Just...

I am through with seven months of my internship quite successfully. Of course, like everyone else I've had some problem or the other in almost all of my postings but what the hell! I never expected to be given honorary-treatment. I haven't done a single night yet (if you are not a medico then it simply means I haven't had any night duties yet, which is quite enviable for an intern), except of course, the strike period. And thats quite a success! I've just been too lucky. But these seven months did consist of many learning opportunities for me. Professionally, academically and most of all, personally. I managed to grab a few...
My first official clinical posting was ENT. That was after three months of PSM. I dunno why PSM is not considered clinical enough because thats perhaps the only posting where we do what doctors do, i.e., see patients. Executing a doctor's orders is considered more clinical here. But I did learn quite some clinical stuff there. Anyways, ENT was my first clinical posting in the sense that I'd never put an IV line before. Suddenly I was put in a tertiary care centre and I felt like a complete fool. I carried out all the orders obediently, literally. Still felt like a fool. So when the reg chuckled in the OT while I was frantically trying to locate my cell phone crying "pick up the phone" (yeah thats my ring-tone and I forgot to turn it on silent mode) in the loose baggy-pants, I almost got irritated. With me only, I guess. I felt really out of place. Even the servants knew more about the hospital stuff than me. Later that morning the same reg started on a myringoplasty and I just stood behind him, observing. I was completely absorbed and I still am surprised how that happens when I watch a procedure. I just become a passive audience. Some ten minutes must have passed when he cut out a part of the temporalis fascia. I took a break and suddenly realized that it was getting pretty cold out there. And then I saw the reg's back. Beads of sweat were growing both in number and size on his blue changes by the second! That was the first time I smiled to myself, of course behind a face-mask. Its all a process and I've just started.
One is bound to be nervous here because one has to be responsible. This is one profession where even a second attempt is considered a mistake. But then, everybody makes one or more at some time during their practical life and this is the best period to make it, when you are already considered a fool!
And then there are moments when you see God!
I had an evening duty in labour ward during the strike period. There I met this new lecturer who used to be a reg when I was posted in his unit earlier as a student. I wont name him here. He was tall, dark and beginning to get obese. He had nice features. His mouth reminded me strongly of Hemil! (I always notice people's mouth and eyes. I can't remember any other facial feature unless I really pay attention to it.) He looked like a gujju but wasn't one. He even had that some what high pitched voice, a nasal twang and a dragging tone. Basically, he reminded me more of a business guy than a doc. Finally he asked me what I'd like to do in future. And so a conversation began. During that time I was beginning to feel uncertain about my choice to be a researcher. The process was tedious and I wasn't sure I could commit my life to just one research-field. But he finally made me give up on the idea. He only told me ground reality. And the fact that I will have to leave my country! That really put me off about the whole GRE and PhD stuff. But only later.
At the end of the conversation, which was rather abrupt cuz someone decided to come to this ugly world, I concluded that he was another frustrated young doctor who could only see the picture in negative. Inside the labour room, among the screaming and shouting and of course, the gross visuals, he took me and my co-intern to a patient and casually told us to rupture her membranes and then left us staring at each other. Thank God I remembered Kocher's. The baba (student nurse) was expanding with pride when we looked at her for help. She gave us the instrument. We put pieces of our vague memory together to construct the steps of the procedure. I let my co-intern try first. She came out unsuccessful. Then I tried. When I came out (that sounds funny) I had clamped my gloves! I finally decided to accept my incompetence or whatever openly for the good of the patient and call the lecturer. When he came the patient was screaming her lungs out. He just held the forceps in his hand and asked her name. Before she answered he had gone in, ruptured it and come out! And I was in complete awe. Then he conducted a forceps on her.
It was just the way it was conducted. He didn't shout at her, he narrated the steps to us and he just did it so well. The spontaneity with which he made his decisions was amazing. He didn't even considered options. He spoke when he had made a decision. And then he was the same again. Talking to me about how pathetic is the whole system everywhere. As if he was human again.
That day I learned two things- one, its not just the skill that counts, one has to be confident to practise it. Two, you gotta be really strong to pull that thing out of that thing!
And just when you thought this is a really long post, I've got more on my mind...
About a week ago, I witnessed an emergency in dermat! I had been sent to skin ward, which is shared by psychiatry too, to monitor the vitals of a patient started on steroid pulse therapy. Well I was doing my job there, checking his pulse-BP every half an hour and reading in between and later listening to radio. Suddenly a patient walked upto me and said, "Namaste sister! Kaise ho?" I knew I was in ward one so I just smiled and he moved on to greet the next person he saw. Just then the hefty patient sitting on a bed right in front of me, started clapping, staring into void space! "Wow!" I thought, "These are the people I intend to spend the rest of my professional life with!" After research, my interest has rested on psychiatry. Amongst all this 'madness', I vaguely was aware that another patient of dermat was being prepared for a liver biopsy. From the way they scrubbed the patient I was certain that they were not surgery people. I guessed patho. The procedure was uneventful till the drawing out of the tru-cut needle with the specimen. Barely two minutes had passed by and the patient started complaining of severe pain. They gave voveran. They gave tramadol. Twice. Then his abdomen became rigid. Then his BP fell. Blood was ordered. The residents who had done the biopsy called their entire unit to the ward. Then I realized they were gastro people. The patient was collapsing very fast and he was damn 'roudy'! Reminded me of the head injury patients I saw day in and out during my trauma posting. I can write another entry on them! Skin residents also came down to the ward. Obviously from the orders that were passed it looked like they were suspecting a bleed. But I felt odd about it. For one thing, the clinical features were quite out of proportion for a bleed caused by a tru-cut. And secondly, it happened way too quickly.
Finally the patient was shifted to E-ward under surgery people. They confirmed that there wasn't any hemorrhage under USG. So the diagnosis settled on anaphylactic reaction to LA.
You've got to be careful every time.
Well, thats enough talking for now. Do comment.