Thursday, July 21, 2011

to be a patient

It’s hard to be a good patient. “Strength is important, so is health and hence the rest,” I say to patients, some of whom are workers working for daily wages hence can’t tolerate or afford the ‘rest from work’… some of them still co operate, some get admitted and take complete bed rest, some have to go for ICU, and they do go there… I’m a medical student, an intern, and at least two three beds in ICU here are always reserved for people like me, and I don’t require to be in a critical health condition to get admitted in the ICU.

… But what happens when I myself get ill is contradictory to the situation; I’m the most unruly of the patients I’ve ever met. I take medications whenever I feel need of them (especially the pain killers- even though I know that THEY ARE NOT GOOD FOR HEALTH), then totally forget about them (something like the antibiotics or the vitamins). I like to stay away from other doctors (I don’t trust them), I never consult seniors about my own health, and I never take what it’s called as rest. One day absence from work for me accounts for one day extension of my internship; and I want to reach my destination as soon as possible…

I keep on working, doing job of an intern physician even though my capacities are seriously impaired, even though I’ve to struggle with my lower cognition levels and headache due to fever for doing tasks like measuring the blood pressure or inserting branulas or taking blood samples or taking the patients to the CT scanners… or even taking histories and advising treatments (that includes rest)… but doing tasks requiring still more cognition like reading understanding, working at night without sleeping becomes just impossible, I find myself sleeping miserably when I want to write or to do something meaningful for my goal of life. Still no one understands and even imagines that I might be suffering from something called as deranged health condition. And I get bombarded by duties of patients one after another.

Am I a bad doctor? I don’t think so, I never do injustice to patients… and I try my best to protect my health from being deranged, never even taste bad foods never go for addicting chemicals and try to give time for my body for doing exercise; maybe that’s the reason I’m able to work in conditions compelling others to lay helplessly in bed. But to do tasks those I love, I need to be healthier………….. but it’s hard to be a good patient!

Sunday, July 17, 2011

being a human

Life is like some journey from birth to death, some people are lucky to choose what type of journey they want… they may take it like some entertaining trip or an adventurous tour or like some mission to discover something or to help someone, or like some routine dull rush of everyday life where more than the journey something else is important! But there are some people for whom life is nothing other than an everyday struggle to survive… when their existence is in question, creativity is a far away thing… they never get a chance to get their neocortex used and developed. They too have a journey of life like us, but it’s restricted, instead of enjoying and learning from new experiences they’ve to turn their back to them and to ignore them to conserve their energy only to have their life sustained till death arrives. They get tired while attempting to fulfill their basic needs to the extent that they don’t even think of having big goals and planning to achieve them…

We don’t wake up worrying about what to eat and where to sleep; instead our worries are totally different. We’re among the lucky ones, who’ve got education and some safety… we’ve got a chance of using our parts of brains those are exclusive to humans; we can exploit being a human, and we have to, I feel. And instead of turning ourselves into some highly paid robot, we’ve to preserve our humanness and have to try to give the world something as a thanksgiving for this rare chance it gave to us of being and living like a human, and have to work to make this world a better place so that each and every human will get a chance to live like a human…

Friday, July 15, 2011

diary of an intern

I wonder sometimes what’s in the alcohol that makes some person an honest slave of it…. an honest consumer who’s almost never honest about his (yes I see almost all males) drinking habit. I know the neuroscience of addiction, I’ve read it, and I also have read that it uses the reward centre of brain- the same that gets activated when we feel happy and makes us to crave for something, the same that gets activated when we fall in love with someone or something, the same that makes us to feel the bliss. Then why people go for alcohol when they can get the same joy from other things like being addicted to some good habit or to some good person? Are they all depressed, or ignorant about the effects of that drug which can damage anything right from the guts, the liver, the brain to the DNA? Is it peer pressure, or pressure from the stress of life, or a silent slow way of doing suicide? Though ignorance can explain alcohol addiction in illiterates, I wonder why people who themselves are doctors also go for it. I’ve read that alcohol forms long term memories and associate the positive feelings of the environment of consuming alcohol- like a group of intoxicated funny talking friends, high fat foods which themselves stimulate the reward centre, the music of pubs to the alcohol and makes the person a fan of it. But our brains are not dead hard wired things and we can change the programming whenever we want, at least theoretically… long term potentiation isn’t a permanent thing. But then why it doesn’t happen in reality, why people continue to go for it again and again even when they know that alcohol is dragging them to death, when they get complications like cirrhosis, ascites, fatty liver, alcohol induced dementia, tremors, anemia, gastritis, and even alcohol induced psychosis, when they have to get admitted in the hospital for these complications for number of times? Why do they go for it at first place, and why do they lack the willpower to fight against it when they become slave of it? I’ve seen people shouting for alcohol when they’re laying on the death bed constructed for them by alcohol only… and I wonder what would have happened if they had loved some person or cause to this extent…

