The Senior Resident’s First Day

 

It is the 3rd of July. The time is 10.00 am. I am walking towards the Dept. of Surgery office to join as a senior resident. While walking my heart is beating wildly. I am feeling unsure of myself. I have not felt this way since I first entered the ward as an intern. Not even when I joined as a Junior Resident.

Why? The interns and the Junior Resident are workers to a large extent. They remind me of the poem by lord Tennyson – The Charge of Light Brigade. “They are not to question why/ They are but to do and die”.  The Senior Resident's job is not only to work but also to supervise the interns and the junior residents working under him. He has to make the day-to-day decisions in the wards. Decisions that can mean life and death for the patients. The wrong decision can mean the end of life for the patient and the career of the senior resident. I am feeling unsure of my ability to handle this new responsibility.

   With a beating heart and racing pulse I submitted my letter of joining to the clerk at the Dept. of Surgery office. I am asked to report to the Dept. of Emergency Medicine. I went to the Department of Emergency Medicine and reported to the faculty in charge of the casualty. My voice faltered as I introduced myself. I am asked to join the batch working in the casualty. I introduced myself to the other doctors in the batch and got down to the job. I found myself looking at the clock on the wall more than my patients. I just want the time to fly and my duty shift to end.

  Suddenly I realized that some new doctors had arrived in the casualty. I looked at the clock on the wall. It was 1.35 p.m., five minutes past the time for my shift to end. I had not looked at the clock for the past 1 hour. The rush of patients demanding my attention in the casualty had had its effect. They left no place for the thoughts about my abilities, to make life and death decisions, to enter my mind.

It was time to give over, i.e. explain the status of the patients who were already in the casualty and seen by our batch, to the new evening duty batch of doctors. While giving over I noticed the ease and confidence the evening shift surgery senior resident was looking over the patients and their case sheets. Then I realized that even I was talking and explaining about the patients with the confidence to match his. While inside, my heart was still beating wildly. I realized that the senior residents, whom I have admired and hero-worshipped, must have felt what I am feeling now.

  The handing over is finally finished. With some reluctance, I walked out of the casualty, where I was reluctant to enter just a few hours ago.

 When we take on new responsibilities, some amount of inner turmoil is natural. It is up to us to handle this inner turmoil and project an outer confident picture to the world. Believe in your ability and the persons who have selected you to handle the new position.

Secondly, when fully engrossed in our work, all our doubts will simply disappear, and out will emerge a new and confident self.

— ND

(Based on allegedly true incident.)

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient and students as foremost and according to NMC and other Board norms. 

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The Hungry Resident Doctor

 

The operation theater (OT) in AIIMS, New Delhi used to run non-stop from 8.00 am in the morning till 4.00 pm afternoon. The surgery professor was operating and two junior residents were assisting him. One of the junior resident doctors had just joined the surgery department and it was his first day in the operation theater. 

Midway through the operation, the new junior resident asked the professor, “Sir, it is 2.00 p.m. and I am feeling hungry. Can I go to the hostel and have my lunch?” 

On hearing this all movements stopped in the OT. Everyone stared at the new junior resident in astonishment. The surgery residents used to work non-stop when the OT was running and the junior most residents used to not even get time to go to the hospital canteen adjoining the OT let alone the hostel mess.

The surgery professor looked up icily at the new resident and replied, “You can go and have your meal today. But next time either don’t come to the OT or don’t ask to go for lunch during OT time.”

The junior resident went for lunch that day but never again was seen leaving the OT for food after that day.

In the same operation theater, while the operations were going in full swing, the anesthesia professor who was supervising two operation theaters entered that OT and asked the anesthesia assistant professor, “Is the patient stable? Is there any problem?” The assistant professor replied, “No ma’am, there is no problem. Everything is going smoothly.” 

The professor further asked, “How many residents are there in this OT?” The assistant professor replied, there are two junior residents and one senior resident posted here with me.” The professor asked, “Did you all have tea and something to eat with it?” No, ma’am” replied the assistant professor, “None of us had eaten anything since the morning after the OT started.”

