Sunday, July 29, 2007

angry me.

One more chapter.

Residency years are the worst years. You are practically a slave. Feel like doing or not; you have to do it. many a times you fell like exploited, cheated, and so on.

Whole night I was awake. Was about to sleep at 9 am. Suddenly came to know that sunil commited suicide. Ohhhh god. Can’t believe it. Came out of the room and it was. People were sad, some crying, some with extreme sorrow. It hurts more when someone more sincere and hardworking has to suffer. And same goes in AIIMS. When you can cheat consultants and they don’t notice it people call it talent. Wow. ..
Definitely sunil was not that type.

Hard working, smiling all the time, sincere towards his job this is how I know sunil.

I know him since last 2 years. We joined in the same year. He joined MCh. For the next one year I saw him running like a mad dog. For AIIMS consultants residents are like dogs. For me real dogs are AIIMS consultants. Since they bark I believe so.

For initial years residency is hell in south ASIA. This is how it is. What British taught them is slavery. First they were and now they want it. These people are powered with a so called degree. An A4 sized mere color printed useless paper, a dream of every medical student including mine. I would have not come here, had it been known to me earlier. I prefer MBBS rather than doing residency and wasting my fruitful three years in AIIMS. I don’t know about branches of medicine but surgery is like a brothel. No way u can learn surgery. Does not look like a teacing institute. Half of its surgery residents are in us doing residency in internal medicine.

I used to see sunil running in the casualty for getting a CT scan for head injury patients. Polytrauma patients with head injury he personally used to come to us. Always used to say “clear patients from your side. I will send the patients to some other hospital. But do it fast.” He was soft spoken all the time. I know neuro sx is hectic branch but he never used to look tired.

People rank ortho next to neuro in terms of hectic duty schedule. Still remember those days. Even I was stressed in initial few months and thought of quitting residency. More so after my batch mate resigned after one month. He could not bear he left. Again I was stressed and determined to leave after one year when junior resigned. I prepared resignation and was about to submit it. but again thought what I got after one year, and what is harm to consultants if I leave. Work will be done by other residents who are in the departments. So why to leave? better stick somehow and wait every single day to pass off. That’s what I am doing.

But neurosurgery consultants are very rude and harsh. Even we have some such characters. Whose sole work is to find out where resident is lacking. Raise the fault and highlight it till their orgasm. Our life is hell with these sadists in the department. what the f-cking human right is doing I don’t know.

But in the afternoon I could see some guilt in their face. The so called top neurosurgeon in this country ( no way they are) were hiding their face in the meeting with director. If God is there they should get a lesson in life. They should be punished for taking somebody’s life. After three years of rigorous residency if these bastards threat of failing candidate every body will be pressurized. This could be the reason behind the entire story.

Any way these rabied surgeons will never change their attitude. Cause their attitude is the reflection of their blood. If blood is polluted every second it pollutes your brain with every pump of the heart which is even getting same polluted blood. So I won’t expect much from these people. But one thing is clear you don’t have right to abuse residents in public in the mid of round.

May god rest his soul in peace. You were born to become surgeon and you will be wherever you go.

Don’t bother if somebody is teaching you or not. There is nothing you can’t do. So why to accept their slavery just to learn one or two surgery. Let our moral not be low. Lets not sell our self respect for the shake of bloody one surgery. If u don’t want to teach,don’t teach. I would love not to learn from u in such environment. Let us give MD in surgery not MS in surgery.

Oh its too late. should sleep now.

Friday, July 27, 2007

I can give headache to aspirin.

finished the book complications. i found the book superb. but what happened after that book is more than i can say.

light was not sufficient in my room. still i struggled hard to finish it . wake up whole night result was terrible headache since morning. i think i need to take rest . i have to give rest to my ciliary muscle which were tired of focussing inspite of bad light.

similar headache was long back as far as i remember. won't settle with analgesics. its all just because of my astigmatism.. sucks this astigmatism. .

slept for a while. no change in the magnitude of my headache. took diazepam and slept. bit relieved. learnt a lesson "dont strain your body for a mere satisfaction" what would happen if not i had finished last night. people learn from their mistakes. but how long?

got a long mail from ZENU. hostel life, performance anxiety, and homesick must be the problem to her. dotn worry everything will be alright. you are not too far from home and family. every week you can meet them.

i think i need to talk to her. will call her tomorrow.

need to sleep now.

