Friday, May 18, 2007

residency vs slavery




what a f--king residency!

I’m writing a blank I suppose. just a situation compelled me to write like this . In these instances, I have learned, the optimal solution is to write something which just feels you to write. . Looking back I realize it’s kind of immature, but, right the way it goes in most south asian region.

Tomorrow, 8 am sharp, I embark on a new journey. I will be one of the poor face of the team. This team will encompase one house surgeon( PATTI and X-rays doctor) , one ward incharge (that is 6 months senior ), two surgery residents (mostly same batch who came in rotation), 3 junior residents but senior by years or two. 4 senior residents ( neither working properly nor taking responsibility BICHWALA) and 6 consultants ( A WALkING LIVE EGO COVERED IN SHINING LAPCOAT.)


To serve the readership yet unfamiliar with the medical hierarchy that governs today’s fine medical establishments I will now take the time to explain this stepladder of ass-slurpers. The understanding of this is essential for our future relationship and so if you have any questions feel free to ask.I will comprise the list to range from least kissed ass to practically dripping. Remember, each member of the team has a primary goal, a secondary goal (if applicable), friends and enemies. It is long; I am sorry for this, but essential for the upcoming month. Let us begin:


HOUSE SERGEON (1st yr resident)
Junior most and newly joined in the department. Came with high hope of being an educated and qualified doctor. Must have sacrificied better oppurtunities and few must have compromised the departments they like most. Loaded with steth, gloves, micropore, surgical blades and so on any time even if has to go to toilet. Literally spending most of time in the department. Comes early in the morning and leaves late in the mid night. A contineous machine with no smile in the face with regular features of skipping fuels – meals. Still active. Has potential spikes of quiting degree and run away from ass sloughing brothel. Few really can make it happen. Half of the time running from nooks to corner for no reason ( delevering sample to lab if late or ordely has just left your sample because you are late by minutes, collecting their reports, collecting cultute and histopath reports cause by the time they come at their own (government orderly brings) it will be too late for the patient and consultant will eat half of your brain. Even if it is not prepared consultant will think you are telling a lie. The main hurdle of this young guy is getting a portable xrays, CT scan , MRI and other tests ( most of which very few knows where it is done inside or outside the college. Getting a early date is most difficult task for him more than it is getting it’s report and more than that really a victory is getting a film of CT, MRI. Fuck! patient pays for these investigation and they don’t hand over film to the patients and this poor guy has to run to issue the film. Find the senior resident in radiology in duty that day. Plee in front of him, he will talk big as if he is the consultant. Approach the radiology consultant he will scold you first, shower his anger and fraustrations upon you and finally after wasting 2 – 3 hours films comes in hand. Poor he goes for breakfas then. But its almost lunch time. Poor he never has time to read what is written in the report or how many film are inside. Its non of his business. Everyone ask why not these ? why not those? Gets puzzeled whom to listen and whom not. But nobody even dares to ask did u have lunch? Did u slept well last night, or are you getting time to study. Is everything fine in your home? Or you want a short break and say hello to your old parents.

Primary goal:
To impress patients and realtives by providing a PANI and PATTI and DABAI. Apart form them he has to impress his ward incharge as well as consultant. Comes in round with details of patients and a detailed X-rays and iamging perfectly arranged in orders carrying all the way in round (nearly 20 kgs holding for 2 hours). X-rays says the consultant and there it is. Take it out latest to late in orders if not he will be strangulated with words.

Secoary goal:
To become a ward incharge or ward head differs department wise. Best friend is ward incharge. Can share feelings when both are scolded like a street dogs in frot of patients, attendents, or openly in the lobbey, in any case someone dies in ward or they are late or a feeling of smooth running of ward is questioned. Interestingly enough, they are each other’s enemy as they are always being judged comparatively to each other. This undercurrent of hate is masked very well and only a thorough Freudian understanding of the subconscious can uncover it. Has a single target of discharging of patients in medicine/ pediatrics and PAC clearence in surgical departments. For whole six months they stands nowhere in the department. They are just like a contineously workign machine at spinal level- not to decide at their own.


WARD INCHARGE/WARD HEAD

Sounds like big but generously small. Just promoted form house sergeon. Projected to be a big face for patient. Sounds really good if consultants tell patient to talk to ward incharge and run aside from his responsibility of talking to patient. For me ward incharge is like a boil at the bottom of scrotum of a newly married young male. Doesnot take part in action ? Because house surgeon takes care of rest of thing and still can not enjoy? Due to constant pain. Though he has oppurtunity?
A middle man between commandents and field worker. Certainly has to work like field worker in few places where house surgeon fails to prove his efficiency. Mostly collecting CT/MRI films, sending few academically acclaimed investigation to satisfy intellectual masturbation of consluntants. Fully loaded with newer gizmoos like cell phone/pagers. A walking encyclopedia of patients . answers phone every 5- 10 minutes starts with YES SIR, I WIL DO IT SIR, YES SIR , FIT SIR, AND A PAUSE IN BETWEEN MEANING BY HE IS GETTING A HARSH SCOLDING. A MEDIUM TONE SORRY FOLLOWED BY CAN I DISCHARGE THAT A. B . C SIR? Synonyme of this half grown resident is discharge doctor, incharge with no power exactly like our prime minister manmohan singh. Less patient means less work is his principle.
His enemies are senior resident off course house surgeon and at most the sick/old patients. very well known as LIAR. Every body complains that ward incharge tells a lie . he is spyed many times by senior resident, house surgeons, and sometimes by ward sisters for bosses. Finally a man responsible for iatrogenic anaemia of sick/ old patients. god knows how much blood he has to suck to keep them alive otherwise he has to sacrifice his ass.
Primary goal:
Make patient feel happy- medicine
Make patient fit for surgey- surgical branch
Make house surgeon feel happy-an obedient prostitute
Aggressively discharge patient
Oh god one more sick patient – donno when he will be fucked for his death in mortality meetings

