A Tale of the Guy who feigned Malady

Like any blogger gone M.I.A, I should probably start this post by explaining my long hiatus to my imaginary audience and fans perhaps, if there are any. The frailty with which the latter statement strokes my ego tickles me I tell you. So I will just hit you with the usual ‘I am a medical student’ crass, ergo my absence is self explanatory. Bottom line, I’ve really missed posting here. Its been a while.

I have never had a brain scan done on me, but I have a feeling it would closely resemble something like this…

But here I go again…

There was this day last week, my two nerdy colleagues and I were just from sitting for the mother of all exams. The end of years for the first year of clerkship are surely no mean feat. The hardest part of junior clerkship is perhaps when you have to convince your seniors that you are of at least average reasoning even when sometimes they leave you wondering whether you have the intelligence quotient of an enema bag.

Summarily, I had walked into that exam room with caffeine in my veins and I walked out with diffuse axonal injury. That’s medic-lore for something more severe than a concussion. I actually had to grope out of the examination room. To our utter dismay the university transport available at the time wasn’t enough to ferry all students back to our campus which was half way across the city.

We decided to sketch our way to the bus station and use public means instead.

The scorching tropical sun, noise and choking fumes from the traffic did not make our early afternoon any easier. Couple that with cranky, overly sleepy minds and the colossal duress of examinations resting squarely on our aching backs and we were one glum trio. Somehow, we managed to hop into one of the commuter trains from whence the drama started…

As we waited for a few other passengers to board, some young man got into the bus. Well, there wasn’t much pomp about him until seconds after his uneventful entrance when some chesty, cut-throatish voices rent the front of the bus. Barely craning my neck, I noticed the same guy holding some banners and writhing his frame in the strangest of manner. It was a complicated blend of a drunkard’s gait, a seizure, and worm-like movements. His face was overtly bathed in big beads of sweat, his facial muscles contorted into a worrisome grimace: the portrait of a man who may have been experiencing his worst episode of constipation yet.

At this juncture, thanks to medical school, all my weariness slipped away fast as curiosity immediately sank in its place.

This fellow was passing the miniature banners around begging for money. When he got to the back of the bus where we were seated I tried to study him closely; his demeanor and behavior to figure out exactly what was wrong with him. His fliers didn’t help much either. All they had was a request for financial assistance so he may get medical help and what was supposed to create contrast and earn sympathy: a picture of a younger version of him in elementary school perhaps. Frankly, the only change this guy seemed to have gone through other than his very weird aura was physiological aging. I dug into my exhausted mind to get a fitting diagnosis but it clearly didn’t want any digging into.

Anyway after failing to get any help, the young man shuffled back to the passenger exit. Then something even more strange happened. He just totally snapped out of it. He straightened up and slapped the door vehemently asking the driver to slow down so he could alight. And all about him were clearly amazed and very perturbed by his act. Who really does that?

What do you even make of such a man?

I’ll tell you this. Other than the fact that his performance could earn him a place in a good drama school and probably be a sturdy foundation to a stellar acting career, I will choose to overlook the fact that his moral compass blatantly points to the true South. My diagnosis for such a man is nothing more than severe mental myopia.

Healthy and seemingly talented, he yet chooses to live in the paucity of fleecing plenty of hardworking others off their change. Maybe I am missing something. But for the larger part, I think it shows what happens when we refuse to recognize the profoundness of our natural abilities and hence fail to exploit them in vigor, beneficence and sincere gratitude.

As such this should not merely pass as an experience, but be ingrained as the important lesson that it is. Pulling weird acts in buses makes other people really uncomfortable. It doesn’t pay that well either. Okay, here is the real lesson- If there are better things you can do with your life, never settle for less.

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An Encounter with a Silent Killer

For most people, the word tumor is synonymous to cancer: the diagnosis of which is likened to a ‘gift’ delivered from the grim reaper himself, with not-so-much love. Medical truth however suggests otherwise. From it, we know that benign and malignant tumors exist. It is the malignant ones that most doctors dread: and the doctors who (as it seems) don’t are called oncologists. I wouldn’t wish a malignant tumor on my worst enemy, nor advise them to pursue oncology. The latter is indeed (and infamously) the most depressing specialty in medicine, reasons behind this being rather obvious. Some encounters with malignancies however, are worth recounting.

Now, for many a student there are those moments when your conscience tells you that you would rather sit out a class than attend and let yourself down. This happens to me sometimes: after all, some classes can be quite a task! On this particular day, I was with a close friend of mine. We made our way to the hospital’s casualty where after entering the consultation area, a familiar voice caught our attention. It was one of my good doctor friends who I am tempted to describe as follows. He is an ample guy; indeed, an aspiring epitome of the consequences of unhealthy eating. He is a jolly one too; often punctuating his sentiments with billows of chesty, heartfelt laughter. He even lightly comments how the KNH Trauma department is a refuge center for thugs whenever we assist him in the minor theater. In essence, he has a contagious personality- an infrequent thing from a doctor working in this particular hospital.

He beckoned us into his consultation room.

There, we found a half dressed sexagenarian lady on the examination table. Many similar scenarios had trained us to put professionalism and deep respect for the patient before shyness or lad-ish mischief. Our host immediately got to work on our now eager minds. He pointed at a swelling on the lady’s right loin, asked us to examine her and make a diagnosis. My friend and I asked for consent then got to work- inspecting keenly for color changes, deformities, scars or swelling then palpating for tenderness, lymph nodes, edema and any other notable things as per protocol. All we detected were the inguinal lymph node swellings the doctor had earlier pointed, a mildly edematous right leg and a dark, irregular patch on the heel of her foot on the same leg. The patient was not in pain. This, in our naïve minds was puzzling.

