My overconfidence got busted ! - Doc confesses - 2

Not even 2 weeks into my internship, I was bubbling with confidence.
Overconfidence, actually.
I was posted in the dept. of Medicine and the residents were cool and they let me do many procedures. And I did them quite well for a first timer. I was already so much interested in medicine since my pre-final year and my confidence levels were sky-rocketing ! To help it all, I was free from migraine attacks.

I felt that Internal Medicine would be the area of my specialization. I actively involved myself in patient care. I tried to do more that what was required of me.

Now there was a 55 year old guy who had a 1.5 x 2 cm liver abscess. A diagnostic tap was required.
"I will get this one done", I declared. 
"This is not the first time I am doing one"

I took the patient to the procedure room and bored into his liver. I did everything correct. You can believe my word. I did do everything perfectly fine. Except for one little thing! The radiologist had surface-marked the abscess with the patient in the sitting position while I did the procedure in the lying position. I did read the radiologist's report but didn't notice this line ! And we know the liver moves significantly between the two positions and the abscess was small. My bad luck, I got 2 drops of thick pus in the aspirate and after that whatever came was dark red stuff.

Believe me, at the sight of blood, I was about to faint. My heart almost broke my rib cage. My useless double agent brain was frightening me more. "You've given your patient a hemoperitoneum, well done doc!", "I think you tore the IVC, your patient will be dead in minutes". Such thoughts came like a tornedo from nowhere and tossed my mind. 

Strangely, on the outside, I was calm. I abandoned the procedure and let the patient lie down. I kept checking his vitals every 5 minutes. The IV access was ready and fluids were all kept ready. I informed the residents.

Fortunately nothing happened to the patient. He was stable and fine. 
But me! I went through all the stages of shock and survived!

In a way, I was happy that this incident took place very early in my internship. My overconfidence got busted earlier and I maintained sanity.

The patient knew I had made a mistake. Being a terminally ill patient, he was already depressed and he didn't bother to make a big fuss out of this. Everyday I spent some time talking to him. We became friends. I came to know that he wasn't really afraid of dying. He and his wife lived alone after their children had left them long ago. His grief was in leaving his wife alone. 

Confessions of a Medico - I

I don't have anything 'interesting' to share on these 'confessions' or 'anonymous proposal' pages that have loomed over several social networking sites recently. But this is what happened to me during my medical undergraduate training.

The day I walked into JIPMER, my medical school, I absolutely had no sense of purpose. I had no great ambitions. I wasn't sure of my choice. I had cleared the eligibility tests for JIPMER, AIEEE and wasn't sure which one to choose. And I hadn't thought of other options ! (I had been selected for the National Biology Olympiad the previous year, which stimulated my interested in Biological sciences. I probably thought learning human physiology and pathology would be great.)

Just few days into my first year and I was sure I had made a wrong decision. I badly wanted to talk with someone. I wanted to throw a tantrum and somehow leave the course. Nothing materialized. I was not performing so well in the exams (Though, I never failed one!). As I was struggling through, something happened to me that changed me a lot ! Friends ! (Not the serial, I mean my real friends).

In the university exams that marked the end of the first year of MBBS, I topped all the three subjects. (Actually top marks in two subjects and 2 marks less than the topper in one). That motivated me to move forward. I moved to second year and loved the para-clinical subjects very well. But little did I realize that I had crossed the point of no return !

Second year went on well. But the third, the fourth and the internship were hell.

There was nothing wrong with the course. I simply did not like it. Further to make things worse, there was always a pain to torment me.

I had this problem of migraine for long. For many, migraine was just another headache. But for me, it was a brainquake that occurred once on a happy week, five to six days on a worse week ! The pain's worse, and the pre & post migraine phases were no better. They made me depressed many a time. They robbed me of every little joy in my heart and strength in my muscles.

I can't describe in full how much I suffered. I wanted to run away in between but was too tired to do so. Somehow, I passed every subject with distinction and got some gold medals too.

I don't say that I would have not suffered if I had chosen some other profession. Every profession has its own troubles. It's the passion for the profession that keeps people going. I found myself having none or too little passion towards this profession. However, in all these, I kept patient care a priority. You can read about some of my patient encounters in this blog.

