What a student wants

 

Among the several challenges of being a med student a major one is coping with the difference in the teaching-learning or examination systems between school and college. Our teachers used to tell us back at school that in order to understand a book better you should start reading it from the Preface/Foreword. But it was only after coming to college that one realizes that this is not enough, especially for viva. One must remember the colors of the textbook cover, the full name and qualifications of the author, the latest edition and publishing house of all the books by heart because those are the first questions one faces during viva.

These illogical questions are not the only things that plague the medical education system. The main allegation that the students receive is the below average attendance most of them have. It is often opined that the below average attendance leads to below average performance, which might be true. It is often said to the students during viva that everything was taught in class and attending classes will improve performance. In spite of knowing everything why do students not attend classes then? Is it simply because of casual attitude? Well, it might be for some, but this is only a part of the problem.

In class 12 physics one hears about the hypothetical concept of an absolute reflective surface. It is only after taking classes under certain professors do we realize that this concept is not hypothetical after all. During the said classes students’ brains behave as absolute reflective surfaces where no information seems to be absorbed as they stare blankly at the slides changing on the screen.

Another hilarious incident that occurs whenever the attendance of the class reaches single digits is that the professor starts scolding the people who actually show up. One has to hear fun statements like “Why are you not attending the class?” while actually sitting in the class. And then these students go home regretting the decision and do not come back to class the next day. Does this mean that the situation is damaged beyond repair? No. There are still teachers whose classes the students rush to attend. Haters might say that the crowd is mostly because of good looks but such statements are never entirely true.

What a student wants, is to understand and be understood. Back at school most of us remember teachers who loved us, inspired us and gave us the right amount of push in the right direction. During the transition from adolescence to adulthood, most people are in a state of confusion and lack of confidence when this mentorship is severely missed. Students want teachers who explain in a lucid way so that one can grasp concepts without feeling foolish or worthless, teachers who actually care about their doubts and problems, teachers who inspire and become role models. 

But such teachers are difficult to find in the busy OPDs and overcrowded wards of government medical colleges where everyone is overworked and flustered. Students like to be asked questions regarding their knowledge and understanding about a subject, questions that would help them tackle with problems of day-to-day clinics. However, mostly they are asked definitions and facts no one cares about like “Which college did the author of your textbook study in?” Middle school punishments like parent calls or making students write “Sorry letters” for not attending classes also do not help to strengthen the bond between teachers and students.

It is often said that the students at med school are becoming tuition oriented. This might be because the teachers on these online or offline learning platforms take time to explain concepts in a way students can follow, the questions these apps put to them actually challenge their intellect instead of challenging their self-respect. Is college education all bad then?

For all those who think so, let this author remind you that all is not lost. At times even in these busy wards sit real teachers who share every drop of their knowledge with you. Maybe they will scold you in front of patients, badger you with seemingly out-of-universe questions but they are the ones who will also teach you the science of medicine and art of surgery. You just need to have a thick skin. So the final question is, do you have that?

 

 

We call this place our home

 

Finding love or friendship at med school is not as easy as portrayed by movies or social media. This is because just like testicular cancer, love is mostly one-sided. But one thing that eventually develops in the hearts of all medicos, other than perennial self-reproach and depression, is the undying love for the college which prepares them to face the burdensome responsibilities that come after donning the white coat. This love is subtle and develops day by day with increasing familiarity. Unlike a crush for a handsome senior, this Love does not make butterflies flutter in your belly, or light up your day, it is more like the warm hug of your old shawl on a winter morning.

After several years of bitter sweet experiences in the same college campus it becomes even more dear to us. From the department corridors lined by professors’ offices which continuously remind us about traumatizing viva experiences to the familiar stench of the dead bodies in the morgue, everything brings a sense of belonging.  With time one learns to see their everyday experiences with a new light- the good old library becomes even more beloved, and the giant, ancient trees which have seen so many lovers hold each other in loving embrace or break up bitterly seem like old loving grandfathers.

When our college celebrated its 150^th year, we got to see this ancient institution through the eyes of its alumni and one thing became clear- Time changes, situations change but the love which budding doctors have for their rusty old colleges with hospitals full of germs, filth and diseases remains the same over generations. The dirty wards, the old buildings or the pavements full of patients’ families in waiting might seem unappealing to some but to the medicos this image seems like home. When these same old buildings dress up with fairy lights for festivities, they look beautiful in a simple and quintessential way.

Photo courtesy: Shuvojyoti Rakshit

As one watches old college friends reuniting in the old college campus one dreams of the day when she can come back to this same place as an alumnus and meet the same group which surrounds her today. Maybe even share a meal or watch an energetic concert together. But after the celebration ends, the decorations come down and the sound of the happy banter gets replaced by silence, the college campus seems to grieve the loss like an old woman who just said goodbye to her grown up kids. It is then that the reunion dream seems like wishful thinking and one remembers the assignments due next day with a heavy heart.

With all the hardships med school offers, with the lack of real close friends in most of our lives one wonders why this place becomes so dear to them. Its simple really. One not only ends up loving the place one had sweet experiences in, but also loves the place which saw the worst days of her life and helped her grow as a person. Also, maybe we do not always find what we wish for in college friends but the people whom we share these hardships or these joys with become special to us in some way or the other. College becomes home.

