The vault of information was pretty vast, and while I was mostly blank, once I swallowed my pride, getting to pick up something new about our body's workings and the different ways things could go wrong had a thrill of its own.

The lessons I learnt, however, came less from the mouths of our Professors and more from the patients, everyday observations and each others' mistakes:
Even if clinical findings are more loyal to their textbook descriptions and hence easier to elicit, mastering Medicine requires more than just books.

Lesson #1 - Formula for Failure: ignore the basics.
A more complex statement would be, it doesn't matter if you can blurt out the rare conditions where jaundice manifests, if you don't  know how to tie a BP cuff:  Once, all five unit-mates couldn't figure out why on wrapping the sphygmomanometer (used to measure blood pressure) around the arm led to the emerging tubes being oriented opposite to what was required. The final diagnosis? Trying what's meant for the right arm on the left side.
Stretch that example to glitches in measuring pulse, taking temperatures etc. and you'll know whether you've earned the patients' trust and credibility.


It was further surprising to see how as we ascend the ladder, we slowly discard the riches we'd acquired at the base - considering ourselves, the interns and even the PGs who all stuttered at the simplest questions posed by the Professors. Maybe it's a new perspective, maybe we never thought so deep, maybe with knowledge comes the wisdom that we really have no idea, but one thing's certain - we've got a long way to go, dotted with detours and potholes.



Lesson#2 - You're never too big to prevent mistakes.
Referring to a particular incident of an error in judgement that claimed an innocent life. The victim, a middle-aged lady, was facing complications of Rheumatic fever, which rendered her heart weak. So what was the problem?
Our Sir, a senior doctor, admitted the patient and started her on immediate treatment. She was showing no signs of rapid recovery nor deterioration and was subject to a close watch.
Not close enough, as it turned out, for within hours, she went into cardiac arrest and was too far gone for medical intervention. She passed away, at the tender age of 38.


Only later did one of our PGs remark, "She was too complex a case for the medical ward - should have admitted her to Jayadeva (Institute of Cardiology) immediately. Never admit such patients..." Too little, too late.


Guess we'll learn over time when to realize just maybe we've got too much on our plate. Because sometimes courage comes in admitting when things are too much to handle.



Lesson#3 - Never take your patient for granted
Tragedy struck again when another patient in the female ward succumbed to complications from her ailment. The young diabetic's glucose levels never approached normal, staying in the high range from the time of her admission. So, one day, when she went into a state of confusion, signalling emergency, our PGs rushed her to the ER, and seeing no time to test her, assumed it was another hyperglycemic attack and administered several units of insulin to bring down the estimated rise in blood sugar. Alas, not only had they estimated the polar opposite, they ended up infusing more of the 'poison' that led to the state in the first place.

Lack of time, lack of infrastructure, lack of insight? Irrespective of the cause, the overdose proved too fatal for the 30-year-old, pronounced dead a few hours past dawn. 


This might have been an avoidable disaster, but that needn't be the case always. Imagine a doctor's plight in a world where hypochondriacs exaggerate every menial complaint while perfectly 'healthy' people dropping dead without any forewarning isn't unheard of. Are we expected to follow a principle of 'sick unless proven healthy'? At the same time, is the gargantuan amount of discrepancies in disease ever an excuse for blatant negligence?



Lesson#4 - Life never seems fair.
But how often do we realize when it is unfair in our favor?

One careful look at the medical ward and you realize your life-shattering problems of not being the coolest, owning the best or getting the most out of life are subatomic in comparison to the conditions people survive from or surrender to.

There was the case of the lady with alcoholic liver cirrhosis, whose unconventional drinking problem led to her husband and children abandoning her, everyone blaming her in a society where the reverse situation is condoned without second thought.
The mentally subnormal teenager with severe Iron deficiency anemia and combined vitamin B12 and Folic acid deficiency, rendered too weak and dependent to sit up in bed.
The blind lady with renal failure, looked after by her preteen daughter, who was just as efficient and stoic as people 20 years her senior.
The 18-year-old suffering from Progeria, a rare genetic mutation that made her look 50 years older, while shortening her lifespan by decades.
The middle-aged woman with cerebellar lesion, that made it impossible for her to stay upright when her eyes closed, even momentarily, messing up with her balance, fine movements and co-ordination.
Old men afflicted with Parkinson's disease,  rigidity, tremors and postural instability, making them resemble living ghosts - no expression, little response, limited movement. 

*

The list is endless - be it regarding the kind of cases we get, or the amount of lessons we are invariably taught. At the risk of sounding too much like a Sunday sermon, they're best left for contemplation than preaching.

At the end of the month, I realized that the patients are our best teachers, who teach us not just through the numerous symptoms they present but also through humble examples of strength in spells of weakness, perseverance through bouts of pain and faith during times of adversity.

And doctors, more than anyone, need to instill these into their daily lives.
Amen.

The History of a Med School Sophomore: The Torn Identity

Take things into perspective and life can range from petrifying to side-splittingly hilarious.

Being a medical 'student', for instance.

Initially, I was eager to devote all five senses to caring for the sick.  A few cases done and the examination sequence became purely mechanical, partly thanks to it not paralleling typical TV medical dramas: No impulsive 'code blue!'s, no transformational plastic surgeries, not even mind-numbing love triangles.

The patients we got often placed us at the bottom rung, showing none of the reverence our Professors were offered. Soon as they realize we're only doctors-in-the-making, they refuse to speak at all, preventing us from examining them; in extreme cases, altering the entire history to send us off in some tangent. The staff held us in no stellar heights either – every question that came our way only yielded aphasia.

True, it did little to revive my dying self-esteem. Yet, to me it was a badge of freedom – from responsibility, from duty, from blame. A green light to the mistakes our superiors would have to answer to; all in the spirit of learning.

But what happens outside the hospital is a whole different story.

Voila Community Medicine: a branch that announced the return of the driest school subject crossbred with the Science of healing. Don't get me wrong - in the real world, Preventive and Social Medicine is what MBBS is all about - looking after the needs of the masses, administering basic healthcare, averting major and minor medical mishaps, extending from the humble village doctor all the way up to the World Health Organization. But within the confines of college life, its monotony is seldom debated.

 The first week of the month-long posting, we were instructed on what we'd be doing out in the real world. Field visits consisting of us mimicking door-to-door salesmen, conducting surveys from a ready scheme, analyzing the allotted community's situation – the only reason we looked forward to doing them was to escape the dreary classes explaining the entire thing.

