Lone Traveler

 

When one steps into med school in first year, it feels like being in a forest of unknown faces. While some people are lucky enough to find some of their known faces in this crowd, not all have such luck. Slowly introduction begins, followed by exchange of phone numbers. Before we know it we are divided into a couple of huge groups. Study groups form, as in first year everyone is motivated and reading all the standard textbooks seems like a status symbol.

However, the funniest part about these groups is that, seldom do they remain intact. As the so called “friends” show their true faces, hearts are broken, trust is shattered and phone numbers are blocked or archived. The study groups then fall at the bottom of your contact list waiting to create a surge of nostalgia before being permanently deleted. Sometimes it is about two friends liking the same person, at other times it is about inferiority or superiority complex based on the all-important, “Mb results.” After all, not many people have the openness to accept that the friend you used to teach and help before exams ended up scoring more than you.

But humans are social beings after all, and hence they form new groups again, smaller ones this time. These new friends initially seem so much better than the seemingly toxic groups you left behind. The initial few days are spent in discussing the ‘red flags’ of the people you left behind, or who decided to leave you behind. But soon, even the new group seems only slightly different from the old one as new ‘red flags’ are discovered. Actually, knowing a person is like viewing a slide under a microscope, the closer and more magnified view you get, the more pathologies you are likely to find. Finally, when they decide to enter ‘khep groups’ in final year without telling others the decision to label them as selfish, self-centered ‘batchmates’ seems only too easy.

At the end it is only you and your closest friend(s) who decide to stay, and accept your ‘red flags’ as they are. The others reduce to people you say “Hello” to in corridors or who ask for pdfs before Final MB. Though we have many friends to start with, by the end of Final year, we are essentially solo travelers, left with colleagues or batchmates, not friends. Some people become so much like strangers that one is even scared to ask, “Hey we were best buddies once. Remember?” A small voice inside us says, “Leave it. They probably do not remember.”

This is probably what makes final MB tougher, as one cannot turn to others for support, everyone has to fight their own battles. Does this mean that people stop helping each other? Definitely not. They still provide crash courses to each other outside exam halls, ask doubts, roast that one examiner who kept asking questions like “What do you think was the relation between Bailey and Love?” But that’s all. Thus, when at night you are alone in your study room at home, or your hostel room and the syllabus seem too tough, too big and the exam too near, you tend to call up your mother only to hear that small, “Everything will be fine tomorrow, sleep now.”

Photo courtesy- Shuvojyoti Rakshit

Someone once rightly commented, “If after MBBS you end up being in touch with even six of your college friends, it is great.” Movies like “Chhichhore” or “3 idiots” give us utopian ideas about college friendships but no one prepares us for the harsh reality. So, when reality strikes the heart protests a little, “This was not how it was supposed to be. Where did I go wrong?” The answer to this question is nowhere to be found. Maybe it is a part of adulting to be able to suck it up and move on after someone leaves. But is it the right thing to be expected from a person- to leave or to be happily left? How can we trust anyone then? God knows.

 

 

The perks of being a first bencher

 

On the first day of school, sometimes even on the first day of college, our parents teach us about the perks of being a first bencher. They tell us that first bencher is the first step towards becoming a topper. In college however, the attitude changes and the middle and last benches tend to fill up faster than the front benches which mostly remain empty. This trend continues till third year. In final however the picture changes entirely. One finds a long line of students standing outside the doors of seminar rooms waiting to run to the coveted front row as soon as the door opens. Sitting in the class feels like a musical chair contest, where chairs are literally snatched away even before one can blink.

This scenario continues in most classes throughout the year until exam comes up. Then one finds most of the confident first benchers rushing back to occupy the back benches because, the saying goes: “Desperate times call for desperate measures.” If you are late to the exam hall or attract too much attention to yourself, the invigilator might invite you to occupy the ceremonious “First bench”. While most examiners prefer to bring the back benchers to the front bench, there are certain masked men who prefer to bring the already doomed first bencher further forward, that is, when two front rows are empty, they call the poor third benchers (technically first benchers) to fill the front row. If you had this sort of an experience during semesters and thought that it could not get any worse, well this author then has to tell you that it can.

Photo courtesy: Dibya Adhikari

Sitting on the front bench during final MB right in front of the CCTV and the observer’s desk is a different game altogether. The Dean of Student Affairs asks the poor first bencher everyday, “How’s the paper?” Probably she expects an answer different from, “Its terrible.” But one doesn’t always get what they expect in life. One doesn’t get to turn, has to talk in sign language if at all. At any point of time, one finds at least one among the many invigilators staring her down. As the observers munch on tasty patties, the poor first benchers are distracted by the smell, and find their stomachs groaning as exam time breakfast tends to be light for most people. The torture doesn’t end there. One gets to be within earshot to hear departmental gossip, family issues of the invigilators and how they believe that this generation is doomed.

While some invigilators are kind enough to provide some MCQ answers even without asking, most others are not so. Some of them make up ridiculous rules like: “No extra sheet can be given in the last 30 minutes.” Some others like to take away students’ answer sheets in the middle of exams and another third group, shout so much and so suddenly that students tend to drop their pens as a startle response or forget answers they were about to write. As someone once said, these strange people, as soon as they catch someone cheating, react in such a way as if they have caught an entire gang of drug dealers.

To add to the students’ woes come a bunch of perverted bouncers who take the opportunity of frisking to touch the poor students in inappropriate ways. One wants to scream, “Why are they getting money for doing this, while I have to toil through this month-long torture just for a meagre internship salary?”

But dear reader, if at any point of time in the exam hall, you feel helpless, do remember to look at your first bencher friend who sits infront of a bunch of observers, and try to imagine yourself in their place, you will probably end up feeling better. Do not tell yourself that the person is writing so much, and probably does not need help, because you never know exactly what a person is writing, and how much related it is to the question asked. So, take a chill pill and thank your lucky stars that you are not having to listen to the chatter of your irritating invigilators.

Photo courtesy: Unknown

 

 

" What is your case?"