At the end this author is reminded of a couple of lines from a famous song called “North” which probably sums up the emotion med students have for their newfound home:

“Let the years we're here be kind, be kind

Let our hearts, like doors, open wide, open wide

Settle our bones like wood over time, over time

Give us bread, give us salt, give us wine”

Contemplating a murder

 

You know that phase of life when you just feel drowned in depression and anxiety, nothing seems to go right, you live one day and fear the next one and after spending a day you are left wondering how on earth you lived through that? What do you call it? Winter of your twenties? Depression phase? Apocalypse? Well, we MBBS students call this the exam season.

Medical colleges give their students exams which are tailor made to test the highest levels of their endurance, patience and cramming capacity. In short, they just want to torture the hell out of the students. Scheduling exams during the festive season, giving no holidays in between exams and setting some really creativity-provoking question papers are just some ways in which medical colleges aim to make the students “tough” enough to deal with a doctor’s life.

If one looks around the exam hall one can see all kinds of students: the ones with revolving heads, the ones who write at full-speed as if their life depends upon it, people who simply stare into the horizon or people who frantically scratch their heads or bite their pens to find some idea or motivation to write.

Like students, questions are also of different kinds. Some questions laugh at us from within the question paper as if saying, “You saw me but dared to turn the page. Think I am unimportant, eh? But look at me now as I grace the 10 marks section. Its revenge time.” Then some others are like those unfamiliar faces one sees on public transport. One does not know from which chapter they are, what they stand for or even their pronunciation for that matter. Also, there are some savior questions which you have studied and when you see them on the question paper, you cry tears of joy. Finally, there are some legendary questions in some subjects which makes one silently contemplate murdering the invigilating professor using a one-side sharp blade kitchen knife and imagine the appearance and depth of the stab wound created thereafter.

The invigilating professors, unlike the students seem to enjoy every bit of this exhilarating exam journey. One finds them eating delicious snacks with coffee in the exam hall, taking short breaks to change the seats of some poor student caught asking something to the person in front. Sometimes they would come and say, “You are asking him? Ask me instead. Now, now, which MCQ do you want? Number 4, is it? It was written with purple ink on the umpteenth page of the Textbook of Murders. Does that ring a bell? No? What a pity!” While at other times some of them are kind enough to provide some actual help with some really difficult questions.

In life we always tend to think that we have plenty of time and we can always do something “later”. These exams probably come to teach us that this is not true at all. That’s why a famous Hindi saying goes as: “Jo kal kare so aaj kar, jo aj kare so ab”. (What can be done tomorrow, do it today. What can be done today, do it now.)

Flashes Of Joy

 

I first heard the term ‘Flashmob’ from my elder sister who explained the term as follows: “A group of people gather in the road or at any other public place and suddenly start dancing.” The concept struck me as weird, very weird in fact. I even thought, “Why don’t these people get run over by cars while dancing? And why don’t others protest, because surely enough, dancing in the middle of the road will cause trouble for both vehicles and pedestrians.”  So as one can easily tell, I had completely misunderstood the concept of Flashmob.

The first time I saw a real Flashmob was in 2k22. It was performed by our seniors and batchmates and I realized that flashmob is not about “suddenly dancing in the middle of the road ‘’. It is about weeks of practice and finally a power packed performance consisting of expert dancers taking one’s breath away by their graceful moves and some non-dancers forgetting steps, getting nervous and secretly hoping that no one saw them. Also, I realized that it is not so easily done on the road. One needs to book a proper location for a Flashmob.

I have always been an out-standing dancer. Meaning- when I went to learn Odissi in second grade I spent more time standing outside the classroom after messing up mudras and steps than I did dancing. Naturally I lost interest after 3 months or so and joined music classes instead where due to my teacher’s immense patience and perseverance I ended up learning something. When one of my friends convinced me for dancing in the Flashmob and I actually said “Yes” I could not believe my own self. Later, I was also invited to sing with the group in Rock-mob and I agreed to that as well after a long convincing session by my friends. At times I wonder whether I am pathologically incapable of saying “No” to friends!

Thus began a month of practice and hard work when classes, edufest meetings and practice sessions for both Flashmob and Rockmob were all scheduled at the same time. I remember an incident where I was busy doing Garba when one of the members of the Edufest committee stood in between two files of dancers trying to convince me to stop dancing and come for the Edufest meeting with the Flashmob organizers shouting at both of us in the background. I also remember always sitting in a corner with my kindle in between practices and keeping my ears open to hear my friend (one of the Flashmob organizers) shouting my name angrily at the top of her voice before my dance segment came up; following which I rushed to stand in the entry line.

Video courtesy: Dipankar Mondal

There were all kinds of people at the flashmob practice: the first category is that of the smiling late-comers. These people were always unabashedly, unregretfully late and took in the organizers’  scoldings with a smiling face. The second category consisted of the serious people, who were always on time and practiced with enthusiasm. The third category consisted of people with a moderate level of attendance but those who gossiped or trailed off into books between segments and were always confused about where to enter from or stand. In other words, this group consisted of people like me. The fourth category consisted of the forever complaining and perennially tired people, who utilized whatever time they got between dances to complain to their friends about how unfair life has been to them. In rock-mob this group did not exist though, because there is little chance to complain when one’s mouth and voice are busy singing. The final category consists of the cameo appearances. These people showed up whenever they felt like, practiced as long as they saw fit and then disappeared never to return again. Some of them did not even show up on the final day.

Many of our older faculty found this idea of medical students openly dancing to Bollywood songs scandalous to the reputation of medical field. While they said that it was outrageous that students did not attend ward postings and classes for inconsequential things like Flashmob, it was funny and ironical to see that the took out the anger of students not attending classes on those who actually showed up thus making them question their decisions. One of the departments even threatened to call our parents if the attendance continued to be low. Ridiculous as this sounds, this method actually worked because many people showed up in class the next day!