Seven long days later, we assembled in the college's parking lot, to be dropped to a slum nearby. I boarded the bus pre-occupied with the thought of conversing with people. I am no smooth-talker, but with the additional burden of communicating in a language I couldn't speak well enough to save my neck, things seemed pretty bleak.

Once there, two friends and I approached the first house. A teenage girl shyly stood by the door to their modest abode, occasionally shouting for her mother to help her with some answers. While the questions were purely ordinary, the interaction proved more insightful than anticipated.

There was the old lady who was so offended that we didn't have time to survey her house while we finished her neighbor's, she made us promise we'd return the next day itself. Or the mechanic and his family, crammed into a single room - sans kitchen, sans bathroom but not sans contentment. Despite prodding him more than once, what changes he wanted around the place, he assured us beyond doubt, he was as satisfied as humanely possible.

Contrast that with the B.Com Freshman, who was dismayed by the general apathy of the slum's residents towards development and  the lack of concern shown by the authorities.

The attention we got was flattering - offered tea, invited in, in one house made to wait a half hour, while the mother ransacked her house to locate her kids' birth certificates, ensuring we had genuine information. That last incident had us missing our bus back to college, forcing us to heckle a Rickshaw driver to rush us in time for class at the lowest fare possible, all in vain.
Yet, the minute he saw us don our white coats as we entered campus, he wouldn't accept anything more than 20 bucks - Rs.5 less than what we'd bargained for.

Funny too, when we're showered more attention than we deserve. What about the Rickshaw driver who picked up a few of my friends and me from college? On our way, we witnessed a minor accident, with the victim being carried off to the sidewalk while we got down. Just as people were trying to figure out whom to blame, our hero of a driver stepped forward shouting, "Have no fear - they are all doctors here!"
While five language-impaired Malayalees shot one question after the other to the confounded lady, I kept bugging them to check her vital signs, oblivious to any legal consequences. Declaring her fit as a fiddle, we disappeared as soon as a three-wheeler would permit.

Where do we come in, then, between the extremes of an omniscient practitioner and clueless freshmen?

Every course is multi-faceted, and medicine universally so. High about knowing 'stuff', overwhelmed by the distance still to be covered, so often insecure about the here and now  - it's all different versions of the same story. Irrespective of our route of entry, every pupil is dragged through a thousand and one sleepless nights, triple that amount of medical tomes and the adrenaline-rush of facing examiners that hold our fates in their collective palm, before being churned out a ready-made doctor.
Yet, one wound healed, one soul repaired, one life saved is sufficient for all those hours of pain to make way for a large moment of hope, achievement and gratitude.

Come to think of it, it's a vital part of our polishing into doctors. What better way to conquer suffering and serve faith than to be put through shades of agony and bliss ourselves?

Atleast that's the way I take it now.

Philosophically yours,
Dr? Lamya 

The History of a Med School Sophomore - Around My World In Eight Days

For a doctor in the making, here's one truth that stands stark against the rest - nothing remains the same. 

Just as I was settling into college, I grew sick of the course.

Soon as I decide to apply the 'rip it off like a band-aid' principle to hostel life, I begin enjoying it.

Amidst a perpetual cycle of let-downs and pleasant surprises, an amalgam of moments of pride against getting stuck in a rut, came the  announcement of our batch trip.

I was left twirling in another emotional whirlpool when informed the destination of our week-long expedition -

Kerala.

God's own country. My native place. A vacation. Home. A new experience. In the same old places. 

What was I to expect?

Reporting from behind the lens, as opposed to in front,
here's letting pictures replace the proverbial thousand words, for each of the seven days:

Munnar:

Beginning with a classic landscape shot

Our ambitions soon branched out skywards.

From macro shots demonstrating 'small is beautiful',

To nature's uncanny sense of symmetry.

Lending glamour even to the unlikeliest subjects.

Never ones to be chained

We decide to take things into perspective

Focusing on things, near at hand or out of reach.

Our aim: to leave a mark wherever we may roam.

Trivandrum:

Stepping into Sree Padmanabha Temple, to witness tonnes of gold and golden sunlight.
http://en.wikipedia.org/wiki/Padmanabhaswamy_Temple

Alappey:

Whether the grove of coconut trees in Kovalam or the houseboats in the Venice of the East - can never get enough of the water.

Cochin:

Letting sleeping dogs lie

Ketchup with friends over mealtime

Oberon Mall: My childhood fantasies in a nutshell - or glasscase.

Wonderla - was it all a dream?

Fort Kochi: Charmed by the simple things in life

Athirapilly, Trichur:

Falling in love at first sight.

Yeah, we too were stunned to silence by the scenic eye candy.

The road to happiness - or painful death - ain't easy.

No matter how tempting, when testing the depth of a stream, don't use both feet.

Turn your face to the sun and the shadows fall behind you.

"Denial ain't just a river in Egypt" - Mark Twain

Nineteen years  of disavowal later - Home is where the heart is.

                                                                     


Ultimately, it comes down to the choices we make - though the end may not always be in sight. Take that first step.

Wayanad:

That would be the Photographic Sabbath. End of a journey, as well as the battery-plus-memory.




-------

What was hard to endure, is sweet to recall. 

The trip had its highs and lows, sending us from North to South, from scaling mountains to flailing arms in the ocean. We shared secrets, we exposed our vulnerable sides, and witnessed the effect of pressure on our made-up selves.
Still, ask what we got after a week in the Southern Paradise?

New friends, beautiful memories and a fresh start.

(Photos: Courtesy Rahul) 

The History of a Medical School Sophomore - For Crying Out Loud

You know you're in trouble when you'd rather be operated on than watch a surgery live. Atleast that was my state the first 2 or 3 times I was pulled in to the OT, pale and woozy. Diligently, I convinced myself that each incision, every stitch, was just the doctor's duty of alleviating a patient's suffering than some absurd conspiracy to inflict visual torture on me.

Taught by the best Professors in the Department, I did the unthinkable – I fell in love with Surgery, or at least the unit we had been assigned. Having done a 360 in the branch I was most apprehensive about, I mistook my newfound confidence for a power to take on anything MBBS has to offer.
Till I learnt where we'd be posted next – OBG, or Obstetrics & Gynecology – a fortnight of dealing with women's health, expecting mothers and related surgeries.

The thought of screaming women and their wailing babies didn't sound very appealing.

I trailed my unit-mates in locating the "Out-Patient block" of our Women & Children's hospital. On reaching there, I discovered more than just the place – it dawned on me how literal its name was, seeing innumerable women scattered on the pavement in front of the entrance, while the designated waiting area inside lay barren as the Sahara. 

