Mental Health and Pandemic

Covid cases and mental health issues go hand in hand owing to the uncertainty .

People around the world are facing mental health issues , pandemic really has our brain cells knocked up from all directions . The extensive news coverage and an unknown future are root cause towards an upsurge in anxiety amongst the masses along with domestic violence.

Even though I am a general physician who sees and treats various forms of depression , bipolar , epilepsy and panic disorders. I resort to an experts advise on management of these disorders during these UN-unprecedented times .

It has always bothered me to the core when people read up on psychiatry texts books , post treatment of a psychiatric illness , read psychology books or do a 6 week in course in something in the name of psychology start preaching it or practicing as psychologist . You need knowledge , a mentor and a good amount of practice under supervision before you let lose in the world to deal with people who really need help.

I resorted to my really good friend , Umme Kulsoom Kazmi MD who has recently graduated as a psychiatrist to share tips to deal quarantine anxiety and develop resilience during this covid roulette .

  1. Emotional and Mental well being : One common symptom everyone is experiencing at home is anxiety. This is a natural response from your mind but if you feel like it’s debilitating , you are unable to work from home , you are depressed and have recurrent panic attacks then schedule an appointment with your psychiatrist . If you are in the middle of a therapy then do not skip an appointment . Do not change meds if you have been taking them . If anything is affecting your mood then discuss it over with a professional to figure out whats causing it and chalk out a solution . Alot of times we find people have thoughts of self harm which is a red flag and needs attention .
  2. Limit social media and news : Being on social media is has it’s pros and cons. It devours us on a flood of information which usually is a bad news. The best thing to do is schedule time to read news . Try to read it during the day and schedule an activity after it like walk , exercise or call someone who comforts you . Try not to wake up or sleep to bad news. How you sleep sets tone for the next day. Being on social media also makes you believe you need to be a part of some activity and not sit idle this again provokes anxiety of not being productive .
  3. Time off family : It is imperative to understand during these times most of us are not going to feel like our normal selves , some of us will not feel like being online , some of us will not be comfortable talking to people on the phone. if you feel this is what you feel like doing then unapologetic-ally and guilt free take that time off . There should be no sense of feeling accountable to check in on people because now is the time you need to check in on yourself first . So when you are available to your family you are able to present a quality version of yourself as opposed to checking in everyday and feeling more anxious and adding in part of your anxiety on to others .
  4. Physical well Being: A scheduled life like pre corona times is important . There should be a fixed time to eat , sleep and exercise. Try to get dressed even if you are working from home this makes one feel motivated . Make one designated work area in your home which shouldn’t be your bedroom . Take breaks for lunch or chit chat with friends just like you would at your office. Try to stick to timings .
  5. Exercise : If you feel unsafe going out of your house then even a 15-20 min walk or exercise indoors is important . watch yoga videos and do them at home. The key here is movement to release endorphins that are responsible for feeling good. Sitting all day and not moving at all makes you feel more lethargic. Also There is a question that people are feeling more fatigued than usual despite being at home because a lot of our energies are being utilized to help us function during the day and keep that panic at bay – a part of our brain is utilizing more energy than it usually does to help us maintain ourselves during these changes circumstances and we might not office work but we surely have other gazillion things and new tasks to deal with while at indoors.
  6. Gratitude Journal : You can do this once a week. a study published at John Hopkins showed that people who practice gratitude journaling decreases the relapse in depression . As we sit and look at all the things we have lost during covid it is vital to also give heed to what has gone right and write it down stuff like I haven’t gotten it , my friend recovered , I have eyes , roof , family etc . It is in human nature to see things in black and white and always focus on the wrong. It is not because people lack to capacity to do but sometimes our anxiety and depression present this way . This exercise will put things in perspective and help make things concrete on what is some what better and not to catastrophize it.

Things you should never say to medical students

Getting into medical school is celebrated across the globe. Overnight your life changes. People start taking you seriously and you tend to get more respect than the average college student. But these shenanigans are short lived. Soon after, we find out what people think of our chosen career path. Whether it’s your relatives or your friends, their comments can end up breaking our hearts into a million pieces, all in one shot.

Talking from experience, here are a few things one should never say to a medical student:

1. You look tired

Seriously? Do you not think I have a mirror to appreciate my dark circles?

