Mono-phonic Thinking

Another one from Dr. N.

After examining a case of suspected infectious mononucleosis, Dr. N and the student on call were discussing the diagnosis and management.

Dr.N: "The heterophile test might not always be positive in the early course of the disease.. So, what other test can you use for diagnosis?"

Student: "Give the patient amoxicillin. And watch if he develops a rash.."

(This one cracked me up. Believe me, it might sound like me, but I wasn't the student here!)

Test-imony

Here's a true story I heard the other day from Dr. N while I was ordering labs for what looked like a girl with a sexually transmitted disease.

Dr. N is a Pediatrician, practicing in a small town in USA.

[Writing the anecdote in her words.]

I was working in the clinic one day, when I saw a 8 year old girl with urinary problems. I ordered labs on her. When her labs came back, I was shocked to see Trichomonas in he urine. Now, with a STD in such a young child, it automatically becomes a case of child-abuse. I had to call the Child Protection Services. But before I did that, I had to inform the mother, and try to find out the culprit. This woman was a single mom.

Dr. N: "Mrs. So&So, does the child go to stay with her father sometimes?"

Mrs. So&So: "She's doesn't stay with him. Why she hasn't met him in a while"

Dr. N: "Do you have a boyfriend?"

Mrs. So&So: "Not really, why?"

Dr. N: "Well we did some tests on her, and her lab results show that she has trichomoniasis, a STD. We suspect that your child is being sexually abused, and so I'm going to call the CPS."

Mrs. So&So: " No it can't be.. "

Dr. N: "Well, her urine culture results are right there.."

Mrs. So&So: "Ohh.. then she doesn't have the disease.."

*goes crimson red*

Dr. N: "Wha..??"

Mrs. So&So: "Well, yesterday when I took her for giving the specimen, I took her to the restroom. I waited and waited and waited... but she wouldn't pee. So I just took some of my own pee, and sent it.."

Dr. N: "Well in that case, I suggest you set up an appointment with *your* doctor as soon as possible! You have a STD!"

Image: http://www.pasozyty.net.pl/rzesistek-pochwowy/

This Is Going To Hurt Just A Little Bit

Have not been in a very blogging mood for the past few weeks.

Today I somehow came across this poem that I had in class 7th English by Ogden Nash. It brought back memories of a lot of favorite poems and stories that we had in school.

So I have decided to write a series of posts with those select favorites.

Starting with the poem I came across today. "This is going to hurt just a littile bit".

The poem very humorously describes a guy sitting in the dentist's chair, and the agony he has to endure.

One thing I like less than most things is sitting in a dentist chair with my mouth wide open.
And that I will never have to do it again is a hope that I am against hope hopen.

Because some tortures are physical and some are mental,
But the one that is both is dental.
It is hard to be self-possessed
With your jaw digging into your chest.

So hard to retain your calm
When your fingernails are making serious alterations in your life line or love line or some other important line in your palm;

So hard to give your usual effect of cheery benignity
When you know your position is one of the two or three in life most lacking in dignity.

And your mouth is like a section of road that is being worked on.
And it is all cluttered up with stone crushers and concrete mixers and drills and steam rollers and there isn’t a nerve in your head that you aren’t being irked on.

Oh, some people are unfortunate enough to be strung up by thumbs.
And others have things done to their gums,
And your teeth are supposed to be being polished,
But you have reason to believe they are being demolished.

And the circumstance that adds most to your terror
Is that it’s all done with a mirror,
Because the dentist may be a bear, or as the Romans used to say, only they were referring to a feminine bear when they said it, an ursa,
But all the same how can you be sure when he takes his crowbar in one hand and mirror in the other he won’t get mixed up, the way you do when you try to tie a bow tie with the aid of a mirror, and forget that left is right and vice versa?

And then at last he says That will be all; but it isn’t because he then coats your mouth from cellar to roof
With something that I suspect is generally used to put a shine on a horse’s hoof.

And you totter to your feet and think. Well it’s all over now and afterall it was only this once.
And he says come back in three monce.

And this, O Fate, is I think the most vicious circle that thou ever sentest,
That Man has to go continually to the dentist to keep his teeth in good condition
when the chief reason he wants his teeth in good condition
is so that he won’t have to go to the dentist.

PS: I have copied the poem from someone else's blog in good faith. Let me know if there are any copyright issues.

Comics!!

Two web comics that I'm following these days.

#1. My Cardboard Life: Amazingly cute and innovative idea this! Read the adventures of Colin (the cardboard guy) and Pauline (the paper girl).

I just love the expressions on them!!

#2. Agent- X comics: Created by Agent-X (doh!).. you can enjoy these comics only if you are into social media.

If you use twitter and facebook and the internet in general, then you'll love this series too.

Thank you internet for access to such lovely stuff.

Cheers!!

PS: Also reading the good ol' regular stuff like C&H and Animal Crackers, at GoComics. They have a huge collection!! =)

Annd score!!

