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

 

Misdiagnosed

 

One very important problem faced by medical students appearing for clinical subject practical exams is history-taking. Starting from the difficulties arising due to misinformation from the patient to the questions asked by extra-observant professors from the points one thoughtlessly writes in the history, there is a really long list of problems. “What should be the chief complaint?” “Do we have to write this point in the history or will this invite unnecessary questions?” These are some of the questions one keeps thinking again and again while frantically writing a clumsy history during exams.

Here again pdfs come to our aid. Clinical case histories written according to exam pattern come in lovely compiled pdfs handed down to us by seniors. Most people rely on them during exams until their mobile phones are discovered and confiscated by professors, who sing contemporary Bengali movie songs part time. While copying from a well-written history seems lucrative, it is also important to remember that every patient has a potentially different story. And this story is already known by your professor sitting at the viva table. So, even if you think that you don’t really know about a point you should not entirely delete it, not considering its relevance, just because it is not present in the pdf. If one thinks that the professor is going to ask weird questions from the history and it is better to stick to a diagnosis you know everything about, they should rest assured that the professor will also get mad if he finds that the history has no points and gives no relevance to the actual diagnosis which keeps the patient in the hospital and lays the entire emphasis on another accompanying diagnosis which is of less importance. And if one lands up with such a history in front of our respected singer professor, they leave the viva room singing his famous composition “Just let me be by myself!” (Translate to Bengali)

On the exam day, as one walks briskly around the department searching for the assigned patient in the assigned wards, one is forced to halt and question one’s vision when suddenly she observes the letters “Antenatal Ward” proudly engraved on the door head leading to a ward which is supposedly for pre-op male patients. And to find this in a department where “Push” and “Pull” posters are stuck on doors and “Do not sit” stickers are stuck on tables, is totally unexpected. But one learns to ignore such mistakes, especially during exams, as one runs into the “Antenatal ward” to ask a patient about his ear perforation history. There again, one gets creeped out as the patient only gives her a crooked smile and a strange look when she asks “What brought you in, Sir?” However, one needs to learn not to be fazed by inappropriate behavior if one needs to take a proper history. So, she simply moves over to the short case, a well-behaved female this time, making a mental note to come back with the whole group to take the long case history.

P.C-Shuvojyoti Rakshit

Then begins the long and tiresome process of collectively trying to write a history where everyone tries to mold the case according to their convenience and every student comes up with a slightly different version of the history. But one must remember that the real art is not just writing the history but actually being able to explain whatever trash you have written, in order to make it sound believable to the all-knowing Almighty sitting in front of us.

 

Lights out

 

In this season of love many couples tend to go out for candle light dinners. But only few lucky people get to experience something called a Candlelight Lunch. But as a medico one gets to experience many strange things- be it watching dead people’s skulls being cracked open during autopsy or a candlelight lunch at the college canteen.

P.C- Shuvojyoti Rakshit

Nothing pisses you off more in the morning than when you just put all the spices in to cook your breakfast noodles and then you cannot turn on your electric kettle because of a sudden power cut. Initially you think it’s a mistake and power will come back soon. But 9 hours later you realized that it was a pretty long ‘soon’. If one is lucky enough then one gets a bed near the window in hostel. However not everyone is as blessed and for them a sudden power cut means immediate sunset and a pitch-dark night. So, one is left with no other option but to remember the traditional Indian Gurukuls and go and sit under a tree to read the never-ending syllabus. But unlike traditional Indian Gurukuls where you just had to listen to your Gurus, in modern medicine, practical examination means going through an outrageous number of long pdfs the day before. If you don’t have access to practical pdfs, you are a goner. Some sensible people put their phone on charge right when the charge goes down to fifty percent, but there are some other people who like to challenge their phones: “How long can you live without charge?” For such people power cuts bring a different challenge, that is, to make the best and the most judicious use of the 20 per cent charge on their phones. You need to answer phone calls, go through pdfs, go online and reply to texts throughout the day, all on 20 per cent charge. It is needless to say this it is impossible.

Hence one gets to have the wonderful experience of sitting at a General surgery ward where thankfully power supply is not cut off and charge her phone sitting on a random patient’s bed while being stared at by random PGTs and interns who intermittently come to investigate why on earth a strange girl is studying Community medicine sitting on a patient’s bed at a General Surgery ward on a Sunday afternoon. But desperate times call for desperate measures. And if you are foolish enough to put up a social media update about it you receive a string of “Get wells soon” texts from your friends who assume that you are in for an emergency appendicectomy or something. This is followed by frantic calls from your worried brother who ends up scolding you when he realizes that it was nothing but a prank on your part. Again, it is what it is.

However, the best part is to go to the washroom which seem right out of a horror movie alone, and suppressing the urge to sing “Mere dholna” to avoid scaring yourself and others!

If anyone is wondering what happened to the breakfast noodles, let me tell you that it remained soaked in spices and water all day long and at the end of the day when the cook discovered it, she was confused as to how the noodles got totally cooked even without fire. But the cook did not know that soaking up water and softening is not the same as getting cooked as far as noodles are concerned, so she had to throw away her beloved noodles because they turned out to be unpalatable.