The final day performance looked awesome, as was the feedback given by the crowd, thus bringing the colors of success to all the efforts of the organizers and participants. This event taught us one very important thing, “Things are always more beautiful, successful and enjoyable, when done together as a team.”

Photo courtesy- Swapnanil Sen

Photo courtesy: Unknown

An Ode To The Departed

 

Sometimes bad news catches us unexpectedly. At other times it so happens that we know about the impending doom for months. We are scared initially but then begin to live with it, even practically forget about it until one fateful morning, when disaster strikes and we become dumbfounded even after knowing the inevitable for months. It seems as if, just because it got delayed and we were granted a few more months of peace, we had assumed that the disaster will never happen.

As the entire college prepares for ECSTASY 2k23, a grey shroud hangs over all of us. An unexpected, unwanted separation makes our hearts heavy. Today when I see “Embrace the explosion” written on the ECSTASY posters, I am reminded of that quiet, shy girl who disliked explosions or loud noises of any kind for that matter. She was the one who used to make diligent notes even in the most boring lectures while we softly bantered in the last bench oblivious of whatever was being taught in class. I remember being envious and asking her the secret to her long, black lustrous hair. I remember our peaceful conversations during breakfast at our hostel canteen, where we discussed our views on studies, music and the world even though they varied grossly between the two of us.

When I first heard of her illness, I remember stepping into the CCU for the first time in my life to visit her. She had asked us to pray for her speedy recovery. While most of us actually prayed for our beloved friend, all our prayers combined were not enough to thwart destiny. This leads us to wonder, why is destiny so cruel? The one who could have been an expert and compassionate doctor had to suffer so much and meet such an untimely death while many people whose demise would actually serve the society and mankind in general continue to thrive. The answer to this question is not easily determined by common people like us. Thus, we continue on our journey to meet our destiny while simultaneously cursing destiny itself throughout the way. It’s a weird paradox.

I do not know whether Heaven exists or not, but if it does and if my life is honest and fruitful enough then I surely hope to meet her there someday- my quiet, kind, unselfish friend. Till then it is essential that all of us, as future doctors, remember her life and death. So that, we are careful about the tests we perform, the diagnoses we make and the medicines we prescribe, because the test reports and prescriptions are not just sheets of paper with medical mumbo-jumbo scribbled on them. They are keys to correct diagnosis and treatment respectively. We must never lose empathy and compassion towards those helpless people lying in our ancient, foul-smelling wards, because their lives depend on our decisions. Delay or mistakes in our treatment can kill them, thus we must tread with caution.

Most importantly we must remember to be thankful for this life and this opportunity to fulfill our dreams. An extremely brilliant and deserving student among us was brutally robbed of the opportunity to fulfill her dreams, by her ill fate. On the days we feel desperate enough to end our lives or give up, we must remember that we are getting to live what one of us could not. We should try to make the most of this opportunity while it lasts.

Adieu my dear friend. May your soul rest in peace.

 

Queries of the medical mind

 

When one cracks NEET there are people who give him or her an extremely rosy view of what to expect from medical colleges while others come up with a more realistic view. But what no one really mentions is that med-school is not all about classes, ward postings, huge syllabus, or exams. It is also about a lot of other things like getting sponsors, sitting (or if you are unfortunate enough then, standing) in long meetings, preparing questions, dealing with difficult and strict HODs and welcoming guest speakers. In short, besides being about studies, it is also about organizing grand events like the Edufest or cultural fest of your college.

The day you step into the common room for the first fest-related meeting is the day you start questioning your life choices (if you were not doing so already). Thoughts like: “Was getting myself into this a bad idea?”; “Why are all these people not listening to me?” or “Why is this guy shutting us all up?” start crossing your brain. But by then of course for most people it is too late to reverse the decision and start afresh, except for some genius people who are so fed up after the first meeting that they decide not to come for any subsequent meetings and not do any fest-related work after that day. More power to them! However, some people remain true to their responsibilities and keep doing them till the last day of Fest. Kudos to them as well.

There are some events of the Edufest which attract a lot of participation from the crowd – like medical Pictionary, quiz, medical movie trivia quiz. But not all events are so lucky. There are some events for which the organizers need to keep extending the dates of registration hoping for at least five or six entries. Being an organizer of such an event I would say that it is a nightmare! If an event has too many participants and you feel crowd control is going to be a problem, then set those thoughts aside because the fear that there is going to be almost nil participation and there will be a greater number of judges and organizers than participants is a bigger problem.

It’s not that huge participation does not bring its own problems, especially in case of workshops where the number of participants exceed the limits specified by the departments and one has to go to the department every other day to talk things over with HOD Sir so that all those people can be accommodated. But one must admit that hosting workshops proved a tad bit easier than the events or guest lectures because in case of workshops, taking the participants to the departments on time and providing food packets to the professors and department staff pretty much sums up the job of the student organizers. The rest is taken care of by the departments. However, organizing a quiz event where there is huge participation and all the questions need to be framed by the organizers is totally something different. It leads to a different kind of depression when you can only frame about twenty questions sitting and toiling day-in and day-out in the library while your brilliant co-organizer seems to be conjuring up tens of never-heard-of God level questions right out of thin air; questions which even the other organizers can’t answer. Then on the final day you have no spectators and many of the participants give you defeated looks even before their turn comes up because apparently, they never heard of such questions!