Careful not to step on anyone's feet, the seven 'doctors' parted the sea of patients to get in. Contrary to the cacophony outside, the clinic was dead quiet. A half hour later, Professors, PGs and interns filed in, ready to tackle the herd of expectant ladies.

Day one passed with instructions on determining the age of the fetus by merely feeling the protruded belly, in addition to declaring the unborn child's position in utero.  Basic concepts aside, we were asked to measure the blood pressures of several subjects before being let off.

Two days later saw us all scrubbed in to watch surgeries in action. Three operating tables stood parallel to each other, with two different cases for us young guns to witness – a fibroid removal and a hysterectomy. Just as the uterus was being separated in the latter, my unit-mate Laxmi prodded me and Kriti to check out the case of a 'huge abdomen' in the adjacent chamber. Little interested in seeing insides stitched up, we abandoned our station to observe the new arrival.

The patient had already been given the spinal tap required to shut out all sensation from waist down. A scalpel came out of nowhere and promptly cut the stomach with a clean, horizontal incision. Droplets of blood spurted out the layer of fat and muscle, as gloved hands grabbed the opening to tear it up wider. Before we could comprehend what was happening, something was pulled out by a nurse, just as it broke into a shrill cry.

 We had just witnessed the birth of a beautiful baby boy. A Cesarean.

The blue preemie was rushed to the incubator where a pediatrician ensured its stability while checking its sex, weight and general health, oblivious to the three awe-struck second-year students. On finding our voice, we started thinking of hypothetical names for him, settling on Kriti's suggestion of 'Pratham', Sanskrit for 'the First'. After efforts of cooing and whistling bore no outcome, I moved on to singing everything from Guns 'n' Roses' "Don't Cry" to "Happy Birthday" till the clock forced us to proceed to class.

The fourth day saw us summoned by our Head of Department, who was ticked off by our failure to report to him hitherto. After a warning, he handed us over to our Ma'am, whose first assignment for us was to figure out the layout of the entire hospital. That exploration had us charting everything from the labor wards to the neonatal ICUs onto our notebooks, with no idea why we'd suddenly turned cartographers. Only later were we informed of the gravity of admitting people to the wrong ward by ill-informed doctors, often proving fatal.

Curiosity got the better of us during the subsequent visit; we decided to hit the NICU instead of taking the routine history in the ward. We tip-toed into the sterile, air-conditioned confines of the unit, immediately meeting a dozen incubators housing the tiniest babies ever seen.  I hovered over the heated containers, experiencing both the joy of survival and the misery of suffering the pre-term neonates symbolized. At one point, the nurse who came to check on them, handed over a newborn for us to hold – each of us girls fully utilized the opportunity to cuddle the bundle of joy as long as allowed. Bidding it farewell by letting its minute digits curl over my little finger, I halfheartedly made my way out with the others.

Rounds were the least attractive part of the week. Shadowing Professors who completely ignored us to teach Post-graduate students, we were confined to asking the same old questions to women admitted into the hospital with complications like high blood pressure, Anemia and Diabetes. Announcements from the NICU wafted in now and then, beckoning the respective mother. "Lakshmi Vaibhav Kumar" came the first one. "Geeta Vaibhav Chandra" came another. One after the other, each amusingly with the same middle name, aroused our interest. It took "Noor Vaibhav Ahmed" for us brainy group of 7 to realize the nurses had an odd way of pronouncing 'wife of'. So much for our implausible theories of pre-term births connected to a particular maternal name.

As medicos, the most-expected and the least-awaited event of the department was labor. Days before we were to wrap up with OBG, we ventured off to the Labor Ward, the site for natural births. We went to the second labor ward, with cases prone to complications, where the soon-to-be-mom was lying in the typical delivery position.

I had anticipated the rush of emotions this particular experience would draw, but revulsion wasn't one of them. Being a poorly-funded government facility, it got away with filling the wards with numbers way beyond its capacity – in the 6-8 beds crammed into the tiny space, on the floor, underneath cots, the scene was pathetic. None of those admitted were provided the luxury of drapes or sheets to obscure them from the public. The state of the beds and instruments used was further appalling, but there was hardly anything we could do.

The lady lay writhing in agony, having been in labor for over a day, subject to the added annoyance of nurses screaming, "Push!", "Don't you want your baby?" and other remarks that didn't seem quite fruitful. Seeing her exhausted, the obstetricians decided to resort to an episotomy – a procedure to surgically widen the outlet of the birth canal. Jelly-like blood emerged in copious amounts, making us dread the mother's condition. Further difficulty in the process forced the doctors to seek the aid of a vacuum pump which used negative pressure to quicken the delivery. On pulling the infant out, its umbilical cord was seen dangerously wound around its delicate neck, leading to all the complications that ensued. As the baby was carried away, the medics remained for stage three of delivery (after-birth) and to stabilize the bleeding and pain.

While the specialists got busy with ensuring the mother's well-being, we went to see the baby boy, a celebrity in his own right, being photographed and recorded by the staff. Kriti suggested "Prateeksh", Sanskrit for 'the next', as other baby names got trumped in the discussion.

Strange enough, by the end of the week, I was a tad poignant about leaving OBG, its social relevance and medical importance a new chunk of awakening for me. Though I still don't see myself pursuing this particular stem of medicine, I have a newfound respect and awe for everyone who does.

More importantly, I've been cured of my wish to swap places with the patient, now totally content at playing the spectator. 
Announcing the rebirth of my passion for medicine,
Until next time.   

The History of a Medical School Sophomore – Blood, Sweat and Tears.

Five minutes. Four weeks. Twenty years. There's something about exact periods, I find the need to conform to - you won't catch me switching back to my textbooks at 6.19, or waking up at 7.38. Not superstition, just out of habit. So, a month after returning to college, here's the reality of the second year of medicine. So far:

September 8 – normally no big deal – was the year's most dreaded date; that from someone who survived the RGUHS University exams. The day I was slated to bid goodbye to my two-month long vacation back home and head to Mysore. My ticket was scheduled so I could reach early enough for the 9 AM clinical posting that started this year. Thanks to hauling 30 kilograms of luggage through Bangalore traffic, it took time to recover from exhaustion and sink into homesickness.

An unlikely selection to the college's group song for the inter-college Fest kept me busy for a week or two. The three-day event got over soon as it began, and while the practice sessions had its highs and lows, ultimately the big day saw me able to sing only alto, completely off-key, thanks to a well-timed sore throat. That remains the only experience still lingering from an otherwise amnesia-ridden event.

