WHAT SHOULD I EXPECT DURING INTERNSHIP?

“Complete medical school… go on to complete internship, then you shall be on a course to a great path.” Such nice words should stick and like those before us, we get to see the results immediately. Such, was the earnest comprehension of what the medical field offered six years ago. Six years, life was simple. It was a routine like now, only then I did not have to worry about what followed. I just had to read for the exams when the period was ripe. During those innocent years, even what you read was literally that and may be a little bit more. I dreamt of graduation like it was the world to be. No idea that graduation would come and all I would think of is when does all this end. Being a medical student meant your friends called you “musawo” and you swayed your head in that direction with a bit of gait.

It is now almost a year since internship begun and so the end is nay. Even if I have been weathered, battered and drained to an oasis, I am actually not bothered by being told how much weight I have lost (I wonder at how much I actually had). Yet again, I am confused by the dimorphic feelings of this period. May be it was that period when I felt hopeless with a client or that one euphoric time, when by doing something a life was saved. But if you asked me if I would do internship all over again; may be in a different setting I would be maniac to affirm to that. Life is as it is, one stage ends and another begins. Basically, you move one and get going.

There is so such to look back at and in equal measure a lot to forget. The beauty of it, is that this fast paced one year has the good, the bad and the ugly in proportionate quantities depending on whatever your priority is or will be. It is the heart beat of anyone’s medical career or may be not but it serves a lot to lay a foundation on how someone might follow up their career progress. So, do not despair, the love in war stories have such a nice ring to an end; they end.

The good, the bad and ugly of this period is that it is one year; one year of a lot of activity to last you a lifetime. You might see certain conditions once (one example in my case twice- Varicella pneumonia aka chicken pox) in your lifetime and others so frequent dust could not settle on the knowledge.

At the final bend, one asks oneself the same question asked to graduands; “what next?” at almost all corners, rumor mills spin about the latest on the job mart and study opportunities. Whatever your options might, the GPS of your internship could actually be fulcrum to that decision. For those joining, keep your wish lists short and expectations without reservations. For those who are this end with me, the ship is about to set sail.

One mother's love

“Movies always give a certain anticipation to know about the end.” When tension for a follow up act is missing, we usually lose interest in a movie. In about two hours, we assume to have understood and appreciated one’s life’s story. In it, we settle the palpitations with the knowledge that this is after all fiction and the "dead are not dead" but instead suspended from any further set. Oh, how I wish life could actually be.

I decided a long time ago that I could only watch horror movies only if they are the last left for my own obvious reasons (It’s always normal to look forward to a nice ending). As a new career doctor, the reality of death becomes passive. You tend to become supple to the fact that it probably shouldn’t have happened had it just been fiction with a good ending. A good ending, it is almost always evasive when faced with the most challenging of the cases.

I have most recently come close to one such case where I almost brought now the walls of my still and emotionless being in a clinical environment. Compassion, an adjunct to the sick is one I only show whenever am not overwhelmed however passion is usually intrinsic and hard to push back. 
The case is about a female child of 20 years brought into my care with an acute chest syndrome. After a  zillion hospital admissions, this was to be the last time she was in the hospital. She was a patient of sickle cell anemia, 4^th born of a single mother but until recently caused estrangement between her elder siblings and their mother. 
You see, she had growth retardation due to a stroke (bled in her brain) at the age of 10 and since then hospitals had become her other abode. Subsequent unfortunate events meant she would never have a normal life but to be under constant care by her mother. A role only a mother’s love could take on and indeed she made no qualms about it and vowed to do that all her life. In return she forgot to notice how lost time and relationships had moved.

Every morning, I walked past the bed they shared and at all those times this mother held her daughter in an embrace of never to let her go. She fed, bathed and nursed her at each minute of the day. They lived their lives synced. 
I always made it my starting point when beginning my ward rounds, adjusted the treatments accordingly and followed up twice a day. Investigations we had carried out were never comforting, but between the doctors taking care of her we kept this information between ourselves, one last bit was shared with her when almost all hope was evaporating. Soon her situation deteriorated  and she developed acute kidney injury (her kidneys had started failing to excrete the wastes from the body). This we noticed was secondary to sepsis (as per evidence of infection and systemic inflammatory response syndrome). Even at this point we soldiered on.

This “little” girl’s situation became hopeless each passing day two weeks after but witnessing the mother’s love gave me extra motivation to go an extra mile. There was always a sign of despair but with interludes of hope, we believed and prayed for a miracle it was never to be. How shattered, the mother was when the daughter passed on in her sleep on a Sunday morning while they shared their sleep.

Oh, how I wished this was a movie and someone shouted “cut” and then we moved on to the next act. As intern doctors we are faced with many challenges and at times with far reaching consequences than we ever thought of. The love, care and concern of a doctor is at times driven by the changes in environment and previous experiences and nothing will ever prepare for this.

With each imagination one might harbor, you wish someone waves by and off they go home healthier than they came.