But since you asked, I’ve been preparing for my anatomy tutorial for a week. And I have to ace it because an overconfident “Mr Know It All” competes with me and I can’t stand losing. Side note: I study better at night.

tired jet lag GIF by CBC

2. How much longer will you study (Kab tak parho gi)

I wish we had the answer to this question but sadly we don’t. Every med student is different but for the most part, we know what we signed up for, and the sooner we get to it the better we feel. The day we stop studying, we literally go blank. Books are to medical students what laptops are for tech students or paintbrushes to artists.

school studying GIF

3. Tum budhi hojao gi

Are we running a wedding quest? In all honesty, ‘doctor bahus’ aren’t too worried about getting rishtas. They know they’ll be in demand even when they’re 35. Desi aunties would do anything to get their lawaris sons married to a doctor. Also, in general, stop caring about when other people will get married. It really is none of your business.

4. What will you do after MBBS

If you really want to throw a med student off, go ahead and ask them this one. We barely have the capacity to figure out where our next meal will come from. Do I really need to worry about ‘after’ when I’m already having an existential crisis? (Wait, what will I do after MBBS…)

season 1 starz GIF by Blunt Talk

5. You have no social life

Trust me, med students have quite the roaring social life. If anything, we use the ‘I have to study’ card just to avoid gatherings that end up being worse than actual studying. We, bunk classes, go to all the festivals and despite our daily tests, we also pursue our hobbies. We just don’t talk about it.

6. Other majors are equally hard as medicine

Let me assure you, nothing is as complex as the human body. But to each their own. And comparing different fields in a bid to figure out which one is harder is an exercise in futility. Best to discourage it as you’ll only make yourself look silly.

7. Doctors don’t get paid well

This has to be one of the worst things you can say to a med student – that all their hard work holds no value. Two things for those who often dish this piece of wisdom: 1) best not say anything when you have nothing nice to say 2) medicine takes its sweet time before it rewards you well.

Broke No Money GIF

How To use Potted Plants At Home

Gardens have the power to add serendipity at home. However not everyone has the luxury of having a garden at home. For such homes the best thing to add some greenery, is to set up small green corners at home that serve the purpose of beautifying home while augmenting color at the same time.

I personally love the use of potted plants indoors to add some exquisiteness to home décor. They let you cultivate your creativity while expanding your green environment.    22391866ff4e0ff5f9cc6e20cc46f4c6--southern-living-magazine-spring-colors

It is easy to buy plants from a nursery and place them at places you desire but one needs to keep in mind a few pointers while doing so, in order to maintain the plant. Here are a few points on how to  make an effective use of potted plants at home:

  1. Make sure about drainage:   This is as vital for plant growth as sunlight. If the water has no drainage then as you water the plant the water gets soaked up in the soil leading to death of the roots. Pick pots that have a hole in them. A hole enough to manage water drainage. In case your pots lack holes then drill some holes beneath or on sides.   6a6944a65d48d947ed7508f86f57fcbc--flower-plants-potted-plants
  2. Evaluate light:   Always easy to place plants near the windows or in gallery so that the light is ample for the plants to grow. However some plants require less sunlight and can be kept indoors like money plant, cactus and etc. Always evaluate light and then place plants at places you want to.   bathroom-plants-on-shelves
  3. Fertilizers:   Potting soil lacks minerals. Since the soil in potted plants is less effective for growth hence it is always advisable to make use of fertilizers and mixes that help the plant grow well.   shoe-organizer-garden
  4. Make use of home containers:   It is always easy on the pocket to make use of potted plants at home to cultivate your garden. If you have a tough time buying pots then make use of home containers, paint them, decorate them however you want and settle them in gallery or wherever. You can also make use of old shoe holders, climbing plants and old bottles. Plant them whatever plant you desire and get your garden game on.   ivy-plants-against-white-backgroundtumblr_mo8wgi99Y31stf1zao1_500

 

Remember, maintaining a potted plant garden at home requires attention and hard work. However it is one appealing sight to eye.

Doctors Perspective on the corona roulette

In this unsettling atmosphere, I step into the unchartered territory of the Corona roulette. It has taken the world by a storm and everyone is affected by it – either physically, emotionally or financially.   As the virus proliferates in the air, fretfulness flourishes on the soil.

I was appointed to do the morning shift in the COVID ward of our respected hospital.

One of the things that set aside this unit is the fact that it is a negative pressure area and to us doctors, it is comforting as we embark on the Icarus flight.