Wednesday, July 25, 2007

what a good book..

Complications: A Surgeon's Notes on an Imperfect Science

atul is a surgeon in us. borne from a indian doctors duo he completed his education in us. at the age of 40 he became a surgeon. he describes the life of a residents in us in this novel. its a collection of various articles published in various papers by atul. atul holds a powerful post in Clinton's government. he can be seen walking towards white house even. this is what i know about atul.

found this book today. i am planning to finish it today . lets hope i can do it. another noght out to finish it. tomorow is opd i think i can take a rest after opd.

half of the book is finished . found interesting as it reflects my personal life even being an up coming surgeon. it describes residency as same where ever u go. even in america residents are same. but back in india residents are treated like slave thats the difference.

will write more tomorrow.

Tuesday, July 24, 2007


I am a resident in orthopaedics in a center owned best institute of India.—two + years down, 9 months to go. I'm not allowed to make excuses. If a patient needs something done, I can't say, "But my shift is over," or, "I'm too tired." With 100-hour workweeks and many nights without sleep, I'm also trying to learn to be an orthoapedician..

This weekend I was on duty, which means start work at 8 a.m. on Saturday and not going home until Sunday 11:00 am. I have to attend OPD. See few of the patients till 12:00 and go to emergency.

7:30 I was about to leave my room. Got a beep. contact emergency 4706 urgent. Oh god. Its not even 8 and started getting calls. Reached ER. Two days old fracture pelvis managed outside came for definitive management. Patient not stable. Though not on support of any kind. Primary evaluation and investigation ordered. X rays –open book fracture pelvis. Fracture neck of femur right. Monoparesis right lower limb ? sciatic nerve injury. Ultrasound showed no visceral injury. Wrote for admission.

8:30 started OPD. The as usual crowd and never listening patients. Very tough to convince them esp. patients from bihar. For every tom dick and harry ailment. they come just to add more crowd. Bloody this is referral centre. Not the centre for back pain treatment. Get lost.

I was late to come to ER. Got several beep. I was hurried to finish my OPd card. Finished and rushed to ER at 12:15. no breakfast, now time to have lunch too. On top of that there will be many patients waiting in the emergency.

Good job done by my plaster technician. He had collected all the papers and arranged the patients in queue. 10 patients . 7 fracture and 2 ankle sprain and one soft tissue injury of hand.
Called one by one. Reduced 7 fractures and applied pop. My helper applied pop for ankle sprain and gave slab for soft tissue injury hand. So what? If there is no fracture any one can apply pop. And my technician sometime feels me low by putting a good looking cast. Any way took lunch or breakfast whatever at 3pm. While waiting for lunch wrote the papers for all ten patients.

While having food beep beep in pager. Contact ER urgent. Bleeding from brachial artery and fracture humerus,open wound. F**k these ER doc are the assholes they should try to stabilize the patient and give a call.. I added their work. Two units of blood, Doppler upper limb, x ray and vascular surgery opinion. wash the wound and give a compression bandage till I reach.

Informed my senior. God ! compound communited frature with brachial artery injury. Grossly contaminated. Asked for urgent admission. But no bed is vacant. Trial of salvage can be done if bed is vacant. Talked to vascular surgeon if they have bed . no bed vacant their side too. Patient send back to other hospital. Don’t know what happened to that poor guy. Must have been amputated I guess.

Started seeing the piled up cases. By the time I was free it was 7 pm. Ohh have to arrange for emergency operation. Few pending cases from ward were suppose to be operated tonight. Called the anaesthist. Bloody they are always busy. Don’t know what they does. The most no of people in duty is anaesthesia and they never give time to any of the department. every body thinks that they are busy somewhere and these bastards are sleeping or watching tv in duty room. Bloody enjoy your life till you are in institute.