It makes people to ‘see’ everyone as beautiful as their depressed brains can’t recognize the asymmetry of faces, people become more ‘adventurous’ or ‘helpful’ as the inhibition making them ‘shy’ from the prefrontal cortex is reduced… but these depressed adventurous brains are more prone to accidents which could be lethal to themselves or others…

mm… love also makes us to trust others more, to look at and concentrate at the positive things of others, but the causes are different… Is alcohol like love… no, love is totally harmless and alcohol is known to damage many things, we could treat alcoholics with love, but in their case they’re in love with alcohol only… they value alcohol more than any other person or activity in their life, even more than themselves. Whenever they’re happy they celebrate it with alcohol, they look at alcohol for washing away their tragedies and stresses, they go for alcohol for entertainment when they feel bored… alcohol is everything for them, they don’t need family and friends to the extent they need alcohol. Some think of themselves as dedicated to their families, they never drink at home, but for them joy and family are two distinct things… and the ‘joy’ is alcohol.

I’m writing this because I’m really horrified to see the number and severity of patients who get admitted repeatedly only for the sake of alcohol. I encounter poor people mainly who’re illiterate or semi illiterate or maybe educated. They’re mainly males of varying ages, of varying stresses and family backgrounds… till date I’ve seen only one woman who had got admitted for alcohol induced psychosis and she had told that she learned drinking to accompany her beloved drunkard husband.

Alcohol isn’t a small thing to ignore; it’s at the top of list of drugs causing harms to human lives, and still people adore it! I don’t really know why people take everything lightly, including their health, their relationships and their lives? I don’t know why they succumb for drugs like this, and will it be ‘possible’ to make the ‘possible’ thing of changing their synaptic structures possible? I can’t keep guessing now… because I’ve to go, I’ve to tap the ascetic fluid of a dying chronic alcoholic patient.

Sunday, July 10, 2011

diary of an intern

The more you crave for something the more difficult it appears to achieve it, I feel sometimes; but we still keep on craving thinking that at least at some time we’ll get at least a trace of it… I dream of a heavenly world, happy humankind and me a tiny neuroscientist working to make it happier… but what I encounter everyday is a series of extreme tragedies sadder than even those of Shakespeare’s, violence enough to evoke disgust even in medieval soldiers, heights of carelessness, drug seeking behavior putting the whole families at risk of extinction, and me a helpless small intern physician doing my job of internship, preparing for documents of internship completion, worrying whether I will get some extension, trying to concentrate on the necessities for getting a good PhD position, making some vague efforts of reassuring the patients and of reassuring myself that one day or other the situation will be better!

I don’t know where to start and how… I don’t know whether dreaming what I dream is ‘normal’ psychologically or whether I’m suffering from some ‘disorder’. But I dream, truly, that too while awake, and I crave for making them to come true, and I try for them at my best… but this my best is not enough, I feel always.

“Why my right hand is not moving doctor, I try but I can’t move it? I can’t work without it, I can’t eat… there’s no one to look after me, I’ll lose my job… please do something, do anything, leave my leg paralyzed, but make my hand as it was… give me some medicine,” a fifty some man begs me when I reach him to insert branula and to take blood samples. I tell him to practice moving his hand, but who’s there to motivate him, who’s there to give him physiotherapy… is there any drug to reverse damage occurred due to stroke? I can’t wait there with him, I’ve to move on to the next patient, there are fifteen admissions today and my job is to send each investigation of every patient before closure of the labs, to bring the x- ray films, to do other irrelevant meaningless official things an intern has to do…

Not all stroke patients are old, not all hypertensive persons are above forty, and not all patients who visit hypertension OPD regularly have their blood pressure under control… they seem to be waiting for a stroke or heart attack or renal failure. There is a tendency to write the blood pressure as 120/ 80 mm of Hg to avoid complications, no matter what the real blood pressure is. And advices about good diet and exercise are neither given nor taken seriously… even the doctors are victims of junk food and lack of exercise leading to increased girth of abdomen and decreased diameter and elasticity of blood vessels. Some patients are also so horrible that they come to visit the OPD fully drunk, with their exhaled air containing nauseating quantity of alcohol. Conditions like dementia, Alzheimer’s, and even Parkinsonism are not big diseases here, they’re mere byproducts of aging… and people with these conditions are admitted very rarely only and only if there is exam of students that too as ‘exam cases’! Everything is as if superficial, lacking depth, being done just for showing or for legal procedures… nothing including health is taken seriously; there is no question of caring for the health of others. No one has time for useless things like sympathy, initiative and even curiosity… I guess if classical case of H. M. would have happened here, he would have died in the darkness even without getting noticed!

I fear I’ll get blind if I don’t get any light of hope… I fear my curiosity will die and I’ll become an input output machine examining predefined things called patients. I feel smothered many times and I think of giving up… I think of going far away from everything and never to return, I think of finding peace within myself like the monks, by doing meditation and by increasing the size of the brain’s reward center or of becoming mad or drugged to live permanently in my dream ignoring the horrid real situation… I can do that, that’s not difficult, but that’s not challenging either… I want to see my dream as a happening without altering my consciousness. I want to bet my life, no matter how hard it seems even to survive the real situation. I’ll keep on trying and searching for hope… maybe on some blessed day in the future I’ll get somewhat closer to my dream.