To Let Live or Not?

Who gets to decide whether a life is worth preserving or not? Who gets to decide the fate of a newborn who hasn't yet seen the world?

A newborn who might not be able to appreciate the beauty of life. A newborn who may forever be dependent on external support. A newborn who may never be able to fully reach his potential. 

Or who may…

Who may actually be a boon to mankind. Who may entertain millions with his talent. Who may find the cure to cancer. Who may just live a happy life. Who may survive as a fighter. Who maybe just another person LIVING.

Is it the doctor who works his best to save him/her from becoming an ‘it’? For a doctor it might just be an achievement... The 'I saved him' tag. The 'I gave him a second life' tag. But, is he going to be a part of his life forever? No.

Is it the parents who waited patiently to feel the first kick, to hear the first cry and then find out that the baby is 'defective'? Afterall, they are the ones who are going to live with the child… or maybe ‘bear’ with the child (harsh but true words). For some of them, the child maybe a 'burden'- a drain on their personal resources- time, strength and finances. But for others the child can be a pure source of joy.

I have seen the way a mother's face lights up when she sees her baby for the first time. 
I have also seen the way her eyes swell up when she hears that her child needs corrective surgery and that her child, being the tiny being he is, may not be able to survive through it. 
I have seen the way a surgeon's face lights up when the child survives the grueling surgery and the critical post-surgery days. 
But rarely have I seen a doctor getting really emotional about letting the child go. (A defense mechanism that comes with experience, to keep working and carry on with duties.)

So what happens when a neonate's fate is to be decided? What should be done when the decision is to be made? Whose decision is more important- the doctor’s or the parents’?

What should be done when a neonate goes into cardiac arrest? A doctor can save him with the CPR... But those crucial minutes of lost oxygen may render him a vegetable for life. An adult gets the option to sign a DNR (Do Not Resuscitate) to be saved from the torture of ‘hanging up there’. But a neonate? Who gets to decide for them?

What is more important? Saving a neonate from death or saving a LIFE? Giving the ability to breathe or giving a life?

The emotional turmoil of a young doctor can rarely be cleared. These questions don't really have any answers. Experience may just harden up our souls and hearts- make us indifferent to some things.

(Apologies to the Grammar Nazis for the chaotic language.)

Soulless??? (Scrubs Diaries 4)

Death is all around. More so in a hospital. I haven’t been in a hospital long enough to get used to death on a daily basis. I have only been a medstudent and an intern. Both are phases of a doctor wherein everything is new, exciting and adrenaline inducing. Yet… Yet, one would always remember the first death they saw, the first death they blame themselves for, the first death that could have been prevented, the first pediatric death. What is important is that one should also remember the deaths they actually prevented, the lives they actually saved. The balance of our memories is what will keep us sane. That, and of course friends (Twitter friends too) get us through.

 

Like Dr Cox says death is joked about just to distance oneself, to get by. The doctor needs to move on as soon as possible. The doctor needs to get past the emotional aspect of it in order to carry on with work, and in order to learn from it and if possible avoid the next one. Learning from every mistake is important. Mistakes in this field are fatal.

So, doctors do tend to seem soulless over time. But, that is only to preserve the soul they have.

No copyright infringement intended.

 

Gross! (Scrubs Diaries 3)

This scene from Scrubs reminds of a case I saw in the surgical emergency of Dr RML Hospital. This young guy in his late twenties comes with his index finger wrapped in a cloth. His finger apparently got stuck in a hotel food processor. And when he unwrapped the cloth- lo behold, the sight was Gross! The distal phalanx (that would be the top one-third of the finger) was exposed to the bone, covered in blood… and when he shook his finger in pain- a piece of muscle fell in front of me. Inspite of all this, he had a big smile bordering on a LOL face- I thought he was either high or being a 5-star-hotel-employee, I thought the smile was a permanent feature! Well, it wasn’t any of those, it was a mature defense mechanism that our body has, to cope with the immediate excruciating pain… (The body never ceases to marvel!) (Even in the clip, Ben seems to be fine with the nail in his hand- defense mechanism again!).

Anyways, what did I want to do when I saw that? I wanted to faint (just like JD did) but I didn’t. As an intern we see many things that would make us woozy! But, as a matter of fact- I have never seen or heard of an intern fainting at the sight of blood or exposed anatomy. Why is that?

