The House Officer

After rotating through different specialities during the one year of internship, each time entering a new department with its own unique patients and its own way of working you feel like a sponge absorbing everything that is happening around you , dying to squeeze out all this new found experience but wary of what would happen if something went wrong .

The year after internship is the most difficult of all. This is the time you are a full fledged doctor on the ward but know really nothing. Your seniors want to trust you but cant. You are neither responsibility free like in internship nor are you responsible enough to be able to take care of your patient independently.

Its like those awkward adolescent years when you don’t fit in with children and the adults don’t want you around.

But if you can prove that you are trustworthy enough to be left on the floor alone, and your senior does leave you …. You feel like a king. You are in charge of the lives around you. It makes you feel very responsible. I remember being sleepless and extremely careful , rechecking every drug I wrote on my ward round ,reexamining every patient under me so I don’t miss any vital finding.

Also since you are the only doctor the on the floor the patients see most often they get attached to you emotionally as well and you too feel the same about them .

This is the time I remember two patients very clearly . One of them had conceived after a very long time and was carrying twins and was admitted because she had started having preterm contractions . Her babies were only 20 weeks old and it was too early for them to be able to survive if they delivered .

We were on top of it trying to stop her preterm contractions so she would be able to continue her pregnancy till the babies became viable. But despite all we did she aborted the two babies. They came out wailing and feisty, two liitle girls but we all knew that their lungs were too premature to sustain life and we would lose them in a couple of hours. We kept them in the warmer till they would be alive and kept a watch on them. I felt so responsible for that loss that inspite of my duty being over I sat next to the warmer looking at these tiny tiny humans struggling to stay alive.

My senior paediatric resident doctor thought I was probably crazy and he sat in the same room making some kind of a death declaration certificate for them . I was so upset that I fought with him for being so insensitive and didn’t allow him to do that till the babies actually passed on. It was a realization that there are some things that you cannot help however much you try and want to.

 

The second patient was a young 22 year old girl with Eisenmenghers syndrome .

This is a congenital heart disease in which there are multiple defects in the heart compromising its ability to pump oxygenated blood to the vital organs of the body . If such a patient becomes pregnant her risk of dying in pregnancy is around 60% specially within the first week of childbirth. This young girl had been repeatedly advised not to conceive but her yearning for motherhood was so great that she not only conceived but hid it from her family and the world till she was more than 20 weeks of pregnancy when even a termination of pregnancy was as risky as delivering her baby . She anyway refused a termination and wanted to have this baby to we also decided to go all out to try to save her and give her a baby.

At around 32 weeks she went into preterm labour delivered a tiny little baby girl and within 2 days of that went into heart failure and we could not save her.

I was one of the innumerable doctors in the room when she delivered her child and I cannot forget the look of happiness on her face when she touched her baby for the first and last time.

It was devastating to inform her family when she died . Such a young life lost ! I couldn’t sleep for several days after that.

Those were the days we realized that there was something above us which decided the fate of our patients . Armed with all the knowledge in the world we still couldn’t save everybody.

Knowing this is humbling, and the most important lesson we learn as doctors!

My first 6 month house job posting was in obstetrics and gynaecology and that was the time I fell in love with the subject and decided to pursue it for my post graduation.

 

My second 6 month posting was in The department of Anaesthesiology. Another branch of medicine which teaches you humility. As you put your patient to sleep you feel their helplessness at putting their lives in your hands . “Their eyes always seem to ask you whether they will wake up again”. And to wake them up becomes your responsibility. Here again I remember a patient on whom we did a ceasarean in emergency at 2.00am in the night…. She came to us with heavy bleeding in the 8th month of pregnancy and to save her and the baby we had to operate. She was given general anaesthesia because she had already lost a lot of blood . Fortunately the surgery went off well but she did not reverse from the anaesthesia for 4 hours. Probably some metabolic disorder that did not allow the quick removal of the drug from her system but I can never forget that night as we sat up beside her doing this and that trying to awaken her. When she finally woke up it was like WE had a new lease on life !!!!

 

Life is fragile….. very fragile!! No one knows how much time any one of us has in this world . Medicine teaches you to respect life. It brings you so close to death everyday that just being alive seems like a miracle!

 

 

 

 

 

 

 

 

 

Finally Feeling like a doctor……

A long gap in continuation of this blog…. Had a very trying time personally last year. I lost my father …. My strength, my inspiration, and everything to me. I lost the will to write anymore and completely dissociated from everything I loved to do.

But life goes on and it took me a while to accept that even after he is physically gone his love still surrounds me. I still feel his blessings every time I leave home. I miss him terribly but his memory always makes me smile.