“You don’t enter here without wearing PPE’s, “Said a familiar voice. As I looked closely I recognized it is one of my staff from ICU who I can barely identify owing to the number of layers he has over himself and the mask. We all look the same here.

I went to the room and was assisted to put on has bled, googles, shoe cover, then a headcover, N-95 mask with a surgical mask over it, gloves and then a blue gown over the entire thing.  The number of layers over me made it hard to breathe and walk nevertheless I persisted.

Then I rushed to see a patient who was a doctor diagnosed with COVID pneumonia, desaturating but not agreeing for intubation.  “If we intubate you now it will help you “exclaimed the anesthesiologist but the patient replied, “I need to prolong time, I don’t think I will come back “.

This patient was a Middle age dermatologist who had most likely acquired the virus from one of his patients. Knowing the process of intubation and it’s associated complications he could be anything but optimistic about the situation.  However, the process of ratiocination has reached its conclusion and intubation was to be done.  It took us a good two hours to get his consent and once he made up his mind he wanted to write down his will.

This was case one.

Case number two,

The crash call generated CPR done for 10 mins patient revived. Thankfully.   This patient had returned from a religious congregation from where many had been exposed to COVID-19. Just like he did and now ended up in ICU. Even after reviving him due to his deranged blood gases and impending respiratory doom we had to do an elective intubation (put him on the ventilator). As I approached him to explain the process and its importance.  He also decided to pen down a will which took him a good amount of time. He was intubated successfully.

Both my patients were in different rooms. Leading a different life, belonging to different sects, cities  and perhaps a different mindset. However it was strange how both after hearing about being put on a ventilator acted the same.

I have been in practice for six years post-graduation and have seen many patients dying for various reasons. Never have I ever come across someone asking us to wait so they can pen down their will.  A will that talks about loans, return of goods, things that would be worrisome for their kids later and finance to distribute.

This was thought-provoking and disturbing.   It seemed like I announced death to a living.

As the day passed, there was a series of intubations, mortalities, recoveries and everything took a pause in the last hours of my shift.

I realized that the masses devour on the flood of information coming to them from all directions- Facebook, WhatsApp, TV, twitter, etc.  Which is incorrect and haphazard. A version of the third person who lacks knowledge of the workings of medical practice. It is important to filter the information and impart the crux of it instead of random bits of assumptions.  People are of the mindset that they will die of COVID regardless and there is no point of return from a ventilator.

Us doctors know how this disease progresses. We know the prognosis for patients who need to be on a ventilator. We know that if we have a cardiac arrest during the course of COVID infection, our prognosis gets much grimmer. Faced with this knowledge, we make decisions.

Though I admit so far in my experience I haven’t seen anyone recovering either but the fact that the patient here is without a will –power and with a fixed mindset of not returning is hurtful.  It makes us doctors powerless and quite timid too. It brings death nearer to me than it was ever before.

At the end of the shift, I had a talk with one of my colleagues who was with me in this ordeal dealing with the anesthesia aspect of the day. Both of us exclaimed how fearful we are about being healthcare workers as we embark upon this Icarus flight. I fluctuate between calmness and fear. Fear of being thrown in a battle unarmed (I think the PPE’s are useless and limited).

As people make jokes about toilet paper, panic shopping, and quarantine activities. I wish I was someone rejoicing the fruits of boredom rather than standing for 12 hours straight seeing people die, utter their last words to me instead of their loved ones or just deteriorate.

I am implying through my narrative that this time is way more stressful for us doctors not just physically but mentally as well.    While we are in the trenches our communities need to stay home and prevent the spread. Because to be honest we don’t have that much of skilled nurses and doctors, to begin with. Even if you amplify the number of beds and ventilators who will run the show?

Pakistan has been a third world country with a compromised healthcare system from the start and no amount of groundwork can help us deal with such a calamity.  We can’t keep a one is to one ratio of a doctor and anesthesiologist with every patient because it requires years and years of practice to master the art.

Having said that, let’s hope things ameliorate here before they deteriorate.

Doctors do their best to give hope and compassion to patients and use their knowledge to save them. We will utilize everything we have in this crisis to advocate for our patients, to heal them, and to share as much science and information as possible to limit the death and disability that this will cause.

