Tuesday, November 16, 2010

Of clinics and consultants

UPDATE:  Hi ! I'm moving to a new address https://emmanuellazarus.wordpress.com/
See you there!

Clinics! Post boring lecture, during which most of us hardly realize that we're not in bed still, comes clinics. Lets see... empty cubicle smelling of sterilium: Enter tired junior consultant. Enter patient with extended family. Enter mro counter guy with 50 new charts. Enter nurse with 16 slips to sign. Enter dimwit intern, smiling sheepishly, 2 hours late. Enter 15 bored, very sleepy, disoriented, highly unmotivated med students, suffering from acute lecture induced encephalopathy. The expression of the consultant's face has gone from tired to suprised to shocked to absolutely stumped, as he sees them take charge of his opd, armed with army rucksack size bags. Somehow, by some cruel twist of fate, this entire motley crew find seats, 5 on the bed, 2 in the patients chair, 2 on the stepping stool, and the rest stand there, breathing down the neck of the ill-fated doc. So to sum things up, there are roughly 27 people, in an already cramped cubicle that's smaller than a men's hostel boug. Fifteen pairs of eyes look expectantly at the consultant. The tension in the room mounts, and the beleagured doc finally speaks up.

"Are you posted with us?"

Gosh. What a question. Why the hell else would they be there? All the same, just to humor this admittedly pointless query, there sounds a unison of assent.

"Yes sir."

The feel of grimy plastic on his hand snaps him back to his senses.
The patient is fiddling with his mri report, and trying to get his attention by tapping his hand with it,which of course, the doc doesn't want to see. At this point, a head pokes through the curtain.

"You called? " it asks.

By now more heads have somehow materialized at the door, all asking if they've been called. Tired consultant randomly points to one of the heads.

"Full history, examination. 5 minutes."

Head A looks triumphantly at the other heads. He thinks he's being given special treatment, having an entire panel of doctors examine him.
Poor deluded chap.
The entire group stands blinking, waiting for an epiphany. The air is tense, and all breaths are held. They all know from experience, that the first person to make a move will be the one to work up the patient and present- and they stand frozen- darting furtive glances at each other. The unmentionable words are spoken with every look: that raised eyebrow means

" You're working him up, aren't you? ",
or the shake of a head may mean

"well, what the hell are you waiting for? Work him up! "
Others have more subtle techniques.

"Dude, don't worry mach. I'll help you work him up da."

or

"Stud bomb! Macha, i'll get you the history sheet and bp apparatus."
(Note the greater frequency of machas and dudes and affirmations of the other guys intelligence in the sentence.) An effective method to avoid being picked on is to look lost in thought, or at your mobile, and make noncommittal grunts that could be taken to mean anything from

"Don't look at me" to "How dare you ask me!"
There is also, the group effort. When i say group effort, i mean that the entire group somehow disappears for half and hour, leaving behind one or two unfortunate souls who have absolutely no choice but to work up the patient out of sheer lack of options, frustration and fear. The rest of them will, of course, turn up 5 minutes before clinics starts, and assume an air of great knowledgeability and understanding into the details of the history.
Back to our cubicle. The air stirs, the curtain moves and the whole crowd trickles out, patient standing completely lost. One of us ventures forward- "tamil maloom?" Note. By this time negotiations have already started.

"I've worked up yesterday da."

"You said you'd work up today-"

The suitable response to this accusation is to either vehemently deny everything, or to grin ear to ear and make a rotary motions with your opened hand.
(If you got that, then it's your fault.)
Soon the argument includes women's rights and the right to freedom, not to mention, the right to swear, and the right to play a spoilt diva having a tantrum.
Two heated exchanges, four tantrums and fifteen minutes later, they troop out into the nearest cubicle with the patient, his chart, his files and his interpreter.

Gotta go now. Clinics have started. Will continue post again after lunch. Cheers.

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