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What's up?

It's been a busy 9 months of internship. So busy that I had to take a casual leave to update this blog. No, just kidding. The CL was just a coincidence. (I couldn't finish this post on that day. I'm now writing this in the free time at psychiatry department). It is just my incredible inability to do more than one thing at a time that's keeping me from all my extracurricular "responsibilities".

It has not gone waste though. I have been carefully considering the lifestyles that various specialities in medicine would afford me. Such as the busy anaesthetist surrounded by his monitors who can get an adrenaline rush by adrenalizing a collapsing patient or the pulmonologist in his roomy consultation room auscultating chest after chest after chest.

Blessed is the radiologist who can sit on his computer all day. But imagine being an obstetrician inserting his finger into the unseen insides of strange vaginas day after day.

I know my priorities. I want a lot of free t…

Surgery - the rush

Wednesday: OPD  My first OPD.

Showered and left early to the ward to finish work there and be at the OPD on time. It was a continuous rush of patients from 9 o'clock till the time PG asked me to go have lunch.

There was everything - Road Traffic Accidents (RTAs), healing and non-healing wounds to be dressed, deep gaping wounds to be sutured, pain abdomen of various kinds.

My first sutures were on the leg of a patient. Neat 3 of them (or 4?). Dr Mayank encouraged me saying "You're a surgeon, ha?" But those were the easiest sutures that day.

While we were incising and draining abscesses, dressing more wounds, etc. a serious RTA patient came, unconscious. The PGs took direct laryngoscope and intubated him, called up ICU duty doctors for emergency, gave a slew of drugs, gave CPR multiple times, etc. But he couldn't be saved. I was pressing on the AMBU bag for a while and I don't even remember when I handed it over to someone else.

Nothing would stop more patient…

Surgery - feeling comfortable

On the first day my PG had asked me "Hey, how do you like it here? Feeling rushed and busy?". I replied "it's okay". I like rush. I like having a hundred things in my mind. But I like it only when I feel comfortable and confident about the things I have to do.

And on day 1 I wasn't so comfortable. I didn't know what to do and everything had to happen in a jiffy. But over the next few days I started feeling comfortable. I had this aha-moment when I realized "Aha! It's all about the patient. Our duty is to make life the best for our patients." And if we think from that perspective, everything becomes easier.
Saturday: Dressing Dressing is required for most patients with large wounds and especially diabetic patients. Wounds tend to get dirty with dead tissue and pus (promoting bacterial growth) and debridement ensures there is nowhere that bacteria can grow comfortably. But good debridement is a difficult skill to achieve.

I'll write abou…

Surgery - fitting in

On 18th, we made mental calculations about which surgery unit we would be posted to, when they would have OT, etc. and then reached surgery office around 9. There was a table full of dates written against our names according to which the first half would have general surgery straightaway, being divided into units in order (A,B,C,D,E,F,A,B,C,D,E). The first half of the other half would be in Anesthesia. 3 of the remaining people would be in pediatric surgery and the last 3 would be posted in neurosurgery or plastic surgery. As expected, me and Abdu were in C unit of general surgery (headed by Dr Madhu). (After all the diarrhea cases we took together in pediatrics, one more joint venture for us).

Right next to the postings matrix were the wards displayed. I saw that our unit had the wards 10 & 15. I headed to 10th ward and there on a chart paper was displayed prominently what days were what for our unit - "...Friday - OT..." it read. And we ran to the operation theatre.

Fr…

Rules of Work

I had one day of internship under my belt before the actual beginning date of internship on 18th March. This, thanks to my senior who had to prepare for his fantastic dance item for their graduation day on Friday (19th).

Even before that, on 12th, when the final years organized a "summer slam" fun event for seniors, I got one hour in paediatrics emergency (receiving) ward alone (with PGs). That is when the PGs taught me how to manage fever, cold, diarrhea (+dehydration), etc; with dose conversions for pediatrics. In there, though, an intern's main task is to monitor the children continuously. Check their SpO2, check their BP, check their pulse, check their respiratory rate and make sure they are all healthy. When checking for SpO2, if the fingers are too small or the child is too wobbly, you can use the toes. I wrote down all numbers in case sheets and it took more than the hour I was supposed to stay there.

