Enthusiasm within quickly defeated the December chill, many years back, at the moment of the commencement of my MBBS in the Government Medical College, Srinagar Kashmir.
The Principal and Dean of the College, Prof. Girjha Dhar, warmly welcomed us with her usual blend of style and high quality professionalism. “Remember that all human beings have 206 bones, and that the circulating blood is bright red among all races, irrespective of religion, region or race,” she reminded us. “And this profession demands dedication and sincerity. You must all work hard, and then devote yourselves to the
service of humanity, irrespective of cast, color or creed “, she went on. Her commendable sermon is still fresh in the meadows of my memory, although years have passed since I heard it.
Once her speech was over, we all stood up and solemnly repeated the Hippocratic Oath which was read out to us by the Qatar-based heart surgeon Dr. Javed Khan, then CASS2 union president of the College. The function concluded with a cup of Saffron Qahwa, then we left the College’s elegant Anatomy Hall to begin our new lives.
No sooner we were out of the hall than a few esteemed seniors surrounded us.
“Follow in a straight line!’’ one ordered us. “Take them to the Leprosy garden straightaway!” commanded yet another
from behind. “Leprosy garden” – what could that be? The name sounded
scary, but we were soon all relieved to see that it was just the intervening garden between the college and the SMHS (associated hospital within college campus) hospital. Reluctantly
obeying orders, but to the delight of all the seniors, we started the fresher’s march-past. At 4 pm we headed to “Bemina Boys hostel”. In the College, the ragging went on for only a few days, but in the hostel the process continued, and we would only get to our rooms late in the evening.
“At sunset you must go to the dining hall without delay, have your dinner and wait and see what happens next,” advised
one of the hostel seniors. We all followed his advice; it proved to be apt.
Just imagine the stress of the anatomy hall, bio lectures and physio lectures, and then, in the evenings, groups of sirs
waiting for us in the hostel. In short, all new students were sandwiched between the two, between the devil and the deep
blue sea. I would often look across the Bemina Hostel grounds through the window of my room on the ground floor of B block, and envy the passengers travelling in the passing bus
which I would take from time to time. Not only this, but I would often count the days right from Monday until I could
visit home on Saturday. One day I decided to prepare for the Anatomy Stage (a class test) well away from the hostel and its distractions. I headed towards the SKIMS hospital, where my
cousin was doing his residency. Unfortunately, he had already gone home. In desperation, I booked a room in the nearby hotel and started reading. At around 9pm I enjoyed a tranquil dinner in the dining hall of the hotel. The weather was chilly and some of the dining hall customers were to be found warming
their hands around the coal stove. I joined in their chat for few minutes, and left again soon after to continue my reading.
The next day, the stage (my class test) went very well. No sooner had I stepped out of the hostel bus that evening, then
I froze in my tracks, as the person to whom I had been talking very frankly to the previous night in the hotel was my senior. It seemed that seniors were everywhere; there was no way of escaping from them! I tried my best to prevent eye contact with him but his eagle eyes sought me out.
“Follow me,” he commanded and he took me to his room.
My heart started racing, and now I was sweating in the chill of December.
“Where were you yesterday? Washing dishes in the hotel?”
“Sir, I had Anatomy stage and I was preparing for that.” “Stage!!!” the other senior sarcastically exclaimed.
“It has not started as yet! Go on, you will see!” he further exclaimed.
“Don’t waste your father’s money. Next time something like this happens, don’t even think of staying in the hotel,” he
said more gently. “You can come to us and prepare here instead,” he went on.
“OK sir, thank you very much,” I replied gratefully.
The next day, while washing my face I noticed that I was looking a bit miserable. “Ibu! meri Jan: things are difficult here, and it feels as if it will be impossible to complete the MBBS” whispered my heart.” After that, however, things changed steadily and some seniors started becoming friends.
After a few months, the Government Medical College CASS union election campaign started. It was all state of the art, and our group of freshers was an important focus of attention of all the candidates. Suddenly, they were all requesting our votes. Seniors were coming to our rooms in droves. What a
great feeling of importance! The election campaign was interesting, being full of innovative ideas, posters, etc. and
eventually the CASS union was duly elected. Months passed and things changed steadily. All the seniors became friends and wonderful guides. One could almost say we grew up together in that great hostel. Years have passed since then, but there is still great respect for all of them.
