In college, I was never good in academics. I pass, pass. I fail, fail. I pass, I fail. I fail, I pass. I could maintain this consistency throughout my course. Always wanted to tell people 'bout ma constant academic struggling saga *much tears* .I stress out things in a natural way. Its difficult to handle the situation sometimes esp practicals. But. I grin and say- 'Hey, Am dating Bailey and Davidson!'
So this is a story happened last year during final year model examination. The entire story started off when I accidentally slept at 1:30 AM and accidentally woke at 4:00AM the night before surgery practical examination. So I heavily lacked proper sleep. But lacked huge amount of K-n-o-w-l-e-d-g-e too. So, so the construction of exam is in the fashion of one minor case from orthopaedics. One major case and minor from surgery. X-rays and instruments of both, a specimen, and surgery steps with ortho spotters. My strongest point was minor surgery case, I believed.
I do not know whether the next statement is bearable and tolerable to everyone. I mean EVERYONE. Surgery practicals is the adjustable one among others ( sorry, if i hurt any surgeon's spirit and vehemence).
So we all done with the devious spotters and got ma ortho minor case. It was of 70 years old Kalyani with a knee implant. So i was asked to examine her knee joint. I examined her ( I examined her💀 ). Technically, that was a brilliant case of Osteoarthritis of Knee joint. Just after finishing the ortho case, I was directed to my surgery short case. I should repeat it here, I heavily lacked sleep. I heavily lacked knowledge. Wokay. That's it. After completion and exploration, my surgery short case looked like :
Balan, 45 years old, a swimming coach, hails from Palakkad presented with complaints of ulcer on left foot for one year and right big toe for 10 days. H/o diabetes mellitus since 7 years. H/o amputation of left big toe last year.
Done. We need not write the entire thing in the paper they said. And I was like 'Hey cool! This is just a matter of ulcer. Gonna explore it'😎
I still can't remember the zigzag running of surgery house surgeons this way and snaking of ortho house surgeons that way. Along with Hari Raj sir and Aswin sir catching and throwing candidates to surgery long case and short case. NB : I heavily lacked sleep. I lacked knowledge 😖
Orthopaedics case presentation started from either end and surgery short and long case from other end. The chain of presentation rigmarole ended up in two facts :
(1) I didn't get a major case by then
(2) I haven't presented either of the minor cases
So my wait was over, got a 'beautiful' major case. I examined, diagnosed and weighed it as hydrocele with testicular tumor🤸
The point one has to note here is that, three candidates got the same 'beautiful' case. One diagnosed it as hydrocele. Other one presented it as testicular tumor. Me amalgamated both and concluded into hydrocele with testicular tumor. Perfect!!! God knows! So I was taken to present the surgery major case first. I won the game. My testicular tumor with hydrocele got good scores.
KEY POINT for newbies : Study High Inguinal Orchidectomy part thoroughly with Retroperitoneal Lymph Node Dissection (RPLND)🙌
The moment I finished presentation, could see ortho housiees and surgery housiees gushing like comets and handed-over ma ortho and surgery case sheets simultaneously. Two teams held ma hand at the same time as none of the short cases were over and i wasn't confused a bit cuz ma sleepy-lacky brain was already in a position where only the presentation matters. So, the ortho housie took me to HOD. My body sat in front of him :
Sir : Tell your name and roll number.
Me: Gopika, 39.
Sir : Your patient and age?
Me: Balan, 45 years old sir.
Sir : okay. Present the case.
Me: (with unbeatable confidence) Presenting the case of Balan, a 45 year old swimming coach who hails from Palakkad now presented with ulcer of left foot for one year and right big toe for 10 days.
History of present illness : * mama some - thing fishy *🤔
Seriously, it took estimable five seconds to realize I was presenting ma surgery short case in front of orthopedics Head Of Department!
Me : Sir, case cherutayit onnu maripoi. Itu vere case anu. ( apologizing )
Sir : Serikulla case eduth vayikk. *silence* Allenkilum Balan ennoru case ivde illalo. Sorry. Hahahahaha!!
Me : 🙄 ( what was that!?)
Somehow, somehow the ortho part got over. Done with the life story of 70 years old Kalyani. When I left the Male Surgery Ward, could see friends having lunch and studying the steps of mastectomy, Jaboulay's, Hernial repair and that chucklesome circumcision simultaneously. Again, sleepy-lacky brain was questioning me for leaving something behind. Was 't ma measuring tape or the illuminoscope? No. Could realize that I have missed ma surgery minor case presentation. So. I was the last candidate to appear for the prestigious minor case that day. The silly-ulcer-thing I planned to explore in the morning.
