Journey into the past: the medical college years: Dr. Indira Shetty

One of my friends and colleague, Dr. Indira Shetty, who lives near Bengaluru, India, has recently posted a brief account of her journey through medical studies at the Seth G.S. Medical College and K.E.M. hospital. As I was all along with her in the same batch, and we are in touch, she was kind enough to forward her write-up to me and has given me permission to reproduce this in my blog. The article written by her is, in her own words, "straight from the heart" and I must say she has well described everything from the basics to the feelings we all had. Being also a paediatrician like me, her journey has quite a lot in common with mine, though there are some differences (of course).
Here goes:

My Journey in the Field of Medicine

-        Dr. Indira Shetty, M.D. Paed. (Mumbai)

It was a languid afternoon, as I sat discussing cases with my paediatric colleagues at Srinivas Medical College, when two 4^th year MBBS students trooped in requesting us to contribute an article for the college magazine.

Writing was indeed my passion but sadly over the years I had been wielding my pen only to write prescriptions. But now seeing these two bright young faces I felt inspired all over again.

So on the job, I got busy thinking of a suitable topic and I decided to pen down my journey in the field of medicine. Very recently my daughter crossed a major hurdle i.e. the 12^th Board exams and around that time, like all adolescents she was at career crossroads. Her basic instinct drew her to the field of medicine, but the fierce competition made us sit up, do a reality check and explore all possible career alternatives. More the choice worse the dilemma. It was during this soul searching exercise I realized what taking up a career in medicine meant, how important it was for a student to have real aptitude for it; because becoming a doctor is a lifelong commitment and not a one night stand. Sadly quite often some children get pushed into medical college by status conscious parents to up their market value and this can spell disaster both for the individual and the society at large. During my college days the choices were limited. The human body fascinated me and I found the world of commerce humdrum. I was lucky indeed to get into the prestigious G.S. Medical College Mumbai and this is from where my journey starts.

My earliest memories of 1^st MBBS are of the heavy text books, Guyton’s Physiology and Grey’s anatomy which altered as dumbbells and helped develop our biceps. I can still smell the formalin which would assail our nostrils in the anatomy lab, but soon some of us got so comfortable that we literally ate our lunch box sitting next to the corpses, especially a day before the exams. So engrossed we would be in deciphering the deadly details that we hardly realized that lying before us were once flesh and blood humans, now lying stripped and ripped so that we could dig into their vitals and learn anatomy in all its gory details. Little did we then realize that if not for those unclaimed bodies we would not have such insight about body details. Today looking back I whisper a silent prayer to all these anonymous humans who died unsung but played a stellar role in educating us.

Passing 1^st MBBS was a hurdle indeed, our college set us very high standards. Despite the tough exams most of us secured the necessary grades and we marched into the 2^nd MBBS. At last we got to see some real patients and we felt like doctors in the making.

Our O.P.Ds at K.E.M. Hospital, Mumbai were always teeming with patients and our wards were chocoblock with inpatients, some lying under the cots and some admitted in the corridors. And amidst all this chaos we had our grand rounds. Those rounds were grand indeed because back then we had some real stalwarts in the field of medicine who were our knowledge banks. Their rich clinical experience and acumen gathered over years of seeing patients was what no textbook could ever offer us. On the rounds we students were at the bottom of the hierarchy and above us were the interns, postgraduate resident, assistant, associate and the H.O.D. The resident doctor presenting the case would literally get vivisected by his seniors, and we students would be all ears, trying to understand the nuances of the art of medicine, how from history taking and signs and symptoms you zero down to possible differential diagnosis. A few doctors did have the virtues of Sherlock Homes, but majority were like Dr. Watson. Thanks to our teachers who made the art of medicine so fascinating. Today looking back I pay a silent tribute to those Guruji’s who felt duty bound to part with their knowledge (sad to say their tribe is fast disappearing now) and those crowded wards were our temples of learning. 

But having said that, teachers were responsible for only half our education, and the other half was contributed by the helpless under privileged patient lying on the free municipal hospital bed, who got poked, probed and palpated by numerous trainee doctors. I still remember how some patients with interesting signs and symptoms were simply not discharged on some pretext or other. Little did we realize that they too had a life back home. Tell me readers who amongst us would submit oneself to such humiliation of being exposed and palpated. I hope today’s students realize this and treat these patients with all dignity due to them. Very recently I had the sordid experience of interacting with a poor patient admitted in a well-known medical college in our city. Despite her poverty she was charged a hefty bill due to failure on her part to produce certain documents at the right time. I was wondering at the lackadaisical attitude of the social work department which is supposed to guide patients in such cases. Also the high handed manner of the doctors treating the poor patient was appalling! Wake up, dear colleagues after all it is these very patient who fill up our medical college hospital beds, so that we get the M.C.I. recognition.

