Recipe for success in Med School

Preparation time: 5 years

Cooking time: 1 year of internship

Serves: 1 motivated Medical student

Ingredients:

• 1 1/2 cups all purpose hard work
• 1 1/2 cups intelligence
• 1 cup superfine determination
• 1/3 cup best quality support system
• 2 teaspoons faith
• 1 teaspoon sleepless nights
• 1/2 teaspoon luck
• Pinch of confidence

Method:

1. Sift the hard work so that all traces of a social life is removed.
2. Mix the sifted hard work, determination, sleepless nights and luck together.
3. Next beat in 1 1/2 cups of intelligence.
4. Now add the support system, faith and confidence and beat until satisfactory results are achieved.
5. Bake for 1 year

• Pro tip: Garnish with a generous serving of chocolates and milo

Millennials and Mental Health

As the bus slows down to stop at the bus stop a wave of panic hits me as I wonder if this is where I should get off. The feeling lasts only for a minute until I am able to gather my bearings and realize that my bus stop is actually 3 stops away.

I hate using the public bus, I detest using the public bus. Not because it is crowded, not because I might not always get a seat and not because it is not air conditioned but simply because I have this phobia I might miss my stop. This fear consumes me so much that I start getting anxious and worried at least 5 stops ahead of the stop I should get down at.

Some would call it mini anxiety attacks. Do not worry, I am not deluded into thinking that my mini anxiety attacks are in any way comparable to what my dear friends diagnosed with anxiety disorder go through. But having had at least a small taste of it I can only imagine how bad an actual anxiety attack must be.

Yesterday was world mental health day and this year’s theme is “Raising awareness of the magnitude of suicide around the world and the role we can play to help prevent it”. Suicide is pretty common these days and it’s not something that is swept under the carpet anymore, but did you know that every 40 seconds someone loses their life to suicide? I mean that is such a huge number. Honestly it’s baffling.

What is it about our generation that makes us more vulnerable to depression, anxiety and suicidal thoughts?

Obviously there is no single answer to this. One of the key reasons for us millennials to feel anxiety, depression and low self esteem is due to the pressure we feel to always have to look and act like we have got it all together.

Why do we have the need to feel this way?

It is because of you and I, us, the society. From accepting unrealistic beauty standards and comparing ourselves to a virtual life brought to us courtesy of social media. We are responsible for digging our own graves. We only have ourselves to blame for placing unnecessary expectations on ourselves.

So how do we break this vicious cycle?

It’s simple and it begins with you. It’s all about perspective. Next time you find yourself comparing your life with someone else’s remember everything you’ve already got and thankful for. Next time you feel like saying something not so nice about someone’s picture, video or perhaps blog, think again. It might be only words to you but for the person receiving the hate comment it can mean much more.

Favourite things (med school parody)

Patients with murmurs

And surgeries to assist

Blood to be drawn and procedures to perform

New stethoscopes and the smell of alcohol rub

These are a few of every med student ‘s favourite things

Postponed exams and cancelled lectures

Catheterization and suturing

And discharged patients

Patients that cooperate and permit to be examined

These are a few of every med student’s favourite things

Turquoise blue scrubs and slim fitted white coats

Consultants that arrive late to the ward

Cancelled casualty and no new admissions

These are a few of every med student’s favourite things

When the consultant quizzes us

When our diagnosis is wrong

When med student’s are feeling sad

We simply remember our favourite things

And then we don’t feel so bad

The Kandy Esela Perehera: The world’s oldest religious and cultural pageant

It’s that time of the year again, where the streets of Kandy come alive with the sounds of whip crackers, drum beats, trumpet blowers and the beautifully adorned elephants.

The Annual Kandy Esela Perehera which is enjoyed by us Lankans irrespective of our different religions is a hallmark of our rich cultural heritage. This colourful pageant deeply rooted in tradition usually takes place in the months of July or August and is a fusion of two ancient pereheras: Esela and Dalada. The Esela Perehera is enacted to request the gods for rainfall while the Dalada Perehera pays homage to the sacred tooth relic of Lord Budhdha.

The origin of the Esela Perehera can be traced all the way back to the 3^rd Century BC and the Dalada Perehera to the reign of King Kirthi Sri Meghavarna of the Kingdom of Anuradhapura while the perehera that we all enjoy today dates back to the 18^th century to the rule of King Keerthi Sri Rajasinghe and comprises of the four Devale Perehera  and Dalada Perehera.

The task of organizing this complex procession deeply rooted in customs and traditions lies in the hands of the Diyawadana Nilame, the lay custodian of the sacred tooth relic. The perehera is inaugurated by planting ‘kap’ at the auspicious time, where poles cut from a Jak tree is planted within the premises of the each devale. This is followed by a procession held for five days which is confined to the devale premises. In this procession the “Deva Ayude” of each devale is carried.

Then the procession of the sacred tooth relic begins.  The first five nights of the procession is known as Kumbal Perehera.  The Kumbal Perehera is held in order to ward off evil spirits and ill will.  Although it lacks the grandeur and splendor of the Randoli Perehera that follows it,  Kumbal Perehera is still a popular and integral part of the Kandy Esela Perehera.

The Randoli Perehera is held for the next 5 days.  The special feature of the Randoli Perehera is the inclusion of the palanquins.  In the days of the kings, a palanquin was taken in the procession in honor of the Chief Queen as it was not deemed proper for the queen to participate in the procession of the sacred tooth relic.  This practice continues even today where the palanquins are taken as the last item of the procession.

