The White Pillow

The last 2 months in Bombay have been the coldest in recent memory and yes, this is winter to me. I don't have to be told about the inches of snow or the number of people dying due to the cold in your hometowns. The point I'm trying to make is I DO NOT handle cold environments very well. My sinuses start acting up, get nosebleeds, brain freezes & my kidneys obviously start working in hyperspeed & then my legs cramp up from those light-speed approaching runs to the loo to avoid being seen by the residents. 

The problem with a hospital is that no matter how expensive, extensive and brilliant the air conditioning system may be, there'll always be these pockets that are insanely cold. Sadly these pockets hold that which is dearest during a night on-call - an empty bed! The story's from my OBGY rotation that had these awesome on-call rooms attached to the Labor Room. Sadly, they had a huge air conditioning duct right over the beds. The first couple of nights when I went in for some shut eye, I actually fell asleep sitting, trying to hide from the cold draught. Decided I'd be smarter the next time around by bringing some sort of blanket. 

I forgot. 

I was hoping my coat would be enough to sleep through the night. One thing about my gynac rotation was I hardly ever wore a white coat when the professors weren't around. I just felt it unnecessary. If I was needed, I put on the plastic aprons instead; much more effective against you know, blood, meconium and amniotic fluid flying about. Later that night when I went back into the on-call room to sleep, I found it pitch dark, tripped over someone's backpack and then almost sat down on what at first seemed like a white pillow. A few seconds of creepily staring at the pillow revealed it was my cute little tiny resident who'd regressed to the fetal position on my regular bed, with my coat on top of her! So much for staying warm tonight, unless of course she chose that bed for a reason and... 

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What?!? This isn't an episode from Grey's Anatomy! I got back out there and started working. Sheesh, the things people expect!

The Ideal Co-Intern

Now, I'm not one of them hippocrates who passes judgments on residents while leaving my colleagues alone. The Ideal Co-Intern is, in a lot of ways, more important than The Cool Resident. You share responsibilities instead of having them dumped onto you like a car parked underneath an aviary. You go through the same grueling routine, have the same rights, the same work timings. For that month of rotation, you're like Siamese twins, except with fewer awkward bathroom moments (Can't elaborate, you need to have been there, or maybe you'd rather not!). 

T'was two years back with a senior friend when the concept of the Ideal Co-Intern (ICI from now) took shape. He explained how it's not always beneficial to have a friend working with you during internship as the relationship sours over time, neither is it easy to have a total stranger who you don't have any pull on. He explained that delegation of duties is as important as showing up at all; and that you can't really survive without good people around. Here're the qualities of an ICI:

1. The ICI shows up, preferably on time, all the time. You two should have the SAME work timings, unless of course you're taking turns while on-call. 
2. The ICI gives two days prior notice for remaining absent, even if it's for an acute medical emergency. 48 hours are a bare minimum to finish crying and cribbing about the work you'll have to do alone. 
3. The ICI never tells the residents you haven't shown up. "He's off tracing histo-path reports", or the classic "The professor gave him some personal work" never gets old
4. The ICI let's you alternate shifts with that hot new extern who you've been meaning to talk to since before you knew her.
5. If you're surgically inclined, the ICI agrees to take care of the world outside while you're scrubbed in. 
6. The ICI always has backup lists of everything, so if you lose yours, no harm, no foul
7. The ICI shows up when it's not his turn, even when he has a hangover, because he knows you HAVE to show up hungover yourself. Wasn't that sweet?
8. The ICI does not entertain friends, relatives, strangers during on-call days. It's not cool to go visit your uncle, aunt, father, niece, fiance and spend ages in the cafeteria while your co-intern is slogging it out
9. The ICI never forgets to make it clear to the residents that you live extremely far away & that it you must cross mountain ranges, rivers and landslides to get to work on time
10. The ICI always calls at dinner time to make sure you've eaten
11. The ICI always has that elusive EDTA bulb when you need one
12. While on that point: the ICI is a thief! Their bag is littered with an awesome collection of syringes, needles, varied catheters, urosac bags, central lines, micropore tapes, labels & a phone charger! The ICI doesn't mind you raiding his/her bag ever so often
13. If you're romantically involved, you share those all-too-corny cinematic moments when one of you has only syringes and the other, needles
14. The ICI always starts work in the morning without waiting for you to show up
15. The ICI is always courteous and offers you the chance to doze off first while on-call
16. The ICI is NOT a sexist prick! Cause all women are more than capable of performing their internship duties with flair, and men shouldn't have problems getting basic work done by the ancillary staff just because they don't have the right type of 'pair'