The professor exclaimed, “What! It is nearly 1 O’clock and none of you had something to eat. Send the junior residents and then the senior resident one by one to have tea and eat something immediately. Once the senior resident has returned then you also go and have something to eat. The senior resident may call me if needed in your absence.”

It was clear that, unlike the anesthesia professor, the surgery professor had not heard ‘An army marches on its stomach’ a saying attributed to Napoleon Bonaparte and Frederick the Great. It means that soldiers cannot function properly unless they are well-fed. To be effective the army has to be supplied with good and enough food.

Thankfully, in the corporate world, there is now growing awareness and many companies are providing lavish and free food for their staff in their office campus with proper breaks in between as a means to increase employees' productivity and work satisfaction.

Some other points from the anesthesia professor’s instructions: She made sure that the junior residents were sent first for refreshments and the assistant professor last. It happens in many places where the seniors can take a break and have something while the junior most staff keep on working. When the anesthesia junior residents went on the food break, their work had to be shared by the senior resident and the assistant professor. This may be resented by them and they may not allow them to go.  

This used to happen in the surgery department also when the final year junior residents were able to take time off to go the canteen while making the first-year junior residents work non-stop without giving them even time to drink water in between cases. 

Also, the anesthesia professor took on the responsibilities and duties of the assistant professor, while she went on her tea break. It is the duty of the top management to ensure that the junior most staff get the much-deserved break even if at the cost of working in their place.

Making sure that your employees, subordinates or juniors are well-fed is good human resource management and not weak leadership.

— ND

(Based on allegedly true incident.)

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient and students as foremost and according to NMC and other Board norms. 

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The 98 % Doctor

 

Dr. Jolting (fictional name) was taking the ward round with the junior resident doctors. In addition to inspecting and checking the patient’s latest status, Dr. Jolting was also reviewing the status of work completed by the junior resident looking after the patients in that ward which were instructed in the last round. They reached the patient on the last bed in the ward. Until that time the ward round was proceeding satisfactorily as the junior resident doctor had completed all the work allotted to him in the previous round.

At the last bed, Dr. Jolting got angry when he found that the resident doctor had not completed one work that was instructed to him in the last ward round. The junior resident looked hurt. He countered, ‘Sir, I have done almost all the work instructed in the last round. I have missed only this one work, I deserve praise for all the work done and not reprimand for  not doing just one small task.’

 Dr. Jolting asked, ‘Do you know what is DNA?’

 The resident looked surprised at this apparently out-of-context question but answered, ‘Of course, sir, DNA is the molecule that carries the genetic information for the development, functioning, and growth of all organisms. It is responsible for carrying and transmitting the hereditary characteristics or the genetic instructions from parents to offspring.’

‘Quite right,’ agreed Dr. Jolting, ‘And, do you know what Chimpanzees are?’

The resident looked confused at another out-of-context question but answered, ‘Yes sir, they are a type of great ape or monkeys quite similar to humans.’

  Dr. Jolting elucidated, ‘Yes, but do you know that the Chimpanzees have 98.8% DNA similar to human beings? There is a difference of only 1.2%. A tiny difference of 1 to 2% in DNA can make us chimpanzees and not humans.’

  ‘Similarly, our patients, the public, the media, the judiciary, and the world expect us to do 100% of our work with 100% efficiency. So learn to complete 100% of your work with perfection or leave the medical profession.’

— ND

(Based on allegedly true incident.)

Link to American Museum of Natural History Website https://www.amnh.org/exhibitions/permanent/human-origins/understanding-our-past/dna-comparing-humans-and-chimps

 Link to Wikipedia pages on DNA:

https://en.wikipedia.org/wiki/DNA 

https://en.wikipedia.org/wiki/Introduction_to_genetics 

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient and students as foremost and according to NMC and other Board norms. 

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