Disclaimer: Everything written below is for a hearty laugh. Characters are simply inspired from the dazed, confused, overworked yet happy lot of interns from the 2012 MBBS batch of AIIMS Bhubaneswar. I miss you guys!
7:00 am, Hostel
Cuckaroo-coo! My neighbour’s phone screeched ruthlessly, jolting awake an entire wing of somnolent interns. Six months of internship had made us respond to the ring of a phone with instant palpitations and an impending sense of doom – I tell you, Pavlov’s dog was luckier. The owner of the wretched contraption was Intern Pemphigus foolacious, the Dermatology intern. Though it was a fact universally acknowledged that Dermatology interns had to be inside the hospital whenever sunlight was falling on planet earth, this foolish braveheart continued sleeping blissfully. How I envied his nonchalance!
I was awake and had an hour to do something worthwhile. Should I go for a jog? But then a minimum of four miles would be covered anyway while getting reports from Radiology and Biochemistry. Crossed out. Should I read about Wegner’s? There was a patient who was provisionally diagnosed with it and I had vowed with the usual post MICU (Medical ICU) rounds, hypoglycaemic fervour to read up on it. Through the morning sunshine I could see that my Harrison lay beneath quite a pile of thousand page comrades and my single volume Robbins pathology on top was the cherry on the cake. Heavy weightlifting – too daunting a prospect in the morning. There was this nursing student, Sister Pretty, who had helped me with the lumbar puncture the other day. What about a hot bath, a clean shave and finally ironing my sickly, not at all white coat? But then I was going to the MICU, the brewery of resistant bacteria and fungi. I say, two baths in a single day is unquestionably a waste of national resources.
Thinking of the MICU, made me involuntarily think of the sister in charge, Sister Grouchy and shrivel up. Sister Grouchy’s scowl of disapproval whenever a buffoonish intern approached her was legendary. Man, I must make this lady smile at me once before I finish, I decided with resolve.
8:00 am, still in bed
Only when Sister Pretty’s face had started merging into Sister Grouchy’s did I realise that I had drifted off into slumber. In a record 15 minutes, all pumped up with deodorant, I was swallowing away the sort of breakfast I would advise against professionally – greasy, devoid of fresh produce and sprinkled with the sweat of our hardy cooks. The devil phone rang again and the perennially disheveled O & G intern, Intern Nanny hurried off popping a boiled egg into her mouth. Apparently after babysitting a remarkably vocal primi in labour for the entire night, the lovely lady had started crowning the moment she had come to eat. Such providence I tell you!
Intern Haribhakt Yojana, the Community medicine intern sat languidly sipping a cup of coffee. Some interns mirrored their departments successfully and this fellow looked like he had life figured out. He looked like a real doctor, the kind you see in those ambiguous TV ads, complete with his shiny stethoscope. The attire was necessary to be taken seriously because he would be the doctor in the Primary Health Centre. I on the other hand had paired my shabby white coat with my old Reebok running shoes. Stamina to last the day was far more important than impressing Sister Pretty for the time being.
9:45 am, MICU, morning rounds
Lady Grouchy gruffly informed that the professor had arrived for rounds as I gave her my best smile. I hadn’t completed my notes but thankfully it was Professor Greymatter with the Senior Resident, Dr. Swag in tow. Interns liked Greymatter. He acknowledged our existence and made sure we learned something. He probably wasn’t as ancient as he looked and behaved. But then I have this theory that medicine people age prematurely with the opposite being true for surgical branches. Maybe it had to do with exercise – medicine people seemed too philosophical to work out but that’s not evidence based of course.
Medicine rounds had changed from the Osler service of yore. A seamless flow of GCS, TLC, bilirubin and creatinine values took precedence over palpation and percussion. I might not be an athlete or a guitar player or the guy who scores with girls but spurting out numbers and facts was my forte, courtesy, years of memorizing chromosome numbers and IPCs. This process continued interspersed with us, the great healers, hitting a few unwitting patients with a knee hammer, scratching their grimy soles with our keys or flashing bright light into their confused eyes.
1:00 pm, Casualty
There are some departments that make you feel at home. For me it was the Casualty – the blood and gore, the chaos, the speed made me feel alive. Real work was always aplenty.
“No RTAs yet,” said Brother Action grinning as he passed me, always on the go. He used to my partner in crime during my casualty rotation, sewing and fixing fractures.
I had come to pick up my best friend Intern Ryly for lunch. She was busy inserting a nasogastric tube into a cranky old man. As I watched her sternly ordering the old man to swallow, I remembered the shy girl from MBBS. Oh how she had always mumbled, fumbled and stumbled during her vivas. I couldn’t help but marvel at how this long journey had changed us all forever.
