.....THE HELPLESS LOVE......

Once upon a time all feelings and emotions went to a coastal island for a vacation. According to their nature, each was having a good time. Suddenly, a warning of an impending storm was announced and everyone was advised to evacuate the island.

The announcement caused sudden panic. All rushed to their boats. Even damaged boats were quickly repaired and commissioned for duty.

Yet, Love did not wish to flee quickly. There was so much to do. But as the clouds darkened, Love realised it was time to leave. Alas, there were no boats to spare. Love looked around with hope.

Just then Prosperity passed by in a luxurious boat. Love shouted, “Prosperity, could you please take me in your boat?”

“No,” replied Prosperity, “my boat is full of precious possessions, gold and silver. There is no place for you.”

A little later Vanity came by in a beautiful boat. Again Love shouted, “Could you help me, Vanity? I am stranded and need a lift. Please take me with you.”

Vanity responded haughtily, “No, I cannot take you with me. My boat will get soiled with your muddy feet.”

Sorrow passed by after some time. Again, Love asked for help. But it was to no avail. “No, I cannot take you with me. I am so sad. I want to be by myself.”

When Happiness passed by a few minutes later, Love again called for help. But Happiness was so happy that it did not look around, hardly concerned about anyone.

Love was growing restless and dejected. Just then somebody called out, “Come Love, I will take you with me.” Love did not know who was being so magnanimous, but jumped on to the boat, greatly relieved that she would reach a safe place.

On getting off the boat, Love met Knowledge. Puzzled, Love inquired, “Knowledge, do you know who so generously gave me a lift just when no one else wished to help?”

Knowledge smiled, “Oh, that was Time.”

“And why would Time stop to pick me and take me to safety?” Love wondered.

Knowledge smiled with deep wisdom and replied, “Because only Time knows your true greatness and what you are capable of. Only Love can bring peace and great happiness in this world.”

“The important message is that when we are prosperous, we overlook love. When we feel important, we forget love. Even in happiness and sorrow we forget love. Only with time do we realize the importance of love. Why wait that long? Why not make love a part of your life today?”

WHAT TO DO NOW?

Lisa, a fifteen-year-old who recently moved to a different state, is being seen today for the first time by a new physician for a well-child check. He has not yet received her medical records from her former doctor.
In the exam room, she tells her new physician that she is healthy and takes no medications, only vitamins. She says she is an honors student, swims, and plays the violin. When the physician asks whether she is sexually active, she says no, but admits that she is thinking about it because she is in love with a boy from her old school. The two have been dating for a year and have recently started talking about having sex. The physician asks if they have talked about birth control, too. Lisa says they have and tells him that she started taking birth control pills a few months ago. The physician mentions the necessity of using a condom as well to guard against sexually transmitted diseases, but Lisa replies that they are both virgins, so neither has to worry about that.
Lisa's physician briefly leaves the room to let her get undressed for the exam. In the hallway, he sees Lisa's parents, who have accompanied her to the clinic. They say they must speak to him immediately and in confidence. He is surprised, but shows them to his office. There, they tell him that Lisa has congenital HIV and has been taking HIV medications that were prescribed by her former pediatrician. They also tell him that she does not know this—they have told her the medications are vitamins.
Without mentioning anything that Lisa told him in confidence, the physician tells her parents that he thinks it's time they told her she has HIV. Her parents get very angry. They insist that Lisa is still a child, and there is no reason to tell her yet. The physician mentions Lisa's boyfriend and the length of their relationship. He reminds them that Lisa's boyfriend will be at risk if he and Lisa have sexual contact.
Lisa's parents say they know all about her boyfriend, but they insist the relationship is not mature enough for them to be thinking about sex—all they do is play video games together. They adamantly disagree with the physician's view that Lisa is old enough to know her HIV status and say they will sue him if he tells her without their permission.
What should Lisa's physician do?

LEARNING THROUGH THESE TEARS,,,,"SURVIVING A MED SCHOOL".