Cuz it was the end of minor presentation, everyone in the surgery department who had duty that day were present over there. I entered the room stepping right foot and juggling the case sheet. ( I already practiced the whole case to impress the examiner. Wooohoo! So thought to present the same Balan story with additional gimmicks🤡). And the one who scotched ma pre-planned presentation was Mohandas sir!!
The moment I entered,
Sir : Onnano randano? ( one or two)
Me: 🙄🙄🙄
Sir : Oru ulcer ano, rand ulcer ano?! ( Is it one ulcer or two)
Me: Two sir!
Sir : Say only the diagnosis.
Me: *appo njanarayi😔*
Sir : Comment on the only finding other than ulcer.
Me: Sir, he is a chrrrrrronic diabetic- - -
Sir : Atalla, vere finding enta?
Me: 🤔
Sir : Five toes indarunno? ( whether five toes present)
Me : Aaah. No sir. His big toe was amputated which was said by him in the history.
Amal sir : Appo kandillale!… (so, u din see)
Me :😬
My sleepy-lacky brain could see, feel sooo many people in front of me bombarding with the basic easy questions of ulcer like Mitchell Starc's yorkars which I bounced back to them one after another.
Another sir : What are the sites of SCC?
My brain : lips, oral cavity, mmmmm chest, trunk pinne body......
Everyone in the room, except me, made a face that I only seen in Grave's opthalmopathy of Thyroid chapter in S. Das. ( Bailey is a good book 🙏)
Me in brain : kuduthal nannayipoyo sir (no translation! )
Everyone laughed like anything and I could hear the headshakes, even the fan and bulb laughing!
Mohandas sir was already calming me by saying 'air vidu, air vidu' (again no translation!)
Amal sir : What is the lining of esophagus?
My brain for me : Cuboidal sir!!! It is replaced by columnar in Baret's esophagus😭
Sorry to Pathology Gods 😪 Was much stressed out.
Still remember Aswin sir's incapable face upon ma answer. Also had questions that ma brain could and could not answer that day. We travelled to POVD → SCC→ BCC→ melanoma then winded up with investigations.
That ulcer matters. The whole surgery matters. I had enough.Wake up call👼
I had to attend five more stations that afternoon. So the OSCE part commenced with surgery steps. My lot was for thyroidectomy. Thank God : ) I swear no one would attend the surgery exam without scrutinizing the elegant-esteemed-celebrated thyroidectomy.
Next was the ortho instrument part. Yeah, am good at instruments. Done.
The next station was radiology of surgery delt by Mohandas sir itself. He hooked an X-ray showing intercoastal drainage tube and asked me 'bout the Triangle of safety and other things. He again took an X-ray and accidentally his finger was pointing at the clavicle bone. My shaky head said out of ma jitter-ness - Air under the clavicle, sir!!
Buhahahhhah!!!!
Buhahhahahh!!!!
That was the only thing i heard after i said the word 'clavicle'. Did sir hear the 'clavicle' I murmured. But seriously, someone give me a reason why i said clavicle?!
Sir : poyko poyko (laughing)
Me: Sir - - - - -
Sir : Haha! Poyko.
The last station was of surgery instruments. Yeah, am good at instruments. So they gave me fresh Ryle's tube and some other instruments. But the last one went like...
Amal Sir : What's this?
Me : Jolly's retractor!
Amal Sir : Jollyoo?! Ath kudathayillalle. Ith thyroid. Ath cyanide🤢!!
Me : Sorry sir. Joll's self retaining thyroid retractor
Do i need to add an extra comment on this?
The only happy moment i had was realizing Mohamed Fayiz sir and Amalkumar Viswanathansir (one who taught us instruments) were absent that day and the moment waving from our moving car to Mohandas sir after winding the show at 4:45 PM.
Hence, I can not pretermit a surgery practical happened on 16th December 2019. What a colorful hell it was 😂
May be, i would forget this episode but definitely this deserves a place in ma timeline forever. Till Zuckerberg calls off this and boooooom🔥
PS :
(1) Sleep properly during exams
(2) At least study properly for god sake🙏
(3) Mohandas sir oru manyan anu...