Edufest is a grand event coming with its own grand problems- projectors not working, rain hampering your plans, a huge mob of medicos attacking the chief guest with cameras because they want to take photos with him, non-cooperating co-organizers and lack of bouquets and medals on time. But when the event ends one realizes that every effort they put in was worth it- because during these few days one experiences medicine with its own majestic grandeur, one listens to lectures which inspire and face questions which challenge their wits at every turn and builds memories worth remembering for a lifetime.

Many people might be wondering about the title of this blog. To them I will say, I initially planned to name this as “An aquarium of squalling medicos” but then thought better of it, because when we heard the banner name of our edufest, this is what most of could think of! Of course, the guy who came up with this name has stopped replying to people’s texts ever since.

Photo courtesy: Dip Mondal

Photo courtesy: Suchishubhra Roy

 

Pressure Cooker

 

Organizing a big event within a given deadline always comes with a lot of tension and undue pressure. It is almost like the exam season when there is a huge syllabus to study from and very little time to do it in. You put in late nights, try to distribute the work among a bunch of people- some of whom are overly enthusiastic while some are grossly unwilling, try to make plans which never work out. At the end of the day, you go to bed tired, but still tensed about how little you have done all day and how much work you still have left for the next day. All these thoughts compromise on your sleep hours as well as quality of sleep, making you pissed and cranky and unable to deal with the next day’s tension thus reducing your productivity. This vicious cycle continues.

During these difficult times a coping method adopted by most people is pan-b**ching which is almost like a whistle from a pressure cooker which blows off some steam and helps to reduce the pressure. This is a system where everybody says foul things about everybody else but no one really means it. They keep complaining about how much overworked they are, how they have been attending long meetings which ultimately end up not deciding anything at all, how less the others are working, how less appreciated their efforts are, how they feel they just shouldn’t have taken the responsibility or shouldn’t have met these people. But one should not be surprised if the very same day they went back to do justice to the same responsibility with the same set of people, because they did not mean what they said. Those were just words after all.

The inability to spare time, inability to catch up causes breach in friendships and relationships alike. One wonders at times, “Isn’t it too much of a price to pay just for an event or for getting the appropriate credit for you think you deserve?” The answer to this question is complex, because of the complexities that lie in the gyri and sulci of our cerebral cortices. At the end of the day, it’s not a choice between your friendship and your work, it’s a choice between understanding and misunderstanding. It’s a choice between realizing that the person you are blaming is in as much deep trouble as you are or thinking that you are the only person dealing with a lot.

For the most part I have described the story of the overworked group, but there are two other groups in any event. The working group and the disinterested third party. The disinterested people are those who are blessed to possess Harry Potter’s invisibility cloak. Whenever the need arises to take up any responsibility whatsoever, these people simply disappear. While the working group consist of those few people who do whatever is expected of them but never ever bite more than they can chew.

The pressure of organizing a big event drives one crazy and hanging by a thread on the verge of losing one’s sanity and all social relations, one wonders, “Where did I go wrong?” At those times one must remember that while this pressure seems unbearable, it is also true that only extreme pressure makes diamonds. This pressure is probably meant to bring out the diamond in you and make you a better person in the long run.

If some of my readers are wondering why I suddenly shifted my blog content from med school to event management, let me tell you some good med students are also good event managers as is going to be proved soon. The time to be ecstatic is coming people!

The Voice of the dead

 

Medical science is mostly associated with saving lives and serving mankind. Doctors are compared to ‘Gods’ when they successfully save a patient, or to the heartless mythological demons when they fail to do so. But when med students walk into the department of Forensic medicine and Toxicology (FMT) for the first time they realize, there’s more to the medical profession than just this. Being a doctor is also about helping to find out who caused a premature end of a life, about helping rape victims seek justice for themselves, about knowing the best methods for a successful suicide if the need ever arises. Finally, and most importantly, it is about learning medical ethics and several sections of the Indian Penal Code by heart so that they can save their backs and that of their colleagues if they are ever accused of medical negligence.

The forensic medicine department, which is attached to the mortuary and department of anatomy in most medical colleges is definitely a place that gives sinister vibes. It is a place which always demands a mask, even without COVID, unless one is completely desensitized to the gut-wrenching stench over there. The large number of dead bodies coming in and out with occasional mutilated, beheaded, or rotten ones, the cold mortuary, the damp corridors with old, flickering tube lights- everything sets the mood for a spine-chilling horror movie. It happens many a times that while walking down the corridor, or while entering the class one has a sudden eye contact with a dead person, only to realize that his head is not attached to his body after all!

Photo courtesy: Souvik Dutta

One learns many things in FMT- starting from reporting rape cases, and injuries to identifying snakes and poisons. One learns to answer questions like “What are the different ways to kill or injure a person using this bamboo stick?”  One learns to identify the age of wounds, the signs of death, or the age and sex of a person from their bones. But after seeing so many weapons one wonders, “Which is the weapon which can hurt the most?” The answer which comes out remains the same with or without learning FMT: WORDS. Weapons kill only once while words can kill a thousand times.

                                           Photo courtesy: Mehetab Alam Molla

Autopsy is a very important part of FMT and watching an autopsy for the first time is an experience to remember throughout life. Even for people who are accustomed to seeing surgeries on live people, an autopsy seems to be a merciless procedure. While for live people we take care not to injure the vital organs and not to cause much bleeding, the dead seem to be no more than animal carcasses to the autopsy surgeons. They drive chisel into the bones and use their hammers to break open the skull or other bones of the dead body. In one swift movement they pull out the internal organs and cut them open to check for abnormalities.