 

The answer to the question in the title is something we all know: “I am a case of hyper-syllabus hypo-preparation syndrome, Sir.” Sadly enough, this answer doesn’t fetch any marks. Final MB is probably the last hundred meters of the marathon race of MBBS and it is not for the weak-hearted. This becomes clearer as one stands with a smile in front of a sadistic Professor with a Golden Littman proudly hung around his neck, constantly reminding oneself, “DO NOT CRY HERE!”

The centre of attention for students in Final MB practical exams is the revered and feared demon called “Long case.” This is essentially a patient, whose entire history the student has to collect painstakingly and come to a diagnosis about his condition. This is more easily said than done. Some tired and irritated patients give you the wrong history, changing it entirely in front of the teacher, while some kid keeps howling at the top of his voice no matter how many chocolates you give him or how much you sing for him. Some students are unlucky enough to land up with patients who have so many diseases and complications that they are no less than a textbook themselves. The question one faces in the exam hall is, how much to write? If one writes complicated symptoms, it invites unwanted questions, and on the other hand if one misses points in the history, one earns praises like, “You can’t even write a history properly? You are definitely not eligible to pass.”

Photo courtesy: Ritadeepa Jana

Someone once rightly commented, “It is easier to become a long case than to prepare for one.” This author feels that an important part of preparation for any viva, be it long case, short case or tables, should be to practice lip reading, so that if a kind PGT tries to prompt an answer you are not stupid enough to miss it. While some professors come only to traumatize students there are some others, who do not really consider the exam to be an exam. To them, it is just another class in the ward during which they kindly teach students operative procedures like “Evisceration of sac.” When this category of professors asks at the end of the viva: “How do you think your viva went?” one finds herself at a loss to answer. The mind wonders, “Did I even answer any question? Wasn’t it mostly him teaching me?”

If the patient is a baby, there are other issues like, the patient might decide to poop during examination, or both mother and child might decide to follow the Gandhian philosophy of Non-cooperation movement or the child might decide to cry in front of the examiner. As a professor of Pediatrics once rightly commented, “If the child cries during examination, you have to cry too.” But what does one do if the child doesn’t stop crying inspite of the student’s best efforts? Well, the answer to this question is: PRAY.

There is yet another entity called as a short case in Final MB practical. The term “short” case is a misnomer. This is essentially the same as long case minus the writing part. The duration of the viva depends on the nature of the examiner and the performance of the student. Often this is such a case which one NEVER saw throughout the entire duration of final year. Cases like Tetralogy of fallot, hypospadias, papilloma and osteoarthritis make appearances in this so called “short case”. In most cases the only way to prepare for such cases is through hall collection, during which one goes on asking anyone and everyone, “Hey tell me something you know about this topic. Anything will do.”

Photo courtesy: Shuvojyoti Rakshit

The answer to the question in the title can be very tough as, the answer you say may not fall into the examiner’s idea of correct answer. Not many examiners are kind enough to understand the condition of students, so the viva tends to be grueling, physically and emotionally. One way forward is to accept the situation with a smile and wait for that one easy question the examiner decides to ask, answering which can be the game changer. But mostly, one is so drained by the end that even easy answers evade us. This is why during such situations, we must constantly remind ourselves: “It is not over until it is.”

Concentration Camps

 

It is often said that government hospitals do not offer much space to their patients who often have to spend days lying in dirty trolleys in the corridors and cannot be provided with beds. But people seldom speak of the plight of medical students who do not have proper classrooms to learn in. One can argue that wards are the best places to learn directly from patients. True that. But they probably forget or have never faced the plight of being one of the 40 students barely breathing inside a room meant for 6 people at max on a hot summer day trying their level best to concentrate on a chest Xray showing “Egg on string” appearance. The mind at that point becomes a perfectly reflective surface through which no studies seep in and the only thought one has is to jump out of the window.

The same can be said for ward classes during which hapless students standing at the back barely get to peep in and observe clinical examinations. Students often have to hear, “Why don’t you attend classes?” But why would they if class means standing in the ward for 2 to 3 hours being able to see nothing. While NMC recommends small group learning, the reality couldn’t be further from that. Whether one gets to learn in “small” groups depends entirely on the “Unit division”. Some people are unfortunate enough to be posted in units where the teacher asks them to get lost on the very first day refusing to teach or the teacher himself/herself remains lost only to show up on the last week of posting and grumble “Where were you people all these days?” Then again, in the exam these lost teachers are the ones who say, “I have never ever seen you in the ward. No wonder you know nothing.” These unfortunate ones have to loiter from one unit to another often at the mercy of their batchmates who sometimes shun them unkindly for increasing the crowd in their assigned “Small groups”.

Are the people who send their friends away from their own assigned units toxic? Probably not. They do so because of the increasing crowd which makes learning difficult as well as because of some of the over-enthusiastic students who always want to be in front during every class and do not want to make a single compromise, thus forbidding the people at the back to see. One at times wonders why they do it. Well, the answer probably is the fact that by the end of third year most wise people realize that MBBS is essentially a cut-throat race and it is easier to treat it as such instead of falling into stupid emotional traps like friendships or wanting to grow together. In this game of “survival of the fittest”, there is no room for letting others grow. Also, is there a guarantee that tomorrow in a similar situation the other person will step aside for you? Thus, a vicious cycle begins.

In a desperate attempt to learn, one takes the help of unstable chairs, stools or even patient beds to stand up and have a bird’s eye view of whatever is being taught. Unfortunately or fortunately, till date no student has fallen to have a fracture and make the authorities realize the sorry state of UG med students. Will an accident be enough to open their eyes anyhow? That is indeed doubtful.

Does this problem only affect the students? No. It affects the patient who is sick and yet has to put up with 20 students staring down at his groin and then practicing hernia examination on him one by one. It also affects the teacher who has to teach without kicking the hapless female student who sits at his feet during class, that too in kho-kho position, to take up minimum possible space.