Oh! I forgot to mention this: a new batch of freshers joined us a year later. Our batch had conveniently forgotten the stress and difficulty of being a fresher, and in turn, we inflicted the same behavior on our juniors. Only then did I realize that all this was an endlessly repeating cycle of initiation.
Various functions were organized by the CASS union during the following year. I recall taking part in one of the plays
“Mafroor” (The Fugitive) staged in the Tagore Hall in Srinagar.
The hall was packed with students and faculty. I and eight other students, all dressed in white costumes, were supposed to be having a discussion in a café. No sooner had our seating
arrangements on the stage been set up by the organizers than the curtains opened, and we were bathed in the fierce light of the stage lights like rabbits in headlights. We started delivering
our respective dialogues perfectly, while pretending to sip coffee from small earthen cups placed on the table in front of us. Quite honestly most of us had rather mugged up the highly
philosophical theme of the play as nothing had actually traversed beneath the bones of our skull. Suddenly a shower of tomatoes started coming towards the stage; tomatoes were
crossing like jets in front of our eyes. One of these burst near the corner of my mouth. Predictably, it was very ripe, and the juice spilt all over my white costume, as if I had suddenly laughed while taking tomato juice. In the midst of this rain of
tomatoes, Yunis Shah came running from the left corner of the stage, followed by the late Khushal Paul Singh soon after, who came running on after him. Yes – the “conscience” of the person
was trying to catch the “self”. They played a sort of hide and seek on the stage for couple of minutes and finally the “conscience” (Khushal Paul) caught hold of the “self” (Yunis shah), and a confrontation between the two started. “Why do you suppress me so much? roared Khushal Paul (“conscience”).
“Why do you pretend to be what you are not?” he went on. “I have a family, and I am not the only one in this whole wide
world” replied Yunis shah (“self”). The audience was immediately gripped by this exchange, and stopped throwing
tomatoes. Everyone became engrossed in the heated exchange between “self” and “conscience”. Finally, “self” agreed not to kill “conscience” and the curtains started closing. We got up from our chairs and all walked off the stage in a single line while raising the slogans “storm in a cup of tea and tea in a
storm” (chai mein toofan and toofan mein chai).
“Well done, guys!” the director of the play said as we walked into another room backstage. He was puffing deeply on the
cigarette in his mouth. “This was really just the dress rehearsal.
Tomorrow is the actual day of the performance, as the VIP show is then. I hope you will do equally well”, he added. “And I certainly hope there will be no shower of tomatoes”, I said smilingly, while still wiping the stains of tomato juice off my face. We changed out of our costumes and joined the rest of
the audience in the hall. The curtains swept open again, there was a roll of drums and the orchestra started playing. Anil Ganjoo came on from one corner, and Sandeep Kaur from the other, and when they met in the middle of the stage they started singing, “Janey Kahan mera jigar gaya ji ——— (Where did
my heart go ……?), the famous Bollywood duet by Kishore Kumar and Lata Mangeshkar. While constantly stamping his right foot in time to the music, Mr. Anil was at times shaking his
shoulders as well, entertaining everyone in the hall. Inderjit Singh was wonderfully moving his head while rolling the drum.
They were lucky – no tomatoes were thrown at them! Instead, the hall resounded with clapping, and the audience even sang with them. Both the singers started acknowledging the claps
of the audience, by means of the movements of their heads until they finally completed the duet. Various other interesting cultural items followed. The next day, all the items were repeated
in the VIP show, including our play. All events proceeded smoothly, much to the delight of all.
Another CASS Union function used to be “The Sports Week” at Bhakshi Stadium. As I recall, the winner of the musical
chair among the faculty would always be the stalwart, usually an ex-professor, the award used to be as a mark of respect and love for him or her. In short, the Sports Week was a practical
demonstration of team spirit and professional respect.