We got to thinking and mumbling guesses that sometimes screamed loudly of our ‘ignorance.’ The doctor however exuded a fatherly sense of patience. He guided and probed us further, merely asking us to dig deep into what I would consider our ‘shallow lakes’ of knowledge. In a last and almost desperate attempt, I uttered- ‘Melanoma.’ He smiled at me, a gesture which he complemented with a solid affirmative ‘YES’. At last I had gotten it. He then produced a chest X-ray of the same patient. Her lungs’ morphology was uneven with rounded zones of what the doctor told us were metastases. I then turned to the patient, curious for a brief history.

Her foot had started hurting five months earlier as she was working on her farm- a pain which receded after a short while. It was only after she had experienced repeated episodes of coughing that she sought treatment from a local healthcare centre; a journey which ended at our teaching and referral hospital. She was not in pain. However, her body was now an unwilling host to a fast spreading, inconspicuous yet lethal tumor- a malignancy called Melanoma. We let her dress as I exchanged ideas with my classmate. And when she rose to receive her documentation and advice from the doctor, I trained my eyes on her yet again.

She was a simple country woman. Her headscarf had slipped further back now perhaps from her prolonged recumbent position on the examination table. Her hair was jet-black, plain and kinky, few streaks of grey standing out augmenting the subtle creases on her face. Her eyes were sunken, whether because of worry or the disease creeping upon her- I couldn’t quite tell. There was a slight aura of hope on her demeanor though. This hope, I thought, was founded on ignorance. Her lack of knowledge about her current predicament was her shield; a weak one, but a shield nonetheless. As expected, her body looked fairly healthy: save for the X-ray images we had just seen. Our conclusion; she was sitting on a ticking time bomb. Prognosis is guarded.

I pitied her. Deep down, I wanted to give her the benefit of doubt. But I knew a tad better. If not by the disease, chemo-radiation and depression would take its toll on her. There was little chance that she would live through it. The outcome however is always in the hands of a Higher power. Having learnt something new though, we left hoping that whatever her fate was, she would dig deep into her soul and find the courage to face it all.

Why I want to be a Doctor

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The moment right after passing my high school entry examinations remains nostalgic. If I’d travel back in time and passed my exams well enough to get the media scurrying home, I’d wait for that ‘What would you like to be when you grow up?’ question and promptly answer, ‘Adult’. Yes I said it, -Adult. Here is why…

My take is that people have rather deluded ideas of what being a doctor is. The society and even some doctors think that being in the medical field is a calling. I used to think the same till I asked myself; ‘who really called me?’ If it even was a message -let alone a calling, me thinks it was hand written, in hieroglyphics; slit into a split stick and sent to me via the fastest runner within a hundred mile radius. Seldom, I think he only got to deliver that message because I wasn’t running fast enough in the opposite direction. That happens when I am on a low run of course.

The process starts with being a medical student. This is where you are confined to Med School Maximum Security Prison. They pressurize you with all the medical jargon here. The more you learn, the more you realize how much more you do not know and the more you forget. You even forget yourself. In fact, your social circle is relegated to your loved ones, a few like-minded friends with whom you share ‘sick’ jokes, and many more sick ‘friends.’ You appreciate what it really means to be sick get well and accept that people die. Your responsibility- to be seen and not heard… and when it’s required that you be heard, it should mostly be the sound of your tongue diligently licking your consultants boots and making sense while you are at it. Once your saliva is exhausted and your seniors can see a vague reflection of your face on their shoes, they may let you graduate.

Being a doctor is enjoyable. We derive satisfaction from fixing people. It is that rush of solving the mysteries of body versus disease that pushes us forward. The times we are able to cheat death and bargain with life for a little more time on behalf of our patients. Those amazing moments we venture even deeper to do ‘repair’ and ‘replacement’ as in surgery. Believe me, it takes people with more guts than a kid with mega colon. We feel like demi-gods while we are at it. Not many have the privilege to do that after all, let alone the balls. That is what our profession is about. Restoring life, health and purpose where it was dwindling. But then again, it is never that simple.

The world embraces you in its stony arms. Society thinks you are a miracle worker on a path to riches. You have a sworn duty to your patients, and you must keep abreast with new information to stay sharp. You lose sight of what is important. It all is anyway. They miss you at home, you are never there. You console yourself that you are going out life and limb for others, for humanity. Even the closest to you never seem to understand you. You got used to this in med school. Since then, there was never enough of you to go around. This either distracts you, or you resign to forgetting yourself all the more.

 At the hospital, you have many lives to save. Depending on how good you are, you save most and lose a few. Sometimes it is your fault, other times it is beyond you. It’s unfortunate that you can’t save them all. It hurts deep, this realization. You could sit down and wallow in glum; they call it being human. I’ve learnt to square my jaw and forge ahead like it never happened; I call it protecting my heart. Despite all that’s on your shoulders, you tell yourself that you have to do better next time. You don’t have a choice, you simply have to.    

‘Why did I want to be a doctor?’ I ask again. Too many times I have answered this question a little too hastily. I made a choice… No, I love it all. But once in a while, I am not so sure. I could do business, disaster management, or try physical education. Simple things to do, albeit you make way more than your input accounts for. Maybe I should find a better answer to this question. Until then, let’s have a moment of silence, I need to introspect: play me some good music, to whose lyrics I can relate: as I flip through a book, coarse enough to sharpen my intellect: just understand me for being me, that, I’ll truly appreciate.