Is the situation entirely as dreadful? Probably not. Some departments do offer air-conditioned seminar room where the old HOD Sir still teaches the students the art of clinical examination. Some other departments offer spine-chilling large seminar rooms where less than 10 students have to appear for a quiz under the scary supervision of their masked professor. As they say, silver linings! But that doesn’t lessen the problem itself. Will a time ever come when MBBS students can have classes like normal humans? As far as the current situation indicates, not anytime soon.

 

 

THE "CORRECT" METHOD

 

From one’s childhood one is taught the correct method for a number of activities like the correct method to brush, to tie shoelaces or to fold clothes neatly. We absorb these methods by seeing our family, teachers and friends and being able to do such day-to-day activities properly and independently improves us and makes life easier. MBBS is no different in this regard. A medico is supposed to learn the correct method of patient examination by carefully examining their professors and Post Graduate Trainees (PGTs) so that day-to-day patient care gets easier and more effective.

One learns the correct method to palpate a patient’s organs or the best way to elicit reflex responses from a patient. One also learns the best method to coax a crying child to measure his head circumference (Pro tip: Singing about "Washing Powder Nirma" might help sometimes.) or the correct method to wash one's hands in six not-so-quick and not-so-easy steps.

While one spends a lot of time and energy trying to acquire these skills in the ward convincing unwilling patients to cooperate with the learning process, or reads standard textbooks to know the universally accepted methods of clinical examination, in the end the only realization that hits hard during Final examinations is that there is no such thing as “correct method” or “accepted method”.

One can learn or practice a particular method but will it be accepted as “the correct method”? Well, that depends on sheer luck. If “your method” is the same as “examiner’s method” then probably yes, but if the two turn out to be even a tiny bit different then “you are not fit to pass”. No matter what you have done throughout the year, only luck can decide whether you will hear praises or go home in tears.

Speaking of “correct method” one wonders “Does the correct method of conducting an examination consist of telling a student that you are unfit to pass right at the beginning of an exam? Why is the exam divided into so many parts if only one viva can decide everything about one’s abilities?” One also wonders why all standard textbooks mention atleast 3-4 methods of palpating organs if there is just one correct method. Ultimately the difference between the “textbook method” and “examiner’s method” or “student’s method” is much like the difference between a language and its various dialects. While language consists of what you say, the dialect mainly refers to the way you pronounce it along with some fine tuning of the words. If one speaks a certain dialect it does not give him or her the right to insult another one. But alas! Life is seldom fair.

How can this problem be solved then? One way can be to bring out SOPs (Standard Operating Procedures) of all the different clinical examination methods alongwith videos which the students can follow and the examiners, under no circumstances, can deny. However, this is a huge task and as the saying goes, “Who will bell the cat?” So, students can only continue to suffer while clinicians continue to devise their very own, personalized, “correct methods”.

 

 

Khepology

 One of the things final year of med school brings into one's life, besides anxiety attacks, dark circles and constant fear of failure, is the ordeal of "Khep classes". This weird term refers to a set of extra ward classes which final year students take under the guidance of Post Graduate Trainees (PGTs) in order to gain clinical exposure and learn the art of patient examination. 

At the very beginning of the year starts the crazy race of getting into "Khep" groups under various PGTs. Some outstanding students join multiple groups for the same subject to earn themselves the golden title of "Khepologists". While the morning ward classes go predominantly unattended, many students leave themselves entirely to the mercy of these all-important "Khep" classes. Such is the craze about these classes that one sees friendships breaking over one question: "Why didn't you add me to this particular khep group?" The answer to : "Which Khep group did you join?" is guarded as a national secret worth dying for by most students who would rather answer questions about their private fantasies than about khep.

Each of these "Khep" groups has an organizer- in some lucky groups it is the PGT himself/herself while in other groups the responsibility of organizing classes, convincing Mr. Busy PGT, finding patients and informing others falls on a poor, hapless student. Thus, a tough life begins for the poor organizer who always has to answer questions like, "When is the next class?", "Why don't you go and convince Mr/Ms PGT?" . After countless phone calls, unanswered text messages and unfulfilled promises when a class is arranged after all, one feels as if one has already won a gold medal for being "Khep organizer of the year". But at the end of 2hrs of standing in the stuffy ward, one's fellow khep mates comment, "This class was a bit theory based. Why don't you tell him to make the class more clinical examination oriented next time?" This leaves the poor organizer to wonder, is all this worth the effort?

By the end of the year one realizes that maybe all the khep organizing was not worth the effort so one shifts to practicing on friends in hostel. These group study sessions, jokingly called as "Hostel Khep", yield much more in terms of learning the clinical methods and getting them right. As a bunch of people get together to share their cumulative knowledge gathered from books, ward and khep, one also finds probable questions, and answers to one's doubts. But theses classes also come with two major follies: 1) You cannot be sure that the method you agreed upon is indeed correct. 2) None of the findings are generally present (unless your hostel buddy is secretly harboring some disease).

But as it is said, everything has its pros and cons. While the effectivity of the khep classes depends on the enthusiasm of both the students and the teacher, and the effectivity of group study depends on the knowledge of the group members, but at the end of the year anyone who wants to learn truly will get the basics somehow or the other. 

Lastly, if khepology is an art, it has certain formidable, talented artists who attend two khep classes for the same topic of the same subject under two different people within the same evening. Kudos to these rare talents because of whom the art of "Khepology" is achieving new heights every day.

Photo courtesy: Shriya Mukherjee

Beginning of the end

 February- the month of realizations, is finally here. In this month some people realize their love for the next door neighbor girl when they get dolled up in sarees for Vasant Panchami, while some less fortunate people, like the medicos, are faced with the realization that more than half of the exam syllabus is left to be covered with less than 30 days to go. As the shortest month of the year brings bittersweet pangs of love for some people and all-bitter palpitations for upcoming exams for others it stands apart from the other months as the torchbearer of change. This change takes place in our routines, our mindsets as exam tension exhausts most of our thinking capacities, in the weather around us as winter takes a bow for the time being and in the number of cups of our beloved chaye we consume per day.

