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Sarab Sodhi

~ My Life in Medicine

Sarab Sodhi

Category Archives: Uncategorized

Playing Doctor

24 Tuesday Feb 2015

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The words by now flow off my tongue. “I’m Sarab, the fourth year medical student” comes off in a rhythmic flow without a second thought. My position is comfortable, even simple. I am expected to be there, participate to some degree and occasionally know the right answer- I am after all, a medical student. So, I zone out during rounds, disappear for hours at a time and do my own thing- it’s not like anyone is depending on me. Gotta love play time.

I’ve been playing doctor for quite awhile. The thrill of wearing a white coat has subsided as the white coat has become progressively less white. I’ve been seeing patients, examining them, making plans and presenting for almost two years now and it’s all second nature. I look, think, plan and suggest. Other people watch over it and agree. The scary part is that in 70 days I’ll graduate medical school, and I won’t be able to play at being a doctor anymore. In 126 days, I’ll be a resident in Emergency Medicine.

The complacency and comfort of my current position only adds fear to the change that is to come. In a few short months, I’ll be putting an MD after my name. In a few short months, I won’t be the ignorant medical student- I’ll be the ignorant physician.

My future (hopefully) program chair said it best- the only person who should call you doctor after you graduate medical school is your mother. You learn the basics of medicine in medical school. You learn to practice it in residency. For the first few months of your residency, you’re watched like a hawk as like a newborn foal you start to find your feet, wobbling and falling a few times. You’re watched for your safety and your sanity- the sudden onslaught of responsibility and consequence to your actions can be terrifying. More importantly, you’re watched for the safety of your patients. I’ve been told that until your second year of an EM residency, you’re not really a doctor. I guess my playing days aren’t done yet.

Scut Monkey

22 Saturday Mar 2014

Posted by Sarab Sodhi in Uncategorized

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Tags

Lifesucks, Medical School, Residency, Scut, Third year


Image

The comic says far more than I can really. Came across this gem on:

http://theunderweardrawer.blogspot.com/p/scutmonkey-comics.html

 

As a present third year who does a lot of these, I can’t help but wonder why scut is so prevalent on medical student rotations….

Till I figure it out, monkey see, monkey do?

‘I HAVE NEVER VOTED. MAYBE THIS TIME I WILL, FOR THE NEW GENERATION’

22 Saturday Mar 2014

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India, IndiaRising, Politics, Saba Sodhi


Image

My name is Reba. I think I am 37.

The village I was born in, a few hours out of Kolkata, is one of those places nobody knows about. You don’t come to know about it even when you walk through the middle of it. And it’s for that reason that I have no voter card, no ration card, pretty much nothing. So I have never voted.

I have four children. Three daughters and a son. Today was a difficult day. While cutting vegetables at one of the nine houses I work in as a maid, I cut my hand. A nasty gash. I poured water on it and pressed it with a damp cloth until it stopped bleeding. But by the time I reached the third house of the day, the strong phenyl and acid combination I used to mop the floor had infected my wound. I blinked back tears and carried on. After 13 hours of work, with on 15  minutes for lunch, I got home. Instead of collapsing on my bed, I repeated my actions of the day – wash, sweep, clean, dust, cook. This time I was working for my home, my four children, my husband.

Yes, I can see how a lot of you will look at me as soon as I say I have not voted. My daughters — I’ve educated them, one of them is even doing her Bachelor of Arts from Delhi University — look at me the same way. But you don’t understand. You don’t understand that I don’t live in the same world you live in.

You sit in your rooms, debating whether India ought to take a stand against the Naxalites, typing furiously into your laptops about whether or not the price of petrol is inflated. What you don’t understand is that my bicycle and I really don’t care.

I care about feeding my children, I care about helping them escape this torture I’m living through. I care about being able to smile on my deathbed and consider my life determined solely by the quality of life my children live. And nobody actually helps with that. Not one party.

It all sounds very fancy. It all sounds as if they have these grand schemes to help us, but that’s all they are: schemes. I don’t vote because even though I now have an Aadhar Card. Even though my daughters are educated and smart and talk of how important it is to vote, I’m jaded. I’ve been sidelined, ignored, forgotten by the entire political scene. So much so that I don’t ever remember being part of it.

My daughters say I cannot complain about my politicians if I don’t vote. That I can’t talk about a broken system if I don’t do anything to change it. But to me, voting for the politicians here is as useful as voting in Bangladesh – inconsequential. They make big promises, these big men, but I’m no longer affected.

