Tips for the new ones

Intern’s diary by Anedu

One of the most fascinating things about modern medicine must be the way investigations of various kinds, help in the diagnosis of diseases. When it comes to surgery, radiology helps the surgeon to “see” before he actually cuts something open. Work for the surgeon must have been unimaginably harder and riskier before the advent of radiology.

From the simple X-ray to the MRI, if there is something wrong that can be seen, most of the time it will be seen. But to see these things requires experience, and gladly I had progressed from someone who could see very little, to someone who could spot a few subtle changes. Believe me it’s a great feeling when you can!

Rarely, what the surgeon sees when he opens up is a bit different. It is only when this happens that one realizes how dependent we have become on technology. (And how much it still can improve) The news that the next intern list was going to get delayed was probably more disappointing to us than to those who were actually affected. The worst fear was that if they didn’t come, we may have to remain doing the house officers chores for more than our 12 months!

Here are a few words of advice for the new interns (whenever they come) that do the rounds when interns sit down for some light entertainment!

• In any patient management problem, there is only one cardinal rule- the consultant is always right and the intern is always wrong ( no matter what the textbook says)
• When a consultant makes mistakes they are not mistakes, they are the intern’s mistakes!
• Consultants were never interns at one point of time; they were always consultants.
• The things that frighten consultants most are legal cases, telephone calls in the night and crazy interns!
• Consultants can make jokes at the expense of others (which they will frequently do) but will croak if they hear a joke made at their expense (which is also frequently done in their absence!)

On a more serious note, documentation is a major part of the intern’s job. The diagnosis cards (the card that is given to in-ward patients when they leave hospital) serve as a vital source of patient information in our medical system. But these cards are written in English and thus mean very little to the patients themselves! This explains why so many cards get lost, soaked in water and eaten by insects!

Another odd document is the Bed Head Ticket (BHT). Every thing that is ever done for the patient is written on this. As they say in this age of litigation, it is not enough to treat the patient you must also treat the BHT. Most of what is written in this too remains unreadable to the patients.

The highly specialized state to which medicine has evolved is rather disconcerting for a young intern. There are so many specialties and subspecialties that in a tertiary care centre if you suffer from multiple ailments you are bound to do a bit of travelling being referred from one specialized ward to another. If you get into a peripheral hospital you stand the chance of being transferred to a tertiary care centre!This brings us to the question why medicine has stopped seeing people as a whole. We, it seems, are routinely taught to see things through the glasses of each speciality.

In a sense it is the general-practitioner who is the one who sees the patient and not the disease. It was also refreshing to get out of the hospital once in a while to something different and to be somewhere different. It was fun to be just another person in the crowd without a responsibility. Watching the movie Transformers the other day at the cinema hall brought back memories of the past when we as children used to play with transformer toys. It was refreshing to just be out of the hospital and watch people going about their daily work.