Sometimes exam season makes one weirdly productive- some people find time for exercising (something that is easily forgotten on normal days), some lazy bloggers dust the cobwebs off their creative writing skills and get back to work, while some voracious readers complete entire novels on a single day just to experience the thrill of reading forbidden books during the exam season.

While at other times the mounting pressure proves so great, combined with the sleep-inducing weather that even a cup of coffee becomes a z drug which easily lulls one into a comfortable sleep, followed by a surge of tremendous regret after waking up, scrolling through some shorts to clear the mind of guilt, and falling back to sleep with a 'clear mind' after an hour of idle scrolling.

Routines prove useless, all plans fail, study group doubts send chills down one's spine as one realizes that they are from unseen and unheard-of topics, and mostly friends keep piling up their depression on one another so that the net depression level of the group never steps down from the constant high value. 

With so much on one's plate even the Valentines week just round the corner seems bleak for the hapless medicos. While February brings in so much trauma it is also the month we cling to for dear life. We fervently wish the fragile February a long long life just to prevent March from marching in with the heavy load of the formidable, preposterous "MB", whose full form evades us even as we appear for it one last time.

So let some good memories and sarcastic observations bring light into this February. Get ready for a series of trips down the memory lane in this series of entries, so that we can all hold on to our leftover sanity as we prepare for the least awaited arrival of our "Most Beloved"(MB).

Love in the time of protest

 

Firstly, yes. This title is actually inspired from the famous novel “Love in the time of cholera” by Gabriel Garcia Marquez. Why? Probably because this entry will also describe stories of love and unity in extremely trying times.

When a student enters med school with eyes full of dreams of sitting in a doctor’s revolving chair one day one probably cannot even imagine that a day will come when one will have to sit down on the ground and demand justice and protection for themselves and their community. As protest marches continue, slogans change, vandalism shows its dirty face and crime scenes are tampered with, fear creeps in all our hearts. Whatever we are fighting for, is it achievable at all? We have so much at stake, can we really risk it all? As political colors pollute the purpose of the movement, and people with colored flags hit the road to protest, “We want justice” becomes more of a propaganda than a cry for justice. When ideals are wounded, mind starts losing hope and the heart suffers seeing the atrocities all around, love is the only thing that holds the protest together.

Love comes in various forms- the courageous Love which allows friends to console and take care of each other on dark nights when the threat of an approaching mob sends everyone into a state of panic; the caring love which allows brothers to offer to take their grown-up sisters home from a protest meeting on a day where there are chances of violence on the road; the concerned love which causes old friends, teachers and relatives to call multiple times to find out whether med students and doctors are okay in these trying times; the respectful Love which one feels towards their strict professors who come to stand by and support the students during the movement; the cringe Love which causes crazy lovers to hold hands during protest meetings; the fearful Love which at times causes parents to forbid their children from going into protest marches for the fear of violence; the loyal Love which binds us to our colleges and our fraternity and fuels us to continue fighting everyday; and lastly the empathetic and sorrowful love that everyone in feels in their hearts for the victim and her family.

On the days when the future seems bleak, slogans seem pointless it is the light of friendship and humor which rescues us from darkness. Light comes in the form of eating free cakes and biscuits and chit-chatting in between protest meetings or in the form of humoring oneself by observing the people around. Some great ones take the opportunity of protest meetings to sit down and read medical books in between slogans. Some find an outlet to their creativity in the form of making up extempore slogans or long touching messages in group chats or repeating the same statement in different ways on the microphone during protest meetings. Some people misinterpret their talents and try to sing in between protest meetings leading to uncalled for comments from the listeners. Some play video games on their phones, while some show silent, passive-aggressive protest by never joining in during slogans. One observes that particular PGT who comes into the meetings every day for some time to show solidarity, never sitting down, joining in the slogans or saying anything at all and wonders how he is indeed a tall-standing “pillar of support”.

It is this love and humor, coupled with our undying dedication to our cause that keeps the protesters united on the face of every adversity. However, fear still looms in the shadows- fear of failure, torment and violence grips us. Will we really have justice or do we have to see other dark nights like the first stroke of our 78^th Independence day? Only time can tell. Till then, let Love and loyalty unite us all as we, as a nation, raise our voices against injustice.

Photo courtesy: Students of NRSMCH

TERROR

 

When one steps into NEET UG preparation phase with a dream in mind, fights through all obstacles just to secure a position in a government medical college, rarely does one imagine that, in the name of securing one’s future, a person ends up with a profession that offers no security at all.

As blood curdling rage burns through the hearts of young medicos, only one unanswered question hangs in the air, “HOW?” One wonders how does one get brutally murdered at a place we call our second home? How do we secure ourselves, being a part of a more vulnerable gender? How and through what parameters do we judge people to identify the Devil in them? How do we ensure justice?

As a medico, every day is a new learning phase. One attends ward postings, OPDs and demo classes where professors and PGTs take turn to teach and help the students to acquire new skills. As insecurity fills our hearts, fear runs in our veins, we remember the faces of the people we see everyday. The intern who prompts answers when we cannot answer the professor’s questions, the professor who uses his own socked foot as a model to explain deformities of foot, the PGT who carefully teaches us how to examine a breast lump, or gently scolds when we cannot wear our gloves properly. Can we not trust them? Can we not go for late night walks around the campus anymore, out of sheer terror? One also remembers the sick, helpless, seemingly stupid patients and their families one sees in the wards. Some of whom are kind enough to allow novice med student to experiment on them, while others are not so kind and say all kinds of incorrect disease history during exams. Should we be terrified before we offer them healthcare?

After years of learning, inhuman hours of service, does a person deserve to die with her dignity violated? As authorities try to cover up for the perpetrators, the scar on the face of Humanity deepens, as the news channels show this news to the families of each and every female medico, parents’ hearts darken with the thought of their daughter’s endangered safety. Concerned, fearful advices come over phone calls, “Do not go out at night. Do not trust anyone.” But is that really possible for the female intern who is the medicine on-call tonight?

