Sleeping etiquette?

I'm usually quite courteous & polite. I hold open doors, wait for people to finish their sentences & try extremely hard not to slurp my drink when I'm in company. But, for all my collective awesomeness, I can't ever figure out what's proper sleeping etiquette (not what you're thinking, I have that one mastered like an art). You see I'm over half way through my internship. I've done my fair share of night shifts & no matter where I am, who I'm working with, I hate it when 2am comes around! That's usually when the patients stop trickling in, the nurses start to go off to bed & the senior residents decide to run away without telling you, leaving you in despair, in silent need to slit their throats for loading you with the responsibility of any serious cases that may come by; but, I digress.

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Do I go sleep in the on-call room? If so, should I latch the door? Should I change outta my scrubs? There's this nice empty bed next to that patient, would he mind if I slept there? Or would he wake up all startled? Should I go off to bed before my resident? Should I ask him if there's any more work? How long will it take for me to go sneak into the ICU & sleep in there with those comfy beds & awesome airconditioning riddled with multi-antibiotic resistant bugs? Would I ever wake up from the ICU? Would the nurses mind if I hogged one entire end of the table, because for them, I'm almost an alien? Should I just stay awake? If I take off my coat, am I still on-call? Do these idiots even have my number? Could I just drive home right now? Wouldn't that be just perfect? And why God, why, can't You ever have a hot extern work with me during the night?

So many questions... Any answers? Seriously? I'm waiting

HTMKK

Nobody likes a faker! Not one bit! Not in bed, not at the workplace, unless those two happen to coincide. What's the most irritating part of a faker? That they continue to "act out" even when they've been "found out". They will just refuse to give up; talking about a good-for-nothing idiot persevering (wrong place, wrong time)! But, what angers me most is that I can't label my patients - Fakers. It seems someone came up with a cool term - Malingering. So, I'll have to run with that since using outdated terminology is frowned upon in medical circles. Look at what happened to the Ayurvedic doctor who said he was practicing Voodoo! 

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There're a lot of malingering patients I see regularly, we call them "chronic cases", we know their entire past medical history, family history, bowel time-table & even what they had for dinner last night, simply because we see them "chronically", at times more often than I see my family. Their papers read like the what's what in medical symptoms. Not a single organ system is missed, there're always gonna be multiple complaints & usually they come back within a day, "because the meds don't work".

Modern medicine has thrown in everything to try to describe this "condition". They deem it to be a serious disorder that "handicaps" a large section of the population. I, being the young medical marvel that I am, see it for what it is. I don't go around labeling patients, "Systemic Candidiasis Syndrome", "Fibromyalgia", "Chronic Fatigue Syndrome" or some other Voodoo, sorry, ayurvedic crap like that! Sometimes, a pussy is just a pussy! Surprised?

You can't show up in my clinic every other day with tingling & aches & a general feeling of unwell and have the balls to demand a diagnosis. I've run my tests, I've given you a head-to-toe examination, & yet, you have the nerve to question my medical knowledge? I've filled out your entire case history, written out the prescription for body pain & THEN, you remember you've got chest pain? Guess what? Fakers often tend to forget which symptom is to be given top priority, they're not too bright. They heave when they see me, but when they're with the nurses, their breathing normalizes. They come with a BP of 140/90 & say they have "Chronic Low BP". You know what? I should probably just immortalize my name in medical textbooks by creating criteria for a new condition "Pseudo-hypotensive hypertension syndrome". First 100 doctors to make that diagnosis will get a 1000 referrals & a pen from me!

To all these people who have the tolerance level of a fish outta water, watch the next video & Harden The Fuck Up (courtesy of MDOD): 

I have an old friend, extremely laid back & couldn't care less about any damning news you may have to give him. He came up with HTMKK, short for "Haan, to main kya karu?" for whenever someone shares some shitty info he doesn't give a crap about. For those not fluent in Hindi, its literal translation is, "So, what I am supposed to do"; But, when used correctly, it means, "I don't really give a fuck!"

So, don't be surprised to see FSD, HTFU, & HTMKK on your prescription the next time you see your doc

Quick! To the Laboratory, I've got Magic Hands!!

Me: So, how're you feeling today?
Patient: Doc, I've got this irritating cough & nasty high fever which just refuses to go down.
(I feel the patient's forehead & arm, definitely not running a fever)
Patient: (within a second) Seriously, I think it must've just gone down just now
Me: (mentally slapping forehead)

Eons ago, when I hadn't ruptured my internship's metaphorical hymen, I never really bothered with such patients. There was nothing I could do but take what they said at face value & move on. But, as time wore on, I kept noticing a pattern. I was the only person who kept seeing these patients. And according to ALL of them, "My fever JUST subsided".