Secondary goal:
Avoid multiple rounds – every consultant catches for their admitted patients. waste half of his time in roaming for rounds.
Save my own ass- ready to blam upon anyone except house surgeon.
Try to remember patients investigations details- nonsense
Try to smile even with fully torne ass during rounds.
To leave from ward early- but not possible

JUNIOR RESIDENTS:

Poor people at the most receiving end. Impression of hopeless, work cheater, and knows nothing. Any one can come and shine his anger upon these young doctors. Mostly are victimised by senior residents. Burdened with senior residents work( cause they will exploite these residents for getting their work) easy way is to tell boss wants you to do this, which boss must have infact told him to do. Now he has no option neither he can go and ask boss nor he can deny it. A common victim by senior residnts and consultants to satisfy their intelluctual orgasm. They have tendency to ask what they have read previous night whether related or not to subject matter. Starts scolding “ don’t you know this little thing?” Won’t tell the answer and tell GO AND READ !
Bastards ! there are crores of basic things in medical sciences and all can not be recalled at once. What your brain register may not register by others brain. And do u really know all the basics in life? If yes, you would not have barked like a street dog even after being a doctor. And main thing is you were at the same herd few months back. Feel your ass its still licking. And don’t consider yourself to be an inborn intelligent. We even know your detail. We don’t reply doesnot mean we cannot. Junior resident in surgical fields literally gets fucked by these pseudo consultants ( senior residents). Inspite of being a teacing institute you are not interested in teacing juniors. Nobody ask you what you have finished, what procedure you have finished, what left? What I need to help you.

Primary goal:
To impress thesis guide- exam is ahead
Not to fail
To become SR- who don’t want to let their ass heal.

Secondary goal:
Keep juniors happy-motivated and feels that juniors are at their side
To learn from seniors residents – possibly from same state/casts and offcourse who doesn’t scolds u much. All are not the same. These are few good in this earth.


SENIOR RESIDENTS:

Few of the white elephants which medical colleges pay for. These are parasites for institutions who has association with juniors for survival and consultants for working. Never ready to take responsibility. Always sift their work to junior residents. Best known as spy and working obediently for consultants sometimes. So never trusted by junior residents. Ready to entertain intellectual orgasm by asking few questions and not answering them. Always trying to run away from department and works.

Primary goal:
Work less and get more.
Dreams of becoming consultants.

Secondary goal:
Focussed for publication
Operates – surgial fields
Procedures –medicine departments.

INTERN:

Young energetic new doctors who are concerned more on attendance and run away. Come for face presentation in the department and shines away. Still not decided what t do later. The residency what they see from close is definitely distracting or enculcating a feeling of hate of doing residency in India. Still in transition whether to go abroad or accept slavery here itself. Those who are welloff think of kicking this fucking residency. If you have to become a slave why not to become a slave of polite/ cultured master with reward for what you do.
Primary goal:
To arrange money for abroad exams
To finish target based preparation if it is mcqs.
To release the fraustration of undergraduate life- enjoy sometimes.

Secondary goal:
Learn basic procedure in no time . L
Leave the ward in a lightenign speed.


ATTENDING DOCTOR/COSULTANT ON CALL:

Primary goal:

Come for 2 hours in morning, gives instruction, and leave as fast as possible, keep name out of chart so no one knows who to sue later. Busy for private practise outide – unethically and don’t hesitates to teach moral science to his residents. All. Enemy: Remain completely oblivious to the ass smooching going on around you. Wipe ass off after morning round.

CHIEF/CONSULTANTS:

Well educated and grey hair reflecting vast experience. Still with cranium full of ego. A government employee whom government trusts after their retirement they will produce equally competent successors so that health system runs smoothly. But what these grey haired thinks that they will never die and hospital is their private property. Mind it moron its your working place and our teaching institution. So you are paid for treating patients and producing a well manared competent doctor. Mind it when you are dying even you need a medical attention. One has to leave this earth. No one is immortal here what remains is your good deeds.

Secondary goal:

Try to remain seemingly very humble, once in a while outbursts with his anger and scolds everyone ( esp residents) either in wards, infront of patients in between the rounds, but never in rooms. which makes every patients/ attenders feel like resident knows absolutely nothing/ should give up his medical license and go back to medical school. This reflects the fraustration of either getting pressurised from ministers/leadres, going cold relations with wife, or poor performance from kids in school or a feeling of guilt of proffesional unsuccess.

This is the system within which we all operate and we are doing residency.

1 comment:

coffee addict said...

hi, found your blog through technorati. am on a mission to find as many intern's blogs as possible around the world so we can compare experiences.

chin up mate, it gets better.