Monday, March 11, 2013

Post duty: Thousand-yard stare

The 'thousand-yard stare' may be a new phrase in medical field. It’s actually a war or postwar phrase. It describes the look of a wired and tired soldier after the suffering of the war. It was used first after the painting 'Marines Call It That 2,000 yard Stare' in Life Magazine by Tom Lea, World War II artist and correspondent.  He said about the real Marine in the portrait.

“He left the States 31 months ago. He was wounded in his first campaign. He has had tropical diseases. He half-sleeps at night and gouges Japs out of holes all day. Two-thirds of his company has been killed or wounded. He will return to attack this morning. How much can a human being endure?”

After Vietnam war in 1965, then-Corporal Joe Houle said "The look in their eyes was like the life was sucked out of them." The 1,000 yard stare totally describes that look on soldiers’ face.

 Why this war stuff in a health blog? Now see the analogy.

 Your duty starts at 8AM. You start with seeing patients in your unit. You ask them about their overnight problems, any developments and any blood or other reports. You examine them to see any new changes and you also get some new faces to see (new admissions), lucky it you get few. You get all the infos and prepare for the round. After finishing all these if you get chance you can enter to the morning conference.

And the round begins. The length of it depends on the number of your patients, their level of illness, the consultant who is taking the round. Extending upto 1-2 PM in max. With lots of round works to finish in your hand, lot of discharges you are left with empty stomach and achy legs. Patients start to ask you “when will be my discharge paper ready? We have to go long way? Please do us a favor.” You feel like you are the one that is making the delay. You are the one that will make them miss their bus to home. But nobody can work with empty stomach and you are not a Superman.

After filling your tummy and resting for 10 mins, when you come back to ward, everybody is staring at you that you have just killed someone. They just don’t make loud voice but those eyes speak a lot. What can you do? Nothing. Just give them an ‘indifferent look’ and do your work as nothing has happened. After finishing the ward works, be prepared for the next session. Emergency duty. After all that’s your real duty for today.

ER = Full of patients, 2 sometimes 3 in a single bed. Everybody is looking at you like you are a Superhero with super power and save them from that mess. But you know your limitations. So be polite and say that you will have to stay like this for few more hours or days sometimes. You hear their health problems, problems of their home, financial problems, personal problems and many more and write few medicines hoping to cure them all. It may be convincing to them but you can’t lie yourself. But turn an indifferent face to yourself otherwise you can’t survive in that battlefield. They request you “Would you please look bed for their patient, See how bad time he is having here, Please help my patient, don’t you see his problem?” You feel like you are a blind, you don’t see people’s problem, you feel like you are doing it intentionally to make your patient suffer, you feel like you are a sadist. Oops, don’t think so much, just give an ‘indifferent look’.

You fight in that battlefield with diseases, problems, adverse situations, I don’t know what all exactly. Except a short leave for dinner you can’t run away from that war. After seeing so much pain, listening so many painful, heartbreaking stories, you find yourself as a tiny Superman with just few pills in your hand to treat tanks of problems. At ER time runs so fast you don’t know when it’s midnight and when morning has crept in. When you get your eyelids heavier and feel you are carrying somebody else body then you will know its 2 or 3 AM. After all you are a human; you can’t carry other’s body all the time. But you have to prepare for tomorrow’s morning conference about the cases you admitted. Write a fair history, make some differentials, and try to do some reading. Is there anything left now? I don’t think so.

And you go to your duty room and sleep like a log.

Time flies so fast when you are in bed. I don’t know why sun is in such a hurry to rise in the morning. You leave your warm bed again to start the same schedule. You see the last night admitted patients and your unit patients, have a light breakfast and be prepared for the morning conference. Sometimes it feels like it’s easier to make your patients and their family happy than your professors. After an hour you come out of the conference room with a long sigh and washed brain. Do you have time for another long breath? I don’t think so dear. Hurry up; it’s your OPD day. Oops..

When you reach downstairs in OPD, you will see the crowd waiting for you, ready to tell you their problems and expecting good, very good solution from you. Are you fresh enough to hear them? Are you in condition to hold more and reach to the level of their expectations? Umm, I will give a try. Haha, what else can I do. So give an ‘indifferent look’ to yourself and treat the situation as good as u can. With body like a log, with 10 kg of eyelids on your both eyes and ATP soaked soul, you go on hearing the problems and keep on writing on the prescriptions. In the mean time, it’s good if you don’t forget to smile and have some good chat with your patients. After all you are a DOCTOR.

In our OPD it seems like everybody are singing their own song in their own language. Everybody is listening to everybody’s problem and everybody’s treatment. Treatment in wholesale!! With passing time you can’t remember how many patients you have seen. You just know it by thinning of the crowd inside OPD room and cramps in your empty stomach that you are coming to an end. “When going gets tough, tough gets going”. Yeh really a truth. It comes to an end. Can I have a big lunch and a good sleep? You missed something dear. Did you take the round today? Ahhh. Ok, let’s take the round now. Again go to ward and see your patients and have some discharges, blood works. Ok let’s have some lunch now.

Lunch and some ward works. What’s the time now? Who cares.. Is there anything left? Who cares.. Do you have any plans? Who cares.. It feels like Dementors (from Harry Potter) have just soaked all the energy from your body and you are left with your own dead body. Just give a thousand yard stare, carry your bag (why it feels heavier than yesterday) and run to your room. Music becomes your true friend, just have earphones in both of your ears, favorite song in full volume and give a BIG DAMN to the whole world. Yess, this is life, I mean a Resident's life.. :P

Note: Initial few paragraphs are taken from Wikipedia: Thousand-yard stare.


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