Today of course the education scenario is fast changing. Especially abroad, dummy patients and virtual bodies have replaced real patients for teaching purpose. Very recently I read about a virtual liver which will replace real patient drug trials. But looking back I am eternally grateful to all those underprivileged patients who contributed to my medical skills.

Before we realized, we were out of 3^rd MBBS. I was lucky to get my choice P.G. seat in pediatrics and a whole new world opened up before me. Babies you know are known to gurgle, giggle and throw a tantrum. To diagnose their ailment was a guessing game. Even to this day an infant with excessive cry baffles me. But tell you guys I have never repented taking up pediatrics. It sets your age at eighteen and you live evergreen.

Despite my years of training and M.D. degree, when I started my private practice I realized how inadequate my knowledge was. I soon realized that what makes a proper doctor is not textbook knowledge, but experience gained over years of practice. The smile on the face of the babies and the relief on the face of their parents was my report card, I passed some, I failed some and to my joy I excelled some.

Education never ceases and each day you learn something new. And then comes a phase in your life when you graduate from, being a mere physician to becoming a true healer. This is the defining moment in a doctor’s life and the experience can be very humbling. Something lights up inside you and you find that God Spark within you which connects you with your patient . I have landed myself in situations wherein a distraught mother hands over her ailing child in my arms. Her pleading eyes say that she has faith in me. I may not be adequately equipped to handle her baby, but this is where the God Spark comes to my rescue, it gives me immense courage and unknown strength, and when things turnout good, and the child heals, the joy is priceless. The smile on the baby’s face, gratitude written all over the mother’s face and the happiness you experience no Master Card can ever buy. You feel blessed. 

No doubt, medical profession comes with its share of professional hazards; the odd hour calls, the nightmarish medico-legal pitfalls; but bouquets like these that life throws your way make the brickbats seem like a small price to pay. 

Learning never ends, it’s a lifelong process and so my journey too will go on; but this article has to end. Before I pen off I would like to thank the two students who made me write this article. It helped me rediscover myself.

Updates on Dad's health, and other stuff

As I write this on the evening of the 6th of August 2012, I am feeling a little depressed that I am not with my parents and family these days. It isn't that I was expressive about my love for dad and mom; I wasn't, and that is the honest truth. However, I did, and I do, love them. My dad is passing through his worst ever life year, and I am not there to help him or mom, who must be having to struggle with him a lot. Dad remains in hospital. Nishrin, together with Iqbalbhai Bhinderwala (our neighbour in Mazgaon), has helped clean up Dad's house as best as possible so that it is in a presentable condition when Dad is discharged from the hospital and brought back home. Not only did she orchestrate the selling of the old bed and mattresses, but also got the house disinfested with a professional pest control service, got a basic painting job done, and will, by tomorrow, replace the floor carpet etc., thus changing the topography of the house for good. In addition, dad's old newspapers, which had grown in bulk to take over large portions of the house, were all thrown away or sold off, so that a real change will have occurred. I plan to get photos of the new setting through the agency of my ever-willing daughter Hannah, and if possible, share them here with you so that you get an idea of what I am talking about.

My work here is going on as usual. There are hardly any challenges, and when they do come, most of the time, we refer the patient to T'aif. I plan to take a day's leave on Wednesday to go to T'aif and complete some pending bank work. In addition, I may stay overnight to be able to visit the Mall there and get some goodies back for later consumption.

I have been trying my hand at a few new dishes, as well as making old ones with a fresh infusion of instructions from a friend who has been inspiring me to experiment. I made rasam without using rasam powder for the first time last week. 

Rasam

Pasta and beans

Then, yesterday, I procured fish curry gravy from the south Indian restaurant on the highway and added cut pieces of thelapia fish to make it into a proper fish curry. Today, I made Penne pasta and added a can of fava beans and some minced meat to it to compose my lunch. In this manner, I am finding things to do in an otherwise boring way of life.

I would be erring if I said I don't miss my family. I do miss them terribly, especially in Ramadan - and I nearly cried when Nishrin told me on the phone that they are missing my energetic input of spirituality and of getting different foods from Bhendi Bazaar for the iftaar. I suppose I can live with their absence, and they, with mine, but it is a sad thing to happen, and it won't be a day too early when I finally exit from here and go back to my home in India.

