Two weeks at National Cancer Institute, Nagpur.
What I have done aside, this is about the bittersweet experience of clueless intern in a world-class hospital, figuring out the way of life in the city outskirts, and attempting to adjust to a new routine; ending with a changed perspective on the medical profession as a whole.
The National Cancer Institute, Nagpur is a misnomer — because the institute is far off from the main city of Nagpur — situated in Jamtha, gifted with all the space and greenery one needs for a project as huge as this. When I came here for my summer internship, the hospital was not completely built — I would hear construction noises scattered throughout the day and see the workers, in groups, enjoying a samosa or tea in the canteen during sunset. The place had no Airtel towers, which meant that my phone was virtually dead inside the campus. The first day I learnt about this, I was almost down to tears — all amounting from not being able to inform my parents that I reached safely, making digital payments, heck not even being able to send a text or make a call — almost questioning my two-week long stay, praying for a flight back to Bangalore the same day. Eventually, help came around, and I luckily adjusted to the environment.
Here, the empty spaces of a routine-life were filled with observing intricacies instead of my phone lock-screen: how a father, victim to a kind of oral cancer, smiled at his kid laughing and running in the grass; how small families who couldn’t meet the doctors that day decided to spend the night outside on a mat — with small tiffin boxes that would remind you of springtime with your family, only worse because they were patients; and the stack of achaar and chutney jars that were at some patient’s bedside because his wife knew that eating hospital food without them would be nauseating.
Not opening my phone for the eight hours that I would spend there everyday helped me get a sense of control over what my energy should be spent over. While we were made to take notes of history-taking, I would often phase out, thinking about their lives instead of the diagnosis — how every patient there had a unique experience and how history taking could be like writing a story. In a normal government set-up, most doctors and interns are unwilling to teach because of hectic schedules and oppressive work hours. And being a clueless second-year who has read only three chapters in pathology doesn’t help at all. But here, I was surprised to see almost every doctor take an initiative to help me understand the clinical presentations and investigation protocols. They were appreciative of our (ie my co-interns and my) presence, and encouraged questions and doubts.
From performing my first breast-exam, to understanding how a PET-CT reconstructs an image, it has been a very productive yet interesting experience. As someone new to “cool” medical imaging machines, I was overwhelmed at how brilliant the organisation in a private set-up is. Files, registers, and patient details are so flawlessly arranged by each department that you would think they have thirty hours in a day to do that! Barcodes made for each patient investigation, CDs for all the images, and every small detail rightly taken care off, I felt my study-schedules shy out and disappear in my head.
What I have noticed several times and always wished to emulate, is the confidence of carrying out a physical examination of internists, or surgeons listening to music while performing a surgery. It’s the vulnerability that strikes me first, and being hyper-aware of the situation that scares me off, but I believe I understand how to improve on that: the opposite of the new principle I’ve learned to apply to social situations, that is approach, no matter how nervous you are.
The weather here is oppressive, to say the least. Towering over 40 degrees everyday — morning or night, it made it almost impossible to survive without an air conditioner. It rained twice when we were there, and both times, it was pleasant for a few hours, and extremely hot afterward — travelling in summer is not advisable at all :P. Coming from Bangalore, you can imagine the struggle it took to adjust to this.
The paediatric ward had kids, with their mothers at their bedsides. Some smiling, some asleep and some very young to suffer from Leukemia and get admitted. The pathology department, stereotypically, were delighted about medical students paying them a visit. The doctors there were very sweet and excited to see us that day.
The Surgery Oncology were the most interesting, allowing us to not only see the operation but also explaining what they were doing. Apart from not being able to answer some basic anatomical questions (“what vessel is this?”)I had a good time there. I was elated to find that one of the surgeons was a fan of Dr. Mukherjee’s books! We spent almost six hours at the OT, witnessing two operations: a MMR, and a neck dissection for a partial glossectomy. I remember being so tired that day, we hardly got the time to have an evening snack by the canteen.
Apart from the relatively “cool” experiences here, there were difficult problems in the food, accommodation and people criteria.
If there is one major lesson I have learnt from this experience, it is the importance of soft-skills and the “beyond-the-books” efforts required to become a good clinician.