Sighhhhh I feel like comiting suicide after 8. they will start calling from ward. You have to cover ward and ER. Both the places night time is busy. Called my junior how the ward is . he told patients are stable. Noting to worry. Ohh god saved me.

But who will save those bastards who will enjoy the booze weekend and fall or suffers RTA. The big headache in the night is such type of injury.
At last got call from anaesthesist. Shift the case. Hummmm whether to go for dinner or shift the case to theatre. .........Shifted the case to theatre.

Two cases one after another. My senior operated one and I assisted. For another one I called my junior and i did it. Thank god anaesthesist did not get call from other place and I got chance to operate. Otherwise they cancel next case and walk away.

2 am- went for so called dinner let me say treat. Whoever operates in night should give treat to assistant. Sounds good. I started this tradition. What u can get in the mid night except Maggie and cup of tea. Had it and went to attend call from ward and ER as well.

One patient could not sleep because of pain in the ward. Others are sleeping like hell. I sometimes feel greedy seeing people sleeping in the night for 8 hours. Its been years sleeping for 8 hours since I came here. Gave pethidine and phenargan for old man. God night! you will sleep even somebody lets u not.

Got call from ER .urgent. where to go and where not sometimes feels u like mad.. This time must be alcoholics and road traffic accidents.

Few head injury few limb injury. few needs admission. But I have no vacant bed list. Quickly disposed off few patients. Problem was with one of the head injury patient who need orthopaedic intervention also. Neurosurgery resident was expecting me to write for admission. But why me? why not him. Wrote in the paper – neurosurg to evaluate regarding admission and ortho will start intervension only after admission. No vacant bed with ortho E/M. This is enough for them. And enough to save my ass during round.

By the time I finished disposing patient it was 6 am. Now has to prepare for morning round at 8 am. Wrote progress notes for my bed patient. Prepared trauma register. Arranged x rays to trauma conference on Monday. It was 7:30 . now could not decide; breakfast or only tea/ coffee. Had tea and went for round. Emergency free from ortho patients.

My service, for acute trauma comprises 80 % of the surgical emergency patients.

The last time I was on weekend duty, I hardly got time to had lunch and dinner. and it was far busier, more like usual. 50 pager calls a day. Four sick patients post op recovery in needing to be checked every hours. Midnight Saturday. I need to go to the bathroom. My pager goes off. “Reach ER”. I figure that can’t wait. I get paged again. No other option than to wait myself going to bathroom . Ohhh god he died in the emergency before I reached there. sorry we are no one to save life. Its god who decides. Even we have to go……. I fill out the inevitable paperwork.

I reached the ER. The fat man is angry I took so long. I smiled at him and gave in indirect threat. If you were at my place you would not be smiling like me. I finally went to the bathroom.

Round started at 8 took two hours time to finish. I was dragging myself throughout the round. Slept standing many times like a horse. But I don’t mind it. whole night I had no sleep. No proper sleep and food. how can I sustain fresh in the round . after all I am a normal human. Sometimes I doubt I was normal before coming here but don’t know the current status..

Went to check the ER for pending patient though I did not get the beep. Finished the work, marched towards my favorite spot. Canteen and my onion parantha and curd. That’s what my dinner or breakfast or todays lunch. Once I sleep I will wake up at 6 pm….while eating I was remembering the article in NEJM “A frightening study, recently reported in the New England Journal of Medicine, found that long-haul truck drivers frequently nod off on the road. An accompanying NEJM editorial forcefully emphasized the safety importance of adequate sleep. Yet, somehow medicine's premier journal ignored physician training, in which residents work even longer hours without any sleep at all. If driving a truck on five hours of sleep is dangerous, surely taking care of deathly ill patients on no sleep is too.

Sucks after 6 again have to go to hospital….

