Friday, December 23, 2011

[UN]Reality TV: Part 2

Grey's Anatomy, now this one show which raised my expectations like none other. The doctors were all so good-looking, Katherine Heigl was a lead protagonist & I don't have to explain how much she excited me. The men on the show were real men, surgeons who held life by the balls & made it dole out what they wanted it to. The hospital was never short of exciting cases, brilliant procedures. Everyone was free to do what they saw fit. Importantly, I can't recall a single episode where an intern collected blood. Ah, those were the days. 

I went through around 3 seasons in 2 months time. And in the span of some 40 episodes, they'd found a bomb in a body, almost killed a patient and brought him back because Heigl was in love with him & they'd got to scrub in on cardiac surgeries! Yes, Cardiac! The hope of an intern scrubbing in on those is even more perverse than Dr. Chase actually coming to a surgical diagnosis on House MD. 

I remember reading an article that when House MD was pitched to the network executives by the creator David Shore, he promised them a medical drama which wouldn't be all about white coats talking in corridors; a show where the diagnosis would be the lead character. Imagine the exact opposite & you've got Grey's! The show revolves more around relationships than even The Bachelor. Everyone's more concerned about who they're gonna wake up in bed next to than their own careers! 

Dear aspiring doctors, because I'm your friend, I'm going to tell you the harsh truth. While you may find time for a relationship while studying medicine, it's by no means the way its portrayed in movies/tv shows. They want you to believe that you're so stressed with your practice & studies that you just crave quickies for venting frustration. They're WRONG!! Medicine is that bitch which holds your life by the crotch and steers you around in meaningless circles till either your social skills die or your libido does; you decide which one is worse. Most people you'll find are so intensely career oriented that they that you can literally smell tyres burning before you ask them out on a date. Here, time is short, unfortunately tempers are too. So, if you planning to join us in this worldwide social experiment, ask the professionals; stop watching TV shows. Ironically, at the end of five years of training, I can't say I'd like to date anyone apart from a doctor myself. Am I just a glutton for punishment or a perverse sociopath? Medicine's a bitch that also screws with your mind. Did I say that already? Well, now you know. 

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Monday, December 19, 2011

[UN]Reality TV: Part 1

OK, if we could only go back a few years when I was busy prepping for Med School, I'd tell you that Scrubs and House were my favorite shows. I spent the better part of my free time away from books admiring Sarah Chalke and wondering why Jennifer Morrison couldn't be the same. Anyhow, my basic presumptions about med school, medicine in general, and the work environment were so freakishly flawed by these shows, I wonder how I adapted to reality in the first place. And that's not it! One of my friends got me started on Grey's anatomy right after I knew I was gonna get into med school. It took her 2 full months before college began to realize that the show is named after the book, not the other way around! 

So, I'll be sharing my breakdown of the top UNREAL medical shows on TV over the next few days. Here's presenting House M.D:

House M.D revolves around the life of an egotistical, ingenious, ACDC listening, vintage t-shirt wearing, bike-riding, sadistic prick, who would rather get jailed than listen to a patient. Everything on this show is done STAT. You need a f-MRI with PET Scan at 2am, no problems. You want a lap dance at noon, why not? You want to diagnose a never before discovered condition quickly, because you have a dinner reservation. Why not? After all, the show is only 1 hour long.. Oops, 40 minutes without the ads! 

The general surgeon on the team excels in micro-vascular surgery, neurosurgery, urosurgery, ophthalmology & of course, Internal Medicine. That's right, the Genral Surgeon!!

Lisa, I miss you!
The Rheumatologist tries in vain to prove every case is an SLE. The Neurologist looks like he's getting head under the table at all times, cause he fails to react to any outlandish theory that comes up. But, here's why I watched the show: Lisa Edelstein, the sinfully adorable chief of medicine, who I learn has recently left the show.

I'd end this rant by adding that there is no such thing as a department of Diagnostic Medicine in my hospital, regular patients are not that interesting & the doctors are seriously not that good looking, well at least most of them aren't.

Sunday, December 18, 2011

Timing, my dear boy

I'm a punctual person. I always have been. I'm made fun off for always arriving on time for dinners and lunches, while everyone else believes it's important to add the :30 at the end of whatever time they've been told. I'm also anal about getting to work on time. Its more peaceful to wake up a few minutes early, than seeing a constipated face shout at you early morning. So, since I'm so considerate of those around me at work, I expect they be the same with me. I ask only to be left on time. 

For the sake of anonymity, I can't really reveal where I'm currently working, but it's a magical place. As long as I arrive on time, finish my work, I can leave on time. I haven't yet been asked to wait "in case a patient shows up", as asked to twiddle my thumbs. I finally have defined work timings, unlike the other clinical rotations I've had! Some of you may give me some shit about how a doctor isn't supposed to have proper timings & we're supposed to report whenever required. Yeah! When was the last time you lost out on sleep, missed a close friend's engagement, drove 20 kms directly from work to reach a birthday, only to realize you're too late!

We  need to let people go home in this country. The concept off being on-call 24x7 doesn't work with the patient loads we deal with. Accountability suffers in the present scenario. There've been patients who have been taken for surgery without viral markers being in time, only to find out after the surgery that the patient was sero-positive. And I can't imagine how difficult it must be for the first year residents themselves. Even if you live a stone's throw away from the hospital, you still can't go home more than once a month. Someone really needs to stop this madness.. STAT!