Till now, I have no clear idea if I have made a wrong choice. But I have no regrets. Because, in the course of my MBBS, I have learnt the following: (and probably much more, I have failed to pen down here!)

1. "If I have seen further it is by standing on the shoulders of giants.", Sir  Isaac Newton said. If I have come this far, it's because I have stood on the shoulders of my friends.

2. If there's a God, I never understand why He won't intervene and change things for the better. But now, after crossing MBBS, I strangely feel so strong. I feel I can tackle anything that comes my way. I have seen the worst and have survived. Probably God has a purpose in everything of which we have little knowledge! Or that is how we should console ourselves!

3. I have learnt to live life. One day at a time. Trying my best to live life to the maximum.

4. What matters to me at the end of the day?
It's not the knowledge gained or the awards collected. It's not the Facebook likes or the no. of blogger page visits. Wisdom. Creativity and innovation. The positive impact I create on the life of people around me. The purity of love in my relationships. These are the things that matter most to me.

5. Happiness is what we create for ourselves. Respect & Trust are what we earn for ourselves. These are certain things that can never come by force or power.

That's all for now ! Happy week ahead !

My Internship FB Updates: Top 10

Below are some of my status updates in Facebook when I was an intern.

Little things I've realised as an INTERN: Part 1
Patient oriented:
1. The morning prick we make when we take blood sometimes keeps paining till evening. So the needle bore, site of puncture should be carefully chosen and done.
2. If patients are informed about why the test has to be done, they are much relieved.
3. Spending 1 min explaining the route to a certain lab/place in the hospital saves their 1 hour of roaming around.
4. I give kids the chest piece of my steth. They themselves keep it on their chest. Less panic :)

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Things I've realised as an INTERN: Part 2
Self Oriented:
1. Many may try to belittle you..from consultants to nurses, wardboys and even patients cos you are just an INTERN. Never lose self-esteem. Be humble. Cos your heart knows what you are becoming...
2. At the end of the day, the  positive influences you'd had on others' lives make you happier than the knowledge gained. But of course, knowledge and skills are needed to bring the best in you for patient care.

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I'd successfully put an IV line for a 10 day old baby on the very FIRST attempt :-):-)    

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Please don't SCARE little children saying "I'll take you to the doctor n he'll give you an injection if you don't...." Children start yelling in fear just as they see me with my steth!! I feel miserable... 

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I'm stuck here in a hard shell...pressure from all sides, life getting harder and harder......But deep down here, I'm metamorphosing....silently and patiently...slowly and steadily.....when I fly out I'll be something beautiful :)

I'm in OG Postings :(

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Whenever I'm posted in any dept. in INTERNSHIP, I do 3 things:-)
1. Feel that the previous dept. was far better
2. Count the days for the current posting to end
3. Look forward for an easy life in the next posting :-P:-P

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I'm Dumbstruck!!
Unfortunately Actinomycin D, a chemotherapeutic drug, is currently not available in JIPMER. A 25 yr old lady, admitted in ward 16, JIPMER, is on chemo regime containing Actinomycin D. She has to buy the drug herself n single dose costs Rs.439.00
She got the first dose with her money. She later confessed to the doctors that she had no money to get other dose.
A group of Junior Residents, OG Unit 2, Jipmer have put their pocket money for her second dose..I was one of them who contributed. :)

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Best moments of life: 
Me & my co-intern were involved in the treatment of a lady diagnosed with PRES (Posterior Reversible Encephalopathy Syndrome) due to severe hypertension. Her BP was very high and her brain was affected. She was disoriented and possibly going into coma. Every 15 min we gave her drugs to bring her BP under control. After around 5-6 hours of aggressive BP control, I'd gone to check in on her. She woke up and spoke to me, "Doctor, can I drink a cup of coffee?"
I had goosebumps !!

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"BUSE for all, BUSE for all
BUSE for all d JR said.."
Not tho' the INTERN knew
Someone had blunder'd:
Theirs not to make reply,
Theirs not to reason why,
Theirs but to do and die:
Into the valley of ignorance
Rode the budding medico.

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MBBS: when it started, it appeared as a very long and tiring road....
now 5 & a half yrs gone, when it's about to end,
I wish to travel that road again with my friends....
It was fun & frolic all the way.....

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