One wonders, how to do justice to the deceased and her family? Some people might comment that going on strikes and closing the hospital OPDs for common people is a deadly decision, because sickness cannot and should not have to wait. But silence in such a situation is deadly too. While many people might judge this whole profession because of strikes, it is essential to remember that these same people will choose silence rather than protesting against such heinous offences. There will be some other “intellectual people” who will write long social media posts about how women are responsible for the crimes against them. It is time that we learn to completely ignore such people as they do not even deserve as much attention as hate comments. Justice comes at a price, and it is high time that we steel our nerves and get ready to pay that price.

This incident reminds us of famous dialogue from a Turkish TV soap called Magnificent Century, where the famous Hurrem Sultan tells her husband Sultan Suleiman Khan, “Do not look far Suleiman. The traitor is in the palace.” Indeed, the criminals roam free among us and only when we show them their real place behind bars, can justice be served.

 

Immobilize

 

While a number of nation-wide scams depress the budding medicos and the young doctors looking forward to post graduation, the weather around gets thick and gloomy with confusion and fears. The present situation is reminiscent of the COVID period when suddenly all board and competitive exams were cancelled as the nation went into a state of lockdown and the students into a state of confusion which lasted for months. While some might believe that a postponed exam means extra preparation time, but only the hard working, dedicated student who prepares for months giving up on all else, knows how much of a mental toll this brings.

When one is preparing for an examination with nineteen extremely volatile subjects, some of them while working full time jobs, it takes a lot of effort and determination. If one fights such a hard battle, only to realize at the eleventh hour that the examination system itself is broken, the hopeless feeling is probably indescribable with words. While confusion clouds the mind, mindless posts fill social media and news channels host useless discussions and debates the helpless student loses the urge to study, which may create a set back on a strongly built preparation. Or when an unfair examination provides unfair results, months of earnest preparation seems to be wasted. How does one deal with it then?

Final year of med school, though extremely hectic, enriches one with interesting ward experiences and insights about clinical practice as well as life. One such subject probably is orthopedics which teaches one about how to deal with twisted, complicated, displaced fractures. One first does clinical tests and then radiological investigations to understand the situation and get a clear picture. Then the orthopedic surgeon makes a diagnosis and treatment plan for the patient. Similarly, when life gives one such a severe blow that breaches through all layers of protection and creates a deep wound, that throws one into a complex, twisted situation one needs to investigate, get a clear picture with a clear head and come up with a plan to manage the situation.

Moreover, the mainstay of treatment of most fractures is to reduce and immobilize, which may be performed through various modalities. Similarly, when dealing with a deep blow one should learn to protect oneself, probably not get into situations which can further disturb or infect the wound. This is because any wound needs time and care to heal. When fighting a lonely battle, this immobilization is difficult to achieve as the mind flies to social media posts or group chats which cause further anger and disturbance to the mind. But no matter what, one must remember that in times of confusion or sorrow, we must turn to the right set of people. So, find the right people around you, people who are probably just around you and will not be found in social media, news channels or group chats.

Lastly, not only in terms of cancelled exams or shattered dreams, whenever any blow breaks a person, or a bone. Not all of them heal the right way- some never heal (that is they go into non-union), some heal the wrong way creating a permanent deformity (that is they go into malunion) and lastly some blows result in severely infected wounds which result in amputation. What do we do with such wounds? Well, then we accept, rehabilitate and build a life around that deformity, a life that needs a little more courage, more perseverance and determination to live. But it is our life and our battle after all, so we just live it anyway.

 

Buffering

 

After a bad exam with a bad question paper, one finds many people whose thoughts resonate with theirs. People get together in groups, counsel each other, slander the University and say sweet words about the Professors who set such papers, and finally the mood lightens as someone cracks a dark joke that makes everyone laugh in spite of themselves. But there are other days when you and everyone around you craves that resonant frequency that is nowhere to be found. Every heart seems to play a different tune and everything combined seems to create a chaotic din that makes the air heavy.

The wait for results at med school is a test of patience. Weeks full of false alarms, fake news, tension, and flashbacks finally lead up to the day of results when people initially don’t want to believe that this time in fact the news is true. As usual, website conveniently crashes. Then begins another long phase of trying, staring at the words “Error” or “Connection timed out” on the screen and trying one’s level best to keep calm. As friends and family call to find out the much-awaited result, or to ask for your help to see theirs, your mind screams, “For God’s sake, let me be! I don’t know!” And then just like that, standing alone at the foot of a statue late at night, one finally sees their result, and for a moment the mind cannot believe that the buffering has ultimately stopped and what the eyes see is in fact the final fruit of their efforts.

Picture courtesy: Mehetab Alam Molla

For some, it is their long-awaited good news, a dream come true, while for some others it is an unexpected delight which hits them like winning a lottery. There are others who cannot meet their expectations, leading them to wonder, “Was that too much to expect?” Finally, there’s another unfortunate group, whose dreams remain out of reach. As some celebrate and some retreat into a lonely corner, people fail to support one another. The mobile phones flood with texts asking “How much?” But after sharing your scores and wishing each other through a statutory “Congratulations” or smiling emojis, conversation stops. Probably because one is too caught up in their own emotions to care, or because there is no right thing to say. The mind grows skeptical as emotions run supreme. Kind words seem like pity and cheers or best wishes seem like occult jealousy. One wonders, did we all really wait all this while for this day?

Unable to find comfort in family or friends, one feels lonely with their feelings, so much so that even two people in the same hostel room remain oceans apart, each dealing with their own emotions. So my fellow medicos, what do we do to support ourselves and others? Probably by not asking leading questions like, “How many honors did you get?” Or by not texting those batchmates we never remember throughout the year, just to ask their scores on the result day. One can also do their bit by not judging all those who did well, however unexpectedly, just to alleviate their own pain, because this author believes that slandering the successful only increases the heart’s despair.