Remember when you were a premedical student in college? It seems like a century ago for many of us who have just completed the first year of medical school. It feels that way because our lives have changed dramatically. Normal life seems to have vanished, and 24 hours in a day are not enough to get through the enormous volumes of information that we are expected to learn for every exam. It seems virtually impossible. We barely have time to eat or sleep.
Medical school is not the end of the world. Take it from me, 2 students who spent most of their time in the stress out of your never ending exams. Do not let medicine define you; instead, you should tailor medicine to your lifestyle. Otherwise, you might become overwhelmed by the demands of your new life and lose the sense of why you chose medicine in the first place.
How do you survive medical school? From the beginning, time management must be a major priority. If you can manage your time successfully, you can still enjoy your life to a certain extent. Studying in med school is not the same as it was in college; this is a new world where you have to explore different techniques and find what works best for you. In medical school, it is all about studying smart, not studying hard. If you don't know this at the beginning, you will learn it the hard way. Take it from me or else u will learn it by your own experience after paying heavy prices for it.
Studying medicine is a long process and demands a great amount of discipline and sacrifice. But the reward is priceless. I hope that you chose medicine for the amazing field it is: the rich opportunities it provides for helping humans and the avenues it opens for making a difference in the world. The following are some of the most common pieces of advice i have collected:

1. Take care of yourself.
You may face long-term bad consequences to your health if you adopt bad behaviors. Do not deprive yourself of healthy, fresh food. Do not ruin your health by eating fast food and avoiding exercise. Always do at least 15-20 mins of exercise, it not only keeps you in good shape but it increases the endorphin levels in your blood and keeps your mind healthy and keeps you away from depression. Do not pull all-nighters and deprive your body and brain of sleep; the consequences are too severe for what may be only 15 minutes of productive studying. Your brain needs fresh food, water, fruits, and vegetables. Your body needs exercise and sleep.

2. Do not compete with your classmates or compare your grades with others. We all had to be competitive to get into medical school. Although many students still compete with their classmates, it will not make them better physicians. Getting a 95% on your pathology exam does not mean you will be a great pathologist or clinician. As soon as you walk out of your first exam, look around, and you will see people obsessing about what the right answer was for Question 13. It is easy to spot them. They will come to you and ask you if you put "C" for Question 84. Seriously! Avoid everyone after the exam, and make friends with those who share your philosophy. Everyone have their own goals and targets, set your own targets, don’t compare yourself with others. You are unique in this universe and no one is like you. Talk to people who motivate you and encourage you, at the of the college days you will find that those who make gossips and fun out of others dreams and ambitions did nothing in their life. And remember, “Self-confidence gives you the freedom to make mistakes and cope with failure without feeling that your world has come to an end or that you are a worthless person.”

3. Answer practice questions while you study.
  "Studying my notes 10 times is probably the best way to prepare for exams." Wrong! The only way to test your learning is to do practice questions. For example, after studying your pathology textbook, make sure you complete the questions at the end of each chapter. This will help solidify the concepts you just read. Studying the same thing repeatedly does not make you smarter, but getting a question wrong will teach you quite a bit. Professional educators will tell you that it is statistically proven that students who do more questions perform better on boards, and that the only time you should go back to the big books is when you consistently miss questions on a certain topic and the answer explanations are insufficient.

4. Study with groups.
  "I am going to study on my own because I don't need anyone's help." Wrong! Medicine is all about teamwork and sharing information. You have to be able to cooperate with others. Even when you apply for residency, it is important to keep this concept in mind. The moment the residency directors feel you will not be a good team player or that you might have "issues" with your colleagues, your application goes in the shredder. Find a small group of people who share the same healthy habits as you, meaning they like to exercise, they do not like to discuss grades, and they have a positive attitude. Once you find the right group, arrange to meet weekly for several hours to ask each other questions about concepts you do not understand. Even better, ask each other questions on little details you think your friends might have understood. Arrange for a review session the night before the exam for last-minute tweaking of your knowledge.


5. Take time to engage in stress-relieving activities. Every one of us is facing the same amount of stress, some people more than others. You might notice some students walk around with a frown, whereas others wear huge smiles. How is that possible if they are all facing the same pressure? Again, it is time management. If you have extra time, you are able to reduce stress. Spend time with friends, or do something on your own that makes you feel better, like going for a walk with someone who makes you feel better, with whom you can share your dreams and ambitions. Activities like exercise, yoga, listening to calm music, talking to your parents or praying -- there is something out there that makes you feel better. Find it and do it. Do not let the stress affect your studies, relationships and, most importantly, health.
6. Self analysis. 