Yes. Its been twenty one days since that fateful day in October.
Had been waiting anxiously for my score sice the past two weeks, and it arrived fifteen minutes before the scheduled time.

I got that elusive 99.

Happiness.

Yay! Yay!

The past three weeks have been hell emotionally.

I've cried over wrong answers.

Brooded over the difficuilt questions.

Rationalised some ethics questions.

Decided on alternate career options.

And what not!*

I wish the NBME people would post the scores earlier. Whoever heard of the scores of an online exam delayed by atleast three weeks. (Even the state Pre-PG exams results are faster!- However crappy the quality of questions might be! :p) But seriously, some of the questions were maddening. Have never come across such questions, ever!

And even more frustrating was that I remembered a lot of them post-exam!

And now after the results, I feel I could've done a tad better had I not taken the exam as the 'most-important-exam-of-my-life'.

The exam period was spent in extremes. At one hand I was anxious during the early blocks. Lost confidence in the middle. And became complacent in the end-- just wanted to get over with it.

Anyway,

All that is past now.

With a good score, I can hapily leave Step1 behind and move on.

Bring on the next step!!

*All my apologies to Papa, Ritz, D, Kau, Navy, Avi, AnkC, Dibs and others who have had to deal with my depressed mood the past three weeks. I still blame the NBME for the tough test!

PTSD

The exam I'd been dreading the past few months is over!

Yes. Done with it.

And now I'm scared shit about the results.

So we won't talk about that anymore.

As for my life, well, I've been just relaxing since the past few days. Of course, its difficuilt to have too much fun when all of your friends are studying for one exam or the other. So its been mostly me, watching a lot of movies and just surfing the net. Haven't even started on the TV binge yet.

Which reminds me, why is it that when you have an exam coming up, you make lists of all these wonderful things you'll do once it is over, but as soon as, the beast has passed, you just lose interest!

Before the exam, I had to restrain myself from spending hours reading blogs and articles, but post-exam... ehh...nothing! (In fact today is the first time I returned to even my blog, after four full days of doing nothing. So have a lot of catching up to do here.. esp in terms of reading.)

I had this whole list of things I wanted to watch/read/do planned out, but ...nah..not anymore!

So maybe the things-to-do-post-exam are actually just defence mechanisms to distract me from the scary reality of the upcoming exam and loads of syllabus.

And another thing that I've noticed is that medical students are born to take exams.

We are programmed this way.

We crib, and we crib... starting months before the exam, but the when on the other side, there this feeling of actually being 'too free'. Every now and then I get this jolt in my tummy, reminding me that I've got to study.. and when I realise the fact that no, I really don't have to study at this point of time, I get a weird sense of apprehensiveness over the sheer unnaturality (if that's actually a word!) of the situation.

Ah well, I guess that's what Medicine is all about.

PS: Writing this post, has brought back those shivers over the thoughts of all the questions I got wrong. Sigh. *Do not in any way ask/tell/talk/mention my past exam. You are welcome to talk about yours*

PPS: Apparently I am incapable of writing about anything besides padhai (and cribbing about it!) these days. I'd started off with something else in mind (writing some sort of list maybe), but landed up ranting about the exam. Oh well.

Enough about me.

How have you been the past two months?

Cheers!

Arps

Happy Independence Day :)

A very Happy Independence Day to all!! :)

Today my favourite country in the whole wide world completes 62 years of Independence! Yay!!

On a more specific note, what I want to post today is one thing that has been bugging me a lot for the past few days...... actually ever since I came across the news of an increasing %age of seats reserved for a certain caste in the Rajasthan Pre-PG exam!

As if more than 50% reservation was not enough, they (read: the fools who run the Government and make decisions based solely on their vote banks!) decided to add another percentage for a 'backward' caste, and even for the economically backward 'sawarnas'!

That is what I call trying to appease EVERYONE!

When there was that countrywide cry over the caste-based reservation of seats in higher education, some intellectual people suggested that we sould do away with caste0based reservation, and have just seat reservation based on economial backwardness.

Okay, good idea.

But the whole idea was to do away with caste based reservation, and not add the economical clause to the ever increasing list of reserved categories!!!

While what our dear decision makers did was to add that clause to the reservation list too!

Bravo!

Speaking of Higher Education, here's a bit about the Pre-PG exam, from my PoV:

One major point that seems to have passed the notice of the Govt is, that the people who get the benefits of reservation in higher ed (eg: Pre PG exam, in our case) are actually the ones who have come in through a reserved seat already!!

So, technically they are at par with all other students, without any discrimination! They have the same teachers, same books , same lectures as the unreserved.

Then why the upperhand in further competitive exams? Aren't they able enough to compete on their own now?
This policy is just plain (for a lack of a better, more abusive word..) STUPID!!

