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...