Perhaps my attitude is defeatist, but you tell me this: what child is born with that attitude? We’re all born clean slates. Take something from that. Look at why I am this way. It’s because of a lifetime of disappointment.

The new generation is full of hope. The new generation is full of fire. And maybe this time I will vote. Maybe I will, not so my life gets better, I have given up all hope for that ever happening. But for the new generation. I pray the politicians won’t turn them into fragile, cynical things. I don’t know whom, I don’t know how, but I’m praying for somebody, and this time maybe I’ll do it with a ballot in my hand.

As told to Saba Sodhi in Noida, Uttar Pradesh. Reba, who requested partial anonymity, spoke in Hindi and Bengali. This interview has been translated, condensed, and edited for clarity.

Photo credit: Vishal Darse

The Other Side

28 Wednesday Aug 2013

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http://www.consultant360.com/articles/other-side

 

An article I wrote that just got published in the Consultant.

 

The Other Side

Citation:

Consultant. 2013;53(8):572

 

“The boast of heraldry, the pomp of pow’r,
And all that beauty, all that wealth e’er gave,
Awaits alike th’inevitable hour.
The paths of glory lead but to the grave.”
                                                               ~ Thomas Gray

The Medical Student

The EMT pushed the gurney into the emergency room, rattling off key information. A 23-year-old male—unrestrained back seat passenger—presents with extensive injuries, lacerations, and head trauma secondary to a MVA. The patient has a weak and thready pulse with shallow respirations and poor response to stimuli. He lost consciousness at the scene and did not regain it en route.

I may not have been there, but I know how the scene in the trauma bay unfolded. Surgeons and ER doctors rushed in, gowning and gloving themselves as they rapidly fired off orders. The patient’s pulse and blood pressure were recorded, an IV was started, and the OR was put on standby. In that instance, my friend was reduced to a set of numbers, readings, injuries and conditions. His life—the person he was and what he meant to those close to him—was simply not relevant.

In the ER, one of the residents was probably crushing my friend’s rib cage as he performed CPR. Another resident was likely putting a trache tube down his throat, cursing as it didn’t go in and digging the Mack laryngoscope in deeper. The person running the trauma was standing at the foot of the bed, calling out for the trauma OR to be prepped and asking the hapless medical student to feel for a femoral pulse. And the medical student was probably in awe, albeit slightly scared, at his first hands-on trauma experience.

When they did a thoracotomy, cutting my friend’s chest wide open in a last desperate attempt to save his life, that same medical student was likely slack-jawed behind his facemask. And when my beautiful friend died, that same medical student probably walked away focused only on what he had just seen, memorizing the procedures and replaying his mistakes. How do I know that he likely didn’t spare a second thought on the patient who just died on the ER table in front of him? Because as a medical student myself, I never did.

The Friends and Family

I first heard about my friend’s death from a mutual friend who lived next door to the grieving parents. I remember reading the text as I was walking home from a party, convinced this was a twisted joke. It took me a long time to process through all the emotions and regrets that follow when you lose a friend of nearly 12 years. I was still in that state of shock when I went to the funeral.

This is not my first time seeing death. In fact, I met my own human cadaver on the first day of medical school. I’ve worked in the ED and seen many patients with severe injuries. I too was amazed the first time I had to slice open a patient’s chest or search for a bullet inside the body of a patient with a gunshot wound.

Yet, as I stood at my friend’s funeral, I found myself questioning my own ethics. As a medical student, the grislier the incoming injury, the more excited I found myself. Was I wrong to objectify my patients in the service of learning? I struggle to bridge the dichotomy: In the ED, traumas were fun and fascinating, but when the tables turned and my friend was the patient, trauma was heart-wrenching. And as I stood at my friend’s funeral and shared stories of our time together, I thought of all the forgotten patients who I treated in the ER. And in that moment, I realized I hated myself and who I had become.

Learning to Compartmentalize

I began to feel like each time I had taken a case, I had systematically ignored the patient a story, a life, and an existence that was so much more than a set of vitals and a 3-line synopsis. I realized that I had left the human element out of my work. In doing this, I had reduced my patients to a series of vitals and a set of conditions to be fixed. And even more so, I remembered them only for the education they gave me—i.e., the first IV I inserted, the first patient I practiced CPR on, etc. It was callous.

But, I also came to the realization that, in those moments in the trauma bay, the meaning of a life has to be secondary to the immediate necessity to save a life. If we can save the body, then we can give the whole person a second chance.