Sunday, July 22, 2007


शान्त नदिको किनारमा उभिएर
पानिको कल कल सुनिरहदा
अनायसै छाल ले गाजिदियो
हुत्यायो, बगायो: हन्दर् ठक्कर;
मुठी भरी श्वास सँगै माना भरी पानि
जिन्दगी दोभानको भुमरिमा भसिदियो I

पढाईको दोभानमा भासिएको म
शैछिक मुग्लानिमा बिदेसिएको म
खाइ न पाइ शैछिक भिक मागिरहदा
उत्तर्दाइ भनौदा हरुको उनुतर्दाइ जवाफहरु
आगोनै ओकल्ने तिता कहरहरु
हरेक दिन मरेर ब्झिदै छु म
२ बस्त्र लगाएर पनि सार्वजनिक चिरहरन गराउदै छु म I

कमैया मुक्तिको आवाज गुन्जिरहेको बेला
असमानताको bridgeford मा हुन्दुस्तानी बिस्फोट हुँदै गरेको बेला
शाहाबन्सी राजा लाई उल्टो लोप्प लगाइरहेका नेपालि उभिदै गरेको बेला
असमानताको आगो बल्न सक्छ अखिल भारतीय और्बिज्ञान सस्थान मा

परबाट चर्को आवाजमा मध्यए दिन मा मैनबती बालेर
प्ल्लेकार्ड बोकेका नेपालिहरु निस्कन सक्छन
बिद्रोह गर्नेछन चर्का आवाजमा भन्नेछन
सरकारी उदासिनताको मारमा मुङ्लान पसेका शैछिक भिकारीहरुलाई
असमानताका जेल हरु छम्य छैनन
समानतका तराजुमा ऐकातिर काम् अर्कातिर दाम्।।

Thursday, July 19, 2007

thesis progress....

Feeling a bit relief. Imagine you found a public toilet in the mid market which you were searching like a hell since last two hours after finishing a full bottle of mineral water. Compare your face before and after going inside. This is a real pleasure i should say. Got a leave for few days . Instead of going home and wasting i am utilising it to finish my these. So is not it a comparable event.

Thesis is going on. I understood what is to be done and how to proceed. All charts and diagram are now used to . The horrible proforma i had made during protocol submission, i realise it was more than what i understood that time. Guess a newly joined guy in the department gets a thesis topic. He has no time sucking blood and getting the patient fit for surgery. How can he be able to study and give a good outline to a thesis. Any way i have come into a track.

If things go in the right track its a matter of next seven days i think. Its progress is not linear its exponential i should say. Rest is nothing great.

Wednesday, July 18, 2007

Thesis - The Pain

I have to submit my thesis soon. Probably, by the end of November. Till few days back it was lying some where I had not seen. We did not have mid term presentation. Our department is concerned to cut cut and cut, nothing else. Nobody would ask what is going on in our thesis part.

I was really worried how to finish thesis. What to write. How to gather information. Sleep disturbance was a common behavior since last few days. I started dreaming thesis with sleep disturbance. “The incomplete thesis and my struggle to get it signed.”

Since few days I am involved in it. I am fighting hard. Lot may works have been done. Now I can at least sleep peacefully. I think I have ample of time to complete it. Lot of papers I collected. Studied how to proceed my thesis. Master chart and statistics. I think I can finish it by next month.

Watery eyes, heaviness over back of my neck, hungry stomach. this is all thesis work in computer. I found difficult to work for longer time in laptop. And I have no option.

Guess I need a break.

Monday, July 16, 2007

I am reading more about michael moore this week.