What all this reservation has done is, bring about more and more discrimination amongst students..and a creation of groups based on caste. (seen it happen in my college atleast!)

What this is doing is making sure that more and more people who all their lives did not bother about the caste of a fellow, know what-surname-fits-what-group!

A person who uptil school did not know what the value of a surname is aside from being a means of identification of a person, now sees the surname first and then based on it, makes an opinion of the person.

And even if he doesn't, the results of competitive exams like Pre-PG sure work to create a rift!

This kind of discrimination and step-motherly treatment for the 'general castes' breeds frustration (Sure hurts when you see a person with much lower marks, get in through a position that you rightly deserved--just because they belong to a certain caste).

Personally speaking its definitely helping to promote brain-drain!!

XXX

In today's day and age, what we really need is freedom from this kind of policies!!

Happy Independence Day.

Do something good today.

:)

Blawgs!

Since I really don't have much to write just now, except for the fact that life's a mess with a load of studying and a should-be-there-but-is-still-non-existent-tension about the upcoming exam!!

(...err, I still get panic attacks and guilt trips from time to time! So I'll take these as good signs, and conclude that my conscience is not dead yet!)

Okay, not going to deviate from what I wanted to put in, in the post in the first place.

Here's the thing.

Decided to make a 'Blogs I Like' Hall of Fame sorta list, since I've come across some really good writings in the past few days.

Would definitely recommend them for a good read.

1. Dr. Grumpy's Blog: Friggin' hilarious!! Love the snippets form the neurologist's life. Hands down, the funniest blog I've come across!

2. Crowsciousness: Great read. This blogger has the ability to put into writing all that you think and feel.. and well, paints a picture with words.

3. (Shruti's new blog would go here-but since I don't rember the link..let's just leave it blank!): Well, she's my absolute favourite writer (.. after JKR!!)..and she knows it!

4. Twenty something going on Five: I actually just came across this one yesterday, and really liked it. Noting extraordinary, but me liked it a lot. So here goes. *BTW: just noticed that the blog name has 'quibbler' in it. Now I'm sure I've done good in putting it up! :D :D *

That's it for now.

Can't recall the others. Maybe link 'em up later.

Have fun reading.

-Arps

...And Then There Was Computer...

:D

Cheers,

-Arps

Occupational Exposure

Once again one of Pi's posts got me recollecting another one of my stories.

(This may not be exactly the same thing- themewise. But the context is the same--Med Students.)

------
A couple of days ago an intern (let's call him S) was assisting in a laceration repair in the Surgery Mini-Op Theatre (MOT, for us)
He was standing there, helping out the resident working on the wound. When all of a sudden there was a gush of blood and he felt a searing pain.
The resident had placed a scalpel cut on one of his fingers.
There was severe bleeding.

The scalpel had punctured through the gloves and cut over the PIP joint of one of his fingers.
While everyne rushed to help him out and bandage the wound, the bleeding continued for a whole fifteen minutes.
It stopped eventually.
He came back to the hostel.

After he was back and settled for once, did it dawn on him that he had been in contact with potentially contagious fluid.

He called up some friends to check-on what to do. He talked to some doctors.

He visited the hospital again to get details of the patient. But to his horror-it being a OPD patient, just the mention of the name and colony was found in the records.

Apparently, the patient was supposed to return three days later to get the stitches off.

He visited the ART incharge next.He was counselled and given a box of post-exposure prophylaxis, to be taken for about a month.
He starteed the meds, hoping that the patient would come back three days later for removal of stitches.

Three days later:
No sign of the patient. Apparently she decided to get the stitches removed someplace else!

Seven days later:
S stopped taking the meds coz of the horrible horrible side effects! Fever, abdominal pain, nausea, vomiting!
Twelve days later:
(ie today.)
S's absolutely fine just now. And I'm sincerely hoping it stays that way till an antibody test is done six months from now.

Things that I realised:
1. This entire episode, occured at a hospital full of doctors, residents and nurses. no one realised that it was a contact with potentially infectious fluid, and an assay of the patient was required.

(This was one case where the student at least bothered to go the ART centre and find out about the pros and cons of meds. There are hundreds of instances where the ever busy residents come in contact, and don't even bother to get the patient tested even though he's right there!!)

2. The concept of universal precautions- is not something that is very much followed here.

Heck, in the labour room, the residents have just one plastic apron to protect them from any kind of fluid. I've heard of instances where the resident came in contact with the patient's fluid in the form of spurts hitting the face and eyes!
(And oh, PPTCT is optional for the women!!)

3. Doctors in general, tend to consider such a contact as a minor thing, and therefore tend to give you an option to take meds or not.

(Maybe its because they've been in contact with blood and all kinds of fluids since eons, and nothing's ever happened to them!)

4. Being a medico/doctor does nothing to improve your compliance for meds.

Its always the side-effects that win in the end.

On a lighter note:

*Thanks to CartoonStock!