For the doctors who work in trauma day after day, death is another member of the team. It often times is a conscious decision to stay emotionally distant from every person you treat. And, as a medical student, isn’t it good that we look at trauma as exciting, for that is what drives our interest in learning how to diagnose and treat serious cases? In some ways, objectification is a necessary evil to ensure the survival of medical knowledge.

I remember the agony I went through losing my friend and recognize that it is a pain that I cannot tolerate daily. Distancing myself is a way of self-preservation. So, I do not feel guilty when I reduce my patient’s lives to a measly 3 lines. But, I do the best I can to make what is one of the worst moments of his or her life a little more comfortable, a little better. I hope someone did that for my friend.

 

The crazy person in the coffee shop

14 Thursday Mar 2013

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Boards, Coffee shop, Crazy, Life, Med school


I realized today that medical school’s finally done it. I’ve lost what marbles I had left. In the coffee shop as I desperately studied heme-onc for the exam tomorrow I was talking to myself as I saw lab values, describing microcytic and macrocytic anemias and types of leukemias and lymphomas. Looked up, and I saw three people around me watching me with an intensely guarded impression.

I probably look like I escaped a loony bin, talking to myself, cursing and smiling as I get things right and wrong. Maybe I should be sent into one after Boards?

Link

Boards are Taking Over!

07 Thursday Mar 2013

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Boards are Taking Over!

For now, goodbye until I’m done the Boards!

Of Stool Samples and Dr. Goljian

14 Thursday Feb 2013

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Humor, medicine, Pathology, Stool


You know you’re studying GI when this is the joke Dr. Goljian makes:

 

“It’s not a very nice test to do, sending stool to the laboratory  It always gets lost. I can’t imagine how something like that gets lost. But it always does. Especially 72 hour stool collections. For which you probably have to bring in a wheelbarrow. I don’t know how something that big gets lost. It’s an amazing thing. Send it by FedEx, anything, it gets lost!”

 

For those of you who’re cursed to study Pathology, Goljian (and Pathoma’s Dr. Sattar) are some of the best out there!

TLC from a Monkey

28 Saturday Jul 2012

Posted by Sarab Sodhi in Uncategorized

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Tags

ani, India, monkey, Travel


First off, my apologies for the long silence. It’s been a busy few weeks, but I have a quick story I have to share.

 

I went off with some old school friends for a few days to Shimla, a small hill station in North India. While there, we went off to see a temple to the god Hanuman who had the form of a monkey. Thus, monkeys were considered sacred to the god, and a large number surrounded the temple.

As we walked up the rather steep and numerous stairs to the main temple, we came across full herds of monkeys who weren’t shy about how they felt. If passers by looked them in the eye or said something to them they were quite unabashed about slapping them across the face. One of my friends got slapped across the face and consequently was a tad skittish around them.

I, of course, kept walking ignoring him and like a good friend making fun of him about his fear of the monkeys. So after touring the temple and seeing the 108 foot statue of the god, which was quite impressive, we walked down.Imagew

After walking down, I stood around waiting with a friend while my other companions went off to see another temple. As we stood there chatting, all of a sudden I felt something hit my head and my glasses disappear. My friend, in splits of laughter told me that I’d just had a monkey creep up behind me, eye my glasses closely, leap towards me snatching my glasses off my face.

I turned and sure enough, he had my glasses perched on an arch about 12 feet high. In vain I stood there trying to figure out how to get my glasses back. He, smart man that he is, walked across to the men who worked there and asked how I should get my glasses back.

These men had stopped me in the beginning of my walk up the temple telling me to take an offering for the monkeys. I, seasoned traveler that I am, ignored them. Then when this seasoned traveler was squinting at the monkey who had my glasses in confusion they offered me a way out.

The man took two packets of some sort of candy- small round sugar balls basically, and walked up the stairs to the monkey. As he rose, he split one open and threw it in all directions. A horde of monkeys descended on it scrabbling and fighting for the candy. Not the thief though- he wasn’t going to be swayed by a communal offering. As soon as the man got close to him, he threw him the other candy packet. The monkey caught that packed in one hand and neatly dropped the glasses- luckily into the vendor’s waiting hands.

Later on, we realized those monkeys were likely trained to retrieve people’s valuables in exchange for candy- a supposition our hotel manager confirmed while in splits of laughter at my predicament.

So, that’s the story of how I got some tender loving care from a monkey.