The Glorious Wazir Khan mosque

Walking the streets of the walled city of Lahore, it is impossible to miss the famous and aesthetically pleasing Wazir Khan Mosque, which is situated at the entrance of Delhi Gate; surrounded with a bazaar that is still in bloom with fruit, cloth, and khussas. An epitome of simplicity, beauty and pride.

Built in 1634-35 A.D, during the reign of Mughal Emperor Shahjahan, the mosque takes its name from its builder, Nawab Wazir Khan, who was the Governor of Lahore until 1639 A.D.

Much to my surprise the Nawab Wazir Khan (Shaikh Ilm-ud-din Ansari) had studied medicine and was a personal physician of Prince Khurram. The young prince was so fond of his competence that he awarded him the title “Wazir “ which means minister.

It has been said that Hakim Shaikh ilm-ud-din had cured Queen Nur Jahan (1577-1645) for cysts on foot and she had rewarded him with all the gold ornaments she was wearing at that time. The cost was around 22 lacs and this was set aside by Wazir to build a mosque that serves as an architectural masterpiece for generations to date.

It has often been said that it took him seven years to complete this elaborate structure which consists of walls that are lined with the calligraphy of holy verses from the Quran and Persian poetry, delicate and fine frescoes covering the facade along with mosaic tiles ornately decorated with Kashi-Kari work that was uncommon at that time. Several archways in the mosque are lined with muqarnas (an ornamented vaulting in Islamic architecture) while the rest is lined with Mughal style frescos and decorative tile panels.

The floral designs and patterns on the wall give a sense of serenity to the mind as you walk through the echoing halls of the mosque.

The main mosque is constructed with bricks and tiles. There is a large courtyard that opens through the entrance where one could find 22 shops in the ground plan that has antique doors. It was once known as “calligrapher’s bazaar”. The main prayer area opens into the ablution pool which people still make use of.

The mosque contains the tomb of Sufi Saint Muhammed Ishaq Gazruni, Aka Miran Badshah.

Owing to its magnificent beauty it was once the most fancied mosque for the emperors to offer their Friday congregational prayers in the 17th century.

Astounding as it may seem, these structures give you a glimpse of the artistic sense of people at that time along with their way of living. I sense some similarities and some differences while living the same culturally chaotic life.

It is always interesting to walk into old towns and mosques to revisit a glimpse of history and wonder about the people who once lived here, were they like us? How did they live or how were their lives different? What can we learn from them and unlearn from our lives?

The Mughals may not have run the show well but they surely left landmarks that add to our amusement to date.

A Doctor’s Advice On Self Quarantine And More

20190722_094259Most of you may be bored with a quarantine routine that involves looking after home chores, exploring your creativity or maybe just getting tired of staying at home. However, doctors like me still have a hectic life where work has gotten busier than usual. There is a shortage of almost everything – from staff to nurses, PPE,  surgical masks,  medications, beds, and accessibility to food. At times I wish I too could be mindlessly scrolling through Instagram or binge-watching NetFlix, but that’s not my job.

As doctors, we walk into work every day with the risk of catching COVID-19 because of the overseeing of patients. There is a 20% chance of contracting the virus despite wearing the prescribed PPE’s. It is a daily struggle to screen patients, treat them and ensure that you are safe in the process. Waking up every day and going back to the hospital, knowing today may be the day we notice the first of the symptoms, is a physical and emotional turmoil.

Having said that, it is imperative for people to understand their symptoms and not bombard their doctor friends and family with calls, or populate hospitals without that. For all those who are suspicious that they have the virus despite proper hand hygiene and social distancing, here is what you need to know about when to report to the hospital and when to be concerned about the likelihood of the disease.

When Should You Be Worried?

It’s easy to get worried and think that you might be a carrier of COVID-19, but according to the Center for Disease Control and Prevention (CDC), self-quarantine becomes especially essential if:
– You have traveled from a country where the disease has been widespread.
– Been in touch with someone who has traveled.
– Have come into close contact with someone who has a confirmed case of COVID-19 and is symptomatic.
-Live with someone who has symptomatic COVID-19, even if you have consistently followed the recommended precautionary steps to prevent transmission of the virus.

How To Self Quarantine

The primary goal is to prevent the spread of the disease. If you have been in contact with someone who contracted the disease, but aren’t show any symptoms yourself, the ideal thing to do would be self- quarantine yourself at home by following these instructions:
– Do not leave the house unless absolutely necessary
– Separate yourself from people and pets that you share your home with
– Do not share your stuff like bedding, towels, utensils and drinking glasses
– Disinfect commonly touched surfaces daily.
– Wear a mask.

