Gateway to Purgatory- Enter Neurosurgery.

I have deliberately forgotten some episodes from my life. Hmm…maybe not. Precision control of memory is not in your hands. I mean, brain.

But they are repressed. One thinks that that page is turned, but they leave watermarks on what you are. Like the skill to do Spinal Taps.

I was doing my Plastic Reconstructive Surgery residency in Calicut, when one day I volunteered to do the spinal for the patient because the only Anaesthetist who was free had severe arm pain after shifting one patient. I did it with finesse.

“I have never seen anyone do a spinal that easily, before!” She was astonished. “The last one you did must have been at least three- four years back- during internship?”

I bowed my head in mock humility.

The fact was that I had done four months of residency in Neurosurgery, that too at the prestigious Sree Chithradharans Institute of Neurosurgery, at Trivandrum. Every day at five in the morning, I used to do four spinal taps, before my first pee of the day. Then I ran into the bathroom, for that sweet release of the golden brown fluid from my bladder. One doesn’t forget a skill, learnt with so much urgency.

The way I got in, was hilarious.

One doesn’t plan these things- the hilarity. It all started in dead earnest.

After my Surgery training, I had got married, got a job as Lecturer in Surgery at my Alma mater where I did my MBBS, wielding the scalpel with ala-something and all the pretty Medical Students gazing at me adoringly, when I started getting restless. Alacrity- yeah. That is the word.

If I was all alacrity and smooth sailing, what made me restless?

Restlessness is a fundamental aspect of human nature. Haven’t you heard the proverb- “restlessness killed the cat”? It was not curiosity. It was restlessness.

The tediousness of comfort. The urge to climb the beckoning ladder. One had to have that MCh, dammit. Sub speciality was a requirement these days. Or so said some. Who- some? Some so and so, that’s who.

One could give two options in the entrance exam. I opted for Gastro Intestinal Surgery as the first choice. That was because it was seen as a continuation of General Surgery, and hence, the top choice for most. There was only One Single Seat in the entire state for this Residency slot. One had to put in a second choice. I put in Neurosurgery, on a whim. The exam had a separate speciality paper for the choice.

I didn’t get GI Surgery. Come on- that was too much to expect. But here is the key thing- I came first in the state for Neurosurgery! How does one explain that?

I had studied Medicine with some passion. To know the human body and to learn how to treat it. So, though my rote knowledge and marks were not scintillating, I had it in me. That was one explanation. The other one was providence- hey! I was destined for Neurosurgery!

Then why couldn’t I try for the coveted Neurosurgery seat at the prestigious Sree Chithradharan’s Institute, popularly known as Sree Chithra? They had their gruelling three tier entrance process in two weeks time. I called some friends and purchased a book. I can still remember the name, just like that-

‘ILLUSTRATED NEUROLOGY AND NEUROSURGERY BY LINDSAY AND BONE’

It took me a few days to get it, and I read it cover to cover a couple of times. I still have the book with me.

Trivandrum was ten hours away. I reached by evening. I had a friend in the Men’s hostel at Trivandrum Medical College. He had gone home, and I got the key from the neighbour, and got in. Then I went to the local phone booth and made a phone call. That was the mistake.

The one I called was Dr. Ravi Mohan, who was doing Gynaecology when I was doing surgery at JIPMER. Close buddy- get it? He used to reside at the room next to mine. He was a tutor at Trivandrum Medical College now.

The problem was that I was a part of a gang of Residents, affectionately known as the Kanji- gang, at JIPMER. Malayalees were known as ‘Kanjis’ in JIPMER, for reasons best known to the creator of the Universe. Four or five of them were from Trivandrum! A dangerous chance event.

All of them landed up at my room by seven. Tremendous camaraderie ensued. Slaps on the back were a dime a dozen. Anecdotes flew thick and fast. Past love-lives were re-born as stories. We simply had to take our business out into the streets and on to the local bar.

The waiter poured with a liberal hand, and the lubricating fluid warmed our hearts, tugged at our livers, and pleasantly addled our brains. I vaguely remember a war of words with someone from another table, and being gently, but firmly pushed out of the place by muscular men in tight T-shirts.