At this point though the question remains, how do we move on? The answers of course vary from person to person, and on their ways of finding comfort. Some find it on getting drunk with friends, while others find it on dreaming about their fathers getting them a pack of chips. One must remember that everything unexpectedly sad that one faces at med school, is probably a preparation for this morbid profession which can turn gruesome deaths into casual dinner table conversations.

Lastly, these are the days when we must remember a famous Taylor Swift song which goes as: “Time turns flames to embers, you’ll have new Septembers, everyone of us has messed up too. Lives change like a weather, I hope you remember, today is never too late to be brand new.”

 

Dream or mirage?

 

On the days one feels low as a med student they remember their pre-NEET (National Eligibility cum Entrance Test) days. One remembers the hardships one bore to get to the point of being called a medical student and somehow these memories help one fight the hardships medical college brings.

The journey from being a NEET aspirant to becoming a medical student is a long and arduous one, filled with unhealthy competition, lack of friends, long hours of tuition and late nights. Basically, it provides an apt trailer to the horror movie called, “The life of a medical student.” But one still continues with the hope of seeing their dream turn into reality one day.

But what happens if the reality turns out to be a nightmare? As the line of difference between a national level competitive exam and phase 1 clinical trial melts away in the heat of elections, the average student becomes a guinea pig on whom experiments are performed against their will. As the standard of the examination approaches the standard of cleanliness in government hospitals one wonders which is more dangerous- having unclean wards or having undeserving doctors to work in them? With an increasing number of reservations, finding a seat in a government medical college, for a general (to be read as SU-Scheduled Unfortunate) becomes as difficult as making an intravenous channel in a neonate. And to add a chilly flavored icing to the cake, some people achieve impossible and unimaginable feats with the help of grace marks, like obtaining a grand total of 719 out of 720 in NEET UG.

Even if one does land up in a government medical college after all of this, does one really achieve the long-cherished dream? The answer is an unfortunate “no” for most people. Starting from the so-called clinically oriented question papers which are tailor made for torture, to the loneliness and toxicity of final year of medical college, the reality cannot be further from the utopian dream one learns to see in the preparation phase. And all these hardships lead to? Yet another exam with lesser seats, more reservations and a bigger syllabus. So the race to that utopian dream continues for some while for others it ends as the competition breaks them down turning them into the same toxic people they once hated.

How does one achieve one’s dream then? Well, the answer to this question lies in the fact that first the dream of a utopian Health Heaven needs to change. If anything, we are in a dystopian world now, and gone are the days when only hard work and dedication could make a difference. The students need to know this truth from the very beginning. The examination and evaluation system needs a long and strong pull, a pull that could change it, though not altogether. But the first baby step towards change is what matters and that comes only when everyone comes together to raise their voices against this broken system.

One also needs to remember that a doctor’s journey is a lonely one and probably the crowd and media will concentrate on more pressing matters than the mumbo-jumbo of NEET exams, UG or PG. But that should not silence the call for justice and the spirit to fight all adversities to make a change. So, medicos and aspirants, are you up for the challenge?

 

Treasure Hunt

 

Have you ever played a game of treasure hunt, where you have to embark on a long journey of finding clues, all of which lead up to a much-awaited treasure in the end? If you have not but long for such an adventure, then welcome to the final year of MBBS- a year-long treasure hunt packed with surprises at every turn. One needs to rack one’s brain to understand and memorize the 4 heavy subjects, put in days of hard work to master patient examination in the wards. The clues are provided to you in the form of books and notes and good teachers, but finding them requires a lot of effort too. All this ultimately lead to the much awaited MBBS degree.

The search for clues begins on the very first day of clinical postings where one is simply given a bed number and the name of an unknown PGT (Post Graduate Trainee) whom they are supposed to visit for classes. The struggle gets real when you neither know where the ward is, nor have you ever seen the PGT in person. Awkward conversations follow, where you go on asking every person you meet, “Have you seen this particular PGT?” until someone replies with a laugh, “I am that person. You are asking me about me?” Or at times it gets worse when you think you have finally met that person, and you address him, but it turns out that you’ve got the wrong person. Same goes for finding patients, where you take at least 15 minutes to locate the room they are in only to find them sleeping, uncooperative or absent.

Throughout the first three years of MBBS one sees many staircases and passageways which lead up to unknown places. In the final year one ultimately gets to follow these passages and one finds out some really interesting places like AC classrooms with beds in them where you can study, or sleep. One also finds soothing balconies offering wonderful views of the campus. One is thus forced to wonder, “Why didn’t I know of this place?”

The search doesn’t stop there. One need to find the best and most concise study materials to study from, so that they can complete the syllabus in the end. Wherever one goes, one finds groups of people holding serious discussions about which books or notes to follow. But this search turns out to be so tiresome in the end that once you have finally got all the books and materials, you feel like resting a bit. Then at the end of this extended resting period, you are late to begin with your studies and in the end the syllabus anyways remains incomplete.

In this year, along with Medicine, Surgery, Obs&Gynae and Pediatrics another new subject comes into being. Some wise and fun-loving person named this subject as “KHEPOLOGY”. This subject is the one in which you get to search for PGTs in different departments and convince them to give you extra ward classes to increase your clinical acumen. Who is the highest scorer in this subject? The one who enrolls in maximum number of “khep-groups” under different PGTs or the one who learns maximum from any one of these groups? The answer is yet to reveal itself.

The treasure hunt of final year MBBS is exhilarating. But it is also a journey which you embark on all by yourself, because in the quest of this treasure of academic success one loses the treasure of friendship they once had. So do not be surprised if friends start losing touch, keeping secrets or turning their faces when they see you. In a treasure hunt everyone tries to win after all, not considering the fact that everyone’s journey is different and not everyone around is a threat to their success. Sometimes one wonders, “Is it all worth it in the end? To lose so much for this?” Who can tell?