Meanwhile classes were advancing in full swing. The ones I took the trouble to attend at least, having depleted all guilt when it comes to cutting class this term. So much for all the talk of being real doctors this year – the first fifteen days were meant for 'intensive coaching', where they ran us through basics of history-taking and patient care. Ironically, half the classes ended with 'you won't get it till you come into the wards – we'll tell you then,' while the other half I bunked. Let down, I fancied at least the theory classes would be captivating. The subjects each looked as promising as the next: Pathology, unraveling the mystery of the crime scene, the human body, hunting for the pathogen in question; Pharmacology and its quest to brew the flawless remedy, sitting back to watch as different parts of the body react to various preparations; Microbiology, exploring the complex world of invisible germs; and finally Forensic Medicine dealing with the legal implications of healthcare and the medical facet of law. Instead, they were simply the perfect occasion to catch up on the sleep our hostel's mosquito population denied me every night.

That fortnight over, my half of the batch got posted in the Surgery department.  At last, some action. Little did I know I'd get more than I asked for. The first day, I forgot the white coat, and was frantically dialing friends up begging them to bring a spare. Once I managed to get one, the Professors came late enough for me to have fetched it myself. There was a lot of confusion with our division into various units, which ended with me separated from Kriti, my ideal lab partner last year. Adding to my dismay was the realization I was sorted with the sharpest minds and loudest mouths of our class.

Fear of being overshadowed gave way to annoyance when I saw the timetable – our unit was to head to the Operation Theater, which meant I never needed the coat in the first place. Crammed in the common room, we changed into green scrubs and waited for further instructions. Soon, a senior walked out, casually checking the notice board, when one of us approached him and meekly asked what the hell we were supposed to do.
A small glance at us and he burst into laughter.
"The operation's over. Go back."

Next when we were to go to the theater, it was a holiday and we missed yet another chance. Third time worked its charm, for we landed the earliest, all geared up to witness scalpels and forceps work their magic. I waited, thrilled and confident I'd long gotten over the anxiety of watching a surgery, all credit to "House", "E.R.", "Grey's Anatomy" and even "Scrubs".

We moved in to the Operation Room, careful not to make any noise. The first thing I see is the doctor administering anesthesia, the syringe lodged in the patient's spine, and all I could think was how in the world the latter was lying motionless during the apparently painful procedure. Then, a few people proceeded to cover his entire leg with caramel-tinged anti-septic. A surgeon moved towards him, picking up a massive scissor-shaped instrument, and started punching four to five "holes" in his calf, as nonchalantly as though he were popping bubble-wrap. My eyes wide-open in shock and mouth a giant circle, lay hidden under the face mask and shower cap. I gulped as the scalpel made its way towards the inguinal ligament, all ready for an incision. I tried to regain composure, assuring myself it would be little different from the dissection we did in the first year.

Only, the skin was the palest shade of brown inside and the blood brighter than ketchup. And I thought they used to exaggerate in movies. My knees grew weak and the room turned dark. I was nauseous and dizzy. All I wanted was pure water and fresh air. I moved aside. Asked whether I was giddy, I nodded, only to be dragged to a nearby bed and made to lie down, the mask and cap pulled down. Before I knew what was happening, a senior grabbed my legs and held them up, so that blood would rush to the head. I went red in the face, both in response to the position and out of sheer embarrassment. I just wanted out of the place, but no one would let me move from the awkward situation.  Declaring myself fit, I heroically went back to the table, but stood behind a screen of students to prevent me from seeing anything, staying sufficiently hydrated, till the varicose vein was removed as required and stitches were put in place. I was the first person out that day.

Day two, we were to get into the wards. By the time I figured out where to go, the PGs had wrapped the ulcer in layers of bandage, leaving little for me to examine. Seeing no other work to assign, they instructed us to take the case history of the patient. There began my next trip downhill – I knew zilch in Kannada, to converse with them. I focused on reading expressions and body language instead, but that only made things worse. I kept empathizing beyond tolerance point, and felt a lump in the throat as I watched the 48-year-old's mother pleading to let the doctors amputate his affected leg, 'for he was useless at home anyway'.

The son was understandably too overcome with emotion and refused to speak anything eventually. Helpless, we explained the situation to the Sir in-charge when he came to check on us, because of which the patient got reprimanded and was told to respond to our line of questioning, 'or else…'

Hesitant at first, we returned to the basic scheme of history taking – name? Age? Place? Occupation? Seeing me clueless, my unit mates generously translated basic sentences to Kannada and asked me to repeat them. As gently as I could, I pronounced each syllable, waiting for the answer. Only, he was as blank as me. My classmate repeated the question, almost too quick for me to comprehend and the response came, glibly.  Not fair, I thought, and decided to listen and learn before confusing him with my accent. Slowly I gather what to look for, how to do so and more importantly, how to stand on my own in the most hostile of environments.

With each passing day, my knowledge of medical terms in the local language is growing, but so are my doubts and fears. Does being headstrong enough to look at a surgery undeterred mean I'd be too desensitized to feel basic compassion? How do I strike a fine balance between empathy and nerve? Will clumsy ol' me fatally mess up a procedure or let my absent-mindedness leave items behind? Would I ever muster enough courage to break bad news – from terminal illnesses to unexpected deaths – to the patient or their families? Will I end up being indifferent to everyone's suffering, the kind of doctor who labels all her patients mere hypochondriacs?

Whether I'd ever attain my goal of being a sincere, sensitive, successful practitioner:
In exact stages or otherwise,
only time will tell...

The Perils of a Medical School Neonate - Springing into Action.

To be or not to be:

Most of the batch had decided to go with the second choice. Who cares if it was a college tradition, we were different. No matter that the seniors were prodding us to get things ready, the previous edition had raised a few issues, so our year wasn't entitled to one.

Till Pallavi, our class rep, took an instant referendum after a lecture:
"As you know, the first year students hold their Socials this time of the year... Now, how many of you want it?"
Not a hand went up. A couple of sneers later, the class looked around to see who was bold enough to disagree. Apparently, no one.

Miffed, Pallavi announced the program was thus cancelled and stormed off.
The noise levels came down a tad bit, people still buzzing about the event on their way to the Anatomy lecture hall -
Socials for our notorious 'anti-social' batch? A night of mixing for a batch always hidden in their books? Come to think of it, most kids probably never realized 'fun' was a part of function. Nobody could see anything positive emerging from the whole affair. The girls were annoyed by the unwritten, unbroken 'Sari-only' rule. Why bother?