 Always make a habit of analyzing your activities of the day before you go to bed. Analyze how productive was your day? Ask yourself whether you have given your best in everything what you have done today? Ask yourself whether you are satisfied with your productivity? Plan your next day in the night before you fall asleep. Fix targets for the coming morning; make a small planning for the next day’s jobs. “Remember one who fails to plan is planning to fail.” 

7. Dream big.

“All men dream: but not equally. Those who dream by night in the dusty recesses of their minds wake in the day to find that it was vanity: but the dreamers of the day are dangerous men, for they may act their dreams with open eyes, to make it possible.” No matter what you are, you never know your abilities and your potentials. Always keep high ambitions and start working for it from today, no matter how slow you walk, you will reach your goal one day .

Finally, and we cannot emphasize this enough; remember that we are joining a great profession. Be passionate about what you are learning! Medicine is a treasure and an art. As Henri Amiel said, "To me, the ideal doctor would be a man endowed with profound knowledge of life and of the soul, intuitively divining any suffering or disorder of whatever kind, and restoring peace by his mere presence."

....."THE FIRST RAIN & THE LAST LOVE"........

It was the first rain of the season when i met her, she catched my eyes in that busy out patient department. Dressed in complete black punjaabi dress with a beutiful smile on her face, a thin line of kaajal and a small black bindi in the centre of her forehead.
I was sitting in the corner most chair of the opd, the reason being that i will face least number of patients. she walked straight towards me & sat on the chair next to me. It was the first rain of the season and the sound of the raindrops falling on the banana leaves was creating an aura within me.
she started ......"good morning sir".
i said.........." how can i help you young lady"?
she said ...."i am having a severe headache & progressive weakness in my right arm & rt. leg since 15 days.
on investigating we found a tumor in the left cerebral cortex.Three days have passed and we had planned to operate on her, i did not had the guts to tell her from wht disease she is suffering from. A number of questions were running through my mind.She was only 22, why she has to suffer from such a deadly tumor? Another question which was worrying me was wether she wil recover fully after surgery or not. Finally i gathered some courage and told her that we will be operating on her for a small tumor inside her head & that she will be allright after the surgery.
she asked......."what if the surgery fail?..........."will i die or will i have to live with some disability??
Finally the day arived and operated her, it took 8 hours to completely remove the tumor, unfortunately she could not regain her consciousness fully, leaving her and her family with little hope of recovery, due to some anaesthetic complication, probabaly hypoxic brain injury due to such a long duration of surgery.she was transfered to "surgical icu(SICU)" with a endotracheal tube.Rupali was in SICU in bed no -9 with all kind of tubings, and chest leads.

she was semiconscious, pale due to blood lose, weak and her long hairs were already chopped off before surgery. she could not speak,her vision had decreased and she was not able to identify familiar faces.

But beyond all this i saw a quite pretty innocent face. I went into the flashback when i first saw her in the opd with a background music of raindrops falling over the banana tree.
I walked close to her, i tried to talk to her but she could not speak. I gave her a peice of paper and a pen and asked her .."can i do something for you"?
she nodded her head and blinked her eyes.I brought the paper close to her and she wrote with a trembling hand ........"C-L-A-S-S-M-A-T-E"...........,,,,,i was confused, she continued......................."A- B-O-Y"........"M-I-S-S-H-I-M-A-L-O-T"..........

Here was a 20 something girl who might live for few more days, and she wanted to see her boyfriend.I did not knew what to do or say, for one moment i forgot that i was in the team of surgeons who operated her. Are we responsiblt for her condition ? many thoughts ran through my mind.

A senior of mine who witnessed all this pulled me aside and said........."look dilip, i understand that it may be difficult for you to get used to all this, but this the reality.Dont get emotional, u just cant fulfill every patients trivial need"

I knew that my senior wanted to give me some comfort, but there was something that was pushing me from inside.That day i could not work.The surgeon within me was trying very hard to kill the dilip inside me.I went home , thinking about all this. I was angry on myself, that i could have done something for her, i could have asked her to write the phone number so that i could call him and let her talk.