 As one might infer, autopsy is not a procedure for the weak hearted. The question that might arise is, ’Isn’t it inhuman to cut open a departed person like that?’ The answer to this question lies within the walls of a courtroom where the evidences from autopsy bring justice to the dead or within the walls of the medical college classrooms where the evidences from this procedure helps to uncover the pathology of diseases.

There are many moments when FMT induces fear of grosses us out- it might be while holding a fetal skull for the first time or while doing classes on paraphilias. But it is a beautiful subject. It gives voice to the departed, which uncovers the truths our dear ones wanted to tell us before dying but could not, which saves the victim and punishes the accused and warns us against the evils of human kind. It is the subject that makes us stand face to face with the truth, and as the saying goes: “Telling the truth is a beautiful act even if the truth itself is ugly.”

                                                 Photo courtesy- Shuvojyoti Rakshit

 

 

 

 

The Friendship Experiment

 

The movies we watch, books we read and the stories that we hear from seniors and family cause us to have a golden image of college life. We dream of a life without the restrictions that bind us during school days, a life full of exhilarating adventures, when we want to try a bit of everything, experience everything and enjoy life to the fullest. But these adventures are never complete without our partners in crime- our friends. Thus, ever since the first day of college we start our battle of making new friends, of trying to fit-in.

It is easy to make friends at school. I remember, when I was in class 7, I asked my seatmate, “Can you please lend me your scale (ruler)?” And she said “Yes.” That was the beginning of a nine years long friendship which continues. But college friendships are tricky. They involve new adults with sensitive hearts who cannot express themselves eloquently thus creating complex situations for themselves and others.

It is a long and difficult journey to fit in for most people. As days pass and college life newly molds our personalities, we often find that the friends we once made do not remain friends anymore. So, the question that arises many times is, “Are these friendships worth so much time and effort, since we will probably not see these people much after college?” Unfortunately, there is no right answer to this question. While college friendships are difficult, most of us find at least some friends who are worth all our time and effort. The times that we spend with these people become memories. And as is the case of any other experiment, this one also involves several trials and errors till you find the people you can vibe with, the most. Are you willing to take the risk of making all these errors to find the right people? The answer depends on you.

While conducting this experiment we end up finding new cultures, developing new habits, and following new trends. People start enjoying some of these new activities- some fall in love with nicotine and become smokers while others fall in love with Japanese culture and become anime fans. All in order to “fit in.” But do we really fit in, ever? I once heard a beautiful dialogue in a movie: “Why are you trying so hard to fit in when you were made to stand out?”

So, to all the medicos and non-medicos trying to fit in at college, it’s okay if you are a noob about current affairs or do not follow the latest fashion trends and your current social circle finds you uncool. It’s okay if at times you feel you are lonely and everyone but you are doing great in their lives, because this feeling will pass (if they persist for a long time though you can consider visiting a psychiatrist). Remember that even the girl who is seemingly the most popular and sought-after at college goes to bed crying night after night while being under the impression that her bookworm room mate is probably not noticing. Everyone is fighting their own battles and most people do not have friends to share their troubles with.

So, if you are among the lucky lot who has lovely friends you can vibe with, treasure them. And if you belong to the majority of the population, that is, confused, lonely college-goers then maybe you have not found your people yet. Wait for it, and you will surely find them. Till then, as Dory said, “Just keep swimming.”

Photo courtesy: Unknown

CONFLUENCE

 

A very important issue faced by the students of government medical colleges located in cities is the lack of privacy in the campus. No matter where one goes one is bound to meet friends, seniors, teachers, menial workers and most importantly patients and their families. It feels weird to discuss your personal matters with so many people around to overhear, especially for certain pairs of ‘friends’ who need lots of personal space.

The hostelites also have to face other problems like extreme heat in the summer where the slow-moving ceiling fans provide little relief or having an extremely popular room mate whose friends come up to gossip every evening rendering the room unfit to study in. Some people also crave the space to have group study sessions with their batchmates which is difficult to find in the hostel or common room, while some others just want a proper internet connection for their online activities which is again not available in most places in the campus.

There is only one place in the entire campus which provides the ideal solution to all these problems- THE CENTRAL LIBRARY.

 Welcome to this wonderful, fully air-conditioned place with large reading rooms which allows one to escape the heat as well as study in peace without having to listen to their room mates’ constant chatter. Want to have a group study session with your day scholar buddies? Then Central Library is your go-to place. Want to enjoy a cricket match, or a movie or some online tutorial videos on your iPad? Even then, this is just the place for you. Want to spend a sweet couple of hours with your very special friend every day? Well, then also go to the library without a thought. Want to take a refreshing nap after a long day? No place is better than the library with its quiet, cool environment and big, fat, sleep-inducing medical books.

All kinds of medicos are seen in this place- the serious studious ones who do not look up from their books, the mobile addicts who do not look up from their phones, the gossip mongers who sit down and spread all the hot gossips of the college among themselves, the jobless ones who just sit and stare at others and out of the window and the lovers who go for library dates.

