The strangest things become fond memories when the whole experience is completely bonkers. To those new to Bara Snapshots: this is my solid attempt at reflection, trying to make sense of my tumultuous (oddly magical) years as an intern through a series of jumbled snapshots.
The smell of Red Bull reminds me of Trauma (not an ad, lol). I was usually so finished by the end of those calls that I genuinely wasn’t sure if I’d make it home without the sugar rush sometimes. Once my registrar snapped a shot of me sleeping upright, my papers floating in midair from my now limp arms.
The amiable man whose chest drain you remove while wondering about the chains on his feet & his police escort. Then you have to try not to recoil when you remember that he raped someone’s baby/killed his family/shot an officer (it could be all or some, just to keep things anonymous).
It was early February in my 2nd year and it dawned on me that I’d have a Valentine this year. As a non-habitual dater this was a mildly terrifying prospect. I asked some people nearby for ideas and the next thing I knew, we were workshopping date ideas in the cafeteria a where I’d once sat nearly buried in discharge summaries. Soon thereafter (because I was taking copious notes) I was distributing The List before the grand ward round and have received multiple requests for it (which I still have btw).
The little girls in doeks fresh from a shack fire from which they’d escaped mercifully unburnt, a little shook and still smelling of smoke.
The time I made this collage of Tryery (or the disrespectful time I got chicken pox days after my 25th birthday):
Helping a friend swipe right in between taking bloods in the procedure room and watching that situation blossom (we were always rooting for him!) has been a highlight. I fully expect a wedding invite (putting out there).
The understanding that the each exhausted manual vacuum aspiration or MVA (when a pregnancy ends prematurely for whatever reason not everything comes out: enter intern) that you do is possibly a significant moment in each of those women’s lives. You’re doing 5, sometimes 10, in a row in the middle of the night; a perfect storm. Everyone knows the middle of the night is the best time for humanity reserves to be called upon. Also, it does seem to inconveniently court disaster like no other time of the day. MVA’s aside, you also get the happy task of conforming to every other (truly) bleeding woman in gynae emergencies that is in fact the worst day of their lives: “No baby”,”Miscarriage” and ”ectopic pregnancy” are not fun things to say in the middle of the night or ever. Other depressing highlights include all the obstetric scans that end in heartbreak because there’s no heartbeat despite your desperate hopes that it was just your junior skills making it hard to find it. We see humanity and its most naked and we are stripped as a result.
The healthy little girls in clinic that have you puzzled when you find out that they’re the patient. Then you learn that they’re here because a male close enough to them to share the same house did unspeakable things and now you’re the second person they’ve told.
Discovering that there was a bromance that rivaled my vroumance that was quite possibly cuter than mine (it was/is) was adorable. They even stopped fighting our insistence on referring to the other as “your husband” (they are also the nicest humans who will help almost always at the strangest hours despite sometimes repeatedly attending 24 hour calls without food but never leaving behind their awful juju).
Neonates is like going to the gym (at least for me). It’s painful and hard but the results speak for themselves. There’s also nothing more frustrating than being defeated by a drip on a newborn who’s skin is practically translucent (so you can see the veins). The wound is compounded by the fact that you’re being defeated by a human with zero strength or head control.
There were patients that I grew to resent against my will. Those who arrived well beyond the point of no return or with single digit CD4+ counts (the number causing my friend to wonder about the ethics of drawing blood from a patient with a count of one: “did we just take their last cell?” she’d ask, only half joking). I almost felt like they’d come to die at my feet and traumatise me in the process because, while there was little any of us could do, we were still obliged to try. Their relatives giving me a crash course in the destructive and logic-bending power of denial. In quieter moments I would try to empathise with sometimes complex circumstances that preceded the many many bad decisions that allowed things to get to such a literally low point. The stigma and denial; The socio-economic politics. “The factors that influenced health seeking behaviour”, once a freakishly annoying 20 mark exam question, now reduced to its most devastating bottom line.