All had to give me company back to the hostel. We sat talking for hours, and some had brought some drinks and we had them.

See, the thing is, it was standard practice, in similar conditions in JIPMER, for us to sing songs at the top of our lungs and dance at the top of our form for an undetermined period of time at the portico of the hostel.

We saw no reason to discontinue the practice here. When I say, ‘we’, I of course mean, ‘them’. They sang old movie songs from the seventies and eighties, they moved their limbs as if they were having an epileptic seizure, they inserted certain obscenities at crucial points in the lyrics, and they made tremendous asses out of themselves. Let me be very clear. I merely accompanied them.

After a couple of hours of this deplorable spectacle, a tall narrow faced person with a droopy moustache came out from somewhere and started shouting at us.

“Hey, it is that ass, Gomeshvaran!” – My buddy Harichandran, said.

We shouted back. The whole thing escalated, as the diplomats say during a stand-off at the LAC, and Harichandran moved to a forward position, breaching the McMahon line, and landed Mr. Gomeshwaran, a solid blow on the cheek.

“Take that you! Just because you are doing final year Neurosurgery at Sree Chithra, don’t show attitude, ok?”

At this point, I slinked back to my room. Oh, no. I was not worried at all. I had no hope of getting in. I had booked the train back to Trichur at two in the afternoon, after the first round of tests, which was a set of multiple choice questions.  I looked at the clock. It was four in the morning! The exam started at six. I had a bath, brushed my teeth, and gargled my mouth liberally with toothpaste and did the exam. It was tough. I had not slept. The zero order kinetics prevented the alcohol from leaving my body that easily. But the questions were of an applied and general kind. Deep basics. That was my strength. But I had little hope.

I finished, went to the room, packed my bags and walked to the bus stop. On the way, I saw a crowd waiting for the results of the exam to be put up at the notice board in front of Sree Chithra Institute. I decided to wait.

Hey! I was among the sixteen short listed for the next stage!

This was a clinical exam. I had to take a case and present it. I was taking a Neurology case after four or five years. But that was OK. Physical examination was the key in becoming a doctor. This was what I had learned well. I could examine a patient in my sleep. She had cerebellar signs and hearing loss in one ear.

One tall, narrow faced man in early thirties, with a droopy moustache was the skilled assistant, arranging everything. Gomeshvaran!

In between, he looked at me with a piercing eye, and said:

“Hey- I have seen you somewhere. Were you….?”

“No sir. Not possible. I came today morning.” I said, through heartbeats of mine that I could feel like an earthquake.

I presented it as a tumour affecting the cerebellum, possibly localised to the cerebello pontine angle. There were a lot of questions. I answered as well as I could.

The result? Short listed for the final interview! I was with the Director and HODs of all the Departments- at 10 PM. Remember – No sleep till now. I had a small snack at three in the afternoon. It was like being back in Residency. I had a Bheja Fry. Sorry- De Ja Vu. One makes mistakes when hung over.

“Why do you want to do Neurosurgery?” The director asked, twirling his ample moustache.

“The challenge; and the discipline. One has to be ordered and disciplined. We have to push ourselves to the limit, to get optimum results here. The casual outlook is the enemy of Neurosurgery. I am the right man for this.” I answered.

Yes! I was among the four who finally got in. Exciting times.

“Our Assistant Professor, Dr. Gomeshvaran, will give you the instructions on what to do next.”

Assistant Professor. Did you hear that people?

Gomeshvaran looked at me like a policeman looking at a migrant labourer who was caught coughing without a mask during Covid times:

“Hey. I think I know where I have seen you.”

Ha. Interesting times ahead; I thought. (Jimmy Mathew)

Dr Jimmy

I am a Doctor, Writer and Science Communicator. I am a member of Info- Clinic, and have written a few books. This site features my blog posts and stories. Thank you for visiting. ഞാൻ എഴുതാൻ ഇഷ്ടമുള്ള ഉള്ള ഒരു ഡോക്ടർ ആണ് . നിങ്ങളുടെ താത്പര്യത്തിന് നന്ദി .