As the summer temperatures achieve new records every year it becomes more and more difficult to find seats in the library during summer months. Some of us thus go to the library early in the morning every day and keep our bags and stuff on some of the seats thus marking our territory. This is done as a precaution in case seats are not available once we come back from the classes and wards. It is also a challenge to find the ambient temperature locations in the library. Though centrally air-conditioned, the cooling is not uniform everywhere, some locations are extremely hot while some harbor Antarctic temperatures. On the other hand, not all mobile networks offer proper signal everywhere in the library. In short it requires several days of trial and error to find the correct location for yourself, in terms of temperature and network connection. And if one morning you find that location occupied, then you have no option but to sulk all morning and secretly curse the intruders!

Some people maybe of the opinion that despite all its benefits the library is a distracting place with its awe-inspiring sunset scenes outside the window and some diabetes-inducing romantic scenes within its four walls, but such opinions vary from person to person. For the regulars, the library is a beloved place where they love to spend most of our day cocooned away from the heat, the worries and the troubles of the rest of the college. It’s a place which offers one the chance to be with their beloved……subjects or people.

The Volunteers

 

ENT and ophthalmology both are subjects dealing with very small yet very essential parts of the human body. Contrary to expectations however the instruments they use for examining and operating on these organs are huge. The students must develop the skill of using these instruments and demonstrate the same during practical examinations.

While the main exposure to these instruments and their uses comes from the clinical postings, we also have practical classes of these subjects wherein we get to learn about and practice with these instruments further. The main aim of these classes is to help us become more conversant with the instruments and cases that we must face during the final exam. However, they also have an occult aim of bridging the gap in learning of those students who are too lazy to wake up in the morning to go for clinical postings.

In these practical classes patients are generally brought from the wards so that the students can practice history taking and examination on them. While the patients mostly give us long and mostly irrelevant histories about their entire life on simply asking: “What brought you in?” during the clinical examinations they are not that generous. Only a few people get to do the examination before the patient makes up an excuse to run away from the forty pairs of excited yet novice hands waiting to examine them.

It is during such crisis hours that out respected and beloved volunteers come in to save the day. They offer us their eyes, nose, ears and mouth to examine. And most of us show our appreciation by making them gag, sneeze or wince in pain in return. They sit, though not very patiently, as almost 20 batchmates use them as dummies to sharpen their clinical skills, till finally they get to avenge this cruelty by trying out the same procedures on another poor spectator-turned-volunteer.

There are some procedures which the patients don’t let anyone perform on them ( not even the PGTs or Professors), mostly because they cause a lot of pain and discomfort to the patient. They simply refuse and walk away giving us dirty looks. Then volunteers become our heroes and we get to practice on them not even bothering to wash the instrument of change the gauze in use while switching from one volunteer to another! These procedures are mostly not done in routine clinical practice, because now we have better and more sophisticated tools for these procedures now.

However, this refusal and somewhat hostility on the part of the patients leads one to wonder about the changing relationship between doctors and patients. These techniques were invented years ago before the advent of digital and x ray imaging. Back then, these were the only techniques of examination and the patients trusted the doctors and medical students enough to allow them to perform such procedures on them, no matter how much discomfort they brought. Where is that relation of trust gone now?

While the doctor patient relations have changed, we still have that trust from our beloved volunteers who know that we will not make them swallow a roll of gauze accidentally, and we can also count on them, as we know that they won’t mind even if we pull their ears to hard or poke their eyes with our fingers while checking for intraocular pressure.

 

The Patient's language

 

The first thing that is taught to a med student when she steps into a clinical posting is history taking. Old timer professors are of the opinion that a good case history along with a thorough clinical examination allows the doctor to reach a diagnosis even before any laboratory tests are done. A quick clinical diagnosis can be life saving for many patients, hence this stress on history taking. But the main problem arises when different departments and professors teach different formats of history taking and students remain confused about which one to follow!

One of our seniors once told us that, there can be no correct or wrong format of history taking, as it is as much an art as it is science. At the end, it should help us formulate a clinical diagnosis, the format that we follow doesn’t matter. I couldn’t agree more with him. Anyhow, in the initial phases when we are novices in game of diagnosis, having a format to stick to does help at times. Reaching a diagnosis is like a game of treasure hunt where you have to find your way to the treasure, and this format can sometimes be a compass for this journey.

We have to record the history in the patient’s language as per instructions from our professors. This proves to be a major problem sometimes, especially when the patient speaks a different language. It becomes difficult to convey the medical terms to the patient. Since our textbooks are written in English, at times we end up speaking the English terminologies in front of patients who give us blank stares while at other times we struggle to translate terms like “mucopurulent ear discharge” into vernacular languages.

Sometimes even when we convey what we want to say to the patient, the patient might end up giving wrong information, especially to training med students, immediately changing their statements when senior doctors ask. I remember a patient who told me when I took his case history that he had no hearing loss in either of his ears. I recorded the history as per the information given by him and presented the case to our professor. Then the patient, as soon as our professor came to see him, reported hearing loss in his right ear! I was awestruck. Meanwhile our professor glared at me and said that I was sure to fail in the semester and started explaining the case to us. When the patient was sent to the nursing staff for hospital admission, Sir’s glare finally melted into a smile and he told me, “Never trust them completely, half the times the patients don’t know what they are talking about. Next time do all the clinical examinations thoroughly before presenting your case.”

This is a common problem faced by medical students as well as patients in government settings. While the med students try to learn as much as possible in their clinical postings the patients are tired of the several batches of students asking them to repeat the same history time and again and not being able to offer any help in return. This is what makes them non-cooperative or causes them to resort to malingering in order to derive some sadistic pleasure from the pain of these dumb students.

