Surgery residency, most young medics know, is meant to be tough. The hours. The sleeplessness. The heat, the lot. In India, a crushing hierarchy and slavish obeisance. A continuous hum of vague self-pity. Deliberate implantation of a feeling of worthlessness. The perpetual emptiness of never, ever being appreciated.
It was a bit muted in JIPMER. A reasonably good place. The general air- the atmosphere, of most other centres in the country had to be there too. Come on- it wasn’t an island.
But the only person who could make a difference, did. The head of Surgery was a formidable, but reasonable man affectionately called the Chief. All trembled before the Chief. The Chief was the Boss. He had strict protocols for resident training. That meant we didn’t have to fight and elbow for it. Do the work and get trained. That was good.
The good thing about the Chief was that while he induced a parkinsonian tremor in the residents, the Senior residents and the Consultants trembled too. Even the Unit chiefs did, in a fine, hyperthyroid kind of way. The next best thing to a democratic style of governance, which is simply not available in any set up in the country, was one in which, the Chief was a strong, yet good man. Merely good doesn’t count. He would then be swallowed up by a mass of scheming, virulent hyenas. It was a hyena-eat-laughing-hyena world out there. It still is, I guess. The merely good just exist; if at all.
The second year was almost over, and I was beginning to calm down. The going was good. The work, though tough, had become, from intolerable, to merely challenging. ‘Ah! I can do this, man!’- I thought.
Then one day my Unit Head called me into his room. He was called Smart Ben by nearly everyone, no one knew why. The etymology of the nickname was buried in the darkness of the remote past.
“Hey, man. Have you started working on your thesis? I expect you haven’t. Laziness is probably a congenital illness. It is doubtful whether you can complete it in time.”
It was a grim statement. I realized I was going to get fucked, or in JIPMER lingo, buggered. I mean, as a resident, I was getting buggered, as it were, but my thesis-buggery was going to be an add-on feature.
It was horrible. Each of us were expected to do research on a topic and produce a thesis, printed and bound, references and all. One was at the mercy of the Guide, and this was Smart Ben, for me. The thesis was a favourite weapon that was dangled on top of residents. For finishing the residency, one had to do it. The Guide could make you suffer. Big time.
“Hey, you! This topic is not going to work, man.”
Goodness. I had put in some work, running around in between the busy schedule. Pouring over the bound volumes of decades of old journals in the basement of the library. Yes! I know this gives away the fact that I am ancient stuff. There was no internet! Hard to believe, right?
I had measured scores of patients with hernias for anthropometric something to see the difference in their muscle mass and the idea was to find out the correlation between that and whether their hernias were direct or indirect. I had some data. Muscle mass was definitely lower in those with direct hernias. It would be- Direct hernias occurred in older persons who had relative muscle weakness, while indirect hernias were usual in young, strapping individuals with a certain peculiarity in their anatomy. It was, well- rather obvious.
“Why, Sir?” I couldn’t hide my dismay.
“It is rather obvious, isn’t it?” said Smart Ben.
Bloody hell! Of course, it was. I had already pointed it out to him when we started. That time he had told me to shut up and get on with it if I wanted to finish my residency.
Now then, I don’t blame him. Now I understand that I could have been quite a young rascal then. Impervious….? No. Innocuous? Absolutely not.
Impertinent. Yes. That was it. I must have come across as quite impertinent. I had a curious knack of being quite direct in my dealings with my fellow men. Then. Now I know better. I was from Kerala, and the hierarchy was much flatter. In Thrissur, post graduate residencies were not yet there. As interns, we were kings, and could actually talk to the unit heads and the heads of the departments. Yes- face to face, using human language. Unbelievable, yet true.
So, looking back, I don’t blame him. He was merely doing his job. Maybe he was a perfectionist. Maybe the sight of me just drove him mad.
I had to settle on a retrospective audit of all electrical burns that got admitted in the last ten years in the hospital. I had only a few months to finish it.
Oh! I ran around like a mad, wet hen. After continuous twenty-four-hour duties, I would descend, unshaved and sweating into the depths of hell- the Medical Records Department. The head clerk thought he was God. So, I had to bow down and crawl on all fours for an extended period of time, before he allowed me to rummage in the papery, moth eaten, dust laden chaos that was there.
I started to write. I got some references, after ransacking the entire library. Someone told me that a new contraption had arrived in the top floor. I got a letter ratified by the principal, and a clerk designated for the purpose put in your key words, and rolls of printed paper belched out. Journal articles and abstracts! It was amazing. I got twenty or thirty references like that. It was early internet.