I also changed my job. Just needed the change, more challenges, different place of work.

My daughter finally chose her subject of postgraduation as Internal Medicine unlike Gynaecology that she had initially thought about. She is also well on her way to becoming a physician. And as the world is going through its turmoil on whether to love or hate doctors I see in her the love for her profession. Compassion is the only quality that makes a good doctor and as she is growing in her subject I see that shinning through.

So really a lot of things happened in my absent time. But I am back again and this time I promise to keep the flow of thoughts going.

 

To begin where I left off…. The results arrived after a lot of sleepless nights and lucid dreams of flunking and reappearing for those dreadful exams. Sometimes the dreams used to involve writing the paper and not being able to answer a single question….. sometimes they were like standing in front of the examiner and not knowing what they were asking….. waking up in cold sweats and trying to imagine what it would be like to pass in all subjects.

I passed in the first attempt in all subjects with relatively good marks and at that moment surprisingly didn’t feel anything. Just a blank feeling of what next.

Without a single day off to celebrate had to join internship so that I could complete it in time for further Housejobs and postgraduation.

An intern is the lowest rung in the chain of doctors. Considered to be more harmful in the wards than even the staff nurse who knows more than the poor intern. So we are more in the way rather than a help on the first couple of days till we learn how to do a few things like shift a patient from the bed to the trolley and vice versa, assist the staff nurse in giving an enema, make thousands of entries in multiple registers, carry multiple vials for blood investigations ( of course we still haven’t learnt to draw blood) and tail behind our senior doctors on rounds trying to look important.

This year there are a lot of practical things to be learnt and our teachers are the staff nurses in the wards. If you be good and polite with them they teach you almost everything that you need to know and do. Not to forget mentioning some Dracula sisters who you see and hide from …. Specially in the operating rooms where you might accidentally and foolishly touch sterile stuff …..

Your immediate seniors are the house officers, the most harried lot of people who are constantly trying to finish work which kind of never ends. They hawk on interns and take out all their exhausted wrath on them.

But this is the time, if you keep your eyes and ears open and are willing to learn there is plenty of knowledge flowing around. An eager intern probably gets picked on for work the most but also learns the most.

This is also the time you come in contact with real patients. Even if it is only taking a history of their illness or drawing blood for the investigations … you get to use all your skill and knowledge on a real alive human being. And if you have done your job well the patient considers you the real doctor sometimes even more than the seniors who visit them once a day. And when a grateful patient gets better and leaves your ward the happiness you feel makes all the years of study worthwhile.

As you rotate in all the specialities you can also make a choice about what gives you joy and what you would like to specialize in.

I remember being the happiest in the obstetrics ward. The thrill of bringing a life into this world to this day remains the happiest moment in my life!

 

 

 

 

The slogging……

The second year at medical school is slow and dull and dry. The reasons is mainly because by then you realise that you are not even close to becoming what you imagined yourself as a doctor, and also the subjects in second year are so dry that all you see are books, books and more books.

You study about the pathology of diseases, which you are going to see later , about microbes causing them, and drugs which you will get to use in the future if you pass the subjects. The only interesting subject in second year is forensic medicine, which partly makes you feel like a detective from the telivision serial “CID”.

Somehow you manage to cram all that useful information and step into the third year where now you are allowed somewhere near a patient. But for all your ‘beginning to feel like a doctor phase’ there is a senior colleague who thinks you are only getting in the way of his work. You are anyway the lowest in the food chain of medical school and are either eaten up raw in your bedside clinical postings by whoever can get his hands on you or are unceremoniously shooed away.

But you have to brave all these terrors and stand patiently in the wards observing , absorbing and learning all you can, from whoever is willing to teach, including the paramedical staff on duty who definitely know more than you at this stage. And then everyday sit down with your books and correlate and assimilate all you learnt to make some sense.

Final year passes off leaving you wondering where the time went and suddenly you have final year final exams.

This is one exam I must write about because there can never be anything like that ,ever, in anyone other than a medical students life. There is no syllabus. The subject is the human body, and even though for sanity the subjects are divided, it is the whim of the examiner whether he wants to stick to his own subject ,or ask you a question pertaining to another speciality.

When we gave our final year exams we had 11 theory papers and 7 practicals spread over a duration of 45 days. The practicals were the worst. We were called in at 6.00am in the morning and the case presentation , viva, specimen spots etc used to go on for the whole day . We would finish around 8.00pm and next morning had to report for the next practical at 6.00am. No time to sleep or to study for the next day. We were zombies …….. the walking dead, but still expected to brilliantly and correctly answer all the questions asked by a variety of examiners, all masters in their own fields.