At other times it is difficult for us to even decipher what the patient is talking about as they use terms like ‘chirik’ or ‘jhilik’ to describe pain, terms which no dictionary or even Google can translate for us. Some patients say yes to whatever symptoms we ask about leading us to wonder, “How is this person even alive with so many problems?” Many patients, especially females can’t stop once they start describing their symptoms. You end up listening to their issues with their husbands instead of their vision problems or nasal polyp.

If you remember your language classes from childhood, learning “patients’ language” is also similar.   You master it slowly and gradually, and eventually learn to reach a correct diagnosis from the limited and often distorted information provided by the patients. So, happy learning!

 

P.C-Suchishubhra Roy

Future: What happens NEXT?

 

The word ‘future’ has always been a source of great worry to the over burdened and long unemployed medicos. When some of our engineering friends get ‘placed’ and go on to post status updates about the first salary of their lives, we are still in final year fighting tooth and nail to at least pass and finally earn the long coveted MBBS degree.

Many people told us that life will be “set” after you enter MBBS but it was when we finally came to med school that we realized that life out here is actually full of “setbacks”. The long course duration, the huge syllabus, the long practical classes and clinical postings, the lack of holidays all sum up to make life difficult and at times depressing for med students. But these problems have been there for years, these have been dealt with, by our seniors before us and will be faced by us and our juniors too. We have been made to realize by seniors and professors that the syllabus that we read as well as the clinical postings and practical classes we must attend are an important and necessary part of medical education. We know that five and half years is in fact the minimum amount of time that we need to give ourselves to learn properly. This is because at the end of the day the knowledge that we gain must help to save lives at the most precarious conditions.

As per the new NMC guidelines, NEXT exam is set to take place in the month of November this year. It is an MCQ based exam supposed to check the clinical knowledge of the students. The exam will take place over three days on six main clinical subjects and other pre and para clinical subjects “allied” to them. Without clearing these exams, a student will not only be considered ineligible for PG but also, he/she will not be allowed to pursue internship. Post internship the phase 2 of this exam will be held in which the clinical skills of the students will be tested.

With these new guidelines many questions are hovering in our minds depriving us of sleep, “What happens when a student wants to attempt NEXT more than once for a better rank?” “How will one complete the huge final year syllabus within November?” “Is it really possible to check the clinical knowledge of students by making them solve MCQs?” “With no importance of practical classes or lectures, can we really end up making good doctors?” “Is it possible for students to attend clinical postings everyday and at the same time prepare for this MCQ exam? And if not, which should get a higher priority?”

As the fear for our seemingly bleak future looms in our minds, we hear comments for non-medico friends and relatives, which make us laugh and cry at the same time. “MBBS was always difficult. You knew what you were getting yourselves into. A few years from now you people will charge in lakhs from poor patients. Please don’t forget to give me free treatment then.”

Aunties and friends, we promise we did not know what we were getting ourselves into. No one does, until they reach the point of no return. For us, it was like going for a surgery without any MRI or CT scans done, and suddenly spotting a crucial anatomical anomaly which, if not taken care of, has the potential to change the prognosis for the patient entirely causing unexpected death on the table. We need to make some big decisions but do not know what to do and unlike the surgeons for whom decision making skills develop with experience, we don’t even have enough time to gain any clinical exposure or experience.

It is a popular yet infamous opinion that medical field follows the principle of “Survival of the fittest”. This makes many of us wonder, “Am I fit enough? Can I do justice to the profession I chose and to all my future patients?” This is a question only Time can answer. Till then, spend all your energy on surviving this battle, maybe you will automatically end up being the fittest.

 P.C-Shuvojyoti Rakshit

 

 

The Song of OT

 

The first day a med student sets foot into the Operation Theatre, the experience she has is unique. It cannot be compared to anything else one comes across in day-to-day life. For some, the sight of blood seems so scary, that just before fainting, they make a quick vow never to go into a surgical specialty! While for some others the experience is exhilarating!

 The soft buzz of the surgeons and nurses speaking, the continuous beeping of machinery, the intermittent high-pitched scolding from the nurses when they feel that there are too many people inside the OT compromising sterility, the loud whooshing sound of the suction pump and the occasional ‘peeeeee’ sound of the electro-cautery, all sum up to form a beautiful musical composition- “the song of OT”.

At times, especially in case of surgeries that occur under local anesthesia, this song is also mixed with songs from the radio. The surgeons play their favorite stations on the radio while operating and at times one might happen to catch them humming the tune, an indication that the surgery is going really well.  It is fun to watch the surgeons asking patients not to concentrate on the pain but on the song in case the patient happens to stir during operation (it doesn’t happen always though, as the patients are mostly heavily sedated before surgery). It makes one realize the beauty of music therapy- where one simple song comforts the patient who is undergoing the operation, helps the surgeon to concentrate better and calms the scared intern assisting the operation who is often scolded for handing the wrong instrument to the surgeon. Also, for the med students, who many a times do not understand what the hell is going on and are too scared to ask, this same music is something to occupy their minds with.

There are different kinds of students who go for surgical postings- some are nauseated by the blood (as I already mentioned), some go just to click selfies wearing the OT scrub and are never seen again after the first day. Some belong to the studious kind who understand and explain procedures to their not-so-diligent classmates, ask a multitude of questions to the surgeons and save others from the blow of the occasional unexpected questions hurled at us by the professors. Lastly, some belong to the ‘well camouflaged’ variety. The people of this last category are probably the most in number during clinical postings- they neither ask nor answer questions, they listen quietly, stand in a corner, and try to absorb whatever bits of information they come across. If driven away by one surgeon, they simply move to the next OT table. Their insignificance is almost to the point of invisibility and they just enjoy it!

