We medical students handle a great deal of information too early on in life. That is our tragedy. The non-medical community or should I say the world in general, has too little information about us. That is theirs.
When we were welcomed into this discipline in our first year, we were told that the life of a medical student holds two major experiences. One, the first time we walk into the Dissection Hall to attend our first anatomy lesson. The other – the first time we walk into the wards of a hospital wearing the formidable white apron with a stethoscope around our necks. The idea of getting to apply the knowledge that had come our way, the idea of being looked at as doctors….. this was the life we had signed up for.
As students we are expected to work at gathering a good history from the patient- the ‘what’, the ‘when’ and the ‘how’. We talk to their patients and their relatives asking them what brought them to the hospital. In ninety-nine cases out of a hundred, neither party in the conversation has the privilege of understanding the other. Here in KMC, none of us know the local language and most of our patients nothing else. In such cases there are but three options open to us-
- Evaporate (now that’s impossible)
- Let the one Kannada speaking individual in your group do the talking while you take notes of the proceedings.
- Attempt a conversation in broken Kannada yourself. (the most viable option and also the most unseen kind)
Once the language problem has been handled (or not) the patient’s story comes out. They could confess to you about the month-long diarrhoea they’ve been having. They may be very modest about the quantity of bodily fluids they have been generating (read: sputum and urine). Sometimes they may forget to mention it at all. So sometimes we suspect one kind of disease while in reality it is something else entirely.
We then proceed to a general examination of the patient. (To elicit signs the patient may not have noticed) Different mnemonics are brought to mind to remember all the steps, but woe betide anyone who lets slip the fact that they were used! In our profession there are no short cuts, only open secrets.
Once we are through we present the case to our teachers. Now this part one may have seen in TV shows. How stark and dry the real thing is; and also how unglamorous. A patient who just wants to brood over his illness, surrounded by ten pasty-faced, tired students with their minds on lunch. Some students do excel in this round, while the others stare balefully into the distance. I forgot to mention- one wrong finding and the already tottering edifice of our case falls to complete rubble.
The patients themselves are as interesting as the maladies they present. We get the average sick person who is eager to share his tale of woe with anyone who will listen. Then we get the professional hypochondriacs who appear to have every symptom in the textbook. Aside from these we have the strong and silent type, who would rather talk to weapon-carrying Nazis than to us. I had it from a friend that a patient put a sheet over his head in an attempt to escape to his happy place. Yet, the ones who did cooperate are the ones to whom we are forever indebted, for they taught us more than any lecture possibly could.
So why do we do whatever it is that we do? We do it to learn. We watch how our senior doctors worm the whole truth out of patients and then diagnose the illness. We watch how they generate a sense of trust while asking personal and often disgusting questions. Beyond all reasons we do what we do because in our world human beings and human interactions are paramount. We learn to accept humanity and all it encompasses – the vitality, the hope, the darkness, the difficulties, the mundane and also the quirky.