After 18 months we had to sit the first professional exam. The preparation was an uphill task and examination itself was
quite tiring. “Listen Ibrahim, I have a friend in Lolab. It will be a nice break to visit him there. What do you think?”, said
Sheikh Nissar Ahmad, my friend and batch mate. It was the month of September when we boarded a bus in Sopore. It moved at a snail’s pace, but as it moved, fresh currents of air filled
the bus to Lolab. The driver went on intermittently picking up stranded passengers on the way. After Sogam, however, the road was rough, and if any bus came from the opposite direction,
the dust thus swept up would enter our bus, forcing us to lower the window shields. This we did quite unwillingly for
the area is gorgeous, like a bride, and the wonderful panoramas unfolding along the way constantly engage the imagination of the traveler, making it very interesting journey. After almost
four hours on the bus, we reached Warnav, a small village in
valley Lolab3 , famous for Moulana Anwar shah Kashmiri, the famous Kashmiri Islamic scholar of international repute. The view of the lush green valley was quite mesmerizing. Once we arrived, we were warmly welcomed by my friend’s father, who was sitting in the compound of his home. The compound was very large, and interesting too. In the corner of the compound a cow was tied to a small wooden peg. I imagined that she had just been milked, and now her beautiful little calf, which was brown, mottled with few white spots, was drinking thirstily from its mother’s udder. It was making wonderful little to and
for jerky movements during this process, and the cow had turned her face towards the calf, the better to lick her baby
affectionately. What a beautiful display of “unconditional love” it was – and alas, rarely seen among human beings.
Their house, though old, had a unique charm. There were multiple loops of red chilies and other vegetables hanging on
one wall to dry, in preparation for the harsh winters in the area when fresh vegetables could become scarce. A wrinkled old lady could be seen sitting on a mat woven from dry gross (called Patuj in Kashmiri), holding a long stick. She was safeguarding the paddy, which had been spread on the mat to dry, from marauding birds. My friend’s father led us upstairs up a partially lit wooden staircase. As we walked up it, up our
steps produced a characteristic chrick, chrick sound. As our host opened the door of their guest room, the friend arrived and he, too, warmly welcomed us. He threw open the windows
and wonderful fresh mountain air filled the room. After a refreshing drink of tea, the friends took us around to give us
a bird’s eye view of this beautiful area. In the evening it was quite interesting to listen to the friend’s father. “My dear sons,” he would address us, “never consider other person inferior to
you. Your position in life is part of God’s great plan. See it simply as a test of your character. Conceit or pride will take
you nowhere in life; remember that an overinflated ego can destroy a person. Remember never to boast of things you own or of your achievements in life.” He had no formal degree, but he was a man who seemed to have learned about life’s great truths from nature. Alas we can say that in modern times literacy may have increased, but education in its real sense has decreased, with values all over the globe changing. It took
me years to understand just how fragile and vulnerable human beings are, and that there is nothing one should be proud of! Over many years of practicing medicine, I have observed how
an individual’s pride can be dashed to the ground as a result of relatively small alterations in chemical reactions in a human body in a diseased state. For example, after a small bleed or
the formation of a thin clot in the parietal lobe of the brain, a billionaire doesn’t recognize his own face, as his or her memory gets washed away forever and he becomes completely dependent on others for his every need. I could cite innumerable medical examples like this, all of which serve to remind us that a person should refrain from pride and conceit. Coming back to our stay in their home, I am reminded that after a delicious dinner had been served, we slept like logs under our warm blankets. The crowing of a cock woke us up at the break of dawn – cock-a-doodle -doo – I awoke with a yawn, and soon – chrick, chrick – I became aware of the same sound of the wooden staircase I had noticed when coming upstairs the
evening before. It appeared that the family had got up for morning prayers, and had wanted to do so without disturbing us. What makes the cock crow, and who sets its biological
clock and why? I wondered sleepily. I went on thinking about this until I turned over and fell fast asleep again. What a
wonderful order exists in nature. I am sure that you will agree that the disorder, if any, seen in the world, is crafted by none other than human beings, the supreme creation of God Almighty.
Soon after breakfast we again set off on a brief tour of the sub-valley where they lived. By the afternoon we were all set
for our return journey. Our friend – for now he was my friend too – and his father accompanied us to the bus stop. After a short wait of about half an hour, a bus arrived from the nearby village. They bid us a warm goodbye and a few hours later we were back home again.
A few days after we returned, the results of our exams were made known. I had passed! The next step for us was to
start our clinical postings. The third year of MBBS study really gives the feeling of becoming a doctor; you wear a white coat and a stethoscope round your neck, while visiting various hospitals. The clinical rounds in the associated hospitals of our college used to be of the highest quality. Every morning, the patients’ attendants would be removed from the wards by the paramedical staff, and then the team of doctor and us students would start the clinical round, led by the Professor.
