the brain and all its mystery!

My 5th term as a medicine resident, and my neurology rotation. Eager and excited i began two months ago, hoping to finally solve some of the mysteries that have so far always eluded me. But as i understand more, i also realise ,just how much we still dont know. The human brain is probably the most intricately designed circuit of all time! And the more we image , the more we biopsy, the more we study, we still so very often draw a blank, at what it is that has actually gone wrong.
And besides the neuropsychiatry component can never be ignored. A patient so often confuses you, and the most important, is to distinguish whether the complaints are organic or functional. Or simply put , whether his brain is conjuring them up or he actually has a disease to go with them.
The importance to be patient, understanding has never been more strongly impressed upon me. An important part of a neurological examination is history taking. A good detailed history, can be extremely helpful, and many a time extremely misleading. But that is where our skill as doctors comes into play, to separate and sieve through the mishmash of symptoms presented to us and figure what may be relevant and what may not.
And so as i learn and understand more, i also realise just how much i dont know.

Reason: A prayer

I vow today, never to accept any fact, opinion or thought without reason. Never to believe without questioning. Never to understand without asking why. I vow to always be true to reason. Always to give a thought, and figure it out myself, why this must be so. To adopt a more scientific approach to life and all its dealings. And I know that this in itself will be my big contribution to society. By not being another unthinking face in the crowd. Adopting the majority vote. Not believing or even imagining that there can be another way! A solution out of the ordinary. I will escape from all that is mundane, and strive to be extraordinary. To NOT fit in. To not mould myself into the existing forms, but find a new, individual one, that suits me. I will not be sorry for my strikingly different thoughts. I will stand by myself, even if no one else will. I will be who I am, and to do this I will accept myself, for myself.

dignity in death

Working in the ICU since a month now, and because where I work is a tertiary care center and we have a lot of referrals from other centers throughout the country and even outside. So we see a lot of patients in a terminally ill condition whose every bodily function is at the mercy of some machine, drug or intervention. They have a tube sticking into every orifice, every accessible vein punctured, and everything but their soul, laid bare for everyone to see, scrutinize, analyze, assess, monitor. We rack our brains and try to think of where the mystery lies, refusing to give up, or god forbid, should death and disease have their way. We refuse to accept defeat from these worthy adversaries. We refuse to believe that the medical advancements of our age are inadequate. And so on and so forth, we go on until sometimes there is no semblance of a human being, a dignified one, left. So I ask myself, have we robbed that patient of his chance of a dignified death? Would I, in my final hours, want to be laid bare like that? Would I want death to be a struggle till the end? Would I rather not pass on from life to death in a much more peaceful manner? Can we not draw a line where we should stop fighting? Its not about giving up. Its about accepting a natural force, which, try as we might, is STILL beyond our control.

Lessons to remember

1) never ASSUME anything
2)never take a patients symptoms lightly.

normalisation of my life.

so today i've had a regular day. 8 to 5, came from home, going home. then plans for a movie. listening to radio, and writing my blog on my way in the bus. will sleep in my own bed. and will repeat the same routine tomorrow. yea!!!!!! life is good! 

the helplessness of my profession.

>The last two months of my residency have opened my eyes to a new reality. Something which so far i have fought and denied. That medicine as we know it today, is still, even after our so called progRESS, IN MANY instances , is stiLL HELPLESS. THERE IS ONLY SO MUCH WE CAN DO FOR A PATIENT. WE EITHER JUST PROLONG THEIR SUFFERING OR MAKE THEM SPEND THEIR LAST FEW DAYS IN THE HOSPITAL WHEN THEY COULD HAVE BEEN AT HOME. WE GIVE THEM HOPE WHEN THERE IS NONE. WE MAKE THEM HOPE FOR A CURE, WHICH DOES NOT EXIST. WE GIVE THEM A LIFE, BUT AT WHAT COST. AT A FINANCIAL BURDEN, EMOTIONAL AND PHYSICAL TRAUMA WHICH NOT ONLY THEY BUT THEIR FAMILIES MUST BEAR. AND AT THE END OF ALL THIS WE STILL GLORIFY IN OUR ROLES AS DOCTORS, AS HEALERS, IN OUR PROFOUND KNOWLEDGE, IN OUR EXCLUSIVE COMMUNITY, WHICH NO ONE CAN ENTER. BUT REALLY DO WE LIVE UPTO IT. ARE WE HEALING? ARE WE CURING? OR WE ARE COMING IN THE WAY OF A NATURAL PROCESS, WHICH IF ALLOWED TO CARRY ON UNHINDERED MAY JUST CONTINUE AND TURN OUT FOR THE BEST. MAYBE WE ARE INTERFERING IN WAYS WHICH DONT ALWAYS LEAD TO THE BEST RESULT. MAYBE INTERVENTION IS NOT ALWAYS THE BEST ACTION. MAYBE WE NEED TO LEARN WHEN TO LET NATURE TAKE ITS COURSE. WHEN TO REALISE OUR INADEQUACIES AND LIMITATIONS, GRACEFULLY.

all things grey!

One thing i cant get over, is my fascination for all things grey. Not the colour literally, but the metaphoric meaning of it. In personalities of people especially. Whether its a movie or literary characters, i always enjoy them far more when they're not ALL good.

The reason this thought came to mind again is because I've been reading peter pan. And almost all the central characters have mixed shades in them. Except Wendy. She seems all nice. But that i feel reiterated what i have always believed in. No one, or almost no one ( the exceptions being few almost unreal people who are oh so nice and perrrfect) can be all good and nice, all the time. Everyone has some evil/ jealous/ wicked traits in them. Which emerge on certain occasions. Like we're all multi faceted, have multiple personalities, and they all rear their heads once in a while, but depending on which one is stronger, they may or may not manifest themselves.

I see myself struggling with mine ever so often. And i really have to fight on so many occasions, to keep the evil ones at bay. So i guess when i see so many similar examples around me in movies, books even, i feel reassures in a way. That i"m normal too. Or almost.