Eye Openers

 #USA

Post#20

The very next rotation after cardiology was Medical ICU. 

 Back in India I had no experience of ICU and ventilator setting adjustments. During Cardiology rotation the fellows in that department adjusted ventilator settings in the CCU. Here in medical ICU the senior resident was responsible. An intern was a slave for him. When on call we took care of things at hand and were on our toes day and night. If we were lucky we tried to catch a quick nap before preparing for rounds in the morning. My senior resident would sleep on a gurney right there inside the ICU, me in the on-call intern’s room which was on a different floor.

One night about 3 am or so the beeper rang. I had barely left the ICU and reached my room. I called the ICU staff from the nearest phone. They gave me some update on a patient’s pressure readings on the monitors that didn’t look good. I had no clue what to do with the vent settings so I told them to check with my senior resident who was right there inside the ICU.

Next morning the attending rounded with the team. After the rounds he asked to talk to me privately. He said he got a complaint that I wasn’t doing my job and thrusting it on the senior resident. I explained to him what had happened. I didn’t know how to adjust the vent settings and he needed to be woken up irrespective. If I knew it would upset him that the nurse woke him up I would have walked there myself to ask him.

The attending could see I was naive, not lazy or irresponsible. He told me candidly that day : “color of our skin matters. That’s why you have to be extra careful and work twice as hard as anyone else “. He was himself an immigrant from Hong Kong and knew exactly why I had rubbed my senior resident wrongly.

On the same rotation another day this same senior resident was trying to put in an arterial catheter into a patient. One catheter tried, unsuccessful attempt, catheter deformed , thrown into the trash can. Second attempt same thing. Third attempt same thing . I watched in horror.

 This was not how it was when I was doing residency in Mumbai. The patients couldn’t afford these expensive gadgets but scrambled and arranged for the money when they were told to get it from the pharmacy across the street . We did not have the luxury or heart to damage it. It was just too precious and we had to be precise in our first attempt . The indiscriminate wastage I was seeing in this new place was too shocking to say the least. Fearfully I asked my resident if I could try to put in the catheter because I’ve done it before. He let me do it and shrugged his shoulders when I got it in one go. As a foreign graduate those days if you did it better you were damned, if you didn’t you were damned. Fortunately I made it through because there were good players as well. 

On the general medicine wards too I was bullied by my some junior and senior residents. Even after all the day’s work was done, afternoon rounds were done , labs were checked they wanted me to stay longer so they would have a slave to fetch this and that for them . When I made my way out by 4 pm they didn’t like it. One of them went and complained to my attending. He called me to his office to ask about it. I told him Sir, I have two young kids at home, one is not even a year old and the other is not 3 yet. I leave home early and get here before everyone and once my work is done I leave because the kids need me. If the residents find a fault with my work you can scold me or write me up. But just like there is no rule here what time to start work ,there is also no rule when to leave work. From that day no one stopped me from leaving once I was done with my assigned work.

The saree for this post is a rather colorful non-jari kanchipuram silk with Ganga Jamuna borders and motifs on the borders and pallu depicting Yali ( a mythological creature seen in temple sculptures). This is a relatively recent saree( 5-6 years old) with no connection to the times discussed in this post.