I wanted to start writing. I would show Smart Ben what I did. But he would want me to re-write. Write, Re-write. Write, Re-write. I felt like tearing out my hair. But I didn’t. Not much were left. I lost a few kilos in weight.
I would ask Smart Ben for some free time or leave to do the work, and he would, very graciously and politely, refuse.
Smart Ben wanted me to go and get some journal papers from Kilpauk Medical College in Chennai. I was given only one day leave to do this formidable undertaking. To my considerable surprise, I managed to do it. A friend had given me the address of a contact in Madras Medical College, a resident in Neurosurgery. He said he had heard about me from my friend. He wanted to hear me sing Thamil parody songs! He got a few of his friends, made us all drink a bit and I had to compose cheap imitations of classic Thamil film songs on the spot and sing them. Ever had to perform under duress, feign happiness, and do comic numbers while drunk, hiding anxiety and despair, just so that this guy would drive you to Kilpauk and introduce you to the Burns Centre there? No? You have no idea how lucky you are!
But that didn’t help me. I had to take an extension. Most of my friends submitted their thesis and were studying for the final exam, which was only four months away. They were also relieved off most of their clinical duties. I had to slog, and work ineffectually at my thesis. It was hopeless.
A big smog of despair filled my life. I called home and told Mum and Dad:
“I may not be able to take my exam. Thesis could be a problem.”
One day, I was taking a coffee break in the Nurses’ room. Sister Sulthana was chief OT nurse. She was a big deal. Very kindly but quite strict. Junior doctors were shouted at, for some breach or the other.
She looked at me with a piercing eye.
“Doctor, we all like you here. Why aren’t you shaved? Why are you so down? Why do you look like a specimen that the cat brought in?”
She asked, or words to that effect.
I told her about the problems with my thesis in a few words. I was quite short, I remember. Didn’t whine or ramble. I did not tell her anything bad about the guide.
“Is Ben buggering you?”
I staggered. It was funny. Her English was fluent, but a bit too influenced by JIPMER student lingo. I hummed and hawed.
“Let me see, doc, what I can do.” She spoke.
Next day Chief called me. The Boss. The Head. Thalaivar.
I guessed that Sister Sulthana had talked to him. She was a young nurse when Chief had joined as a young Senior Resident in JIPMER. Even then, I was surprised. Strong bonds are forged at young adult life. Who knew!
“What the hell are you doing with your thesis, man?” The Chief scowled.
“Lot of revisions, sir. I have to collect a few references more. Guide thinks that I am not ready….” I blubbered, deliberately obfuscating the main issue.
“Show me your data and references- now!” He barked.
I ran and came back with the lot. He went through it carefully.
“Hey- This is enough. Start writing. Go”
I ran back to the ward and started my work. How to broach this with Smart Ben? This was torture. I couldn’t tell him, right?
But the next day, Smart Ben turned to me and blew like a volcano.
“Start writing your bloody thesis, you fool!” He said. “Just do it”
He had a frantic look.
No free time or leaves, yet. Still, I managed to write it, and get it in order. It was a race against time now.
It was the last day. You couldn’t submit the five copies at the JIPMER office now. I had to go to drive to the Pondicherry University and give it there, before they closed at five pm. I had given it for formatting and printing. I had to sit with them for at least half a day to actually get the copies in my hands.
Smart Ben refused to let me go. It was operation day, and there was a shortage of residents. I would be free only by evening.
I resigned myself to my fate. I couldn’t sit for the final exam this year. I could do it next year, maybe. I changed into theatre scrubs and entered the operation suite. I thought I would first go to the surgical ICU and have a look at our patients. My mind was heavy but numb. The world had collapsed but the work had to go on.
Chief was doing rounds in the ICU with his entourage. He beckoned me to come. I went and stood and good-morninged.
“Are you aware that today is the last day of submission?”
“Yes, sir. I have given it to the computer centre. I have to finish and submit.”
“Then what the hell are you doing here?”
“I have to be in the theatre, sir. The list is quite packed.” I said.
“That is ok. The others can manage. You go.” Chief said.
Again, this was a delicate situation. How can I go to Smart Ben and say- “hey, chief told me to go!”. Unthinkable.
I went in and looked at the case sheets. Walked up and down a few times. Then started washing up for the case. Patient was already under Anaesthesia. Smart Ben was washing beside me, in the adjacent tap. He didn’t notice me for a moment. Then he turned to me in a panic:
“What the hell are you doing here?” He cried, waving his arms like someone signalling our state transport buses to stop. His eyes bulged like a couple of shiny swollen testicles afflicted with epididymo orchitis. The Chief must have talked to him. That was fast!