The attendants would remain waiting outside the gate and the gatekeeper would often be seen struggling to keep the door closed; at times he would be seen lashing out at misbehaving
attendants. In those days there was a lot of emphasis on clinical medicine. The professor would listen carefully to the case history recounted by a house officer or a postgraduate student, then
he would lower his glasses and finally start examining the patient himself. This would invariably set the presenter’s heart
racing. The professor would almost always find something unusual in the patient, which had been missed by the house officer or the postgraduate presenting the case. One day while
we were busy on our on clinical rounds, we heard the cry of a woman patient who had recently been admitted to the ward.
“Have you admitted a patient with meningitis (the inflammation of covering of the brain)?” interrupted the professor, while he was listening to the case history and examining the patient in front of us.
“Yes sir, in fact we did admit one patient with meningitis yesterday evening,” replied the admitting registrar, looking
up sharply with look of surprise on his face. “That is a meningitic cry!” replied the great professor.
Those great teachers would share their irreplaceable experience with us, and not just theory, as many of them were accustomed to making diagnoses without the many methods of investigational support we have nowadays. Their clinical decisions would be spot-on, and at times when the patient was poor, they would opt for a therapeutic trial. I remember the patients calling them “saints”. They used to be full of respect for these great doctors, and, in turn our teachers were full of empathy and sympathy for them. “He trains what lies between the ear pieces of your stethoscope; respect him as he is your
teacher, whereas I simply demonstrate”, said one of our professors while we were examining a patient with a heart murmur (an abnormal sound heard on listening to the heart, usually through a stethoscope, produced by the blood passing through deformed heart valves) in the presence of one of these great professors. The discussion on the genesis of heart murmurs used to be very interesting. Each consultant would provide arguments in support of his / her diagnosis. The patients would patiently submit to the elaborate auscultation process. Days later, echocardiography would prove most of the diagnoses to
be correct. They had a passion for teaching and sharing their knowledge.
One day one of the professors brought an old patient of his to his outpatient clinic in order to discuss the case with the students. “Just examine his heart, but don’t talk to him” he instructed us, pointing towards the patient on the examination couch, waiting for the students to examine his heart. One after
the other we used our stethoscopes on him, but no one could locate his heart sounds. When it was my turn, the patient
pointed with his finger towards right side of chest but still said nothing. I placed my stethoscope on his right side and
found wonderful heart sounds in that location. Yes, he had
dextrocardia4 . “So: what is your diagnosis?” the professor asked
the students. “Sir, dextrocardia” I replied, but despite my efforts, the smile on my face indicated that I could have received a clue from the patient. “Sir,” I explained, “I didn’t talk directly to the patient, but he pointed towards the right side of his
chest”. Everyone in the group laughed. Well, I have never come across another such case in my career to date, and had that great Professor with his passion for medical education not brought that interesting patient along, it would have remained a theory in our minds.
I recall a middle-aged male person who would often be seen moving around on a wheel chair as his both limbs had
been amputated following Buerger’s disease. It is also known as thrombo-angiitis obliteran, and is caused due to heavy smoking. The hospital had given him some small job so that he
could survive. One day it happened that we were in the middle of the clinical round led by Professor and leaving the ward.
The legless patient was coming towards the ward on his wheel chair. “He is the living example of disastrous effects of smoking.
I can only advise you to never smoke yourself and, during your career, advise all your patients to quit smoking.” the great professor advised. I often see this patient in my mind’s eye
when I do just this! Another interesting and often seen person was a middle aged well-built man who was a little mentally challenged. You could ask him the time at any time of the day or night, and he would flip his arm and look at his wrist (which never had a watch on it) and he would tell you the time, accurate within a minute or two. I witnessed this myself a number of time, I could never understand how he did it. Extra sensual power (ESP) and what science doesn’t or cannot explain in full can kindles many thoughts in a sensitive mind.
The general environment was a very favourable one for clinical teaching. After their hectic schedule of the day, all
postgraduates would go from one ward to another in the evenings as well in order to examine cases with findings and
discuss these amongst themselves. I would often visit my esteemed seniors Dr Shariq Masoodi and Dr Fayaz Kanjwal to examine the cases admitted to their respective wards. One day I went to ward 3 of SMHS hospital to see some case.
“Ibrahim, examine the patient admitted on bed 3 in the main ward. I will be joining you,” said Dr Fayaz Kanjwal, while he was preparing the discharge summary of an admitted patient
in the house officer’s room of the unit. I went to examine the patient and found a heart murmur but could not time it at all.