Monitor Your Symptoms And Have Faith

Watch for fever, dry cough, shortness of breath, myalgia and diarrhea. If you have any of these then the best thing to do would be to rush to the emergency and get tested and treated. Remember, this pandemic has proven that we possess limited healthcare facilities worldwide. The videos about overworked healthcare workers with overwhelmed hospitals are factual and palpable. In the wake of the impending surge, remember that nurses, porters, doctors, technicians, registration workers, and even the guards are working tirelessly in suboptimal conditions to save lives.
When the dust settles, we will emerge victorious, albeit with more gray hair. Regardless, this experience will allow us to become better – individually, as a system, and as a global, unified, social team.

Doctors : Don’t care about your hand writing ? You Should

A quintessential art of communication is a well-written note. A decent note is one that is self-explanatory as you read. However, to read, you need to understand what is written, and decent handwriting is vital. Unfortunately, neat handwriting is something tough to find, especially when the writer is a doctor.

Image result for doctors dont care about your hand writing you should

While doctors may be the smartest students in their class with gold medals around their necks, immaculate in appearance, polite in speech, and humble in etiquette, they sadly lose it on one aspect of life — good handwriting!

It is a known fact that when you think faster than you speak, you stammer, and your writing gets messy.

But in some professions, like medicine, you don’t have the choice of being slow, and specifically thinking slowly.

A doctor is trained for four years in a residency program to develop reflexes that quickly fire red alert signs in the brain when they see a patient with an altered level of consciousness or fever. He has no power over himself to slow down in times of emergency. Instead, he acts faster to save a life. In this process, the one thing that mirrors his mental process is his handwriting, which at times looks like an abstract art piece.

I have always been notorious for my writing. Someone who has a passion for art but is miserable with the pen is how I have always seen myself.

I may not have the art under my belt, but what I do have is my clinical skill.

At work, I prefer being organized and focused … a mind preoccupied with the patient and their plans. I don’t realize how much the phenomenon of thinking faster than speaking and writing has on my daily doings.

On a sunny Wednesday, the last day of my rotation as a resident on the floor who sees consults. I was overworked and tired with caffeine in one hand to keep my neurons functioning and a stack of papers in the other.

There’s the chaos of greeting patients to thoroughly examining them head to toe, being overly cautious not to miss any finding that would change the treatment strategy. I rewrote my notes, and while doing so, it struck my mind how I missed the old review of medications.

I rushed back to the patient, grabbed her file, and started noting down her previous medications. The attendant stood next to me, amazed at what I thought was my speed; however, she broke my proud moment and uttered, “Doctor, do you understand what you write ?”

I paused, glanced back at my writing, and laughed. “I don’t,” I replied and re-wrote this time in a slow legible way.

In medicine, a simple rule applies to all calamities: If you didn’t document it, it didn’t happen. Hence writing notes is extensive in this field compared to any other. Plus, constant scribbling against the paper makes the small muscles of the hand overworked.

Many times, the small discrepancies made on prescription paper could be bad news for the patient.

The way my patient questioned me about my written notes made me realize how important it is to pause and not rush things, even though I may be doing my job well. I am amazed that people around me will not remember me at how quickly and informed I am working or their treatment, but how I talked, walked, and wrote rather than what I wrote.

It is from then on wards when in a hurry, I practice the pause, especially when I have someone standing next to me who is inspecting how I work.

Natasha Khalid is a physician in Pakistan.

Impact of Sports Anthems

With sports season in full swing, Pakistani musicians recount some of the greatest sports anthems in history and what makes them timeless.