An Open Letter to CNN from Michael Moore
Dear CNN,
Well, the week is over -- and still no apology, no retraction, no correction of your glaring mistakes.
I bet you thought my dust-up with Wolf Blitzer was just a cool ratings coup, that you really wouldn't have to correct the false statements you made about "Sicko." I bet you thought I was just going to go quietly away.
Think again. I'm about to become your worst nightmare. 'Cause I ain't ever going away. Not until you set the record straight, and apologize to your viewers. "The Most Trusted Name in News?" I think it's safe to say you can retire that slogan.
You have an occasional segment called "Keeping Them Honest." But who keeps you honest? After what the public saw with your report on "Sicko," and how many inaccuracies that report contained, how can anyone believe anything you say on your network? In the old days, before the Internet, you could get away with it. Your victims had no way to set the record straight, to show the viewers how you had misrepresented the truth. But now, we can post the truth -- and back it up with evidence and facts -- on the web, for all to see. And boy, judging from the mail both you and I have been receiving, the evidence I have posted on my site about your "Sicko" piece has led millions now to question your honesty.
I won't waste your time rehashing your errors. You know what they are. What I want to do is help you come clean. Admit you were wrong. What is the shame in that? We all make mistakes. I know it's hard to admit it when you've screwed up, but it's also liberating and cathartic. It not only makes you a better person, it helps prevent you from screwing up again. Imagine how many people will be drawn to a network that says, "We made a mistake. We're human. We're sorry. We will make mistakes in the future -- but we will always correct them so that you know you can trust us." Now, how hard would that really be?
As you know, I hold no personal animosity against you or any of your staff. You and your parent company have been very good to me over the years. You distributed my first film, "Roger & Me" and you published "Dude, Where's My Country?" Larry King has had me on twice in the last two weeks. I couldn't ask for better treatment.
That's why I was so stunned when you let a doctor who knows a lot about brain surgery -- but apparently very little about public policy -- do a "fact check" story, not on the medical issues in "Sicko," but rather on the economic and political information in the film. Is this why there has been a delay in your apology, because you are trying to get a DOCTOR to say he was wrong? Please tell him not to worry, no one is filing a malpractice claim against him. Dr. Gupta does excellent and compassionate stories on CNN about people's health and how we can take better care of ourselves. But when it came time to discuss universal health care, he rushed together a bunch of sloppy -- and old -- research. When his producer called us about his report the day before it aired, we sent to her, in an email, all the evidence so that he wouldn't make any mistakes on air. He chose to ignore ALL the evidence, and ran with all his falsehoods -- even though he had been given the facts a full day before! How could that happen? And now, for 5 days, I have posted on my website, for all to see, every mistake and error he made.
You, on the other hand, in the face of this overwhelming evidence and a huge public backlash, have chosen to remain silent, probably praying and hoping this will all go away.
Well it isn't. We are now going to start looking into the veracity of other reports you have aired on other topics. Nothing you say now can be believed. In 2002, the New York Times busted you for bringing celebrities on your shows and not telling your viewers they were paid spokespeople for the pharmaceutical companies. You promised never to do it again. But there you were, in 2005, talking to Joe Theismann, on air, as he pushed some drug company-sponsored website on prostate health. You said nothing about about his affiliation with GlaxoSmithKline.
Clearly, no one is keeping you honest, so I guess I'm going to have to do that job, too. $1.5 billion is spent each year by the drug companies on ads on CNN and the other four networks. I'm sure that has nothing to do with any of this. After all, if someone gave me $1.5 billion, I have to admit, I might say a kind word or two about them. Who wouldn't?!
I expect CNN to put this matter to rest. Say you're sorry and correct your story -- like any good journalist would.
Then we can get back to more important things. Like a REAL discussion about our broken health care system. Everything else is a distraction from what really matters.
P.S. If you also want to apologize for not doing your job at the start of the Iraq War, I'm sure most Americans would be very happy to accept your apology. You and the other networks were willing partners with Bush, flying flags all over the TV screens and never asking the hard questions that you should have asked. You might have prevented a war. You might have saved the lives of those 3,610 soldiers who are no longer with us. Instead, you blew air kisses at a commander in chief who clearly was making it all up. Millions of us knew that -- why didn't you? I think you did. And, in my opinion, that makes you responsible for this war. Instead of doing the job the founding fathers wanted you to do -- keeping those in power honest (that's why they made it the FIRST amendment) -- you and much of the media went on the attack against the few public figures like myself who dared to question the nightmare we were about to enter. You've never thanked me or the Dixie Chicks or Al Gore for doing your job for you. That's OK. Just tell the truth from this point on.