The last Randoli Perehera which is known as the Maha Randoli Perehera is the icing on the cake of this grand festival.   The pageant ends with the Diya Kapeema which is the water cutting ceremony which takes place at the Mahaweli River in Getambe followed by a Day Perehera. The water cutting ceremony symbolizes the divine aid necessary for a good harvest.

The Kandy Esela Perehera complete with its whip crackers, flag bearers, dazzling array of Kandyan dancers, traditional folk dancers, fire breathers, drummers and elaborately dressed elephants truly is a symbol of our rich cultural heritage.

Why?

People ask me why? Why do I want to become a doctor? I could never explain it to them, to make them understand what it is that is fueling me. To be honest I don’t think I truly understood it myself either until today…

It was the second Tuesday of my cardiology rotation and my turn to be at the clinic and take histories and present to our consultant. While I was taking the history from a patient, I noticed the patient seated next to him. He looked really familiar on closer inspection it hit me it was Tom from my medical rotation.

Tom was a patient from my first ever rotation. He was in the medicine ward when I was doing my medicine rotation. A military veteran he had a whole host of problems from intracranial hemorrhage, stage 3 chronic kidney disease, ischemic heart disease,  diabetes mellitus, hypertension and epilepsy. In fact I wrote about one of his epileptic seizures in double double fits and seizures.

Owing to his many problems we never saw him walk or talk during our rotation. I remember feeling sorry for him at that time thinking that he would never be able to walk and talk again. So it was quite shocking for me to see him seated by himself with his file ready to meet the consultant. As if that wasn’t enough of a shock for me he smiled at me and told me that he remembers me.

At that moment it dawned on me how far he had come in the past nine months. From not being able to walk or talk today he was able to come on his own and meet the consultant. Although I played no part in his recovery I felt so happy. I could only imagine how happy the doctor who cured him must feel if I who was a mere spectator was feeling this happy. At that moment amidst the hustle and bustle of the clinic Clarity hit me and at once I knew why I wanted to become a doctor.

Every medical student has their own story as to why they want to pursue medicine. Whether they have been cured from a serious illness and want to do the same for others or whether they want to follow in the footsteps of their parents. Everyone has their unique story.

For me it is the joy I would feel once I have been able to cure someone and alleviate their suffering.

Note : Name and identification details have been changed to protect the privacy of the patient

Not Every lemonade is sweet

If life gives you lemons, make lemonade they say.

But what if the lemonade is bitter?

Don’t get me wrong I’m generally  ‘the glass is half full’ kind of person but my recent experiences at the surgical oncology ward has made me question if every dark cloud really does have a silver lining. I mean what if the cards one dealt is so bad that no amount of bluffing can help you win that jackpot like in Poker?

What do you do if you are a 30 years old mother of a 5 year old son with esophageal cancer; where both surgery and chemotherapy has failed, where you cannot eat or move without support and is in immense pain in spite of being on analgesics? Do you give up on life or do you endure the pain and suffering in the hopes that someday you would be miraculously cured?

That was the dilemma Jane faced and in her case she chose the former and tried committing suicide twice during her stay in the ward even though she was only given a couple of months to survive by her doctors. I can only imagine what her pain must be that she was so ready to leave her child and family and end her life.

Out of all life’s adversities cancer by far is one of the worst that one has to deal with. Not only is the treatment for cancer painful but it also has long lasting side effects. Even if your cancer is successfully treated, it doesn’t stop there as there is the possibility of recurrence of the cancer, survivors of cancer constantly live with the fear of getting the deadly disease again.  You really are never rid of it.

In the surgical oncology ward you see many patients who at the most will have a year only to live, who need support in eating and sitting up. But the thing is most of these patients are elderly unlike Jane. At first when I got to know that she would be dying pretty soon I felt so sorry for her. Here we have our whole life ahead of us to attain our goals, complete our bucket list and enjoy our lives and I wanted to be able to give her more years to live. But when I found out that she had attempted to commit suicide I realized the cancer had not only robbed her of her health but also her dreams and goals in life.

Sometimes life does give you some pretty bitter lemons that even the lemonade you make is too bitter to drink.

What do you do then?

Note : Name and identification details have been changed to protect the privacy of the patient

Antibiotics

Sir Alexander Flemming was an absent minded guy

But his carelessness was a gift to mankind

While some may argue about the evils of Antibiotics

All I know is that his discovery of Penicillin

Has got my work cut out for me

From Beta lactams to Aminoglycosides

From dosage to mode of administration

From spectrum of activity to mode of action

From resistance to side effects

There is much to remember when it comes to antibiotics

Whether you’re a gram negative or gram positive bacteria

Staphylococcus, Streptococcus, Pseudomonas or Clostridium

There isn’t a Penicillin that hasn’t got you covered

Some of you Enterococci, Pneumococci and Staphylococcus aureus

May think you’re smart by developing resistance to Penicillin

But have you forgotten Penicillin’s rich cousin Glycopeptide?

Chlamydia, Mycoplasma and Ricketssia species

The sunflowers in a world full of roses; the atypical bacteria

You’re not forgotten either we are giving you a dose of Macrolides

Beware gram negative and positive bacteria

Sulfamethoxazole and Trimethoprim’s double act

Is enough to annihilate you

Last but not the least is Chloramphenicol the one feared by all  

While bacteria take cover at the sight of antibiotics

Viruses look on smugly for no antibiotic can touch them