When I Grow Up . .

I want to be a Professor of Medicine.

Seriously, academic medicine rocks my socks. Having been away from it for the past three years or so, I'd forgotten how cool working in a teaching hospital could be. There is a structured environment, an academic culture that supports your learning. Morning report, noon lectures, professors' rounds. And most important of all, patient care itself, the individual therapeutic encounter between you and your patient. Because no matter how much you read and learn from others, it's what bring to that therapeutic alliance that exists between you and your patient that really matters at the end of the day. And nothing teaches you that as much as actually doing it. As someone once said, "The secret of patient care is in caring for the patient."

So, I'm working at a teaching hospital these days. It's an awesome experience. I'm part of a team of four doctors, residents at various levels in their training, and together we're responsible for a ward of twenty-five patients. I'm the youngest member of the team, and contrary to popular conceptions, including my own, am being handled with a great deal of kindness. My senior resident is an exceptionally talented, very hard-working young doctor who doesn't mind me pestering her with questions as long as I help her with the scutwork. I got an idea of her dedication one afternoon when we were sitting in the doctor's room after a round. Dr Sabeen was post-call, which means she'd been in the hospital for the thirty or so hours, and was slumped in a chair waiting for the clock to strike so she could go home. We were all tired. It'd been a long round and the professor had grilled us with all sorts of inconvenient questions whose answers we hadn't known so morale wasn't particularly high. A nurse came rushing into the room.

"Dr Sabeen, your patient on bed 12 just crashed." (The patient had gone into cardiac arrest.)

Dr Sabeen leapt out of her chair, raced across the ward and jumping on to the bed, started performing chest compressions while a nurse ventilated the patient. We all followed behind her and watched as she did a few cycles of CPR but it didn't help and the patient passed away. She was a very ill young woman who had severe, widespread infection in her body and had been slowly deteriorating for some time. The prognosis had been a guarded one. And yet, to watch Dr Sabeen shake off her exhaustion and apply herself so ferociously to the resuscitative effort was a lesson in patient care. These things are reflexive responses, acquired through practise and dedication, and it's moments of crisis like these that reveal where you truly stand as a doctor.

Strangely enough though, for all the suffering, ward medicine also has its moments of comedy. Like when you ask a patient who only moments ago was lost to cold metabolic stupor how they're feeling and snap comes the slurry reply, "Fine! And you?" (There's something very touching about that, how people retain their instincts for manners.) Or when the professor looks like Inspector Clousea from the Pink Panther and his assistant like Hagrid, towering behind him solemn and observant, possibly weaving a silent spell so that a pair of doves may rise from the Inspector's lab coat and flutter through the ward. Incidentally though, both Hagrid and Dr Clouseau are superlative teachers and it's a pleasure attending rounds with them. I can only hope that I am as good for my patients as they are for theirs.

Here's wishing you all a great new year!