We were mentally mauled and assaulted everyday and at the end of each day we used to feel we couldn’t go on. But still the next morning we would get up and go for the next exam hoping it would be a better day.

There used to be nervous breakdowns happening all around us. I am sure no medical student would have cleared medicine without an occasional suicidal thought.

I don’t know from where we got our strength. Our seniors our juniors our batchmates all hung in there with us and finally pushed us through those dark days.

But then as they say “ Dark clouds have silver linings”. Our silver lining was the fact that our examiners too were medical students once, and though tough task masters did award us our degrees unless we made big blunders in our exams.

Most of us passed,and it still sends a little shiver down our spine when we think of those days.

 

 

The Making of a doctor

The college life at medical school was pretty much the same as all other hostels and colleges but as expected our studies were different. We were going to be studying about Gods most advanced creation – the human body!

If we break up the functions of the human body we can realise that it is not just one subject that we have to learn about. It is an engineering marvel, a biochemical wonder and a conglomerate of different organ systems working individually yet together in one body so deeply interlinked with one another that the failure of even one system can cause the entire structure to collapse.

And most of all it has a very special component called the soul where all the research in the world stops. The soul is supposed to stay in the human body as long as all the systems are working fine but can slip out without rhyme or reason at any time. No one can control it or hold on to it. All our medical education fails when it comes to the soul.

As we begin medical school we are on a high. It appears that we are studying to be Demi Gods. The feeling, that if we do everything right we can save all life, is overwhelming. The reality of the fragility of life and the minimal control we have of holding on to it dawns much later.

Our first encounter with a human patient is actually a cadaver. As we reach on day 1 for our anatomy class our brain is clouded with the overwhelming stink of formalin preserved cadavers. If its not the smell then it’s the sight of a lifeless human body lying before you that completely hits you in the head. The weak hearted usually swoon away and have to be whisked away to another room to recover. The brave manage to survive the double onslaught on their sense of smell and sight and sit down around the cadavers to acclimatise for a couple of days before our esteemed teacher hands us a scalpel and asks us to begin dissecting the body. The initial hesitation of using a knife on the human body over a period of time gives way to the need of learning. It is usually here that you can differentiate future surgeons from future physicians. For the next one year as that cadaver falls apart it teaches us all we need to know about the structure of the human body.

I remember the cadaver allotted to our group… a middle aged female. I often wondered who she was when she was alive. A daughter, a sister, a wife and a mother to someone. I wondered how she must have died, what must have been her life and her dreams. I learnt that when that essential component called the soul departs from the body it feels nothing. No pain no joy no sorrow…. Its just a piece of organic matter ready to return to dust.

And all our life we spend focusing and caring for this body which is meaningless without the life force within it .. without the soul. Do we really do anything to preserve and enhance this force within us? Is there a way to transfer this consciousness from one body to another? The day we can find a way to do that we would probably have solved the mystery of life and death.

 

 

 

The Mad Scramble!

Class 12!!!! Results are out and there is a mixed emotional energy all around. There are children who have scored good marks, and children who have done badly and there is also a third group of children who feel they have not lived up to the expectations of their parents and teachers! These days’ scores are phenomenal!!!! But I completely fail to understand how a student can get a 99.9 percent in subjective papers! In the good old days there used to be answers that meant the same but were written uniquely by different students, which by the choice of the teacher or the beauty and flair of writing got them scores, which were not the same. It stumps me how an answer can be an exact replica of what the examiner correcting the paper has in his mind! We used to lose marks on spellings, handwriting, formatting the answer and so on. Are these things of no consequence nowadays?

Anyways inspite of a significant number of children getting these kinds of scores there is always a run for the colleges and seats. Closing percentages are mind-boggling and a lot of students are left wondering which particular word they missed writing in their papers to get left behind.

Now comes the irony! The top rankers turn away from Medicine. The second rung also desires branches that require less study time and an earlier settling down period in life. Medicine comes to three kinds of students. One who does not get a desired branch, the second who comes from a doctor family and is gently pushed into medicine and the third who is the true crazy who has chosen medicine over and above the other subjects. So you can imagine that except for the third variety of students who really want to be doctors we are actually going to put our lives in the hands of people who did medicine for all the wrong reasons. And need I say how unhappy a person can be if he does not like what he does for every single day of his life!!

As for me, I remember I gave several entrance exams and to my horror didn’t clear any college. I just couldn’t believe it. All my life I had but one dream and all my studies directed towards fulfilling that dream and here I was with nowhere to go. Like everyone else I was made to think of an alternative and I joined a college for B.Sc. . All my friends were packing their bags to join courses they chose and I was left behind!!