Next morning, after a worried and sleepless night, i went to SICU to see her.
i asked........" do you have his phone number?"........she blinked her eyes. she started to write the number, her hand writing was unclear and incomprhensible. With extreme difficulty and a after a number of permutation & combination i got the correct number. I read out the number and she again blinked her eyes and gave me a "thumbs-up".

I called up the number, but no one answered. I told her that i will again call up in the evening and let you know tomorrow, she again blinked her eyes and gave me a thumbs up.

It was a huge challange for me, i was a surgery resident i knew how to take history, i know how to examine & operate, but calling the boyfriend of a patient who might pass away any time? I was not trained to do so. what will i tell if he asks me how she is? Should i tell him that his girllfriend could not talk & cannot identify familiar faces.Should i tell him that she might pass away any time?

The more i was thinking about her the more i was regreting that why i ever got involved in her. But ultimately i had given my words, I had made a promise, i must keep it no matter what happens.

I dialled the number, he picked up the call................."hello he said".....
i started....." i am a resident in neurosurgery, are you rupali's friend ?
after a silence and with a puzzeled cold voice he answered..." yes i am"......."how is she"? his voice seemed cold and almost disinterested. I thought that i was wasting my time and effort.

I said...."she is operated two days back,now she cannot talk, cannot see properly & she might pass away anytime. she wanted me to call you & see if you are all right ? i continued in a awkward tone.

ummmmm....he uttered with a pause., ........"tell her that i am fine & ask her to take more rest"....thank you very much. i hung up the phone.

I was thinking ...does he feels the same as she feels? Does he not care about her ? Is there something which kept him from showing his emotions? does he loves rupali? what if rupali has never expressed herself? I started my dinner in my room, didnt go to mess. My mind was still absorbed with thier thoughts.
About after 15 mins my phone rang. It was his number. This time his tone was totally diferent, i could feel that he really cared for her, but unfortunately i was not in the hospital. It was already 10.00 PM, i said....." will it be okay to talk after 15 mins"?
.....yes.... he said.

Our hospital was 5 mins drive from my hostle, i went straight into the SICU , i was in my night dress, a small half pant and a t-shirt with a lakhani chappal. My seniors and the nursing staff was surprised to see me in such a ..."AVATAAR" in the hospital. Everyone was staring at me as if i have done a crime, may be they were thinking that i have gone crazy.

I was near the bed no-9 in SICU, her condition had deteriorated. she had developed pneumonia and she was less alert than she was in the morning.
...... "can you hear me".....? i asked. She opened her eyes slightly and blinked once.... i continued..." i called him and told him that you are missing him".....i said.
....." do you want to talk to him?".....i continued.
she again nodded her head.
..." do you want me to call him now?...i continued.

I could not exactly tell if she responded to me, but i decided to call him anyways. He picked up the phone, i told him that i am standing few meters away from her and that she cannot talk but she can hear you.
All the nusing staff and few seniors were watching all these, may be i was doing something which no surgery resident will ever do,may be i was wrong for few seniors. But a promise is a promise.

I brought the phone next to her ears.............." she trembeled at sound of his voice", after few minutes she made some noice which i colud not understand. i held the phone close to her ears untill she began waving her hands. I looked at my cell & saw that the call was over.

Although she was not able to smile, but i could feel that she was very happy, she blinked her eyes twice & tried to give me a" thumbs up" but failed. I hold her hand, it was cold & cyanosed(blue) due to falling oxygen saturation in the blood. she had started to develop respirotary failure due to pnuemonia.

I stood near her bed for few minutes. Remembering the first rain of the season. Few drops of tear rolled out of my eyes and i ran out of the SICU.
By then it had started raining very heavily. I reached hostle fully soaked in
rain water. As i reached my room (no 11) in the pg block, i got a message from the boy.
The message said........."I DONT KNOW YOUR NAME,BUT I REALLY APPRECIATE YOUR GESTURE. IF I EVER GOT AN OPPORTUNITY I WILL THANK YOU PERSONALLY. PLEASE TELL HER TO TAKE MORE REST, I AM WAITING FOR HER TO COME BACK. PLEASE TELL HER NOT TO FORGET THE THINGS I TOLD HER. THANK YOU FOR HELPING US." ......