Monday, December 12, 2011

Red Suede Shoes

I spent the better part of last week figuring out what was wrong with me the past month. Was I demented? Was I color blind, or just plain sleep deprived? Or was it someone else's mischief at work? How in god's name did my shoes all get so much blood all over them? Ok, for at least one pair, I had the answer; I was a little hasty and overzealous with a central line insertion. But, for the others, no idea! Even my brand new Nike Classics! Hmph

Now left wondering how I go about fixing this mess. The regular shoe laundry isn't taking any calls. And I'm far too lazy to take care of things myself. Maybe I should just get a spray gun and coin the term "Red Suede Shoes" instead. This entire episode got me thinking about how I badly need a new pair of sneakers for use restricted within the hospital. Or maybe I could borrow those nifty plastic shoe covers we use in the OTs when we have a seropositive patient. Will walking around the entire day like I'm avoiding the flood be a bit too funny? Anyway, finally decided on a cool pair of sneakers to buy. It's not so much about fighting the blood now as it is about flaunting it 

Wednesday, December 7, 2011

Nothing Routine About It

Ok, so I worked tirelessly in my I.Med rotation & it still wasn't enough to finish off all my blood work in time. If I wasn't sending the samples, I was busy procuring bulbs, tubes, bottles & media to send them in! The dreaded "Trolley System" is enough to strike a fear into any intern's heart. For those who don't know, the labs send faceless, nameless & humorless drones with elaborate trolleys neatly marked, into wards at set times during the day to whisk away samples. Time & the trolley men wait for no one! I've had quite a few productive runs tracing the trolley men up and down elevators before they disappeared into their secret passageways.

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While I couldn't really blame my professors and senior residents for demanding a lot of investigations in I.Med, I can't say the same about surgeons. Ever heard the old adage, "Physicians know everything and do nothing, Surgeons know nothing and do everything"? There're so few things a physician can do, that I think they keep ordering crap for interns to get done because they feel an HRCT for a cold could reveal bronchiectasis! Surgeons on the other hand shouldn't need that many investigations, at least that's what my logic told me. So, last month, either my logic failed or my luck did. The unit where I was posted decided it would be great if they could conjure up not one, but two "All-routine" days every week. These were days of joy, laughter & melancholy where I would have to send each & every damn patient's CBC, renal & liver function tests, FBS & PLBS! Ah, what fun! It didn't matter if the patient was a comatose case of polytrauma, or if he just had an abscess drained. The non-discriminatory intern would swoop to their hematological rescue. 

Over time, I grew quite tired of the entire "All Routine" routine, more so with the explanations I had to give patients. They were obviously not willing to give blood for no good reason so often & half my time went in counselling them. Some I could have a good laugh with, others I had to be a tad serious around. There was this one particular chap, who was quite paranoid. Every time he would come up with a new excuse like giddiness, pain in the arms, feeling just about ok & sometimes he wouldn't even grace me with an excuse. On my last day, all I could muster was, "You know what? This hospital pays me crap. How am I supposed to make money on the side if I don't sell blood?" 

Monday, December 5, 2011

Friday, December 2, 2011

Dear Med Student

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So there I was, minding my own business one day during rounds, when a pack of med students suddenly came up behind us. It's extremely funny to think you were one of them not so long ago, but one can't help but be critical of what they do. Circle of life I suppose. Big fish gets to criticize little fish, make it cry & then eat it.

There were all in their second year, in the first surgical rotation. It was so cute how they didn't know what to do. "Should we talk to the professor? Should we tell the resident to teach us? Should we have a look at the patients while the rounds start? When can we leave? Would they notice we're gone?"

Ah, nostalgia, why're you such a bitch?! Couldn't you make me reminisce without making me feel senile?

Anyhow, these guys walk upto me and ask which cases are worth discussing. I skillfully and effortlessly shot off patients that I knew would be too difficult for them, narrowing down on two cases. Seeing that I had to stay in the wards for the next one hour, I kept wondering if I should try my hand at teaching these noobs. Before I could utter another word, they had disappeared. One thing you have to appreciate about med students is, no matter how large a group they are, they can effortlessly appear and disappear!

So, my bungling batch of eager students, here're my tips on how to have fun, learn along the way & not make an ass out of yourself in the final year exams:
  1. Study. I'm gonna sound like an ass, but yeah, you came to med school. You're not an arts student. So, stop asking when's the last day you can afford to start studying for exams!

  2. Ask. It's wonderful what you can extract from your teachers with a simple, "Where? How? Why? What?" If you never ask, you'll never know.
  3. Stop acting like an ass at rounds. You may not realize this, but the hospital does not revolve around students. You contribute zilch. So, if you're attending rounds, you will be respectful to those who are working and pay attention, or at least not grab our attention

  4. Don't EVER reveal you're a student. A lot of patients in government hospitals already have a mortal fear that they're entrusting their lives at a substandard medical center. And then we have students who keep talking in Hindi & Marathi, asking each other questions, discussing crap, displaying their ineptitude, acting casually with the patient. There is nothing casual about fifteen people discussing your illness while you're lying alone on a bed in a strange place. Act like you know what you're doing even if you have no idea! Be confident, read beforehand, think about questions you'd like to ask and what physical exam you'd like to perform. Don't just show up, read the diagnosis on the chart, and then happily poke and palpate away.

  5. Do not be a critic. You will come across a lot of teachers over time that could do little more to grab your attention; worse, you could meet people who are hell-bent on teaching treatments that you could lift off any TV show depicting a witch-doctor. When you're being taught, you must be grateful. The next time that person is arranging a clinic, ask yourself if you learned anything the last time & decide whether its worth attending. Run around, follow, stalk, bully & pass on death threats to good teachers! Get them to teach you anyhow! Learn from them, emulate them.

  6. Teach. I can't give enough credit to my senior friends who taught me so well over the years. It was their clinical acumen, patience & support that pulled me through the exams. Medicine is all about passing on one's knowledge, whether it's to a colleague or a subordinate. Teach because you want to be taught. Circle of life