A stadium full of hundreds and thousands of fans. Sports teams play. Painted faces, screaming chants, teary eyes, deafening noise and overwhelming emotions. If there’s anything that enhances the already electric atmosphere in any sports event, it’s music.
Stadium or sports anthems bring out that raw emotion out of people and are played to motivate the teams and rally the fans. Imagine the immortality of Queen’s 1977 song ‘We are the Champions’. More than 40 years later, it still riles up a crowd of any magnitude, thanks to its catchy hook and melody, and inspiring lyrics.
Go to any American baseball game and you will hear ‘Take me out to the ball game’ (1908), a classic that has lived on for over a century.
The Final Countdown by Europe has the melody to lift spirits instantly, whereas Gerry and the Pacemakers immortalized composer Richard Rodgers’ 1945 hit ‘You will never walk alone’ when Liverpool F.C started the tradition of playing it at football clubs.
spectators-singing-along-with-the-band
Similarly, The Cup of life by Ricky Martin and Waka Waka by Shakira are other such examples that did well on the charts and gripped the world’s pulse.
Essentially, sports anthems become iconic because they connect to the people’s one emotion that unifies everyone from communities to cities to entire nations. For example, recent domestic league matches have shown how each participating Pakistani city has its own theme song. An even better example would be Jazba Junoon by the great rock band Junoon.
SooperJunoon -Ali & Salman rocking the stage
According to filmmaker and Chand Tara Orchestra guitarist Babar sheikh, “A sports song should be such that it gets the adrenaline rush going inside you when you hear it! To make that impact on the audience it has to have the right hook and melody”.
He recounts that his earliest memory of sports songs is a recollection of songs by an 80s rock band called Survivor. “They did songs for the film Rocky. Rocky 4 was the absolute epitome of everything American. Songs like Burning Heart and Eye of the Tiger were so strong. Burning Heart is one of the first songs that I associate with sport, that is boxing.” Since Sheikh is also a football fan, he associates heavy metal and rock n’ roll music with the sport.
SooperJunoon - crowd at the concert
He recalls the 1992 World Cup anthem ‘Who rules the world’ as a memorable stadium song. “That was a great song and that world cup is unforgettable in the eyes and minds of Pakistanis because we won it.”
He further shared that songs like ‘We are the Champions’ by Queen, nationalistic songs by the famous Vital Signs, Call and Junoon have a raw mix of emotions, hence they resonated with the crowds and became a major reason for their success.
“Nowadays campaigns take over music and the lyrics are based on a creative brief rather than sentiments. These tailor-made songs lack the essence of what real sports music should be like. That’s what waters down the emotionality and accentuation of a song,” he says, adding how the recent domestic cricket league songs haven’t matched up to the bar.
While recent local cricket league songs may not have been etched into our memories yet, there is one that has remained popular for over 20 years: Jazba Junoon.
The song has the tune to get you moving and lyrics to lift spirits in time of need. Not only that but it is also close to the hearts of many Pakistanis, owing to the country’s loss in the 1996 world cup, and how the song subsequently helped them keep their never-give-up attitude alive.
SooperJunoon - Ali Azmat performing
Junoon’s front man Ali Azmat, who crooned the song and took it to a whole other level, says, “There hasn’t been much after Jazba Junoon. It obviously brought the nation to the point that after losing the match, the idea was to tell them it’s not the end. The message resonated with the masses.’ Hence, the song was a hit and decades later, is still the Pakistani anthem for cricket.
Azmat also echoes Sheikh’s sentiments, saying, “The main thing is the melody. No matter what you do, if the melody isn’t good, it doesn’t work. The rest, including the lyrics, is secondary.”
campus-cricket-player-celebrates-victory
No doubt music is an imperative part of Pakistani culture and cricket the most popular sport. Hence anything pertaining to it is made with a lot of thought process and hard work by the musicians especially when it is for something as serious as the World Cup.
Asad Ahmed from rock band Karavan stresses on the fact that lyrics and rhythm are essential for any kind of music to make it a timeless classic.
He also remembered Jazba Junoon as one of the songs that bring out the patriotism. “Songs like Hum Hain Pakistani by Vital Signs and Jazba Junoon by Junoon will forever be associated with Pakistani Cricket and August 14 as a reminder of our allegiance to this land we call home… Pakistan!”
While most musicians are fans of the old classics, Ali Hamza from the band Noori feels that the one track in all Pakistani music that has always helped him stay calm and going during the game season is “Saya-e-Khuda-e-Zuljalal” by Noori and the evergreen “We will Rock you” by Queen.
He explains, “Anthems are about easy-to-remember melody and lyrics. It is when they really drive the body and emotions that is when they shine in the sporting arena”.

Chronicle’s of a resident’s life

I love working as a resident physician, but I truly detest taking exams. However, life seems to only give you more of what you fear, so I recently found myself responsible for my residency program’s weekly clinical grand rounds — an exercise in which I would present a real live patient and be judged by my faculty and colleagues on my clinical acumen and physical exam skills. Passing would be a quiet victory; failing, on the other hand, would be a public humiliation.