In the end, I may as well add that when my blog goes back into the public mode, this post and several others before it may make less sense than when they were read in live mode, but I indulge my readers to read them with the same love and care they have bestowed on me before I went private a  month ago. 

Thank you all.

Day 25, Saturday, 10th December, 2011

I began to realise for the first time, today, that my stint in this country was about to complete a month. When this thought occurred to me first, the immediate next thought was ... what a long way I had come, and not just in terms of distance. Some of you readers have already been there, done that, and still others among you are dwelling far away from your motherland, so you can understand what I am passing through.


Do I miss India? Do I miss Mumbai? Mazgaon? My home? Of course I do. Let me make a list of the things that I miss most (after the most obvious things like family, parents, practice, etc.): a) Food: batata wada, punjabi samosa, 'gila' bhel, sev puri and pani puri, dosas, McDonald's Filet-O-Fish, Khichda, sabudana wada, b) Places: my clinic, Kalbadevi and its sights and sounds, my Bhendi bazaar and J.J. locality, Love Lane, Nariyal wadi, Dockyard Road and its kabab-lamba pav, V.T. and beyond, for all the things the business district is famous for - its stationery shops, big shops like Akbarallys and Globus and others, the Jehangir Art Gallery and the NGMA, the cinemas with their own world of movies, food and fun, the hustling and bustling crowds around Flora Fountain and the Gateway of India, the Horniman Circle, whose charm is totally different once one steps inside it and gets into a quiet and different world from the one just outside, the curio shops and stalls near the Museum, the sandwich outside Kapoor Lamp Co near Kala Ghoda, the indescribable charm of walking along Marine Drive ....c) People: the icecream seller at Shiv Cream center, who has a no-nonsense attitude right from 10 a.m. to 1.00 a.m., the various shop-keepers of Matharpakhady  Lane - the grocer, the vegetable vendors, the bhel-puriwala who sets up his shop after 9.00 p.m. outside Mazgaon Rest House (he, of the thin body but a resolved mind), the thick bearded guy who sits in his hardware shop next to the chinese food restaurant just before the Mazgaon Circle, the walkers and runners at the Mazgaon Hill, some of my neighbours whose friendship and company I used to treasure, the ubiquitous traffic policemen standing around the corner with their challan books, greedy expressions and wet palms, the BEST conductors who have stopped making their snap-snap noises as they now use an electronic machine to "print" tickets, the cabbies who continue to find ways to trap you and fleece you of your money, the doctors and nurses of Masina and Saifee Hospitals, the Dholkawala Maternity Home and Saboo Siddik Gen Hospital,  the patients who used to be loyal and invaluable to me, my receptionist and the various servants in my house and the clinic, the dozens of Medical Reps who used to visit me to ply their wares, and so many more ... d) Special events: My nature walks, my bird watching just outside my own house, my movie trips, my various day and night trips to bring back and leave Nishrin, Inas and Hannah to and from wherever they wished to come from/go to, my visits to my parents' home, my calls to cousins and friends, the calls I got from close friends and well-wishers, the various people and institutions I corresponded with, the trips I undertook to the BMC offices, the meetings with old friends from school or medical college (there was one of the latter meetings in late November, and boy, I missed it so much), and more ...


A large paragraph, and many of you may not even identify with more than half of what I have written, and yet, I am sure you can all identify with the universal pain and anguish that I felt as I wrote the above, and the continuing sadness as I recall my life back in India. 


Saturday morning blues ... when I wrote this to a chat-friend on Friday evening, she wrote back "Ha ha" ... and this is exactly what it is like, here in Saudi Arabia. Friday is the last day of the week, and Saturday here is the equivalent of Monday in the non-Islamic world. I experienced this in full force today as I got up late and also reached the hospital later than the usual time of between 7.50 and 8.00 a.m. The day also marked my first on-call day. As I wrote yesterday, I was apprehensive about how my on-calls would go, but, I am happy to say, that my first day went off well. There were no calls, and I was totally free during the evening. It was while I was returning from my evening walk that I began to feel a little chill. I thought it was due to the weather, but by the time dinner time came around, I knew that the chill I was experiencing was due to my own body responding adversely to some unknown insult ... and my suspicion turned to reality when, by midnight, I began to feel distinctly hot and my nose began to run. I tossed and turned throughout the night, and before the next day dawned, I was sure I had the 'flu. 


In between, I took out the time to go out and make a few purchases, a new Mobily Internet connect being one of these. I did not have the strength to go far from my house, and returned within 15 minutes or so of leaving the house. 


That's it. Please comment about this entry and let me know how well you adjusted after leaving your homeland (applies to those of my friends who have worked overseas in the past or are still doing so).