P.S: I know the difference between Hippocrates & hypocrite. Do you? Or did you miss that altogether? Good job either way

Who kidnapped good 'ol Humour?

It may come as a surprise to many, but I was once a child. In my early formative years, I made friends with a chap called Humour. Humour was always there to protect me from bullies, unfair critique, and even some relationship issues I'd got myself into. Humour made me believe that as long as I had him by my side, nothing could go wrong; or at least if it did, it didn't seem so bad. Humour didn't ask for much in return, except to humour him when he was friends with other people. Humour explained, being able to take stick well is just as important as being able to dole it out with class. Sadly, it seems Humour didn't make too many friends over time. I pray to the mighty Bearded One each night that others discover my friend as I did, open their hearts to his awesomeness. 

Why am I ranting about personified abstract ideas? Well, because there's way too much "Real" out in the real world. It seems that somewhere between illustrating the Kama Sutra and humming along to Kolaveri Di, we Indians lost our sense of humour! Here's what you need to know:

• Top Gear, one of my favorite shows of all time is lambasted for making a documentary about a road trip across our great country which showed us as quirky, eccentric people in the lightest vein without being judgmental; but importantly, they were honest about it unlike a certain movie which the world lapped up. I'm pretty sure the presenters and producers steered  clear of the usual Indian stereotypes, creating new ones along the way. I thought the show was amazing, but hey, I'm friends with Humour. What do I know? More info here
• Jay Leno recently cracked a joke about Mitt Romney's wealth by showing a picture of the Golden Temple, saying it was Romney's summer home. Where he insulted the Indian community, I have no idea, but people aren't having any more of it, I tell you! Read this. Was it racist? No. Was it derogatory to a holy shrine? In my view, derogatory is a very strong term. The joke may not be in good taste, but is definitely not derogatory. I'm not trying to start a war here, but this doesn't even come close to the sort of insult and 'derogation' that other deities have faced in the past. One wrong doesn't justify another or make it bearable. But, one really has to look at it from the writer's point of view. Type in "Golden" in Google Images and and the first picture resembling a building is that of the Golden Temple. More than anything, the joke reflects the writer's ignorance. 

We're the land of a thousand cultures, a billion people from a million backgrounds, and yet we lack a single funny bone. Hey, it's a free world. People have the right to crack jokes and people have the right to be offended & lodge protests. But, I equally have the right to brush aside those protests because they seem to be stemming from what I can only imagine is a 10 year old cranky child quite pissed cause he dropped his ice-cream. Grow up for God's sake! 

There's this line in The Inscrutable Americans, "We Indians are extremely arrogant, without much to be arrogant about". I can only imagine how these borderline-hardliner protests make us look to the international community. I know the BBC refused to apologize for TopGear and I can't really see Leno doing anything else. Where does that leave the Indian High Commission in both these matters? Yes, looking like a child whose ice-cream just fell to the floor! 