I was on the fence on this one. I was certain my batchmates would be more comfortable clearing cadavers off fascia than approaching someone from the class whose existence they weren't particularly aware of.
 For the same reason, I wanted it to take place, if only to launch people from their cocoons. I  let my fear of being noted prevent me from lending Pallavi any support; I had been all for it when she first mentioned the matter - but I wasn't so sure myself.
Here were a hundred kids, who saw a week-long mass bunk go awry with lack of basic unity. Yet, weren't they the same bunch that had the guys cheering their girls' teams and vice versa for the recent sports events? The friction between the seniors and the female half of the batch made me reconsider in favor of the soiree - word had it we were to be royally ragged on the big day, hopefully cracking some ice between freshmen and their superiors.

A few of us quietly took over the process of convincing everyone of the need of the hour and setting up the evening to perfection. The equivocal were roped in with certain strokes of genius, while the outright-opponents weren't as easily swayed.

A dozen of us assembled after class around the within-campus (dry) pond. There stood Samreen and Roshni, small talk in progress with Bibi and Charulata, next to Pallavi who was busy in conversation with Shanmukha, slightly hiding Rahul and Melvyn from view, a couple of meters away from who stood Utsav, Vinay, Manoj... the group was bigger than I'd anticipated. What am I doing here, I thought. I had no clear visions and clearly no talent useful for the show. Still, tag along was all I had in mind originally, and little harm done.

Soon as we established the fact that we would do everything to make the night a reality, we set off in two directions to book a ballroom. Some tempting offers later, we settled on nearby King's Kourt to avoid transport hassles. Only, that also meant the date had to be fixed - the options weren't the best possible, but we had to move fast. April 9th, it was decided, despite the guys fighting for more time for blazer-hunting. I was pleased, till I realized one of my friends couldn't make it. My enthusiasm was running out - I was more spectator than participant and no longer held much faith in our abilities to move mountains. When I said 'don't mind me', I was hoping to be more accommodating, but who knew I'd be taken seriously.

We stayed back after class the next day, assigning everyone roles and I had to come up with a title for the event. Naturally, when brains were called for, my system shut down and I was blank. Pulling Melvyn in for inspiration and borrowing Rahul's phone for information, we set off to work - what does the function signify? What feelings does it invoke? What do you want out of it? No line of questioning got anything interesting from either of us. I fumbled with Google translate, converting random words into fancy foreign versions. 'Color', 'Diversity', 'Fun' - pointless.
"How about Primavera? That's 'Spring' in Galician," I joked. Somehow it sounded rich enough to the others. Twisting the whole concept to revolve around 'a new beginning' theme, the name stuck. Funnily enough, neither he nor I was satisfied. Regardless, we went about figuring out a tagline to follow it with, till we struck gold with, 'If Winter comes, can Spring be far behind' from Shelley's 'Ode to the West Wind'. Happier, we spent the rest of the evening fitting things into budget, and simply chilling.

'Twas the afternoon before the Socials. There sat Pallavi and I, paying no heed to dissection, more interested in making sure everything was in order for the next day. The hotel was booked. The performances lined up. Mementos ordered en masse, banner printed,  invitations sent, items were quickly struck off the mental list, till she realized -
"- we have no MCs for the night"

Before that could sink in, she suggested Melvyn be the anchor. And me.

Not known for her humor, she wasn't joking, but I was tempted to burst into laughter anyway. The idea was ridiculous, Melvyn would do it alright, but me? I made a fool of myself the first time I took to stage at the raw age of five. I hadn't spoken onstage for a good six years. Heck, the last time I went there was for the Fresher's Day disaster. My mind was up - No. Way.

Neither would hear of it. Who else can do it, they argued. A couple of names were at the tip of my tongue, but they'd said the magic words. I did the unthinkable. I reconsidered. I disagreed. I thought further. A few rounds of silent debating later, I had my answer:
"What have we got to work with?"

 What if my performance was forgettable, or even memorable for the wrong reasons? Atleast I could try something new, boast of having played host, be part of an entirely different experience, and I had Melvyn to back me up. I was in.

That indomitable spirit was short-lived. It was no cakewalk. Neither of us had ideas conventional in MMC. Little by little, we strung our plans together, painting as big a picture possible, a brainstorming duo. Surprisingly, I was able to contribute a lot to the writing process, but I had no faith in my speaking. I was dead nervous.

I owe it to Rahul, for inspiring me to get back on my feet: "People don't know your past. They don't know whether you have hosted a million programs before or whether this is your first. All you gotta do is go there, full of confidence and show them what you've got."

Saturday came before we could pronounce 'Primavera' properly and it saw its allotted emcees bunking class for an early morning practice. Take one, take two, maybe three. We were bored with rehearsal and gave it a rest, watching everyone else instead. It ought to come naturally, and we didn't give it any further thought than that.

By two in the afternoon, we returned to our hostels to glam ourselves up. Draping the sari itself took two attempts and I was wondering how the rest of the evening was gonna be. By four, all of us were instructed to assemble in our quadrangle, some pre-Socials ragging in order. A half hour fashionably late, we waited at the far end of the ground, standing according to room numbers.

Manisha, Laxmi and I - roommates through celebrations and controversies, more trouble to each other than anyone else, stood hand-in-hand wondering what we'd be asked to do. Watching everyone being called in groups of three and hazed based on their 'hobbies' we were thinking of ways to outsmart them. Well, my interests were creative writing and drawing and I had no problem demonstrating either one there.  We were summoned, and put through the customary questions.
Laxmi was asked to sing something she didn't know the lyrics of, which we were supposed to dance to (talk about originality). To save face, I volunteered to sing 'Pretty Woman' instead. They couldn't care less, so agreed. We were let off after that, till I was called in time and again to sing some other song.
The ragging took longer than anticipated and the organizing committee broke into sweat - we had the hall booked only for a few hours and we had to rush if we didn't want to hold our Socials out in the street.

As soon as pencil-heels permitted, we hurried off to the hotel, where we got busy checking the sound system. The hall was decorated neatly, the mini-stage highlighted with a huge red banner, everybody was looking their finest and I had butterflies in my stomach. No one had any idea what was going to happen.

Seeing my co-host relatively relaxed, I completely let go. Somehow I could go from unbearably restless to the zenith of serenity within seconds and I was waiting for the signal. Pallavi's welcome line:

"O-okay. Hello, good evening everyone. Welcome to this year's Socials. As you can see, we - we didn't have much time to assign hosts for the show, so we would like to request one of you to please come forward. Anyone?"

Déjà vu. No limb fought gravity. Pallavi was about to respond when suddenly, from the back of the audience:
"Pallavi, Pallavi, I'll do it. Me!" He ran towards the mic and grabbed it.