 

The Right to elect

 

With the on-going Lok Sabha Elections 2024, the right to vote, the right to choose is probably the talk of the hour. While everyone goes on about importance of choosing your own leaders, medical college authorities quietly smile as they rob the students of their right to elect. Whether it comes to choosing your Students’ Council members or your elective subjects, there is no need to bother yourself, because there is always someone else to do it for you, while you happily go on pretending that you did it yourself.

The beginning of final year brings a special period of one month called Elective Postings. The idea is to allow the students to spend 15 days each in gaining some extra knowledge about 2 subjects of their choice. When one hears this initially, it sounds interesting. Some students look at this as an opportunity to learn new thigs while some others secretly exclaim, “OMG! I don’t even have a favorite subject! What do I do now?” But then, one fine morning, there comes in a roster which strips the students’ right to elect their "elective" subjects by assigning them random subjects roll number wise. Not only that, the students also lose the right to choose their government as the elective posting starts the very next day after Professional exams end and there is no chance to go home.

While attendance is compulsory in these postings, most students take leaves according to their own wish, which is probably their way of protesting against this dictatorial act of stripping them of their fundamental right to elect. The real fun of course begins when students actually start showing up in various departments apparently for some weird thing called “Elective Postings” which nobody seems to have heard of. The professors, interns, juniors and residents stare at you as you aimlessly wander through the wards and OPDs for the first few days hoping to find patients for conditions like Surgical Site Infection or Narrow Complex tachycardia or Acute Flaccid Paralysis.

In some departments one finds HODs who care so much about these postings that the students find themselves standing every other in the HOD’s office trying to enumerate and explain causes and complications of pancytopenia or answering questions like “Who was the father of the great Bengali author Upendrakishore Roy Chowdhury?”

 However, there are some other departments where HOD himself remains occult- you visit everyday with the patience of a saint waiting to meet God, but to no avail. Until, suddenly one morning, a couple of days before your posting is supposed to end, you see him appearing through a fog of insecticide spray in the ward, like a hero, and you realize that your prayers have finally been answered. He then gives you a simple order to go and visit another teacher for further details, with a sweet smile and the advice not to spend too much time on electives. Just when you think you are going to have an easy end to your posting you are handed with the responsibility to collect, compile and present different case series on various clinical topics. And thus, the struggle changes from finding your HOD to finding your cases!

At the end of the posting one wonders, what was the use of doing all this? Well, there can be various answers to this question. These postings teach you a lesson of patience, a small taste of what awaits you in final year, introduces you to some really helpful residents, and most importantly, it teaches you to work with a team where all members do not share your enthusiasm or your work culture. The art of making people work without allowing them to realize that they are working is the key to a successful project.

Many of you must be wondering, this entire entry talks about clinical subject postings only. What about the non-clinical subjects? Well, that is a story for another day.

Jeopardy

 

MBBS exams always bring a plethora of emotions. Probably no other field of education offers you the splendid opportunity to toil through a month-long examination process in the scorching month of April in a tropical country. The bed or chair on which you sit down to study feels like a burning pyre while your head feels heavy with all the information you just crammed. Yet while you break into a cold sweat in the air-conditioned exam hall on the final exam day, you ask yourself, “All that work and what did it get me? Why did I do it?”

Festivals take a back-seat, faces of family members grow blur as one stays on far from home fighting for a seemingly lost cause. The number of phone calls from home keep growing incessantly, as parents ask you, “You have a break between exams. Why don’t you come home?” But a student knows for a fact that no breaks are allowed, because even with continuous studying for 3 days the night before exam hardly offers you 4 hours of sleep.

On the day of the exam however, you get your sweet surprise, sweet and deadly as aconite. The question paper doesn’t test your knowledge per say because with the very first question you realize that you are in for a creative writing contest. The exams apparently designed to test your understanding of health and diseases and your clinical acumen, ultimately just test your patience, perseverance, ability to make up stories to fill pages, your hearing and multi-tasking powers as you keep one ear open to hear discussions while writing with the hope that you might pick up an answer and most importantly, your ability to continue fighting till the end even after knowing that you are probably writing all hopeless answers.

At the end of the day, you wonder, “Why did I study? None of it came up in the exams. How will I pass?” The answer to this question probably is the fact that the true utility of medical knowledge is not for the sake of answering horribly made-up question papers, it is more about patient care, of finding solutions to people’s health problems. The spirit of learning medicine does not lie in remembering which IPC to apply, or which magistrate to call for recording a dying declaration when a young woman with burn injury comes up to your emergency. It is more about trying not to let the woman die in the first place.

But while these thoughts help you find justification for your hard work, they don’t necessarily help you bear the emotional burden that such an exam brings. What this does for most of us is creating a life long hatred for an interesting subject, which was meant to be enjoyed. One only wonders that are some doctors this unsatisfied with their fields that they plan to reduce the number of post graduate students in their subject, by inducing an unforgettable fear and dislike for the subject? Probably so that no one else has to suffer the doom of studying and practicing that subject throughout their lives?

Only Almighty knows the answer to this question. So, all one can do is keep asking Him to reveal the answer to this all-important question and also bless us to make us pass while He is at it.

 

Alone

 

When you step into med school you are excited, not only for the joy of learning medical science that awaits you but also for the joy of enjoying college life as a whole. Especially when you are a batch of medicos who have been stuck at home for most of the first year of college due to a pandemic situation, the prospect of actually visiting your college feels like a much sought-after forbidden pleasure. You dream of being free of the rules and regulations that kept you bound at school, dream of finding friends who you can actually vibe with, and you dream of having the time of your lives together.

For a while after coming to college things seem to go according to plan as everyday offers a new experience and you seem to meet new, lovely people every day. But this phase is short lasting especially at med school where the burden of academics grows heavier every year and the level of competition increases manifold. The people you started out with either go far ahead or are left far behind in the race of academics- both ways they just leave your side. Then you end up forming a new group again for another short period, till that falls apart too. Life feels like a book of short stories- where each time you are a new person in a new setting but every time your character is doomed to have an unsatisfactory ending before moving on to the next page which is yet another different story. Sometimes even when you don’t want to leave one story or the characters, you just have to, because the greatest author of all says, “It’s climax time!”