1:30 pm, Mess (either way a mess)
I made it a point to have a slow lunch, come what may. The Pediatrics and Surgery interns, Intern Frustoo and Intern Cut-it-off sat beside us. Intern Cut-it-off was bragging with glee about the sebaceous cyst he had just excised.
“Didn’t rupture the cyst wall at all,” said Intern Cut-it-off, adding proudly “See, see, I took photos too. What a beauty! Sir reckons he will give me a hydrocele next.”
“I climbed up and down three times to give samples and get reports for a lumbar puncture I did not even do,” interjected Intern Frustoo glumly, in his usual depressed tone.
“Come on now, you made such a big difference in that kid’s life,” said Intern Patience, the Psychiatry intern kindly, trying to calm Frustoo down, “You have to use mature defence mechanisms to deal with these challenges . Voluntary suppression, dear or why not use humour?”
Intern Baba, the Anesthesia Intern, suddenly spoke up from a corner. Baba was seldom seen but rumours have it that his special hideout was in fact the library, a place rarely frequented by other interns.
“Forget all that. Listen now Frustoo and listen carefully. The advice I am giving has had a hundred per cent success rate in all departments,” said Intern Baba, the all knowing, “First – tunnel vision. The minimum eye contact you make with residents, the less work you get. Second, be as slow as humanly possible. You and only you can dictate the pace at which you collect a report or fill up a form. You must make them realise that you are incompetent to be trusted with important work. Lastly, dazzle them with a smile whenever you are given fresh work. It screws with their mind, makes them feel guilty.”
With that Baba disappeared, undoubtedly to the library again. Frustoo wasn’t much convinced with the pearls of wisdom and began moaning again. Sensing more tragedy was to follow, I made a hasty departure.
3:00 pm, MICU, evening rounds
Armed with two files in one hand and two MRI films in another, no doubt looking like a pompous fool as Sister Pretty sat watching, I had returned from the Radiodiagnosis department. I looked at the crumpled up list of To-Dos that the Senior resident had entrusted me with – 50% done, not too bad. There was a time when I would have honourably tried to do it all. But no more. The radiologists were usually the cool lot, nerds staring at the black and white, oblivious to the sputum, pee and cries. We interns, specially the likes of Intern Frustoo who visited the department at least half a dozen times to discuss some child’s wrist or brain scan had frustrated them enough. They shooed us away these days.
Not that it bothered us anymore. Being at the bottom of the screaming chain, every intern’s self esteem hits a nadir midway through his internship but afterwards it takes a turn for the better. The scrappy intern starts adding drugs and doses to his/her repertoire – Rabeprazole, Omeprazole, Pantoprazole – we mug it all. For blood, ascitic, pleural or lumbar fluid we poke and poke and succeed in draining the poor patient eventually. With punctures and per vaginal and per rectal exams on a daily basis, the previously feeble ego rises resolutely. We know something after all. With the dawning of this epiphany the humble intern stops caring when being told off. S/he now realises the one true goal: arm yourself with knowledge for the future.
I quietly told my senior that his personal presence was necessary for the rest of the work and joined the evening round. Hakuna matata.
1:30 am, MICU
BRCA1 gene is on chromosome 17. I was rereading the same sentence in a loop. My job was to monitor an old man, GCS 3, hooked on norepinephrine, dopamine and whatnot. Though my knowledge regarding ECG changes, ventilator settings and emergency drug dosages was fuzzy to say the least, I knew enough by now that he might crash the moment I go to nap.
“Hey,” said Intern Frustoo, “What are you reading there? Might I join?”
Frustoo apparently had been sent down to the adjacent PICU (Paediatric ICU) to monitor a sick child. Most likely his reward for following Intern Baba’s formulae for success. He held a sheet of paper with columns drawn for all the vitals to be recorded every 15 minutes – I thanked God that my time there was done.
“Surgery MCQs,” I replied grimly, “Last ditch effort to fire up the dead grey cells and do a miracle.”
PG entrance exams was our Betaal that clung on to us. We had to carry the ghost everywhere but like King Vikram we did learn something because of it. So we sat, two reasonably good looking, arguably smart young chaps as my dad puts it, mulling over breast and thyroid carcinomas amidst the beeps of the monitors and the farts and midnight wails of the ICU patients.
8:00 am, Hostel
The best feeling was walking back to the hostel knowing that you owned the next 24 hours of your life. Thankfully, the old man had lived through the night and I had been saved from doing all the paperwork. For all those judging me, I tell you, it is quite a challenge to the muddled, sleep deprived brain to get the carbon papers oriented correctly to make three copies of three different forms.
Inspite of being a Sunday, ironically Kumbhakaran had arisen early and I met him in the corridor. Pemphigus foolacious took one strong look at me and ordered, “Eat. Bath. Get ready in an hour. 10 o’ clock show at Keshari.”
I grinned as I entered my room, all sleep vanishing. With friends such as this, internship had sure become a ride to remember.