This kept me awake at nights, wondering what it was that made my patients seem spontaneously healthy in my presence. I asked myself a lot of questions:

• Is my skin insensitive to high temperatures?
• Am I running a temperature, so I can't figure out if someone else is?
• Is there a Higher power at play?
• Am I exuding some sort of magic pheramone that makes people alright?

The first just wasn't possible, I had myself tested. Ditto for the second one too. I even asked God why he was playing tricks with me; I did not get an answer *cough typical cough*. What does that leave then? Magic Hands? Of course, that must be true! Off to the lab, I dare say... Let's take some biopsies, run a battery of tests, hook me up to monitors all day long, draw some blood, urine, stool, saliva, semen even. Run me dry! Bring me a slew of fever patients, let me cure them all. Perhaps I should start to grow a beard, wear a turban & be named "Fever Baba" instead. No wait... that's too primitive! I'll call myself Dr.Paracetamol™ ! I'll even trademark my name! Doesn't that sound like a plan?

What's the other option? Saying my patients are lying, that they're cases of Fibro or FSD? How dare you?!?

The Screenplay: Good Resident, Bad Resident

So, I mentioned I was writing something completely stupid & new in my earlier post. Believe me, it didn't  take two days to write the damn thing, I just wanted to build up suspense. In case you can't see the entirely oh-so-cool retro effect I've given the post with the font, you'll find it here. So, here's my first attempt at writing a screenplay:

Good Resident, Bad Resident

By

Scalpel Sculptor

Inspired by a true story narrated by

Helpless intern

Fade in. Interns, running around in a medical ward. Suddenly, the sound of shattering glass. Everyone moves towards sound. Fat Man at back starts roaring. Audible nonsense becomes less clear with time. The gathered start walking away. Fade out.

Fade in. Canteen. DAY. Interns chatting among themselves over lunch. Pan camera to door, residents move in. Cue stupidly dramatic music. Fat Man waves to interns to come over. Pan camera back to table, zoom in on girl’s eye filling up with anger. Pan camera back to residents’ table.

Interns told they need to do double shifts. Fat Man stops looking at interns. Interns stand still. He waves them goodbye. One of them gestures he would call to another resident [Friendly Resident]. Fat Man sees this through corner of his fat eye. Fade out.

Hospital Ward, evening. Intern on his way to meet Friendly Resident; “Don’t worry, I’ll take care of everything”. Intern breathes sigh of relief, removes his cellphone, dials co-intern’s number. Intern smiling while talking on phone, walking out of ward. Fade out.

Hospital Ward, morning. Interns called again by all residents together. No chairs left for interns to sit. Residents look constipated, interns feel nervous diarrhoea coming on. Camera zooms, shows jaw twitching, pans, shows fists forming. Fat man roars, “There is nothing you can do. Don’t try to go over my head. Eventually I’m the one you deal with. Know the consequences of antagonizing me”. Intern thinks, “Antagonize? Too big a word for fat man to know. He must’ve been told this speech”. He looks over to Friendly Resident. Change camera to Friendly Resident’s vision. He does not look at interns at all. ZOOM OUT. FACE TO BLACK.

Residents’Quarters. Night. Darkness. Glass breaks. Bed rumbles. The light from passing cars’ headlights shines through: shows intern with needle, he has pricked fat man’s head. All the hot air from his head is now leaving him. Gradually inaudible whistling sound fills the room. Another light shines through, Fat Man has now taken form of Friendly Resident. Metallic clink of needle falling on floor. Light shines on horrified intern's face!

CUT TO BLACK.

CREDITS.

END.

Good Resident, Bad Resident

Ever seen an old American movie about cops or even a bad recent one? There's usually a scene where the protagonist is taken into police custody, made to sit alone in a room for ages with the police watching him/her through a one-way mirror. With a loud bang, the door opens and two policemen walk in. One invariably looks better than the other, cause the latter looks like a rabid dog! The decent looking chap starts asking the questions, explaining how it'd be nice if they'd cooperate. Every now and again, the mean cop would shout, scream & finally threaten. The hapless convict feels safer with the decent cop & eventually does what he says, even though that isn't in his best interest. This entire charade is called the "Good Cop, Bad Cop" routine. Neither one of the cops is actually good (at least in the movie), and they pull this off in unison after having discussed how the interrogation should play out. The entire idea revolves around the fact that when you're in a fix, you take whatever help you get, whoever you get it from! Hey, at least it's not the cheesy third degree that you find in Indian movies!