Running his fingers through his hair, Mel continued, to deafening applause and cheers: "See, those guys want me here, don't you?"
A spirited yes-no chorus later: "Ah, I feel at home already... but it's starting to get a little lonely up here. How about some female company?" followed by loud hooting. "Divya, why don't you come up? Punya?" and a couple more guaranteed-not-to-come-up-and-ruin-the-whole-plan girls.

"I know! Yes, the perfect choice, why didn't I think of it before?"

 Keeping the crowd guessing, he announced:
"Ladies and Gentlemen, put your hands together for your hostess tonight - Ms. Lamya Ibrahim!"

Spotlight on me. Was my head shaking frequently enough? Were my eyes popped-out convincingly enough? Was my mouth too wide open? I never did find out, but the audience was wild. Giving in, I drifted towards the stage, looking peeved, when he broke into a romantic Kannada song, leading to further catcalls. I took the microphone and  offered to show him how to do it, after reprimanding him for lack-of-seriousness. All scripted, mind you.

I read a monotonous speech that was both boring and informative regarding the name. In the middle of my robot impersonation, Melvyn snatched the offensive scrap of paper from me, balled it up and threw it towards the delighted audience, to my mock-anger. Citing that a reason for introducing the prayer song performers, the two of us moved towards the side to make way for the singers.

Silent understanding, tacit reassurance, a mutual can-do attitude - we might survive the night after all. Regaining composure while Sam and Roshni explained the initial round of games, we sat back to watch everyone getting into the spirit of things. Shortly, our Physiology PGs and an Anatomy sir, our official chaperon, arrived. Not wanting to keep them waiting long, we shuffled things around a bit, and this meant improvising a lot. Wonderful.

Next came the 'Rose bidding' which was the highlight every year - roses auctioned off to guys (and in rare cases, girls) eager to wear their hearts on dry-cleaned sleeves. The first one, a 'special rose' showed promise. What started off at 499 bucks endeared an aggressive bid to end at Rs.1500. The atmosphere dampened a bit with the Bollywood drama, declarations of undying love, that followed the flower presentation.
The second rose, 'Pretty Woman', was offered a starting price of 300. It looked like none of the ladies was getting the flattering title. "Four," came the bid, eventually. Another battle followed and the rose ended up with the original contender at 800.
I was called onstage, this time not for hosting duties. Presented the red rose, 'for friendship,' I was at a loss what to do. I mumbled thanks, took the rose and left it with a friend.
More roses were handed out, but the program stretched to breaking point.

We decided to bring in the performers - first up were Rahul and Samreen, who introduced themselves with breathtaking solos before moving on to an admirable cover of 'When you say nothing at all.' Charulata followed with a song from 'Wake Up Sid!', encouraging the audience to sing along. The last for that segment was Bibi who decided to entertain us with a rendition of 'Tu Bin Batayein' - unfortunately a terribly slow song. She started off-key, but thought better than to stop and continued despite massive jeering from the crowd. Laughing in between, she sang till the end, walking back to her place in the audience to the loudest applause of the night.

Prolonging dinner no further, buffet was declared ready. Oddly enough, even the normally-insatiable Melvyn was too worked up to force a plate down his throat. I looked around and was glad to see almost everyone had turned up - heck, even Spoorthi who went on a hyperventilating spree when asked to don a Sari, showed up in Salwar Khameez - and happier still to note only the waiters were bored.

Song bidding  went on same time as the collective stuffing. Anonymous dedications, impossible auctions, photoshoots, all brightened everyone's mood and it was time to announce a few more games, especially ones pairing opposite sexes up. Participants and onlookers seemed to be having the time of their lives, when the hotel staff approached us and asked us to quiet down, inquiring when we'd empty the place. There were important clients checking in and they needed the hall as well. So, in addition to two wardens' midnight curfew weighing down upon us, we had to cut the night short by another hour.

Which meant, we couldn't invite Rahul for a stunning cover of 'Hotel California'. Which resulted in the cancellation of Melvyn rising to a mock-challenge to surprise everyone with his flawless singing of 'Yesterday'. Which saw us moving on to the later stages of the evening, fast forwarding to the presentation of titles, predetermined both by the boys for the girls and the other way round.

The girls were given titles based on aesthetic qualities, while the fairer sex displayed their wit in the names they called our boys. "Ms. Looks" went out to Bibi, "Ms. Fair & Lovely" to Vandana, "Ms. Chubby Cheeks" Kriti, even "Ms. Petal Eyes"  yours truly. "Bucket Rani", "Ms. Chatterbox" and "Ms.  Tomboy" dared to deviate from that theme to give Manasa, Spoorthi and Laxmi their titles.

In the meantime, Shanmukha, the event's main organizer, earned 'Mr. Punctuality' for his sparse attendance, while the 'barely-seen', in an entirely different sense, Pragati was determined Mr. size zero. Mr. Zygomaticus Major, in reference to the most-exercised muscle of athletic Utsav, saw him sporting his inexhaustible smile to justify the vote, while his big dreams and infinite slumber saw Melvyn crowned "Dreamy boy". Abhishek R. became Mr. Retro, while Jom was 'Mr.Draupadi'  for being forever in the presence of atleast one of the girls. Everybody's favorite Nandan turned out to be  'Mr. Threshold' and his own buddy Ganesh 'Mr. OOOO' - the former for his infectious enthusiasm in doing things big and small, and the latter with respect to his vocal reactions at the dissection table.

The hilarious ones were over and now it was time for serious business. First, who was to be 'Mr. 2k10'. Determined by the public, the line-up included everyone from drama king Mukherjee to ubiquitous Melvyn. The votes were counted and good-in-every-sense Pratap emerged the winner.
The ultimate race was for the 'Rose Princess', the very essence of the night. They were all good friends with everyone, the nominees - Manisha, Roshni, Vandana, Bibi... but it was for Samreen that almost every hand in the room (including both of mine) shot up. Unanimous choice, yet she was still surprised while adorned her sash by the batch's other musical marvel, Rahul.

Barely minutes left to be thrown out, we exited the stage to let the audience take over and dance into the night, to all kinds of tracks. With much regret did we unplug the music system, helplessly trying to pacify the students and the hotel staff. Time to hand out prizes, bid goodbye, and to thank all. Melvyn and I were grateful to every name that came to mind, exhausted from standing more than 5 hours.

In fact, so tired was I, I didn't bother to stay back for photos after ending the show. So bushed, that my legs gave way on approaching our hostel just before midnight, and I collapsed into my friend's arms. Nevertheless, we stayed up a few more hours, recollecting every detail.