When you read about people choosing extreme ways out of their problems dropping out of the course or even ending their own lives, you are forced to wonder, “Was there no other way? He could have at least talked to someone or given himself another chance.” And it is then that you realize that in this race of MBBS most people have to run the entire distance alone. Even when surrounded by friends, professors, seniors or juniors, the worst battles one fights are internal and the ones no one else knows about. These are the battles that test even the best of us. Some make it till the end while some, though equally brave, just can’t.

P.C-Shuvojyoti Rakshit

“What should I do then?” you ask yourself. The answer to this question, you know, is complex. While an untimely exit should not be an option, continuing this journey also seems to be difficult. These are the days that one needs to remember that though the career path ahead looks solitary, there is life outside med school as well. Bits and pieces of the life you left behind to be here, still exist outside the college. So, pick up the phone and make that call to your weirdo school friend who earned the nickname “Horse” for her love of standing, or that shy, crazy seat mate you had back at middle school who just stared apologetically at you even after you slapped him for destroying your pot painting. After gossiping with them for hours (which unfortunately seem like minutes) and getting the load of academics and college stress off your head you realize that probably, even if you are fighting the battle of MBBS alone, you still have fellow comrades left in the battle of life.

The Voluntary Donor

 

MBBS needs your blood, sweat and tears. While sweat seeps through your clothes in summer months when you have to run from one ward to the other and tears come on the night before examinations, blood is extracted from you not only in the form of physiology practical in first year but also in the form of regular blood donation camps which are supposed to replenish the hospital blood bank. Being a medico who has seen tiny kids suffering from chronic conditions like thalassemia and hemophilia needing regular blood transfusion or a fateful operation in the gynecology OT where the patient lost such a great deal of blood that a med student almost fainted seeing that, one finds herself happily obliging to donate.

There are generally two options- one can either donate at an organized donation camp, or, if one is really crazy enough, she can show up one fine morning at the office of the blood bank in-charge suddenly volunteering to donate blood. If you go with the first option, you get to donate with friends with familiar faces all around, and donation is followed by a delicious food packet. However, if you go for the second option, you are surely up for an adventure.

P.C- Unknown

First you follow a dingy corridor to the donation room where the registrar looks at you incredulously asking a string of questions, “You are a student? You want to donate for a particular patient? No? OMG, you are a voluntary donor? But why? Why do you suddenly want to give up on 350ml of your own blood?” Then you need to patiently answer him explaining how you missed the camp because of family issues but you really want to donate, so you showed up. This is followed by a long form fill up, where the registrar advices you, “Go through the form properly. This is a gold mine of info for competitive exams.” And blimey! He is right! You find the form to be full of info you did not know. Finally, when you reach the phlebotomists, they treat you like some delicate blood donation fairy they have never seen before. They say things like, “I can’t find your veins madam. And I am scared you will be hurt, if I do something wrong. Let me call my senior.” Then the kind registrar comes back and hands you the form asking you to learn it by heart to pass the time. Ultimately the senior phlebotomist comes, only to insert a big fat needle and do a long and weird vein-searching under your skin which causes you to develop angry looking red bruises the next day.

When you are done, you get a pack of cake and juice and send the entire department into a flurry of activities where everyone runs after giving you a certificate and a donor card, but are utterly confused about what to write in the certificate. At one point, you just want to scream, “I don’t want the certificate!” But you cannot as the phlebotomist comes and presents you the certificate almost with a bow, adding, “Come back after 4 months madam. We need more donors like you.” Then you promise yourself to go back the next time and also get a photo of that form for future reference.

 

Revisiting old love

 

Many a times when life gets busy and tiresome, when nothing seems to go the way you wish it to, when the friendships you made with so much effort seem to fall apart, you tend to end up thinking that maybe you are not worthy of love and care. It is at these times of despair that revisiting the place and the people who made you feel loved, cared for and confident helps. If you are like this author, that is, your school is the greatest love of your life, then I think it is best to revisit that place where it all began once in a while. This is because your seemingly crazy physics teacher there might actually help you rediscover that “crank pot” inside yourself, whom you seem to have lost in today’s work-a-day world.

But even revisits can be painful when you find that many of the familiar faces are gone, the familiar class rooms and the open corridors where you used to run around with the all-important “Class Diary” to get it signed by teachers have now been remodeled. The terrace where you used to feed croissant to birds, the old color coding of the floors, and your beloved Primary school building which looked like it was right of a world of fairy tales are now gone. Things change with time but some things remain the same, like your fear of seeing your old mathematics teacher whose famous dialogue was “This is hundred per cent wrong” and feeling the same old fear gripping at your heart. So much so that you are ready to scoot after talking to him for two minutes.

When one revisits school after years one also has the privilege of giving a cold shoulder to teachers who made life seem hellish back then, without having to face any consequences. Trust me, no matter what the books say, certain teachers cannot and should not be forgiven for the trauma they give you and when you finally get to walk away without having to stare back even when they stare at you, it is like a dream-come-true moment, as you finally tell your old teenage self, “We had our revenge today.”

While your eyes search for that familiar, formidable grey-haired lady who was always ready with her slaps, nothing seems sweeter than when you hear from your other teacher, “You miss her right? We do too.” You get to pacify your teacher whose son is not being able to score well in his internal assessments at med school by telling her that these exams are not important and MB is all that matters, and it is not that difficult to pass that exam, while hiding the fact that there is a very good chance that her son or you yourself might not pass this year.

Many a times in day-to-day life at med school you feel that you have changed so much from what you were back at school, in the pre-NEET era, and you regret some of the changes your personality suffered. So, when you get back to school and your teacher tells you, “You are the same old X (replace with your name), you have not changed at all”, you are not sure what to feel- happiness for being the same person to your teachers or guilt, knowing that what she thinks is not true. It is this thought that you keep thinking as you exit the school premises with the mental note to come back again next year, probably for one last time.

Photo courtesy- Sayantan Kundu