Now imagine this entire scenario with an intern in the midst of a lot of residents. Incredibly bad residents are  generally difficult to find. Those that fall in the gray zone are a dime a dozen! Off late, I've kinda been a magnet for the most ghastly ones. Most of the times, these 'gray' and 'dark black' residents move around in packs, with an obvious pack leader. Now, I could've used a more glamorous metaphor like a "pride" of bad residents (like the lion) or even the modest term "herd", but I was too lazy to google what a group of Hyenas is! But, there's no better comparison out there; hyenas are cunning, generally disliked, move around in groups that seem strong, but the moment one is alone, they're easy to kill! 

You can learn more about hyena behavior here: (And just for fun, let's imagine I'm Mufasa)

What did you expect? The Discovery Channel?

So, it was a few weeks back that I realized one of the residents who I trusted turned out to be this other asshole's personal bitch! Imagine the shock and surprise! Turns out she was nice to us to get us to open up about everything that's going on, only to go squeal on us to her seniors. So, did you get the "Good Cop, Bad Cop" analogy? It's like being conned in your own backyard! 

Imagine how low one needs to be to actually get into an argument about when I could take a holiday because I wasn't feeling well! I'll take it whenever I damn well please, fucker! You've already dictated a lotta crap to me, but you're not gonna dictate my damn biology!

I recently borrowed my friend's copy of The Shawshank Redemption Screenplay. Easy to say I was bored to bits, but it kinda gave me an idea for my next post. You'll know what I'm talking about when you see it.

DISCLAIMER: To my actual friends who are pursuing residency (old ones as well as recent), I sincerely  have great respect for the work you all do & am in no way trying to take a jab at you. But, just like you sometimes come across bad interns, I've come across some bad residents. If you'd like to share bad intern stories (stories about bad interns, not bad stories about interns!), write to me or comment here. I'd love to have you as a guest blogger with the tables turned!

FYI: A group of hyenas is called a cackle!

Social Medicine

We're all currently being carried on along a "social" wave, and recently, I saw this ridiculous TV advert by Vodafone about Facebook, click at your own risk:

Apart from the fact that the ad made me incredibly nauseated, it got me wondering what the hell ever happened to Orkut!

Sure, I was one of the earlier adopters to Facebook, but now I'm wondering how I can get back those hyperbole-studded testimonials that people wrote for me! Yes, I'm THAT self-obsessed!
Eventually, it hit me that I'm 4 social generations old. How?

And three of those generations have come during the lifetime of my medical course. As if it wasn't enough that other people gawk at the length of my degree, now even I've gotten in on the cynical fun!

How many social generations have you passed by? 

I did not need to know that!

What is it about us studying medicine that makes everyone we know want to come up to us and tell us their medical problems? Wait, let me rephrase that! 

'What is it about us studying medicine that makes everyone we know want to come up to us and tell us things we don't ever want to know?!'

It freaks me out!!

Now, as interns, we come across a lot of people everyday, narrating things that they wouldn't want anyone other than their doctors to know. They're usually secretive & hush-hush about things concerning even the upper half of their bodies. God forbid they have to utter words like penis and vagina! But, we're forced to be sensitive to their issues & speak about their problems in the same soft tones, use the same mindless lingo for their genitals & breasts & never ever ask more than 3 questions about their sex lives:

"1. Do you have sex?

2. Have you ever had sex with a prostitute?

3. Any infections?

That will be all. Thank you"

We're quick and discrete during our practice, because every normal human being would be uncomfortable divulging way too much information (I'd rather not get into the details of how our entire social structure is anti-medical history cause noone wants to tell us shit anyways!). So, I have to ask again -  Why are so many people I know coming up to me and asking me these things? Because my logic tells me that they should be embarrassed outta their pants (no pun!). Maybe they're just plain dumb! You can't ask me what the side-effects of a single dose of Fluconazole are without me figuring out you've got fungal vaginitis! Don't show me medicines I do not want to know about & ask me names of diseases that aren't really code words that your doctor invented. Turns out, I know what they mean too! Or even worse, I may know how you got it! I need not know what sort of discharge you've got coming out from which orifice, how your bowel habits have been altered by which medication & please don't ask me if Ayurvedic medication can help you sexually. Give it a shot and let me know. I'm just as curious about those ads in local trains. 

Maybe it's because interns are in this twilight zone, where everyone thinks we're eager to learn, good enough to guide & yet not learned enough to deduce their dirty deeds effectively. Or maybe it's cause I happen to be around & I don't charge a penny. What's the going rate of a half-decent medical intern's consult these days?

To everyone I know: Keep it in your pants, within your head & don't let it outta your mouth. I couldn't care less!

Anonymosity?

If you haven't yet figured out the title of the post, the rest should stump you as well. I started this blog because I felt I would have a lot to share over the course of internship. I love to write, it comes easily; though it's more taxing compared to when I'm just rambling to myself. I wanted others to see the humor in the strangest situations. But, sadly, over the past month or so, I haven't been able to see a lot of the humor myself. Much like the monsoon, it's been a gloomy, dark & wet past month, with all my "worst case scenarios" coming true.

