Internship for Dummies

To become a doctor, you spend four and a half years of your tiny life in the medical school. When you start, you have that spark, the will to excel, you (and your parents) are on cloud 9. I have seen a junior ask a senior, with all the seriousness on his face, “Sir, Top karne ke liye kitna padhna padta hai?

And then the dream shatters. You have incoming missiles by the name of Anatomy, Biochemistry and Physiology. And as you succeed to dodge one lot, an even deadlier one is headed your way.

And when you somehow manage to survive this brutal massacre, you enter into this new world where you are no longer supposed to remember complex names but learn the process to make the patient healthy. And this is different from anything that you have done before or seen people doing. It’s called the internship.

It starts from something as simple as drawing blood! (Actually, that’s most of what you do). The first time that I was asked to draw blood, I had only seen it being done a couple of times. I was explained the procedure… just push the needle into the vein and draw. Simple! Well, it is. But the thrill you get when your needle punctures the vein and dark red blood gushes into the syringe is immense.

As time goes by, you start doing things that are way cooler than sucking blood out of every vein you can see. Pushing a needle up patient’s spine and collecting the CSF… How cool is that? With a little practice these are fairly easy procedures. But the sense of accomplishment is what makes everything else worthwhile.

This is just the start. As you go to the surgical side, the journey becomes more thrilling. Not able to find the vein and your patient needs fluids? No problem! Let’s cut it open and put a catheter right in the vein. Excising cysts, suturing wounds, draining abscesses, they all are much more interesting when done than read.

What you also end up doing for most of your surgical posting is dressing wounds. And not just clean healing wounds… there are ulcers that have been rotting since months waiting for you to dress them. Then there are wounds with maggots crawling out of them. Wounds with muscles and tendons exposed and pus draining. And you are supposed to clean it all up and try to make it healthy!

Then there are the surgeries. The first time you hold the knife and incise the skin, it’s a really scary moment. What if I cut too much?, you think. And then you see your senior butcher his way in. It’s all so exciting to see blood on your gloves, even if all that you have done is no more than retracting the skin! And then there is your first surgery as first surgeon! Of course it’s going to be just a hydrocele surgery, but the excitement of cutting things open is great!

And then there is the part where you deliver babies. Really scary… you start to try to remember all the various ways the baby has to bend his way out, something that had twisted your brain in the final year and would definitely put the best yoga gurus to shame! And then all of a sudden, the head pops out… after a few chants of laga laga the shoulder, the hand, trunk and finally the legs are out! And then you start to think… what did you really do? Why in the name of god did you learn all those relations of the fetal head with the maternal pelvis, when all you had to do is some fielding practice!

And how can we forget the OPD. You sit there seeing patients after patients, referring most of them to the specialists. And every now and then, prescribing them… that’s right, prescribing them drugs! This is such a wonderful feeling of… grandeur!

All this sprinkled with a bucket load of clerical jobs is internship in a nutshell. Yes, it gets monotonous at times. Your PGs would make you go through all sorts of crap. At times you would be stuck in the wards for days, cut off from the outside world. But what this does is makes you feel like a part of the system. You can now associate yourself with the medical profession. Internship as a whole is many small experiences put together. Each one special, each one different, each one thrilling. And when seen together, it’s one heck of an adventure!

Community time!

3 more months and I have (sorta) completed my PSM posting. PSM, the Preventive and Social Medicine… what it did for me was it prevented me from socialising at all! For starters, we were locked away in ‘jails’ about 25 kms from sevagram. A dirty room with a motheaten bed, crappy food, no source of entertainment what so ever and to make things worse, notthing to do.

We would sit in ‘Kiran Clinics’ from sharp 8 to 1 and see 3 patients. One of them with nonspecific body pain and has come to get his free aspirin refill that he has been taking since the last 20 years. If I distill the aspirin out of his blood, I might have enough to have a major pharma company running for their money! The second, an old lady, had an unique presentation of fever, that starts on her legs, then crawls through her spine to her chest and finally goes in her up to her head. A presentation, epidemiologically speaking, confined only to the rural indian masses. And the last guy was there just for the bi-weekly dose of injectable vitamins.

After we have run this quackery, we would go eat our crappy food, make some of our own if its too crappy to eat, take a nap, and then go and ‘study’!! Thats right..STUDY! Who in the right mind expects interns to read? Add to that, literature about how elderly in some remote village have health problems! Next comes the the best part, come evening and we are free. So we sit outside of our room and… well thats it, thats all that we did. We sat! Fun, ain’t it?

The better part of PSM was the GOPD postings. Again a strict 8 to 1 schedule. But now we were more like real doctors on a real hospital and were able to prescribe real medicine for some real problems. And there was less worry as if our young brains failed, we could always refer them to a specialist… and we always did ;). The best part was that we were free in the evenings and were at home!!

Over all, a complete waste of time. All that we did was stick to a strict time schedule and allthat we learned was doses of the likes of PCMs and CPMs! Way to go PSM!

Medicinal Blues… and the other colours!

It’s been 3+ months since I have joined my internship. And I have finished my medicine posting. I started off with my ward postings. My job discription – Drawing blood, filling out forms, making entries, and grossly doing anything nobody else wants to do! But the Verdict – Fun! (most of the times)

When I started, I was scared. I will actually be involved in actual patient care. What I do will matter. And if I don’t exist, the system feels a hollow! That is a great responsibility on my shoulders. Then you start pricking patients and drawing blood right, left and center. And that very disposable needle eventually breaks the bubble!

But the life in the bubble was wonderful. That first time your needle enters the vein and the blood gushes into your syringe gives you an unimaginable sense of accomplishment. Then there are pleural and peritoneal taps. You push a needle in the cavity, and draw the dirty water out! How cool is that!! Every now and again, the bubble starts to form… to burst again. But the little time you get in it is great!

I spent a lot of time in the ICCU. And most of it was spent taking Blood Pressure, measuring Blood Sugar and recording ECGs. That doesn’t mean that the bubbles didn’t form. I did a couple of very successful LPs. I put tubes up (dead) people’s throat. Gave a couple of CPRs.

On the down side, I must have completed atleast 500+ patient files. Filled out thousands of forms. Made innumerable entries on the computer. Filled in the discharge papers. But all this isn’t all that bad. I mean it was no fun, but not that bad either.

Over all, I would give it a thumbs up!

Doctor Who

Classes, clinics, practicals, teachers, professors… It’s all over now. The results came out and the way I lived my life has changed! I am now an employee and not a student. But what excites me the most is that now I am a doctor!!

4 and a 1/2 years of slogging your ass off makes you really despitate to achieve your goal. And once you really get it… you are extatic beyond words!

Plus, on top of that being a doctor changes the way people look at you. You see a new respect coming your way. They respect you not just for what you are but for what you can do… save lives!!!

But the system has a way to bring you back down to earth. It’s called Internship. For starters, they pay you just 1700 bucks. We are what they call, cheap desparate labours. On top of that they make you do the lowest level of work. All that we do is suck blood, send it to labs, fill in forms, finish paperwork, make entrys and take BP. We are just a bunch of glorified attendants!!