Archive for the 'Med school' Category



Post by Deepta V Narayanan:

Today I saw this 8 year old child admitted in the Paediatric ward.
He is around 32 inches or 77 cm tall. His arms and legs are stick thin – the diameter of some two or three of my fingers put together. His hair’s withering. He can only walk, and feed himself and use the toilet. He hasn’t developed speech, he can’t see very well, cannot hear very well, or even if he can, he can’t really understand, and only makes monosyllabic noises and clicking sounds – the kind one makes at a horse. He led me and a friend of mine around the beds. He had a surprisingly strong grip for one so frail and malnourished. But apart form a brief moment of a tantrum and flailing hands and trying to hit somebody when too many students had crowded around him to ‘examine’ him, ‘see’ his eyes – as if he were some curio and Bitot’s spots some special display, he was a smiley, happy appearing child, unknowing of the injustice and neglect and suffering he’s been subjected to.

He’s eight years old, stands as high as a tall 2 1/2 or 3 year old, can’t understand the world. Has no idea that he’s in a hospital, sick, and has been underfed since he was a baby.
His mother lay on his bed, smiling for some reason. She didn’t look too old. She said she’d been to a doctor when he was 4 months old and that had been told he would get al-right and that she never bothered to go again. She left unsaid why. She didn’t look worried.
I’ve seen other sick children’s parents. They might talk normally, but one can tell their anxiety from their faces. She was just – I don’t know.

I told my mother about the child. I could hear her perturbation. I thought of my aunt’s son – my little brother. I can’t till this moment stop thanking whatever forces – call it God’s grace, call it Karma or just anything on earth – for the impeccable, wonderfully ordinary childhood we’ve had.
I can’t stop. I wanted to take a picture of his, the child’s, I for some reason stopped short. Maybe I will tomorrow.

His mother probably isn’t much older than my 20 years. Or wasn’t when she had him. Barely world savvy, poor, married to a man who is in all probability not very nurturing. I still don’t think any of that is an excuse to have left him to deteriorate to mere skin and bone. I mean to say, if she could come now, she could’ve earlier.
I remind myself not to blame her. I have absolutely no right to.

He’s eight years old, and the parts of his cortex responsible for speech and understanding, and even hearing and comprehension are probably not only underdeveloped, but also degenerated to some degree.

I remember studying about how speech and hearing if not developed by a certain age -giving it a maximum of around 5 yrs- won’t develop. And I’m pretty sure that understanding and cognition also need similar early stimuli when the neuronal plasticity is still high for complete normal development.

And here I am, sitting day after day, feeling bad about my own ‘short comings’

He might be dependent life long. Being poor, and having a pathetic family (I’m sorry, I’m angry. It’s not my place, but I can’t help it right now), he’s not likely to get support. Even if our doctors manage to get him to put on weight, I don’t know how his hypothalamo-pituitary and other such hormonal pathways and complex neuronal circuits will ever just overcome the immense early neglect.

I don’t understand what he’ll do when he’s older. When his parents decide they can’t support him anymore.

Tomorrow I’ll find out about his siblings. I was too scared to find out today.

But today, regardless of what he may have to face tomorrow, he was an active child -probably because of the food he’s been getting in the hospital for the past couple of days.

When I was 8, I’d known for atleast 2 years that I wanted to be a docotr. I was reading a Harry Potter book, loads of Enid Blytons and in general having parents, grand parents, aunts and uncles all tecahing me things and caring for me.

To all urban Indian children who go to the ‘prestigious’ schools, and well, live like all the well to do poeple in the world, here’s a very sombre reminder – you’re in the top less than 2% of India as far as income goes. The poverty that everyone showcases? It’s bloody darned well real. There’s no getting around that.

This is not just one case. I found out that the average rate of admission of such cases is 2-3 per month in the hospital where I study. And this is supposedly one of the health wise ‘better’ regions of the nation.

I’m afraid I’ve digressed. It’s about this child for now. I hope he does well.

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Being There, Doing That.

It’s been a while, and again, I think I have lost ‘touch’.

Also, that means this one’s going to be long.

So well, since the last I bothered blogging, a new term’s started, and is about to end in less than two weeks from today. That now begs the question, why on earth would I be blogging now of all times? Maybe, with the exams around my brain’s functioning again, or maybe that’s just how it is…. I post four times a year because that’s how many major exams I have.

Anyway, as we started clinical postings at school, I got around to interacting with lots of hospital staff, doctors, nurses, attendants, orderlies and most importantly, patients. I realized that although someday I might float to the top of that hierarchy, I start at the very bottom. As of today, the nurses at the hospital sure do know so much more, and I don’t think I could get through any thing at all without their help…. starting from finding my way around the hospital to actually taking patients’ histories. They keep a huge section of the hospital running.

But the incidents that made maximum impact on me were my interactions with patients… young and old… and I had my share of pleasant ones and bitter ones, but I learnt lessons all the same….1. Whenever I’d walk in the hospital with the steth dangling around my neck without a book or a bag announcing that I was a student, there was sure to be at least one lost patient who’d come over and ask for help. Maybe in directing them to a department or telling them which department to go to, or once to my horror, if they’d got the name of the medicine right. To add to the trauma, I happen to not know the local language. I’d feel so traumatized and well, slightly ashamed of my inability to help, and I’d always just point at a nurse or an orderly or a resident or try to ask the poor soul to ask at the inquiry desk. There was this once I was looking through a patient’s file and going over her charts looking at her progress and stuff, and her son I think it was, he came up to me and ever so ever respectfully but so worriedly asked of me how her condition was and how long it would take her to pull through. She was sick, and had multiple disorders…. endocarditis and hypothyroidism and pleural effusion and had just been treated for septic shock,and still had a GI infection. Now I just about know the meanings of all those words and the basis for their treatments. As I looked at the boy with a blank face, they wheeled his mother in, and he turned to her giving me a slightly helpless look…

Lesson : These people around here, especially the relatives of the sick ones… they respect the doctors beyond anything else and often have their hopes pinned on the race of medical men.

2. When I did have a text or notes in my hand, or when I’d stand over a patients bed, poking and prodding and fumbling as I took his history along with two three of my batch mates, more often than not, the patients realized that we were but students and that we weren’t going to be of any help to their cause as far as their recovery was concerned. This would make them resentful, and they’d want us to just go. They wouldn’t answer properly and would assume a ‘couldn’t care less…go to hell…don’t bother me I’m sick’ attitude. Why, one man even said something as ridiculous as “you people can’t become doctors if I don’t come to you as a patient, so don’t bother me”.

Lesson : I really don’t know. I think it is that if people who are in need of help are getting it from somewhere, they won’t turn to help anyone else who needs theirs. Odd, I know.

3. There was this one lady in the Surgery wards, she had a very large leg ulcer on her right leg, and it undoubtedly hurt like hell. She beckoned to us and said in her tongue “Children, you people must become good doctors, and please ask me whatever you want to, and look and examine the leg all you want, just stop if I ask you to because I’ll only say so if it hurts too much.”

Lesson : Every cloud has a silver lining. To every person that denies you a helping hand, there’s another that will lead you all the way through the tunnel to the other side.

But above all, what I learnt, is that every single one of those interactions was worth it. They didn’t affect me, I was only thankful for every day’s experience in the hospital. I found out how much I want to be doing this for ever and ever.

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