But they say that if you desire something with all your heart and soul the entire universe contrives to make it happen. That’s what happened to me. Almost a month later I got a call from my college saying that I had to report for admission if I had cleared my class 12 examination!!! In all my overconfidence I had forgotten to send my mark sheet to the college. Usually they discard the application thinking that the student might have failed but I was lucky and some hotline connection with God materialised and I received my calling!

Packing my bags I set out for the best roller coaster ride of my life at the medical school. The joys and sorrows, the highs and lows, the unforgettable friends and the memories we made together holding each other up as we sailed through the rough and deep seas of medical education. Thick big books, long sleepless nights, thousands of cups of coffee and tea, innumerable mood swings later we did manage to survive to become what we are today. Still together we all at the zenith of our professions fondly remember those wonderful times…

Why does one want to be a doctor?

There are not many reasons that drive a person to become a doctor. And most of the time they cannot figure out why they want to be doctors. I mean, why would someone want to spend the prime years of their life drowned in books, forget what the world outside looks like while they sit for 18-20 hours a day trying to pass their exams and not know when their education will be somewhat complete (for a doctor studying really never ends) so that they can start earning some money to sustain themselves and buy some more books to study? Why would someone want to spend the rest of their lives not being able to enjoy simple things like a sit down meal at mealtime or a whole night of undisturbed sleep or earn the wrath of their families for not being there for them most of the time?

This is not an exaggeration. To be able to reach a level where a doctor can earn as much as his non-medical peers earn within 5 years of their completion of study, takes almost 10 times the number of years and 5 times more of hard work.

So I come back to the question, “ Why would someone choose this profession?” The person has to be just plain crazy. And it’s actually true. Doctors are made from stuff different from the rest of the world. And those who are not made of that special stuff quit early in their education, even if they get into a medical school. We can say that a real doctor is born, and not made.

Sometimes I try to think about the time when decided to be a doctor and as I delve deep into my memories, all that comes to my mind is that I always wanted to be a doctor. In fact it seems like I was born with that thought. I don’t know whether it was an unfulfilled desire from a previous birth, or a desire planted in my mind as a child by both my parents who wanted to be doctors, but could not, due to their circumstances.

But one thing I know for sure is that there was nothing else I would ever have wanted to do. Given a second chance at choosing a profession I would have again chosen medicine as my career. The kind of happiness my work gives me is unbelievable.

And I would like to say to all those young people out there who are thinking of medicine as a career……. Look within your soul and ask yourself.. “Are you willing to put someone else’s needs before yours for the rest of your life?” If the answer is yes then and only then choose to be a doctor…

HELLO WORLD!

Hello world,

As you all must have guessed…. I am a doctor. Dr. Meenakshi Sauhta, Associate Director and Head of the department of Obstetrics and Gynaecology at Max Hospitals Gurgaon.

This crown comes with a lot of responsibility and has been acquired after a lot of hard work and perseverance. Not that I ever thought I would be here one day but I guess I was doing something good and right for someone to see me here.

What do I do?

A lot of things…. The best of them being bringing bundles of joy to various families. I ensure the safe arrival of a tiny, tiny baby into this world. I help facilitate the miracle of birth and each time I hold a baby in my hands and see the smile on the face of the parents, I am on cloud nine. Almost 30,000 babies down the line I still feel the same joy I felt when I delivered a baby for the first time.

Besides this I also treat women for their gynaecological problems and help them take care of their health. I believe that a woman is the string that binds the family together and also the last one to look at her health. I try my best to ensure this string stays strong and healthy.

The other little people close to my heart are adolescent girls. Young and full of life these girls are bubbling with energy and rearing to go and need a gentle nudge in the right direction. I love interacting with them and teaching them to look after themselves. Sometimes I try to be the bridge between them and their mommies narrowing the generation gap. After all I have a 22 year old daughter who has taught me a lot of things I needed to know about little girls growing up.

My daughter the apple of my eye, my heart and soul and my little world is all grown up now and a doctor by profession and studying to be a gynaecologist like me which makes me think that I might have done something right in life to be an idol for my own daughter.

When I became a doctor 27 years ago times were different. This profession was not maligned the way it has been today. Doctors were good people and patients used to trust them. Somewhere down the line something changed. The doctor patient connect was broken and as the doctor came under the consumer protection act, things worsened.

I have seen the change and feel really bad about the way doctors are treated and written about these days. Through my blog I wish to show my readers life from the other side of a doctors desk. I want you to see, from the eyes of a doctor and feel the heart of a doctor, as he cruises through life and work.