That night i could not sleep,any how i wanted her to survive. Next morning i went to see her in the SICU.......bed number-9 was vacant, nursing staff told me that she passed away at 5.00 am due to respiratory failure & hypoxic brain injurry.

I did not know what to feel, i was speechless. I was overwhelmed with emotions, i knew that being a surgeon meant not being overtly involved with patients. But sometimes it is very difficult to draw a line when you are facing issued of
'LOVE & DEATH".

I KNEW THAT I DID THE RIGHT THING BY EXTENDING MY ARMS A LITTLE BIT.

ARE YOU SUFFERING FROM THIS DISEASE?

1. Do you think that you have a very bad memory and you frequently forget whatever you read?

2.Do you sometimes feel that a simple headache which you sometimes suffer from is due to a brain tumor?

if your answer is yes for any of the above question, you are probably suffering from a disease called ...."medical student syndrome"

Have you ever discovered a "lump" on your neck or groin after reading about Hodgkin's lymphoma? Or have you ever experienced a pulsatin g headache & nausea suddenly after reading the chapter on brain tumors?

In retrospect, I could pinpoint the exact moment when my medical student syndrome began: it was when i was in 2nd year MS:right after reading about the various symptoms of brain tumors. During the lecture I learnt that there are two pathognomic features of brain tumors one is early morning headach & projectile vomitting. Right after that lecture I began to feel the headache right around my occiput and i started to worry that I have a tumor inside my brain .But there was no vomitting, so i was convinced that it was just a simple headache. But to my surprise next morning i had few episodes of vomitting in early motning. Now i was sure that a tumor is for sure growing very rapidly in my head.

I first went to the staff clinic at my hospital. After examining my fundus the doctor said there is probably nothing to worry, Unconvinced I went to a radiologist at my hospital. He did an CTscan for me. He was also quite convinced I didn't have anything that looked suspicious on the scan. Still unconvinced i got a MRI done, my frined who was doing PG in radiology told me that although there is nothing abnormal in the scan, a better opinion by a senior radiologist should be sought, which is possible only in the morning since it was almost 9 pm.Then I began running through a list of differential diagnoses of deadly diseases and the next serious disease coming to my mind was migrain. Worst thing which happened to me that night was that i could not sleep even a single minute and i searched every possible textbook and internet about the causes of headache and vomitting. The concequence of deprived sleep was nothing but a more severe headache, as if some one is hammering my head, along with headache i also developed vomitting due to sever gastritis. Now i was sure that there is tumor in my brain for sure which my friend could not figure out. I was deperately waiting for the senior radiologist to come so that he could tell me how life expectancy i have. Finally the radiologist arrived and he assured me that there is nothing to worry. Still unconvinced i went to a neurosurgeon to show the scan, he too assured me that there is nothing to worry and the scan is absolutely normal.

This whole process bothered me for about a month but I was anxious for a few more months. My anxiety went down finally when I realized that it was a t.ension headache. A friend of mine later sent me a link about the medical student syndrome. which was exactly the same as my case. At that point, I realized there was nothing wrong with my body and all that fear and irrational behavior was explainable.

I think "medical student syndrome" is a natural reaction as we are confronted with the shocking reality of the multitude of diseases that could happen to the human body. Different medical students react to this confrontation differently. Some are not affected at all but I think a small number like me went through this "syndrome" in a more severe form. If I have learnt anything from this experience it would be the cliched notion "common diseases occur commonly." .

IS OUR HAPPINESS CONDITIONAL?????STORY OF A MEDICAL STUDENT

Is our happiness conditional? Do we delay the experience of feeling happy until we have achieved the next step? At one time happiness was conditional on getting into medical school, next was passing the exams, then it is graduating medical school and finally when we become an attending...then we will be happy. What is wrong with being happy now in the role we fill today?