When he got there, he said: “Ibrahim, let’s put our stethoscopes on him together and when I hear the murmur I will raise my finger. Then you start timing it.” I did exactly that, and only then I could I understand that murmur. It was an excellent example of “peer teaching” as is described in modern medical
education. On many occasions our immediate seniors and postgraduates would teach us on the ward, and demonstrate the clinical findings.
“Friends, I saw classical case of Pancost tumor with Horner’s syndrome5
in the Chest disease hospital in Srinagar”, one of our group mates told us after his clinical rotation in the said hospital. Going to that hospital used to be all fun and games, and when we were there, we would visit Dal Lake and at
sometimes go on a trip to Shankar Achariya hill6 . That evening, a group of students went to see that interesting patient, and later we had a tour of Dal Lake7. As there were no internet or
mobile facilities, we would often communicate in this manner about interesting cases admitted to the associated hospitals of the college. For what modern medical education now describes as “self-study” our self-study was of course self-study with limited resources but many practical examples.
During our medical training the most fascinating posting used to be the “Maternity posting” month at Lala Ded Hospital in Srinagar. A group of 16 students used to stay for 24×7 hours
in the hospital for the whole month. As I recall, no sooner were we allotted the few rooms in the vicinity of the labor
room, we dropped our bags and headed towards the stage-1 labor room. The clinical round led by the Registrar on duty
was in progress, and we joined her round.
“Bring the Doppler to check the fetal heart of this patient’s baby”, said the house officer to one of the maternity students. The patient was tossing and turning with her labor pains and
intermittently squeezing the hand of her nearby mother. She was prescribed medication to ease her pain and fasten the progress of her delivery.
“We will give her a trial of medication and in the event that her labor doesn’t progress well, or there is some emergency, she will be operated” said the registrar on duty to her anxious
“Doctor, please do something to relieve me of this terrible pain!” the patient kept on begging, with tears in her eyes. “I
will never ever get pregnant again”, she added. From time to time we could hear her screaming with pain. Hours later she
was transferred to the room for the 2nd stage of labor, and the midwife started to try and boost her morale, knitting her eye
brows in between her pains, and finally, in the dead of the night she delivered a baby. The cry of her newborn baby helped her to forget her pain – suddenly she was a mother! She could
not keep her eyes off her newborn baby, even though they were falling closed with extreme tiredness after the birth. In
the meantime, the baby’s birth was being celebrated by the family.
The days went by, and slowly we were all learning the art of delivery and its management. One day, having gone out to buy some groceries, we saw an ambulance arriving in the hospital compound. Its windowpanes were smeared with dust.
The driver jumped down from his seat and pulled the back door of the ambulance open, while extinguishing his cigarette with his left hand. We saw a pregnant woman lying on a
stretcher, comatose, connected to an oxygen cylinder. She was accompanied by five or six anxious attendants, and was hurriedly rushed to emergency room of the hospital. After a quick examination in the emergency room, the house officer quickly shifted her to the eclampsia room.
“Monitor her blood pressure, and also the fetal heart”, ordered the consultant on duty. Two maternity students were
allotted the job, and we made a chart. Her blood pressure was quite high, and she was bloated. The clinical diagnosis of pre-eclampsia8 was reached, and the necessary treatment was started in the room, which was kept only partially illuminated, lest the dazzling light should trigger convulsions in the patient,
a feared complication of the disease.
Next day at sunset I found I could not detect the beating of the fetal heart with the Doppler. I immediately rushed off
to find the nearby Intern on duty. She came immediately, and almost tripped on her heels on the way, but neither could she hear the fetal heartbeat in the patient’s womb.
“Ama (mother), I’m so sorry, but the fetal heart has stopped. It seems that the angel of death has kissed the baby in the
womb. We need to take it out of the mother. I’m so sorry we could not save the child, but let us try and help the mother of the baby now”, said the registrar on duty to patient’s mother.
The tears started falling in the mother of the patient as she gave consent for labor to be induced in her unconscious
daughter. A dead baby was delivered hours later. The patient’s condition started improving, and gradually she reached consciousness again. We were all happy that she had come out
of her coma but sad about the death of her baby.