Indian Hospitals: Public and Private

26 Tuesday Jun 2012

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Tags

Healthcare, Hospital, India, Private, Public


So, as you all know I’ve been shadowing at an Indian government hospital for the last few weeks. Recently, I ended up going to an uber expensive, uber nice private hospital with my grandparents. Now, a few words on the differences.

 

Firstly, the government hospitals. The doctors there are excellent- well trained (not by the training, as much as the practice of seeing that huge patient load), they function with minimal resources and use novel solutions and approaches. They offer excellent treatment options, try to minimize risks to the patient and generally do what’s right. They don’t sugarcoat a patient’s prognosis, nor do they mince words. I’ve heard them tell patients with regards to a degenerative disease “baal safed hoten hain, na, voh safed hote rahenge- hum dhere kar sakte hain, rok nahi sakte” namely, as your hair gets white when you age, it keeps getting whiter, right? We can’t stop your hair (disease) from getting whiter (worse), but we can slow it down.

The downside to a government hospital- the crowding. Treatment is uber cheap, but due to the sheer patient load, you hit delays after delays and are more likely to die of an infection than of the treatment’s risks. Also, a lot of the patients who come in are being seen after days- precious days which if treatment were instituted earlier could have had a different outcome.

 

Private hospitals on the other hand, have no problem with overcrowding. Doctors have time for you, they’re soft, polite, soothing and charming. They’re understanding of your concerns and are willing to change your treatment based on what your limitations are. The flip side is, from what I’ve heard from physicians on staff, they are quite willing to “order” surgeries for patients who don’t really need it, to make their required bottom lines. The upside is, they’re shining clean, the staff is typically quite nice and fairly competent. Your chances of dying from infection are rather slim, however the general idiotic actions in medicine, are quite common there. One of the things I’ve heard from a patient at one of India’s best private hospitals, is that after a blood sample was taken and analyzed, the remainder of the blood was (with some air) injected back into his veins. As he put it, he sat there waiting for the pulmonary embolus that would kill him. Thankfully, that didn’t happen.

 

If you ask me, where I would go- I’d say I’d go to a government hospital for a surgery or a consult, but not to be admitted- for that I’d choose a private hospital.

The Joys of Travelling- Random Selection

09 Saturday Jun 2012

Posted by Sarab Sodhi in Uncategorized

≈ 2 Comments

Tags

medicine, Travel, TSA


So, for the first time, as I’m taking someone along on a trip I’ve done at least 8 times, walking through Newark I reach security where I’m supposed to go through the Body Scanner machine. I’m not the biggest fan of the concept, but I choose not to make a fuss. I walk through, and after, as I’m waiting the guy tells me that the image was blurry and they need to search me. No problem I reply, and we walk to a private room. As we enter this private room, one of the two gentlemen tells me that the area that was blurry was my crotch.

 

At this point, I’m just shaking my head and saying to myself, of course it was. So, I assume the position and my search began. Then, as he’s searching my back, smartass that I am, I told him that my back was really hurting and would he be able to just press a little harder while he was searching my back?

 

I’m pretty sure the poor guy jumped- he started saying “Whoa man, that’s just so inappropriate” and slightly chuckling. I apologized, laughing, telling him that I was a med student and I had picked up this bad habit around patients. So, he continues to search me. Funnily enough, as he was “lightly grazing my groin region with the back of his hand”, he seemed  more uncomfortable than I was with the whole thing. Later, I realized that this was a bit of a switch. Usually, I’m the one who’s slightly uncomfortable around standardized patients as they tell me to take a femoral pulse or something- while they’re perfectly comfortable. The role reversal I experienced that day was interesting to say the least.

Now, to be fair, I got through that experience with minimal effects. However, I did find myself thinking that the whole process was unnecessary. Body scanners have been found to be minimally effective at what they do (Refer to: http://travel.usatoday.com/flights/2010-12-27-bodyscan27_ST_N.htm and http://www.eturbonews.com/29190/air-passenger-group-body-scanners-would-not-detect-underwear-bom). Further, they led to the need for me to be searched in private (in a somewhat invasive and demeaning way), my ID photocopied, my luggage to be opened and searched (without my knowledge) for no apparent reason other than a blurry crotch?- none of which happened at any of the less technologically advanced airports where I walked through a metal detector. And don’t get me started on the attitude of the TSA agents in comparison to both Heathrow and Indira Gandhi Intl. agents- they were by comparison rude, brusque and dismissive.

So, long story short, I’m going to be writing a bit of a novella to TSA, and the House and Senate urging them to reconsider using this technology. Thoughts?

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Match Day

Match Day 2015March 20, 2015
The day my future is revealed

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