I have this idea about people I deal with professionally, I always like to imagine the "worst case scenario". Basically, if I'm sure that the "horned" one (note how I used 'ed' instead of 'y') cannot make my life more hellish, I do whatever the hell I want. This usually involves me acting like the uncaring intern I can be for dumbass residents, not intent on learning stupid things & refusing to do things that infringe on my human rights. I work more efficiently, such that I don't need to move about too much. I have learned that that the best way to fix a dumb resident is to twiddle your thumbs in plain sight.

But, I haven't yet mentioned how and why I coined the term above.

Anonymous + animosity = ?

C'mon, even my peds patients could solve that one now! So, yeah. While I've found that my last rhyme which had a healthy topping of expletives turned out to be one of my popular posts, I didn't really start the blog to vent my frustrations about a few talented individuals, brilliant suited to making me feel like crap. Maybe, one day when they read my work, they'll realize they've faltered; or maybe they'll just get worse. The best thing is, I won't be around them much longer to find out.

So, ardent readers, it's back to the basics for me. Eagerly looking forward to my next rotation. Write to you soon

Technologically Savaged

Medical Student:

I'm in love with my phone. It does everything I want it to do & then some. I have cool apps like MedScape & Epocrates on it, they help me look up things on the go; I don't have to feel stupid in the clinics anymore. It's got a hardcore camera so I can take a picture of whatever new I come across during rotations. 

I love the browser, I love looking up conditions in Wikipedia. It has all my music so I can unwind & I keep up with the news when I'm on the move. I can't imagine life without it.

Intern:

I have an awesome phone. It does all the things I want it to do, but only when I've taken out the Sim Card. 

I don't really have time to look things up, which is good cause hardly anyone asks me to anymore.

I use MedScape a lot, but only when I'm alone running a peripheral clinic & I'm stumped; I feel like a good ol' fool checking my phone in front of the patient. 

I don't really take any clinical photographs anymore, what's the point? 

My memory is loaded with music I hardly have the energy to listen to anymore. Yes, I need to have some energy to appreciate music, else I'm just hearing noise. 

And yes, I hate that my phone vibrates & rings. I get a pre-ictal aura every time my damn phone rings & I'm sure I get absence seizures when I see its an unknown number, though I can't really recall. Maybe that's the point of absence seizures, remind me to look it up on MedScape. "I should cut the call, who cares? But, then again, maybe I should just let it ring, I'll say it was on vibrate & I didn't feel it through my coat. To hell with it, I might as well pick it up, I'm screwed either ways."

I can't think of what an interns' life must've been like before cellphones became rampant as STDs. Even now when I'm dispatched for a chore, I get called in repeatedly to ask about its progress, why it's going so slow yada yada yada! 

If there was a day to yearn for the simpler times, this is it!

P.S: I hope you liked the typewriter font. The idea hit me and I just kinda ran with it

Not A Nursery Rhyme For Kids

Prequel to this rhyme: What rhymes with blood?

The calendar's page finally turned,

And so the cycle of blood also adjourned.

For children needed much steadier hands,

And for blood, his help they'd never demand.

Little people, he thought, would be easy to handle,

Not realizing he'd be walking into a stupid scandal.

The residents weren't humans, they were wolves, I dare say,

They made him hop, skip and jump through hoops all day.

"How dare he sit by the corner, twiddle his thumbs in full view?

He'll wish he'd never been born, when I'm through."

And so the residents acted like an ass and a witch,

To over-compensate for their obvious gonadal glitch!

"Run here, get that, fetch this useless thing right now, 

and let me plump myself up to be a useless fat cow!"

He craved for the feeling of a syringe back in hand,

And the queue of endless patients, slowly expand. 

"What am I thinking? Didn't I hate blood collection?"
But compared to the present, it seemed like a vacation.
"Ah, those were the days, they taught everyday,
Now, collections seem like a small price to pay"

He looked around the ward & saw others like him,

No spring in their step, faces gloomy & grim.

Mumbling, "This time too will pass", he kept his hopes up,

But these residents wanted to tie a leash around their pup.

The phone kept ringing, with requests not making sense,

He ran their errands at his dignity's expense. 

He dreamed of of a day he could give them the finger,

In that damn ward, not a moment longer he'd linger.

A pity to see such potential turn crass,

How great they'd be, without a fist up their ass!

Poor boy did all that these idiots demanded,

In a sea of blood, he wish he'd been stranded.

"How naive could I be, dismissing my red-handed chores?

That was nothing compared to working under these whores!"