I kept quite and glared at him.
“Get out!” He shouted. “Get out- change and go.” He was slightly incoherent, and frothed at the mouth a bit.
I got out and ran to the private place that was doing my thesis work. Raghavan was sitting there, looking anxious. I had forgotten him. He was the only other final year who hadn’t yet given his thesis. We were in the same specimen tray.
Both of us managed to get our copies by half past four. We will never get to the University on time. It would take at least an hour.
“ngee, ngee….” Raghvan bleated. “I have to finish my MS and get back to Karnataka! I hate this place. I want to see mummy”
Not his exact words, but you get the gist.
I had got, very thoughtfully, the University Registrar’s number from the office. I called him from a booth in front of JIPMER. I pleaded our case. I told him that we were both late, operating emergencies. He agreed to ask his staff to keep the thesis section open till 5.45. Please get this, people. This is not normal. Indian government set ups are never this obliging. This was a miracle.
We loaded the copies into my faithful Maruti 800 and got ourselves in. I drove like a maniac. Raghavan held on to the seat and tightly closed his eyes, screaming in high pitch during near-collisions and sharp turns.
We rushed into the thesis section carrying our heavy load, sweating like footballers, red like abscesses ready to burst. They were getting ready to lock the door. It was 5.42. They grudgingly took in the copies and gave us the receipt, mumbling under their breath.
It was easily the tightest, tensest deadline of my life.
After coming back, I saw Govindakrishnan, my junior, and gave him money and instructions for the party. Then I took Raghavan to Filo Bar outside the hospital. I was sober for over two months now. I ordered a rum on the rocks and a chicken liver pepper fry. Raghavan was a puritan and a noted sathvik who had never fornicated, masturbated, drank, smoked or ate meat or fish in his life. He had held an egg in his hand once. So, I ordered a bhindi fry and orange juice for him.
Raghavan interrupted. “I want Rum”- he said. The waiter obliged. I was astonished.
He swallowed two pegs, one after the other. When he had finished coughing and grimacing, he asked me:
“Rum is vegetarian, isn’t it?” He was very anxious.
I assured him that rum was 100 percent pure vegetarian. He was relieved. He stood up.
“If I see my guide now, I will catch him by the throat and……” He slurred.
“And?” I was intrigued.
“I will twist his head, till it drops off, and I will pick it up and swallow it.”
“That would be so non-vegetarian” I pointed out.
“Fuck your non-vegetarian!” He shouted. “Fuck everybody!” He made a move as if to climb on to the chair.
Then, he lost steam, like my car when it ran out of petrol. He slumped back into in the chair and promptly passed out. I took an auto and carried him back to Harvey house. In the courtyard, Govindakrishnan, Ash Pathrose and a few other cronies were standing around a blazing bonfire. We laid Raghavan, out cold, by the side of it. Slowly the courtyard swelled with other residents, mostly final years. Many were drinking from a pail of orange juice kept in a corner, into which someone had thoughtfully poured a few bottles of vodka.
Everyone had brought remnants of their thesis work, like notes and copies of references. All of us threw them into the fire, which blazed merrily.
“Thesis is like faeces. When it is inside, it is painful. But when it is outside, it is nothing but faeces.” Someone sang.
“Ha. Not original!” Ash objected. He sang:
“Thesis, we need you, finish you, to pass.
Otherwise, we would have kicked you in the ass!”
Everyone applauded. Then people came forward and started singing in regional languages. Malayalam, Thamil, Telugu, the lot.
A guy from Madhya Pradesh sang a parody of a ghazal. The North Indians went- “wah” wah!”, “bahuth acha!” and similar obscenities.
A fellow came forward and sang:
“All the guides, you @#$holes, F##ers, and drinkers of Piss.
To all of you, sadists and psychopaths, I show you this!”
Then he lifted his lungi quite high up and did a slow turn, showing everyone the appendages, devoid of any remnant of underwear. The fire illuminated them with a ghostly glow.
Then one by one they urinated into the fire, till it died. The solemn, sacred function was complete.
I had only three months to prepare for the final exams. I had to buy the textbooks now. Then- tomorrow was another day.
No. Today. It was four in the morning. The orange sun was peeping out. I could get two hours to sleep, before getting up to go to the ward. There was work to do.
(Note- In this true story, all characters are situated in a fictional, alternate universe. All characters are imaginary. Any resemblances to anybody, living or dead or otherwise are pure coincidental.)