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Sarab Sodhi

~ My Life in Medicine

Sarab Sodhi

Tag Archives: Hospitals

The Things They Carried: An MS3 Story

24 Thursday Apr 2014

Posted by Sarab Sodhi in Medicine

≈ 1 Comment

Tags

Doctor, Hospital, Hospitals, Medical School, Medical Students, medicine, Step 1


Having just finished my third year here are the things that made my life easier.

1. Comfy shoes: Try walking around the hospital on rounds for >4 hours a day and standing in one place in a pair of uncomfortable dress shoes. I dare you. I can’t even imagine how it would be in heels. Buy yourself some comfy shoes for work. I use rockports when I need to be dressed nice and a good pair of sneakers for when I’m in scrubs. Invest in them- your feet will thank you.

2. UpToDate Mobile: You can signup for an uptodate username and password at any hospital computer and download the mobile app. If you’re not familiar with uptodate it’s the best way to quickly educate yourself about relatively recent guidelines, pathophys, treatment etc. Keep it on your cellphone so you can read whenever you get a second.

3. A stethoscope belt: Stethoscopes can be heavy. Wrapped around my neck it started making me stick my neck out like a turkey. Around Thanksgiving that’s a dangerous thing to look like. A stethoscope holder may not be the most fashionable thing around, but a few days in the hospital will make a sartorial slob out of any fashionista.

4. Snacks: Keep your white coat well stocked with snacks. You may prevent a hypoglycemic coma on Surgery, OB-GYN, and Medicine.

5. A gym membership: You need to stay sane in MS3- it’s busy and you’re going to need things out of medical school you can focus on. For me that was the gym. It was my endorphin rush, my cleanser and my calmer. Do what makes you happy dude.

6. Books: Walk around with the books you might need on your rotation. They’re specific so expect a post to follow later, but a good one year round especially around Step 2 time is USMLE Step 2 Secrets.

7. Reference Guides: Everyone suggests you buy the “Green Book” (used to be Red, now is purple). It’s the Pocket Medicine series and was questionably useful on medicine. Buy it if you’re really keen.

8. A credit card in your ID holder: Your stomach will thank you when you’re in the cafeteria with 10 minutes to eat between OR cases.

9. Pens: Black for the hospital- no blue. And keep your nicer pens on the inside. An attending or resident can snag a pen and “forget” to return it…

10. Fresh socks/Undies/Toothbrush: This one should be self explanatory- but post call- these are amazing.

11. Gum: If like me you’re prone to the sleepies especially after 4-5 back to back OR cases while sitting through a fascinating lecture on the biochemistry of transplant rejection- have gum in your pocket. Or your attending WILL make fun of you.

12. Someone to complain to: We complain. That’s what we do. We complain about our lives, the slights both real and imagined that we endure and the futility of our positions. You need someone to complain to- or lots of someones. So keep friends, significant others, classmates, parents, everyone handy. You’ll need them.

This will be one of the best and worst moments of your lives. My two months on IM was the most educational experience in all of medical school. The year will transform you from a bumbling and eager to please second year into a slightly jaded, somewhat educated, rather arrogant semi-physician.

In fact I’d postulate that the bulk of your learning pre-residency happens in this year. Buckle up. It’s going to be a fun (if slightly bumpy ride!)

 

I want a surgery

04 Wednesday Jul 2012

Posted by Sarab Sodhi in Medicine

≈ 2 Comments

Tags

Hospitals, India, medicine


So a few days ago there was a patient who’d come into the out patient department to see the orthopedist we’d been shadowing. She was a follow up patient, who as soon as she walked in repeated her complaint. Let me give you an idea of how it sounded.

“You should do surgery”

“What surgery?”

“My knee hurts.”

“So should I replace it?”

“Well, I cant walk”

“That doesn’t mean I should do surgery”

“Well, why can’t I walk?”

“Because you’re overweight…. Lose weight…”

That was the gist of the conversation. And then, the patient smiling sheepishly left.

It’s a conversation that I can’t imagine being repeated in a US hospital. It’s a conversation unique for being so blunt and requiring a certain relationship between patient and doctor that is present in India, but harder to find in the hospital.

Is that something you’d prefer to hear? Or do you prefer the system presently in place in the US.

Of Broken Spines and Missing Metacarpals: Observing at an Indian Hospital

20 Wednesday Jun 2012

Posted by Sarab Sodhi in Medicine

≈ 1 Comment

Tags

Hospitals, India, International Healthcare, medicine


Over the last few days, I’ve started observing at one of India’s most advanced, most crowded and most over-utilized and understaffed hospitals. I’m starting in the Orthopaedics department, so in the last two days I’ve seen things clinics, outpatient departments and a couple of surgeries- including two spinal fusions (or spondylosyndesis- for the technically minded) as well as the beginning of a surgery involving a severely cut hand which was spurting blood from a severed radial artery branch.

It’s a different world in this hospital- there are patients in all directions, waiting in hallways, on floors, in every situation imaginable. The patients are waiting patiently, waiting for a doctor to come through quietly enduring whatever they’re suffering. As the doctors come through with a bevy of senior and junior residents on rounds they spend barely a minute talking about a patient. They don’t talk to the patient, nor do they attempt to explain anything. They discuss it amongst themselves, reaching a decision on how to treat the patient, with a look at the diagnostic imaging, a glance at the wound, and a few words from the resident who looks after the patient. The first few patient interactions, I was shocked- how could one responsibly be doing this, I wondered? Then, I saw the number of patients. Day one, we rounded on over a hundred patients in a little over an hour. After that, each resident had to run to get to doing all they had to do- be it treating, testing, surgery or whatever. As they do so, they speak to their patients, telling them what decision has been reached, how they will be treated and an estimation of when.

These residents and attendings are treated by patients and patients families with a reverence that is amazing to see. The paternalistic philosophy of medicine is very much alive and well here- the patients are not consulted about their decisions, they are simply told. Decisions are made and communicated to the patients, and for a vast majority of them, they seem to like it. The physicians act and are treated like rockstars, with admiring glances and awe in their wake. It’s a heady combination this, and I can admit to getting swept up in it as I go along. But, for one, I feel like a bit of a fraud in that white coat- I’m a second year med student, not a practicing orthopaedist and I still have a little trouble reading CT scans. So each time a patient comes up to me, with a look on their face that grants me that same level of awe, I feel not yet worthy.

Day two, as we rounded, I saw a woman badly injured, lying on a gurney unconscious. We didn’t speak about her or discuss her, nor did we even acknowledge her presence. But as I walked by and looked her mother and sister in the eye, I felt this sudden urge to speak to them- not for the minimal medical advice I could have given, but to perhaps offer comfort in a difficult time. I understand why it can’t be done in the restrictions one works under in this type of system. Yet it makes me wonder if doing so for years will make one detached and cold to the people one came into medicine to treat.

Each day more patients requiring an OR come in than can be treated by the staff and resources available. So, the backlog grows day by day. The numbers of patients who need closed reduction grows in such leaps and bounds, that they require a day in the hospital but stay a week.

That being said, I’ve seen some of the faculty do amazing work- surgeries with a cleanness and economy of time, energy and resources that speaks of their comfort and competence. At the same time, as you walk the floors of the wards, you see what they’re up against- the sheer numbers that could overwhelm their prodigious skill, and the constant fear in such overwhelmed hospitals- infection. I can only imagine how they must feel, their pride in a perfect spine repair or reduction being reduced to bitterness when their patient dies from an infection acquired due to too many people in too small a space.

I will try to post regularly as I go along, but that’s assuming time permits.

Match Day

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

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