The next morning the patient wanted to know when she had been hospitalized and where her baby was. Yes, the mother
was in search of her child, and unfortunately none of us in the
team knew what to say – we were speechless. The consultant on call during the morning rounds glanced at her and affectionately touched her forehead. “Shift her to the ward in
the afternoon,” she said. “I am late for the operating theater;the list is long and I need to go” the consultant said, and she
asked the registrar to continue the rest of the round. On another occasion during this posting, Mr. Iqbal Fatekhan our batchmate was singing in his melodious voice very famous Kashmiri song in the restroom” —Gachhi nai saaf dil, detie
laaf saasa …..(unless your heart gets cleaned whatever you boost of, it is all meaningless). Another friend had brought a big tape recorder of around 2 feet long which must have been
7-8kgs in weight, and the session was being recorded. While this was going on, someone knocked on the door. We all stopped singing, and some students slipped under their blankets. A few
even pretended to be snoring. One of the students opened the door, and yes, the intern on duty was standing there. “I need two of you accompany a patient to the operating theater as I
need to have a discussion with the anesthetist on call. One of the
ladies has to undergo an emergency cesarean section due to fetal distress,” she explained and then left, the door behind her closing with a bang. At around 2 am the patient was operated on, and her newborn was sent for observation to the pediatric intensive
care department in the adjacent Children’s Hospital. I was asked to monitor the mother’s vitals in the recovery room “Doc, please tell me where my baby is,” she mumbled while
I was tying a blood pressure cuff on her arm in order to measure her blood pressure. “Your baby is in the pediatric hospital next door for observation. Otherwise she’s fine,” said I.
Oh no Doc – another girl child! How will I go home with a third daughter in row?” and she burst into tears, her voice
breaking, and a stream of tears starting from her eyes.
“But it is not your fault at all,” I tried to explain to her.
“You have no control over the gender of any of your children.
In fact, it is the Y chromosome of the father, your husband, that determines whether the newborn is male or female, and not you.” I tried my best to explain this to her, but without success.
Unfortunately, dear Reader, human history has witnessed many gross injustices done to females through the ages. In the olden days in the Arab world when girls were born, they would be silenced soon after their first cry, till the Prophet Muhammad peace be upon him put an end to this menace. On the Indian
subcontinent, until Raja Ram Monohar Roy and others put an end to it, the unfortunate custom known as “Sati” which demanded that women cast themselves onto their husband’s
funeral pyre, persisted for centuries. Nowadays so-called civilized and advanced man has gone still farther, and has been choking female fetuses while still in the womb, “the female
feticide”. It must have affected millions of girl babies so far, and has naturally created serious gender imbalances in many parts of the world. The contribution of women to the world
has been and is still enormous, and is wonderfully summed by William Ross Wallace in his poem ‘What Rules the World’, when he said that the hand that rocks the cradle is the hand
that rules the world. It illustrates the influence a mother has on her child and, in the long run, on society itself. From it we understand that by yielding to her natural maternal instinct to nurture and teach her child, a woman explicitly makes the world a much better place. This puts a great responsibility on the medical fraternity to stop female feticide, which is nothing short of murder. An antipathy against female children in any
society would soon disappear when women are enabled to become strong citizens on a par with men. This is possible only by means of education for girls, in every sense of the word. They should be taught self-defense as well, so that devil’s evil eye remains at bay. A step further towards this goal will
be made when society simplifies its customs and offers equal opportunities to all. Only then will this unfortunate male- imposed gender inferiority of women disappear from our planet. Destruction of this wonderful creation of Almighty would then become a thing of the past. Coming back to our maternity posting, the days continued
to melt and the same group of students lived together for virtually the entire month. We would often study together,
and of course we would also often discuss the process of labor. It was a perfect example of that wonderful model now called “team based learning” in modern medical education. We would
eat together, crack many jokes and in general also had lot of fun. All of us enjoyed the posting and the month flew by.
Although each one’s experience of it was a little different, we left that hospital having learnt many things. A posting like
this shows how much trust patients, better call them saints, bestow on a budding doctor. I remember this period with great affection, and to this day we all honor this great hospital and its great name. It has served many patients tirelessly for many decades now.