I was disappointed that I got more noted on how I looked and for the irony in being ragged into singing a song which shared its title with my rose than for being one of the hosts. I kinda resented the lack of appreciation for not letting my voice ever shake, for not tripping over wires and falling flat on my face, not standing clueless in the middle of my stage debut and a million other catastrophes that I was perfectly capable of. Still, I was riding high on the overall success and decided to hit the sack only on realizing we had some college clean-up campaign early Sunday morning.

"Good night, sweet dreams."

One of those rare moments in life, I had had both before turning in for the night...

The Perils of a Medical School Neonate - Tip of the Iceberg

"There are two things to aim at in life; first to get what you want, and after that to enjoy it. Only the wisest of mankind has achieved the second."-- Logan Pearsall Smith

It preceded with a desperate attempt to make it into any of the several hundred medical school's in the country. It drags on with strenuous efforts to prevent anyone else repeating the mistake.

"To all those aspiring for a seat in medicine, a golden piece of advice: Turn away, head back, run while you still have the chance."
If I had stayed back, cocky about my determination and perseverance before, I now stand corrected. Plunging head first into the first year, I'm willing to belt the same chorus till my larynx begs for mercy - the way I see it, helping humankind formed the foundation of healthcare.

But, I exaggerate.
One thing that isn't blown out of proportion, though, is the amount of diligence required to make it through the course. Be it through a systematic approach of daily revisions or the stupider, harder alternative I chose - figuring out on spotting the questions ("Hey, c'mon, that needs brains! Not memorizing stuff.")

Funnily enough, the reality often strikes you when you're left with just the second option.

Right at the beginning, I was determined not to let a bruised ego and punctured dreams interfere with my ambitions. Soon as it was time to get our textbooks, I dialed everyone I know with a connection to the field, jotting down which ones to purchase. After receiving several conflicting suggestions, the criterion for selection was crystal: If the author sounded familiar, buy.

Thus arrived B.D. Chaurasia, Ganong and Harper as the first occupants of my bookshelf, Grey's Anatomy missing a spot because of its sheer enormity (Even my madness has a limit, I believe). A Guyton, two more Biochemistry books, several A.K. Duttas & I.B. Singhs, Netter's Atlas and tonnes of slowly-collecting dust completed my collection for the year.

Now, I stink at handling pressure. When stress comes into action, I'm play-doh in the hands of Fate. In class, I stood tongue-tied whenever questions were tossed my way. I sought advice and vetoed the inconvenient ones, religiously following the rest. Wise words of "Visit the library, museum, lab, as often as you can" and "revise daily" got sidelined, while "Take it easy," "College is when you should have the time of your life", "Eat, sleep, relax", didn't. 


Mountain-loads of work catch up with you over time. The enormous pile stands in front arresting further progress, till you realize there's no other way but to plough your way right through. Yikes.

To add to the complication, I wanted to gain knowledge and not just score great marks -, the two were exclusive in my head and it never occurred to merge the two. So out went the exam-oriented studying and in with the devil-may-care attitude that threatened to be the end of me.

Till:
"Hey! The time-table for the first internals have been put up"

Confirming that wake-up call was a tiny crowd formed around the notice board.  I waited my turn behind a wall of 6-foot tall boys. The minute I saw the schedule, the anticipated tachycardia made way for momentary cardiac arrest. 
Pathetic.

Sure, the order of headaches was bearable: Boring biochem, then Physio and finally vast Anatomy with a holiday in between. The proverbial straw was when the white sheet mockingly informed us that we'd also be having practical exams of entirely different subjects the same day. And that break in between? Coincidence, one of the only two festivals Muslims celebrate every year happened to fall on the same day. Goat sacrifice to be substituted with human dissection?


As last resort, a few of us approached the Anatomy Head of the Department requesting her to reschedule so that we had enough time to head home and back. Other than being noted as Keralites in an otherwise homogeneous batch, that bore no fruit.

If you can't beat them, malign them. But bad-mouthing too ran dry as we teamed up to tackle the horror of the first set of exams as college students. Samreen and I timed virtually everything from breakfast to breaks between studies, together. We were still dazed about what books to follow, everyone offering their two-cents' worth, with us expecting bankruptcy in the scoring department.
One minute would see the two of us fighting panic attacks, immediately followed by bursts of mutual consolation, ending in 'what's the worst that could happen' lectures. The omniscient seniors promised it would be easy, we comforted each other. People have faced worse, we proclaimed wisely. Hey, it'll be over before we know it, we reassured, uncertain whether that was a good thing.  

Weeks turned into days, days to hours, hours to  - you get the picture. Before you could say 'oligosaccharides', it was the weekend before the first exam. Which coincided with the first time either of us picked up the forever-forgotten Biochemistry textbook.
Carbohydrates, Fats, Proteins, Vitamins, Enzymes - it was all too much to digest. We hit each other with questions, doubts, mnemonics, anything to speed the process up. With the internals time bomb ticking, we could sense every bit of hope receding. "Biochemistry is the toughest exam to pass. Kids usually fail cuz of it," kept ringing in our minds the more we tried to focus on the subject. Practical exams lay neglected, Biochem for her, Physio mine - we were pinning on good fortune to smile on us when cross-examined by stone-faced Professors. 
The subsequent 96 hours:

Day One -
3:00 - Quits snoozing, grabs Satyanarayan, flips through the 100-odd pages.
8:00 - Forces partially edible breakfast down, simultaneously swallowing formulae, flowcharts and structures.
8:42 - Astoundingly avoids major accidents while walking to college with noses in textbooks.
8:57 - Gives up, wishes everyone within a mile's radius good luck, prays for a miracle or two.
9:02 - After filling in the essentials, musters enough courage to check the questions out.
9:03 - Shock wears off. Pen meets paper. Answers come alive, breathing returns to normal.
10:05 - Surprised - been writing continuously for over an hour. 
10:45 - Saturated, with time to spare. Slows down enough to think.
11:00 - One among the first to obey 'Pens down!'. Still too cautious to heave a sigh of relief.
11:05 - Forgets all about the paper, and eavesdrops on batchmates to catch tidbits of revision I pray I'd retain long enough for the viva.
11:30 - Assembles outside the dreadful Physio lab. Echoes everyone else in chanting, "God please don't gimme 'Differential Leucocyte Count'!"
11:34 - Picks a number, walks over to table, sees questions. Would have danced with joy if table wasn't right underneath the Professor's nose.
11:40 - Collects apparatus required for WBC Count, blood group estimation and Bleeding & Clotting times. Sets to work.
12:13 - Almost done. Pricks self at least 6 times. Distressed. Not sure what is viewed under the objective are white blood cells or dust particles.
12: 30 - Gets work checked by Ma'am. Scolded for not recognizing the WBCs for what they are. Asked barely five questions before being written off as a hopeless case.