Operation theatre is a serious place, where one swift move of a scalpel can save or end a patient’s life. So many of my readers might be wondering, is it proper to speak of these things so lightly? Is it okay to listen to music while performing a major surgery? For them, I would say, the best decisions are always made with a calm mind, and mind cannot be calm under a mountain of worries. If you ever enter an operation theatre, as patient, nurse, surgeon or as a confused student, leave your bag of worries outside with your shoes and clothes, and get ready to lose yourself in “the song of OT”.

 

 

 P.C-Shuvojyoti Rakshit

 

 

In the name of Horace and Jupiter

 

Prescriptions are an integral part of every doctor’s practice. What one writes in the prescription determines whether he/she will be worshipped as a savior by the patients or will be laughed at by pharmacists for writing grossly incorrect doses of drugs.

The word “drugs” is first introduced to us when we hear about some dark alley beside school where some precocious kids assemble to taste this forbidden pleasure of “doing drugs.” While for them it is “forbidden pleasure” for most of us its just “forbidden”. We are made to do long projects about the ill effects of “drugs” on body, mind, and society.

It is when we step into the first pharmacology class of second year of MBBS that we find out that drug is something that is “used or intended to be used” for the “benefit of the recipient”, that too it is administered in the names Horace and Jupiter who are Gods of health and well-being. That’s when we start mugging up the long definition of drugs, with special emphasis on “benefit of the recipient”, which is the polar opposite of what we learn during our teenage years. If a student cannot answer anything else in the viva, the definition of drugs is the deal breaker which makes her pass or fail.

A huge part of our second-year coursework consists of mastering the art of writing prescriptions. We are made to write hundreds of long and short prescriptions each with its different sets of drugs and doses. The prescriptions are supposed to be written in a specific format; a format which varies from teacher to teacher, book to book and semester to semester. One can never be sure about the format, even on the exam day. One must memorize hundreds of drugs, their doses, diseases for which they are used, and sometimes an entire set of drug regimes for a single disease (like malaria or leprosy). Prescriptions can drive you crazy (if you were not already driven crazy by the first-year subject that is)!

Another painful part of this subject is to remember the side effects of the different drugs. While the ones with eidetic memory go on to write long lists of side effects during exams, for most of us, the list of side effects ends at “nausea and vomiting” every time, so technically it can’t even be called a list! Some great people even write nausea and vomiting to be the side effect of ondansetron, which is a drug used against nausea and vomiting in the first place!

I remember a fun incident which happened during our pharmacology viva where we were faced by an external examiner who was obsessed with etiquettes and was scolding every student who dared to wear an apron which was not ironed properly. Now, he was a soft-spoken man too, and when he asked one of my batchmates, why she didn’t iron her apron, she misheard him and presumed that he was asking a question about the different iron supplements. She went on to tell him a long and detailed list of oral and intravenous iron preparations only to find out later that he was just talking about ironing clothes!

This subject of drugs may seem boring for some and scoring for some others. But one must remember to take it seriously because this is the subject which teaches us that, when the pain of MBBS grows unbearable, all you need is 650mg of paracetamol to obtain relief.😉😉

 

 

 

 

AETCOM: Extra Marks for creative writing

 

As per the new NMC guidelines, a new topic called AETCOM (Full form: Attitude Ethics Communication) got recently introduced into the medical curriculum. AETCOM classes are supposed to train budding doctors for dealing with patients and their families in a more understanding and intelligent manner. In short, they are trying to make sure that doctors themselves do not end up being responsible for the violence against them. In these classes students are taught about the intricacies of patient care and sometimes the medicolegal impact of their decisions as doctors.

AETCOM questions come in exams for five marks in every paper and of course these 5 marks are our favorite among all the two hundred marks we have to write for. Reason? Its basically creative writing. The questions which come are like:

1.       Write a short note on doctor-patient relationship.

2.       Write a short note on the rights of a patient.

3.       Write a short note about the care of patient sample.

While writing these answers the Shakespeare inside every medico wakes up, and people end up writing some unique, phenomenal and awe-inspiring answers which have been a constant source of entertainment for the examiners for the past few years (alongside our other answers which tend to be laughable too)!

We are actually supposed to read some really long PDFs on these topics from the NMC website, but literally no one does that. This is the beauty of AETCOM, this is the only part you don’t have to study but you can expect to write in the exams. Though most of us write other answers too without knowing anything about the topic, but that’s a tale for another day.

AETCOM classes come with fun activities too, for students. Like, once we were asked to perform a play about the correct and incorrect approach of a doctor towards his/her patients. I remember having immense fun while writing the script for this good doctor-bad doctor play with one of my batchmates.

At other times random pairs are made and they are asked to do role play as a doctor and a patient and communicate about some prevalent disease like, malaria, dengue or tuberculosis. I must mention here that the poor person who has to play doctor is the one to suffer in these plays. Why? This is because the teacher expects him/her to know everything about the treatment plan, long term complications and preventive measures of the disease and communicate the same to the patient who at times (especially if it’s me) asks some really difficult questions just to add to the trouble! And if he does not know the answers then he’d better get ready for impending doom!

In today’s society however violence against doctors and AETCOM classes exist and thrive simultaneously. Every time a doctor is wrongfully accused, provoked to commit suicide or is manhandled it leads us to wonder, can AETCOM classes really prepare us for the things we might face as interns or doctors? Only Time can tell.