Of Growing Up

You're all 'growed up' in medicine when:

• You enter the college library and can't recognize a single face
• You head to the cafeteria and can call out any attendant/waiter by first name
• Its worse when they know the order before you say a word
• You head to the common rooms and see the young 'uns completing their journals. You peek in to find you don't recognize any of the crap they've written or horribly drawn
• You have your own "Tab" in the canteens
• You know all the makeout spots in college. Been there, done that
• You know all the residents walking past and their food habits; "He's a strict vegetarian", "She's a heavy drinker", "He starves himself to make himself more attractive to that Dermat resident", "She never pays for the food bill!"
• The people you so sheepishly ragged when you turned into a 'super' senior ask you for advice on tackling first years
• You rub your face so often while brooding that your hands get beard-burn
• Your friends are categorized into: Still in college, passing out, passed out
• You have an utter dislike for all things un-medicine. Blood feuds with MBAs & engineers are not infrequent
• You can shoot down at least half the exam questions that're asked by juniors to leave only the bare essentials 
• Worse, you're called in to supervise their exams
• You use phrases like "Back then when...", "End of an era", "Time flies", & "Which rat bastard stole my steth this time?!?" 
• You begin to believe in the power of multi-vitamins in curing everything from fibromyalgia to pancreatic cancer

The Cool Resident

Woah! I think it's been ages since I last blogged. Partially cause I was out holidaying for New Year's and then I was detoxing from New Year's. Anyhow, I still had my awesome phone on me where I jotted down all the other itsy-bitsy ideas that I wanted to write about. So, if you were taken aback by my December Delirium, January, or what's left of it, should be a good ride.

"The cool resident" was born when I was interning in Internal Medicine. My first and third year residents were extremely likable, efficient, friendly, & respectful, while the second year was none of the above. As usual, I was spending the on-call evening with friends (sadly also on-call) in the canteen, sipping tea, discussing resident horror stories where we just labelled our senior colleagues as cool or idiotic. What better judge of residents could there be than a bunch of nosy fresh interns, right? Anyway, the concept of the cool resident evolved over time and rotations and here's what we've come down to:

1. The Cool Resident realizes that blood collection, hematology, histopathology is a part of a resident's job description and the intern is merely helping them out, NOT the other way around. He/she promptly starts work in the morning without ringing the interns if they're late, thinking that their oh-so-sexy-morning-voice is enough motivation to be on time for the "morning chores"
2. The Cool Resident  takes full responsibility for errors on the interns' behalf. Vicarious Responsibility is a reality, not a theory! 
3. The Cool Resident gives full credit to the intern for any clinical cues picked up. I hated my senior resident who told the professor he'd diagnosed a patient with Cheyne-stokes when it was I who had pointed it out! (angry fists flying!)
4. The Cool Resident never allows the intern to pick up the bill. I know this is kinda silly, but hey, I'm yet to meet a resident I like who left the food bill to me
5. The Cool Resident  chooses to order the awesomest chicken tikkas and ice-creams when on-call & makes sure the intern eats with the residents in spite of the workload at the time
6. The Cool Resident protects the interns from the nurses and the ancillary staff
7. The Cool Resident preferably plays a musical instrument or sings, even if its terrible. I can't tell you how the sound of crappy old Hindi songs just lifts you up after a night on-call
8. The Cool Resident has a tattoo. I'm just partial to them, period.
9. The Cool Resident allows the interns to perform procedures and offers full guidance during the same. Conversely, after enough practice, he/she lets the intern loose on patients.
10. The Cool Resident trusts the interns' clinical judgement when no resident is around
11. The Cool Resident takes the interns out drinking, because they did a good job
12. The Cool Resident rings up the interns months after their rotations have ended to bitch about their current interns. Its fun getting nostalgic together
13. The Cool Resident speaks to the interns with respect and realizes they wouldn't be where they are today without a solid foundation. They offer the same to their interns.
14. The Cool Resident protects the interns from the professors, associate professors and lecturers, and fights for the interns' rights as stated above
15. The Cool Resident offers to teach every step of the way, even if it means making the intern sweat for the carrot. Give & take. 
16. The Cool Resident makes you go, "Sigh, when I'm all grown up, I'll be just like him"