But then, on 17th, when I was in the same ward from 11 o'cl…

Disclaimers

I have been thinking a lot about the legalities of posting about my hospital work in this blog. As I think about it there are several problems that arise by me writing. But, I cannot not write and lose these posts forever. So, the following disclaimers apply for any post on this blog or any article I link to.

What is written here will not be substitute for medical advice. I might cook up crazy hypotheses and write here. If you follow them and die, do make sure I won't be held responsibleBy I, I mean, I, my college, my friends, my teachers, my seniors, my juniors, my textbooks, my websites, my linked articles, their authors, and so on. Nobody shall be held responsible for what happens to you because you read this blog.The thoughts on this blog are entirely mine and even if I'm writing about others' thoughts, it is my thoughts on what I think are others' thoughts and therefore still my thoughts.Do not think you can use any work in this blog to sue me or my college or my f…

And we begin

I had begun calling myself a doctor from the moment I finished the last practical viva. When I was traveling all last month I could only think of going back to hospital and starting work as an intern. But when on Sunday the result was announced, I had to triple check it wasn't a computer error.

I probably have the lowest mark in my batch. At least, in Obstetrics & Gynecology I have the lowest possible mark in theory. And that too I wouldn't be through had it not been for the theory viva which gets added to the written papers.

But that doesn't matter now. Because now I get hands-on. I will have "my patients". I can be workaholic. I can do as I learn. I can write the original case sheet now. I can make a difference.

The excitement reminds me of the first week of dissection. Eagerly waiting around the cadaver to bring the scalpel out and slice through the skin. That feels like yesterday. Time flies. And this next year won't be any different. And I don't pl…

OBG practical and Internship Dreams

Woohoo. Finally.

I already wrote about the first three practical exams.

OBG was a breeze. Went early to the special (examination) ward. Had a 24 year old lady with a previous Caesarean section as my Obstetrics case. And a 65 year old with procidentia uterus as the gynaecology case.

I told the examiners that the reason for previous Caesarean was respiratory distress (instead of telling fetal distress) and I had to tell everything about fetal distress, all the things that are monitored, and what management to go with, and in VBAC-TOL how to manage first, second, and third stage; whether to cut-short second stage or not. It was more like they were testing if I could go work in the labour room tomorrow.

Same thing followed in Gynaecology. My patient had decubitus ulcer and I had to explain how to manage it (and how to manage the "corresponding" ulcer in surgery (which happens to be venous ulcer)).

Viva had 4 stations.

Station 1: Ultrasound and x-rays. Luckily I got X-ray because…

Medicine, Paediatrics, Surgery practicals.

Oh, the last three days! If I had a moment for myself, I would have posted this one a bit earlier.

I am usually not very tensed before any exam. But being the last set of exams, and losing 6 months if I don't get through gave me some horrible horrible dreams on the night of 18th-19th. Being the first batch to go into Medicine practical, with MCI inspection as an added thing to worry about didn't help at all.

Thanks to some very helpful friends I had everything ready - CNS kit, watch, thermometer, what not. I even bought an aneroid sphygmomanometer hoping that I will permanently need it in two months when I become an intern.

I even called dad and he helped calm some nerves, but there were simply too many of them left jumping at the slightest thoughts.

Temporal sensation was lost to dreams mixed in reality - the first time I woke up (at 2) everything was normal, the next time I woke up (just before 5 when my alarm was supposed to wake me up) I had a morbid dream (which I happily…

Obstetrics, Gynaecology, and Paediatrics Theory question papers

The trend of poor specificity in answers continued.

Overall, there's very good chances that I won't make it in one theory paper at least. Can't figure out which one.