Friends, while the maternity posting offers a wonderful opportunity for a budding doctor to hone his medical skills, it also makes one stop and think about, and understand, one’s love for your mother. A mother sacrifices herself for her children right from conception and through the 9 months of gestation,
and then finally she faces the terrible pain of labor. Witnessing this should remind us how much we owe to our mothers. It should make us stop to think also of womanhood in general,
and in particular the unfortunate social structures which still exist today. After this posting we joined our classes again and after few months we went for a picnic to Pahalgham. During our medical school days, we would often go for picnics to Gulmarg and Phalgham9.
One summer I had a chance to go trekking with Dr Shariq, Dr Mehraj and Dr Rafiq. They had already completed their
training, and were then working in their various house jobs.
Early one morning on a lovely sunny day in August, we boarded a bus from Srinagar to Shopian in order to trek to Kausar Nag10. By noon we had reached Ahrabal, which was also our bus’ terminus. Beyond this there was no public transport, and the whole area is ideal for trekking. Ahrabal is famous for a very big waterfall. After lunch in a restaurant, we started our trek in the surrounding thick forest, carrying heavy rucksacks on our backs. The site itself is breathtakingly beautiful, and despite our growing fatigue, we admired every aspect of it.
That evening, hardly able to move, we camped near the banks of the Kausar Nag lake. Dusk had fallen and the night was upon us, and the moon was waxing as we started preparing our outdoor dinner on a kerosene stove. The sky was a huge dome above our heads. The breeze made lighting the stove somewhat problematic, making the flame flicker and waver, but finally we surrounded it and in this way stabilized its flame so that our dinner could be cooked. The stars twinkled brightly, and the reflection of the moonlight on the still waters of the lake made it seem as if the moon was looking at its radiant face in that huge mirror. There was no sound or trace of any other human beings – it was just us four souls under the vast roof of that beautiful sky. It was mesmerizing to look up in the sky with its vast galaxies of innumerable stars. Who lit these lamps and why? When simple parts of a watch cannot
assemble all of a sudden, how can this vast big unimaginable universe do so? Normally one never gets a chance to think much about these things but life in the open air and this trekking started my thoughts off in this direction. We were all very tired after our trip and all the fresh air we had had, so we retired soon after we had eaten, sleeping like logs in those beautiful blue tents. As soon as the sun started coming up, the
tents got lighter and lighter, and it was as if nature itself was knocking from all sides, and nudging us to get up, which we then reluctantly did. We washed our faces in the cold water of Kounsarnag, and had our breakfast in the sunshine. What a wonderful huge ball of fire and energy the sun is! Yes, I thought
to myself, it is behind all activities on this earth, and for billions of years it has been tirelessly performing its duty. It seems to set only to our earthly eyes, but in reality it never sets, instead
it shines unceasingly. While priests of science postulate the mechanisms of the way it produced its heat and light but why it does do this? These questions go round and round, kindling many more questions and random thoughts in an inquisitive mind. But back to our trek! After having a wondering time out
in the fresh air for several days, we started our return journey.
We stopped at Koungwatan, where we camped for the night. The clouds were racing and moonlight was hiding behind them periodically, but luckily it didn’t rain during the night. After breakfast the next morning we started our walk and after a
few miles, a light drizzle started and the path become rather slippery. The uphill trek had made us all sweat a lot. In fact,
it felt as if we were running a marathon, and now, due to the rain, the sweat from our foreheads was running into our eyes,
producing lot of discomfort. Luckily we spotted a few huts in the heart of the dense forest and we headed towards them. We knocked gently on the door of one of the huts, and an old man
stepped out. He welcomed us warmly and we entered his low hut, made of stones and wood. We introduced ourselves as medicos. “Would you like some tea, and then, would you mind
seeing a few of our patients?” he asked politely. “It will be our pleasure”, we replied warmly. He sent his son to spread the news of our arrival in the area. He was carrying a large black half-broken umbrella as it was raining lightly. As the saying goes, “hunger is the best sauce”, and we really enjoyed maize corn bread and Kashmiri tea we were given in their home. Dr. Shariq had brought quite a lot of medicine along, and he examined a group of patients. As a student, I was more of an observer.
