The Resignation



A year ago, I had cleared my post graduation. Added two more letters to my surname. The joy was doubled as I was officially beginning to share my life with my belle. I was stubborn, wanting to stand on two feet before bringing her into my life. So I fervently looked for a job opening. Unfortunate to not continue in my parent institute, I had to resort to plan B. Plan B was anything other than plan A. Joining a private scan center was a choice many of my seniors and professors questioned. Being a trainee is one thing, knowing I was always under the safe arm of the institution rendered a self belief that shielded me from the outer world. But coming here changed my approach and perspective.

It was a path I had to tread carefully being no doubt a dubious choice considering continued training was imperative to cement up the laden foundation. I moved on, I had to challenge myself.

doctor-cartoonI walked into a department, a far cry from the magnanimity and luxury of a tertiary care. Space between false doors were limiting. Number of faculty in each modality the bare necessity. I met two of my colleagues, who were already working independently. The MRI machine was the same I worked with, so I had a sense of comfort. The CT machine was one that I read about as I studied CT physics – A single slice machine.

I was sluggish with the ultrasounds as I started work, apparently the machine I sat on my first day was ‘the smaller one’ – the older generation machine to do the bulk of the routine scans, incapable of doppler and detailed scans. The average count on that machine prior to my arrival was 50 scan in 6-7 hours. I barely crunched 28 that day. I was exhausted. I had to make decisions. I had to do it on my own. All of a sudden all the confidence that I came with from my three years of training seem to spiral down.

69f5c519fbc392cfbcf7c9f15f282826I reached fifteen minutes earlier the next day. I tried to lift my speed. Soon I was back to the standard average case count. I was happy. Then I started challenging myself to do more, 50 became 55, 60. Then the typical wave of confidence built me up and threw me over the acceptable normal limits. I became nonchalant, I started pulling off errors thanks to my newly driven scanning speeds. It brought me back to being more sensitive with the workload and managing time appropriately.

The relentless night calls, reporting umpteen bike accidents and injuries, has made me oblivious to sleepless nights.

Working with a single slice CT was like cutting three limbs of mine and giving me just one to do everything. I felt handicapped. I felt like I was in the shoes of a generation way behind. I had to adjust. The outer world of physicians are still unaware of the advancement in technology, yet crippled by lack of finances to provision it in the peripheral healthcare. Protracting certain findings, improvising to new methods of diagnosis was a different experience all together, figuring out which artefacts were relevant.

443f9cd6d8b2c0fbcb58b0992e819084Exploring the world of 3D/4D fetal imaging – becoming a window for the mother to the baby, being a part of the journey of life is something I will always cherish. Documenting the moments of family loss are the most cringing moments ever.

It is always the team that makes the work enjoyable. I have been fortunate to have a very good rapport with the techs, nursing faculty, the management team. For the bulk of my stay we had a team of 3 radiologists (Priyank and Prasad), which made work roll by as smooth as ever. Special mention to Mary chechi without whose black tea/coffee I wouldn’t have survived day in day out!

As I googled formats to prepare my first resignation letter, I am very thankful to the management for keeping faith in me and availing my services. To serve humanity, makes life worth living.


Finding the Poker face


Fifteen ultrasound scans through in the first two hours of the day, I was just signing off the report when the sister walked in.

Sister: “Doctor, there is an emergency ultrasound from the labor room”
Me: “Shift the patient in next”

The patient walked in. She seemed familiar. I put out the question I ask all the people

Me: “Did you get a scan done here before?”
Patient: “Yes, about a month back.”

When a patient usually turns up in the labor room instead of the O.P, there is always something worrisome.  (either to the patient or the treating physician)

Me: “What brings you here today?”
Patient: “I am not appreciating much movements of my baby. They sent me from the labor room to see the fetal heart.”

Once she was comfortable on the scanning bed, I went through my customary routine feeding in the patient details onto the ultrasound machine. I wasted no time and used my probe to search for the fetal heart. The heart was not flickering. I turned on other setting to see if there is blood flow in any of the vessels of the fetus. I couldn’t find anyway. The more I was exploring the fetus for any form of physical evidence of life within, the more distraught my face became.

I have been confronted with this situation before but not the very same. She was over 6 months into her pregnancy and I was put in a position to have to declare whether the baby is alive or not. She was familiar with a lub dubb lub dubb heart sounds she had previously heard of the baby. She saw me desperately searching for one. She wished.. and so did I that it would reappear.

After 15minutes of scanning, I took the probe off her abdomen. Her voice was broken as she queried1

Patient: “Doctorr… it’s not there? (Tears welling up)
Me: I nodded. (My eyes had already answered her question)

She took a deep breath and mustered courage to clean herself up and sit back onto the wheelchair. I wish I am never put in a similar situation ever again.

Breaking bad news is as it is a difficult job for doctors. But when it comes to in utero babies, we need a poker face and a strong heart as there is no relation as pure and strong as that between a mother and her child.

The First and the Cochification of my Malayalam

Day 8

I love Mondays, probably more so cause I was born on one. Seem to always find myself with bundles of energy. Was posted in the Ultrasound room. As I sat there observing multiple ones being done, out of the blue, my senior offered me to do one. I was like “Me???” Doing an USG was the last thing I expected to get to do as early as the first day of my second week, but I mustered some confidence and got myself to hold the probe in my right hand and scan the abdomen.

I knew I would be confronted with procedures where I’d have no option but to train myself to use my right hand more than the left. Interestingly yet unfortunately my first scan found a mass in the left kidney which needs further evaluation. I hope it turns out to be benign.

Maybe it was the good rapport with the senior and the nursing staff that kept the nerves shackled away, but am glad I have taken the first step, no matter how small 🙂

My South Kerala Malayalam slang is taking some beating all right! As I speak to more and more mid Kerala staff and patients, I find myself unintentionally tuning myself to their slang. I hope I don’t lose my ‘accent’ 🙂