Well, I can say this for me (and I think for most medical interns)- such things are thrilling- it may sound rude, but it is the fact. There is an adrenaline rush that gets you through it. You don’t want to miss out on the learning experience- you want to be in the spot and see how it is going to be managed. You want to be of help and be proud of it. Also, being exposed to dead cadavers and gross anatomy on the very first day of medschool helps! (There are people who faint then).

Sure, stuff like rectal examinations, or inserting a Ryle’s tube and getting vomit all over yourself, makes me want to vomit! Gross Gross Gross!!! But these urges certainly dont get in the way of finshing up our work.

No copyright infringement intended!

Intern Talk (Scrubs Diaries 1)

As a medstudent, we have ‘lots’ of time (except before the exams of course). The word ‘lots’ is in accordance to the theory of relativity, when compared to the time we actually have when we become an intern. Interns are the lowest in the chain of superiority at a hospital. And by lowest, I mean below ground level- below the clerical staff, the nurses, sometimes even the patients. So, it is pretty obvious that loads of work gets dumped on us (and it may not always involve saving a life!). Hence the little time that we manage to sneak for ourselves is precious- almost magical! Most of it is spent zzzzzzzzzzing. And when we do manage to get around friends and go out- the conversations almost invariably go back to the dump we just escaped from- the hospital.

Intern talk is almost always about patients- the cases that you have seen for the first time, the cases that you were able to diagnose on your own, the lives you saved, the lives you could have saved, the new procedures that you did, the procedures that you messed up, the patients you successfully handled (yea yea handled- we don’t get to treat so easily), blah blah blah…. In short (well I was already too elaborate), the conversations always comes back to intern experiences! And from the looks of this ‘Scrubs’ scene- it is a global phenomenon.

Examples from my own internship- a group of us went to Chandigarh (for an exam actually, but it was a mini-trip, and I didn’t even give the exam!) and in the train we exchanged places just to make sure we could talk to each other (oh yea- you get to see your co-interns very rarely and that too mostly for just hello-hi-bye-bye!) What was the sole topic of our conversation in that 4 hour long ride? You guessed it right- what we did and what we didn’t do as interns, comparing notes! By the end of the journey, the people around us knew we were big-mouthed-budding-doctors. Birthdays, parties, girls-night-out, picnics, anything- if you are around fellow medicos, there is no escape from doc-talk. Even lunch time small talk is limited to the hospital…

So what happens when we are with non-medicos and family (I come from no medical background family)… Simple. You try to participate in the conversation as long as possible and eventually you manage to shift it to your favourite topic- the medical world! By the end of my internship, my parents knew how an ascitic tap, a pleural tap, a bone marrow biopsy…. blah blah are done. Oh yeah, they also get grossed out sometimes most of the times by the gory details (I have been requested to keep my mouth shut on multiple occasions at the dinner table!)

Why does this happen. Well, obviously because we spend so much time in the hospital that we rarely have time for anything else. One would think that once we are out of the hospital, we would want to forget about it, think and talk about something else more cheerful, something different. But that’s not the case. Once we become interns, an entire new world opens in front of us. Everything is exciting, hands-on experience. Everything we talk about is first hand and we are proud of it (at the conscious or the sub-conscious level). We love it when we succeed and we hate it when we fail- we try to learn from all that and sharing these little experiences with others is what gets us through and what makes us realize our mistakes. Sharing the experiences is expanding the knowledge.

(For those of you who managed to read it till here- My apologies. Am writing after a long time- hence the unnecessary small talk and the word diarrhea! Also the title of my blog says it all- they are Ramblings!)

P.S The ‘we-don’t-know-about-anything-else' is a teeny weeny bit exaggerated!

No copyright infringment intended.

Scrubs Diaries

For the umpteenth time now, Iam back to my blog. This time with a new concept for resuscitating the ramblings. I have been watching a lot of Scrubs lately. If you haven’t heard of it- where do you live man??? Anyways it is this hilarious medical-comedy show. Hats off to the creators and actors! So, some scenes, some dialogues from the show strike a chord in my brain. I can relate to them. So, chopping those scenes off (thanks to Windows Live Movie Maker and my unemployment!) and accompanying them with my own stupid thoughts and here goes a new series of blogposts that hopefully will last!

No copyright infringement intended.