Srikumar Rao's recent discourse, "Plug Into Your Hard Wired Happiness," really drives home the point that we can enjoy life as it is without setting emotional pleasure aside to await a measurable outcome. He encourages investing not only in the outcome, but also in the process. Unfortunately, we are focused too often on the end goal without seeing the smaller steps before us, whether we fail or succeed.

This principle can be easily applied to life as a medical student. We strive every day to choose the right answers on exams, please our clinical professors, and learn extensive amounts of information for future use. There will be many times when we fall short of an errorless performance. If we recognize the role we are playing now as students, we will make the progress needed to obtain the final outcome we all had in mind at the beginning. Invest in the process and enjoy the journey, it is just as important as the end product.

I love being a medical student. It pushes me to explore my interpersonal, critical thinking, and knowledge based skills. I have made my fair share of mistakes on exams and with my clinical preceptors. Like a child experiencing something for the first time, it is still a wonderful exploration of who I am and who I want to be, despite the difficulties. Don't wait until the end to experience happiness; you might just put it off again. Find ways to be happy every day, even when the going gets tough.

STORY OF SONA

Doctor saheb 1 mahine se saas phool rahi hain….” A middle-aged voice caught my attention on a busy OPD day consisting of mainly patients with nonspecific symptoms..till then not quite a happening day..I turned around to find a village-woman dressed in a typical malwa attire,slender built,pointed chin.. ugly features…”Bacchi bahut bimar hain”…I turned around to find a small girl standing right beside her.. small than her age, looking obvious sick…

I asked her the history,the usual stuff examination & all …. Cardiovascular exam. Positive for a Mid-diastolic murmur.& signs of congestive Heart failure.. “Rheumatic Heart Disease.” I muttered to myself….The girl was not very communicative..Mother was doing the talking on her behalf..I said ”Isko to Bharti hona padega.” i.e she needs an admission & further evaluation.. The lady’s face saddened .she said she had come 3 days back & were also advised the same for admission.I scolded her then why did’nt she got admitted on that day……She said that “kya kare Doctorsaheb, bharti hone ke liye paise nahi the..Jugadkar aaj aaye hu.” Considering that admission to the wards cost around Rs.25 admission fees & nominal 10-20 Rs. Per day for food etc. she took around 3 days to arrange for them, I at once got a overview of her financial status….. I enquired abt her family..The lady had 6 offsprings & sona was youngest among them ..2 of her sons left home & were lost. Her husband died 3 years back…so It was a Hand-to-mouth state of her family…….. 2 of her boys work as a Labourer & ran the family.





“Severe Mitral Stenosis Mitral valve area 0.5 cm .square,severe Pulmonary Hypertension ( PA pressure 100 mmHg),severe TR, minimal MR.” Ah! Our Professor of Cardiology exclaimed….. I bet she is going to require a Balloon Mitral Valvotomy….. ….. Dr.kundan where are you lost in thoughts??? I suddenly jolted from my thoughts…. Plz. Take down the ECHO report of the girl..I relpied “yes sir…..”

Mind kept of thinking abt the girl…How can god be so cruel to a 14 yr old child….?? Severe MS Rhematic heart Disease… the valve of her heart is abnormally narrowed i.e stenosed ,Hampering the Blood supply to her heart…

Where was I as a 14 year old… Happy in my home getting the best of facilities ,enjoying the best of my health……..

Somehow the innocence on the girls face was disturbing…. How am I going to explain to the girl’s mother abt her condition..How am I to face her on my daily rounds?? Where on earth would she bring the 50,000 for her operation???



There are schemes runned by gov.t for the poor …Below poverty line Card Holders.. so that they can get operated / treated..Luckily we could manage to obtain a yellow below poverty card from sona’s home.. But as with any other Gov.t schemes there is a significant delay/Paperwork involved..2-3 mths ..I guessed ..

Till then will sona stay in the Hospital?? Will her mother have such patience… well considering the Fate of a girl child in India, I won’t be surprised if her mother accepts her daughter’s Disease as part of the family’s Misfortune & leave her to fate… take her home without waiting for the govt. help…..We know of SO many SOna’s being lost this way…………………………….

Well for now everyday I feel relieved to find Sona on Bed no. 16 in our female medicine ward 29.. But who knows this Hope may be short-lived…………………………………………………………………..