Enter theatre at 9 am after ward round. No break fast as I was late to wake up. As usual I slept late wake up late. What is new?

Starving theatre. Dehydrating too; these days air conditioner is not working. I hate lead apron. Once you wear it, shoulder pain dehydration and what not.

One case after another. Junior most has to run for everything. Bloody nobody consider for us. No break for ship of water. Forget about tea or coffee. Till 7 pm I was in theatre. Now difficult to decide. Very hungry , either go for dinner or snacks. Too early or too late for both.

Needless to complain. Who will listen you? Degree makes you cry beg and everything u can imagine or think.

Still remember that cute child. Who died yesterday. Who was known to me since last few days and under chemotherapy. God may his soul rest in peace.

Planning to study few pages from the text today.

Feeling happy, watched the documentary/movie by Michael moore – sicko.
All about American health policy. And scientific cheating by the us health insurance company. Any way it was great.

Nothing left to write , cause nothing is new to me . with a same boring routine what new can be expected.

Tomorrow I have 24 hours duty. Has to sleep early. Saturday night people will booze and come with fall and bike accident. Tortute to few hours sleep. So I don’t like Saturday duty. Day time will be cool but all of a sudden night time will be busy.

Interesting event was a call from a fren. A fren from school days. Whom I used to talk very less. But after school days she turned to be a good fren.she used to be regular with emails. “ any plan to get married ? is there someone u have searched ? oh god again pressure from colleague too.

I am tired of explaining the things. No time, no money, no girl frens, no tension. My life is unidirectional once I joined residency.

Please forgive me if I had been rude enough to explain you. And extremely sorry if she would been you relative. But this is my situation and I must explain it. I really don’t have time .

no more blog. Its time to study.

Wednesday, July 11, 2007

nothing sounds good when u feel low. i was physically present everywhere but dont know what i was doing. come back from hospital and sleep. this was my routine for last few days.

sucks! when someone tells me this is viral infection. extreme body ache, fever, throat pain and cough. god let me live in peace.

i am determined no antibiotics this time. let my immunity fight against it.
started cough syrup. magic for dry and unproductive cough. more than it is no abdominal cramps after long dry cough.

rest is fine. have to start my thesis work now. its too late i guess.

still remember what my professor used to say "viral fever - one week with medicine and 7 days with out medicine." holds true i feel.

Tuesday, July 03, 2007

residency or rape-dency

...... so tired. cannot describe how hectic was last night duty in A & E. don't have time to sleep even. gone for routine theatre after 8 am.. free after 6 pm. is it a crime itself or punishment for crime. what so ever it may be don't care now. still remember what my prof used to say in undergraduate days. " IF RAPE IS INEVITABLE WHY NOT TO ENJOY IT RATHER"
any way its time to sleep i guess

Why do students fail in exams...?

Why do students fail in exams...?It's not the fault of the student if he fails, because the year ONLY has 365' days.

Typical academic year for a student

1. Sundays-52, Sundays in a year, you know Sundays are for rest.Days left 313.

2. summer holidays-50 where weather is very hot and difficult to study. Days left 263.

3. 8 hours daily sleep- 130 days GONE.. Days left 141.

4. 1 hour for daily playing- (good for health) means 15 days. Days left 126.

5. 2 hours daily for food & other delicacies (chewing properly & swallowing)-means 30days. Days left 96.

6. 1 hour for talking (man is a social animal)-means 15 days Days left 81.

7. Exam days- per year at least 35 days. Days left 46.

8. Quarterly, Half yearly and festival (holidays)-40 days. Balance 6 days.

9. For sickness- at least 3 days. Remaining days=3.

10. Movies and functions- at least 2 days. 1 day left.

11. That 1 day is ur birthday. How can you study on your B'day??Balance = 0 "How can a student pass?