By lunchtime, I was back in hostel and all set to rush through another Marathon of Blood, Nerve and Muscle Physiology for the next day.

Day Two:
3:00--11:00 - Little different from the previous day.
11:05 - Wishes everyone luck, relieved that own batch hadn't an exam in the afternoon, thanks to the Anatomy Dept. holding their practicals only the following week.

Relaxation coupled with homesickness set in. The next day was Eid-al-Adha, a holiday always spent with family. Last thing on my mind was Anatomy, suddenly the scariest subject on earth.

Day 'break':
7:30 - 8:00 - knowing only too well we'd let festivities come in the way, Sam and I head to the study hall within campus to force ourselves to study.
8:00 - 13:00 - Barely half a chapter and the entire phonebook covered.
13:30 - Decide to treat ourselves to proper lunch, both of us in the mood for some nice, hot, cheese-dripping Pizza.
14:00 - Reach KD Road with the Pizza in full swing in my head, only to realize Ashitha, who tagged along, 'can't stand the stuff'. Settle for biryani silently.

More revision and further sulking were the other highlights of the day. Eid Mubarak.

Day four:
For 99% of the batch, the fine line between Days 3 and 4 was invisible. No one slept that night. Except yours truly, unwilling to sacrifice  sleep even on the eve of an exam I was risking failure in. Sneaking in 4 hours,
2:30 - Wakes up, scared of having overslept, seeing everybody buzzing around with their books.
3:00 to right before the exam - An endless cycle of studying, forgetting, hyperventilating, pulling self together.
9:00 -  Stunned on seeing questions - couldn't have hoped for anything better (Actually no, but let's not go there) Mechanically answers the entire paper, squeezing in diagrams every chance gotten.
11:00 - Gives paper up, hopeful about passing. Rushes to the biochem lab for Practical exam.
12:00 - Gone beautifully, elated that theory exams were over. Anatomy practical exams light years away, at that point of time.

The atmosphere in the hostel was wild. We were like life-sentenced prisoners pardoned for good. Even sleep could wait, celebrations were called for. That night saw us all huddled together on my bedroom floor, playing everything from Rummy to the Killer, talking about anything but the exam.

Despite having half a week to master the subject, we were in no mood to hit the books. A revision class in the dissection hall soon brought me back underground - that was when realization struck how pathetic my Anatomy paper actually was. I listened eagerly as friends explained everything possible about Upper and Lower limbs, determined to recall them exactly for the exams.

Minutes replaced hours again and it was the eve of the newly-crowned scariest exam. While students of the previous batch assured us it wasn't a nightmare at all, I knew that few people would have gone as unprepared as me. I fought sleep as much as I could, skimming two volumes of BD Chaurasia, scanning the Atlas, and toying with bones to learn each crest, foramen and attachment with total conviction.

The big day:
I felt smaller than the slides in Histology, just wanting to run away, buckling under pressure. Solely depending on everyone's claim that nobody failed Practicals, I somnambulated all the way to the Physiology lecture hall, where we were to attend an hour's class before attempting the exam. After contaminating my meager supply of Anatomy with bits of Physiology, I joined my batchmates in going to the Dissection hall, not at all ready for the exam.
By God's grace, the spotters were all within my range of knowledge and I didn't have to resort to guessing much. When I saw the specimens I was assigned, the dark clouds over my head quickly got buried in bright sunshine: I got the 'humerus' for Osteology and 'Knee joint' for Gross Anatomy, both of which I knew enough to bluff convincingly about.
The icing on the cake was when I got the Professor who went easiest on the questions. I couldn't believe my luck.

My performance was nothing great, but I was just grateful for not having fallen flat on my face. Then realizing I hadn't gone through a single word of Histology all that time, I rushed to a quiet spot to get acquainted with the topic.

Sharp at 14:00, the exam started. We were given a slide each, which we focused while students were called in groups to conclude what spotters were displayed. My slide required no microscopic inspection to be identified - the only one with no Hematoxylin/Eosin stain - without doubt the section of a bone.

The smile didn't last long enough.

The examiner started his viva. Which stain is used here, he asked.
At my wit's end, I blurted, 'Silver stain, Sir.'
I cowered under his piercing stare, unable to answer his next question.
'I don't know, Sir.'
Well then, he informed, that's better than coming up with your own answers. In a disapproving tone he further told me that there was no stain involved in the slide preparation, and followed it with a barrage of several other questions, eventually their answers too, as my voice box and memory conspired against me.
This time, I honestly couldn't believe my luck.

Exams were officially over, but the 'tragic' ending spoiled my mood. Besides, Samreen's exam would be finished only 48 hours later and we still had a lot of studying to do. The next day being a Government holiday, neither of us left her bedroom, incorporating every sentence of the book into our minds. Ironically, it was after my exam that I studied the subject thoroughly enough to pass off as a medical student.

Before long she too was done with hers. It took some time for the sense of liberty to sink in. The tests were ancient history and all we needed was a total change of scene. First thing we did was ensure we paid off that Pizza debt - off we walked all the way to Kalidasa road, twice the normal distance thanks to a wrong turn, drinking in sights of the gorgeous city: the expansive grounds of Mysore University, dotted with graceful pine trees;
 the ladder-like railroad viewed from atop a traffic-laden overbridge;
 walking parallel to the calm waters of Lake Kukarahalli, along the busy side of the fence;
 discovering Café Pascucci, the most delightful Italian place to dine;
 a quick dash to Loyal world, entering Big Chicken, only to leave immediately;
 excitement that couldn't be suppressed on stepping inside nearby Domino's, to order a small Pizza;
 crossing the road to reach Pizza Hut for a second helping;
 finally riding a rickshaw back to hostel, where we snuck in a borrowed laptop to spend the night watching movies in Samreen's temporarily empty room.
The perfect ending to reverse a not-so-great beginning.

I'd like to say that after that roller-coaster ride, I turned over a new leaf and into a sincere, responsible, regular student to live medically ever after - if this were a fairy tale. Thankfully, both of us passed all three with above average marks. But more than acting as a driving force, it only encouraged laziness further, in my case, inflating my head with ideas of 'you don't need to work so hard to get what you want'.
Newly-acquired old habits die hard and I am no exception. Soon, I was back to 'eat, sleep, relax' this time with a better justification: I just got done with slogging for a bout of exams, I deserve a break!

And, break time it is.
Till the next post,
Au revoir.