The study of little humans is not for the faint-hearted. I love the rigor with which we have to approach children in medicine. Because although they’re kind of awesome in their resilience and ability to bounce back, we shouldn’t be the thing they have to bounce back from. This is the only time or context where I would ever say “I love rigor” in that order. Paeds is one of my favourite memories and not in small part because of the fantastic teams I got to work with at every level. It was an amazing time (even though we were on call every 4 days) .
There was a day that I left work where literally every single bodily fluid had ended up on my shirt (this shirt has proved itself a magnet for bodily fluids across multiple non-paediatric medical scenarios so we can’t blame the kids for this one). Another friend got peed on twice by the baby that we were repeatedly trying (and failing) at getting a urine sample on. I tell you these gross things for you to understand exactly how wonderful the block must’ve been to be a cool and find memory while still including these unfortunate events. I’ll just skip past babies dying. Nobody likes that. Nobody needs to rehash that either.
I bought Devil chips (so good they’re bad and extra crispy) almost every trauma call (8-9 times a month) and still lost weight. It was a tough time. I remember cooking maybe thrice in the 4 months of Medicine. once when i was trying to remember to take post exposure prophylaxis ARV’s (I failed mainly because I got home and passed out often enough to miss multiple doses, I’m thankfully still negative). My stove literally saw no action until September of my first year of internship.
There’s this look patients give me when they ask: “How old are you?” when I’ve already expended a reasonable amount of effort “doctoring” that lets me know that they heard nothing. Usually it means: ” I wasn’t listening to a word you said because I’m waiting for the real doctor to arrive” despite name badges, formal introductions and stethoscopes hanging. It’s right up there with having your white male students being addressed as ‘doctor’ when you’re clearly the one giving instructions and imparting (possibly very little) knowledge.
What hurts the most is that the culprits are equal across racial lines. It be’s the humans for whom your’e already stretching your limited Xhosa for that say the most hurtful things and insist on calling you sister despite correction. that respect your white students more than you. It’s also your people who feel entitled to (going so far as demanding it in some cases) your back flips. Back flips that they would never request of a doctor of another race. But it be’s like that sometimes (and sometimes that’s not OK). Besides, adults lie about simple things like eating.
One of my top 3 worst days ever (in life and n the job) needs some medical background. A premature baby isn’t necessarily a problem unless they’re born before their lungs are self sufficient (that’s at around 34 weeks). These humans are usually expected and measures are taken (like steroids and in the controlled environments of casesarian sections, alerting the neonatal team to be present) but all of this flies out the window when none of these things have happened and the human has been delivered vaginally. Twins are also a stressful situation because not only are there 2 humans at once, they often fall into the above category.
On this particular day, there were somehow 7 vaginal deliveries of humans under 34 weeks. Within 4 hours. I literally had to be several places simultaneously for what ended up, in most cases, as resuscitations. This on top of running the nursery of relatively sick neonates with various ailments and attending casesarian sections in between just in case. Side note: there are usually 2 people assigned to this job on any particular day but on that day my partner (and senior) was on the other side of the hospital seeing to a 4 hour surgery. Then all hell broke loose because somehow, both obstetric theatres managed to simultaneously deliver 2 sets of premature twins. I nearly died. I hadn’t been able to write notes all day as I put out one fire after the next (often simultaneously). I remember a consultant who was just passing by joining me with CPR (my 3rd one) at some point while we let the other machines beep. At 4pm when I was supposed to be leaving, my partner arrived to find me finally writing the 20 sets of notes that had piled up. I was so upset I couldn’t speak or cry. I still sweat thinking about that day. I now know that I don’t have any autoimmune proclivity for Addisons because if anything could’ve precipitated a crisis, that day would have done it.
Thankfully: no one died. Neonates respond well to resuscitation for the most part.
Thankfully, the babies will save us. they self correct so quickly. I once walked past a little girl who, upon hearing i was the doctor form her grandfather initially gasped then just as quickly accepted the knowledge as pedestrian. another, little black girl didn’t even flinch. In paeds ortho: those kids corrected every knew kid that made the ‘mistake’ of assuming otherwise. They were so insistent and proud. The kids are alright.
Collaborative Eavesdropping 