My anxiety kicked in hard as the time for the presentation drew closer. As I rehearsed and revised just before the moment of truth, I was stricken with a revelation — I hadn’t cut my fingernails.

Alas, my personal grooming had become another casualty of my daily workload and brewing burnout. Ordinarily, this wouldn’t have been a concern, but here, my long fingernails would make percussion during the physical exam almost impossible. I would end up scratching, scarring, and bruising the patient’s poor abdomen with my taps earning a brutal shaming from my attendings in the process.

“Damn, I need a nail cutter, or I’ll fail,” I muttered under my breath, perhaps a little too loud. Cold beads of panicked sweat sprouted on my brow. At that moment, a general surgeon named Dr. S. who was seated in front of me in the lecture hall, turned to face me.

“Give me your nails — I will bite them down,” she deadpanned.

My reverie of impending doom broke. “Uh, what?!”

Placidly, she repeated. “We don’t have a nail cutter. Let me bite them off for you.”

A pregnant pause of consideration ended with an eruption of laughter, as the absurdity of the situation hit me. And just like that, my fear and anxiety dissipated, thanks to a well-timed dose of humor. I calmed down, and the presentation went smoothly — a testament to the power of a minor positive affirmation and the collegiality that so many of us residents depend on daily. I think back on this minor episode often when it feels like I’m just trying to keep my head above water.

And now, I keep my nails nice and trimmed.

Big Nails on examination Day

I love working as a resident physician, but I truly detest taking exams. However, life seems to only give you more of what you fear, so I recently found myself responsible for my residency program’s weekly clinical grand rounds — an exercise in which I would present a real live patient and be judged by my faculty and colleagues on my clinical acumen and physical exam skills. Passing would be a quiet victory; failing, on the other hand, would be a public humiliation.

My anxiety kicked in hard as the time for the presentation drew closer. As I rehearsed and revised just before the moment of truth, I was stricken with a revelation — I hadn’t cut my fingernails.

Alas, my personal grooming had become another casualty of my daily workload and brewing burnout. Ordinarily, this wouldn’t have been a concern, but here, my long fingernails would make percussion during the physical exam almost impossible. I would end up scratching, scarring, and bruising the patient’s poor abdomen with my taps earning a brutal shaming from my attendings in the process.

“Damn, I need a nail cutter, or I’ll fail,” I muttered under my breath, perhaps a little too loud. Cold beads of panicked sweat sprouted on my brow. At that moment, a general surgeon named Dr. S. who was seated in front of me in the lecture hall, turned to face me.

“Give me your nails — I will bite them down,” she deadpanned.

My reverie of impending doom broke. “Uh, what?!”

Placidly, she repeated. “We don’t have a nail cutter. Let me bite them off for you.”

A pregnant pause of consideration ended with an eruption of laughter, as the absurdity of the situation hit me. And just like that, my fear and anxiety dissipated, thanks to a well-timed dose of humor. I calmed down, and the presentation went smoothly — a testament to the power of a minor positive affirmation and the collegiality that so many of us residents depend on daily. I think back on this minor episode often when it feels like I’m just trying to keep my head above water.

And now, I keep my nails nice and trimmed.

What I learned from ” The Five People You Meet In Heaven “

Five people you will meet in heaven by Mitch Albom is an engaging story that includes fictional characters , magical realism . life lessons and perspective.  I won’t give away details of the story or summary . You can read it or watch it . Whatever suits you . But here are a few  thought-provoking lessons  that I  would love to share :

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1.In heaven, it becomes clear that the monsters of childhood aren’t the real villains. People who seem powerful are often victims themselves, and roles of victim-perpetrator can be reversed, even without malice. Even the innocent actions of children can have unintended consequences.

2.Sometimes, things aren’t as bad as they seem, as the unknown alternatives would have been worse.

3.Perception of reality is often misleading.

4.Everyone is capable of falling short, and everyone deserves forgiveness. Pain causes people to hurt others.

5.Redemption is not granted by others, but found through sorrow, regret, and attempts to make things right.

6.Memory is not a sad thing, as memory is another kind of continuation of life

7 . All Human lives are interconnected, and there is often a positive meaning even in seemingly random or negative events .

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