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THE DARK SIDE OF BEING A DOCTOR IN INDIA

"Loneliness"

Profound loneliness. You can be surrounded by friends, family and colleagues, but in reality, you are quite alone. If your family does not consist of doctors, they hardly understand the difficulties that you go through. They sympathize with you, yet are unable to grasp the reality of your training and career. Why you must spend days and weeks and even years apart from them. Why a lot of their calls are unanswered by you, while you are busy during rounds or managing patients. Why you are not at home at the festival evenings.
Your old school friends do not really understand how hard the years have been. Why you couldn't attend all the weddings you were called to. Some just attribute it to arrogance. Some understand. Only a few are driven enough to maintain a relationship where you hardly meet, talk or hang out. Nobody realizes that you hardly have time for yourself, leave alone the closest of friends. When you do meet your old buddies, from various different fields, you can feel a fence that has formed around you. You smile and nod your head. Yet, you are some distance away. The conversations seem a bit trivial compared to what goes on every day in your other life. Your college friends don't stay with you for too long. Forever branching and specializing fields of medicine mean everyone either ends up in a different college, City or country eventually. You do drop each other a message once in a while, especially if you can remember who it is that you are missing. Conversations do not progress beyond a few words, as both of you are busy beyond compare. Time and distances lighten the strongest of bonds. Your partner/spouse/girlfriend/boyfriend understands your trials and tribulations with difficulty. A similar profession leads to conflict, ego struggles and comparisons. A different profession causes irritation and indignation at your personal priorities. Your patients may love you for your clinical acumen but neither do you form friendships nor expect any support in times of trouble. You keep a distance. Always. Proximity causes lack of objectivity. And patients rarely come out in open support of their physician.
Your colleagues in the same branch view you as competition. So much so that they would be secretly relieved to see you fail. You colleagues in other branches form cordial, friendly relations. You meet once a year for joint conferences and sometimes discuss patients which have been referred. You can expect a bit of professional support but nothing emotional or personal. The hospital you work in couldn't care less about you. You are indispensable to them until you are replaced. Not all this is true for everyone in all scenarios, but, yes, you learn to live with this reality. Add to this the constant fear of litigation, violence and disciplinary action. It can get very lonely at the top for doctors sometimes. And the higher you go, the further away you are from everyone.
If this is not part of your story, being a doctor, you really are blessed.

Written by
Venkatesh Kharalkar

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Abdominal incisions

Pathology’s top ten one liners...... .& what they really mean

1) Enucleated specimen of right eye, inadequate for opinion: excise the left eye, too.

2) Small round cell tumour, advised immunohistochemistr y for a definite diagnosis: I don’t know what the hell it is....

3) Compatible with lichen planus: doesn’t look like it. But if you insist, I don’t resist.

4) Florid reactive hyperplasia, lymph node; advised close clinical follow up: boss, wait till it turns into a full blown lymphoma, then I’ll type it.

5) Borderline serous cystadenoma, o***y, with focal microinvasion: phew, this’ll save my skin, if the patient throws a met 10 years later!

6) Early ill formed epithelioid granulomas with occasional acid fast bacilli: I have an excellent imagination!

7) Special stains for fungi, bacteria and parasites are not contributory: I didn’t look hard enough.

8) Metastatic poorly differentiated neoplasm, cerebellum, with possibilities of carcinoma, sarcoma, melanoma, lymphoma . . .: looking for the primary is your job; anyway, how does it matter now?

9) Appendix showing lymphoid hyperplasia: you knocked off a perfectly normal one.

10) Poorly preserved biopsies from multiple sites, unsuitable for definite opinion: only a necropsy can solve the issue...