A young boy around 4 feet tall entered the room, and Dr. Shariq examined him. “Squeeze your shoulders together”
ordered Dr. Shariq. The boy smiled broadly while doing so, his movement surprising me greatly while I watched. “Ibrahim! Just look at this! It’s cledocranial diasostois , or the absence of clavicles (collar bones) from birth. I have to confess that I have never seen such an interesting case later in life! After an hour or so, the rain had stopped and we started footslogging
again. We carefully chose some long sticks in the jungle to help prevent us from slipping during the trek. We talked,
laughed and cracked jokes on our way. When we finally reached home, we did so with refreshing memories and a feeling of great satisfaction. The cramps in legs did not disappear for a few days, but what a great message and motivation this trekking carried with it! As a medic you can be helpful with very little
extra support at any place in the world where humans are living and your books or study materials are present even in
The years passed, one after another we passed various exams which were all tough experiences. They used to play
with the adrenal system and virtually exhaust the adrenal hormones! During these various examination periods everyone used to be tense and tired. Talking about these medical college
examinations with one of the college’s gold medalists, he said to me, “The impression you give when you are in medical college starts right from first stage (class test). That, in fact,
forms the basis of your final test. But one can be better than the best”, he added. And “Make a 3-dimensional image of the subject in your mind and try to understand the subject well.
Only then it will stay longer in your mind.” These were pearls from another gold medalist in our college. I remember one of our Professors often saying, “All of you are intelligent, but your hard work will determine how far you will go in your
career. Remember that if you stop at any level, you will be stuck there”, he would often add.
“On which side does this bone belong, and what are its attachments?”, asked the Professor while handing over a fibula
to me in my final MBBS exam. I was initially stuck, as it was something I had crammed up for in the first MBBS passed
four years earlier, but luckily I recollected the TEEP muscles mnemonic – tibialis anterior, extensor digitorum superficialis , extensor halucis longus and peroneus tertius – and remembered that they all start from the fibula and are supplied by the deep peroneal nerve. “What is the nerve supply?” Prof. lowered his
glasses and asked me further. “The deep peroneal nerve, Sir”, I replied confidently. Thanks to the mnemonic I could reply to
this question but unfortunately the Professor felt that I knew everything there is to know about osteology, and handed over another bone, this time a rib. I had no mnemonic in my head
about this rib, so I could remember nothing about it. Of course mnemonics are very good aids to memory, but at times we students would only remember the mnemonics themselves and
not what they represented. No sooner had I stepped out of the examination room than I asked myself “Why did Prof. ask me a First MBBS question in the final MBBS?” However, years later I realized how important it is to have basic scientific knowledge as well as extensive experience in clinical practice all along in your career. In most of other branches of endeavour, people tend to forget things after they have completed their
courses, but as a medical student, one needs to refresh your knowledge every now and then and carry all subjects safely in your memory. There are many things one only understands slowly, and it is true that some things you only really learn after you have finished your course. The key thing is though, that your thirst for knowledge must never die. One must go on endlessly enriching it and adding to it. All of us were thrilled when we passed our final MBBS exams, and to join our profession as interns. However, with the passage of time, we came to know that we were somewhere near the shore of a great ocean of knowledge. Nowadays, the emphasis is to know more and more about less and less, in
other words, to specialize more and more narrowly. Doctors tend to go for super specialization now, but over the years I have observed that some doctors are delivering better patient care, even without specialization, and vice versa. All branches in medicine have potential and scope, for it is the person practicing it and not the profession that matters. It is a job that requires a passion for knowledge and devoted care of their patients.
While recounting these tales of my life as a medical student, I relive our happy salad days like many of the people in my
GMC batch. All of us are proud of this great institution, its hospitals and its faculty. Over the years I have observed that despite cultural and language differences, all patients demand
love and care. Patients are the saints of humanity and I love my work as a physician. Giving people hope, consoling them when necessary, and providing them with optimism all help a great deal in the management of patients. Furthermore, I believe our work demands very good communication skills, and the
ability to work in a team. We must have due respect for our seniors, and love for our juniors. Sincerity, and the latest
knowledge at all levels both count a lot in the management of patients, and these are our tools. I don’t feel it out of place to mention that patients also need to remember that doctors are human beings too, and notangels. They hold dreams in their hearts as well, and they too have personal lives. Patients should not expect miracles. All diseases are not curable, and in some diseases even doctors cannot help.
“The journey of a thousand miles begins with one step.”– Lao Tzu
Note : Excerpt from the Book “Bumby Roads”
Author is a MD. DM (Gastroenterology) FACP, FACG Consultant Gastroenterologist &Associate Professor at School of Medicine, Taif University, KSA . He blogs at dribrahimmasoodi.blogspot.