Wednesday, May 20, 2015

Career choices - doctor or pole dancer?

“Papa what’s a pole dancer?”
I choke on my cup of coffee and take a full minute to compose myself before intelligently replying with my trademark “Duh?!” accompanied with a couple of raised eyebrows.
I hear the sounds of plates falling on the kitchen floor. Apparently my wife has heard the interesting question too.
“You and mama were talking something about it yesterday” The young lady clarifies.
Oh that. The latest ‘viral’ thing going about in the circle of Indian doctors these days is a lovely piece written by Dr Roshan Radhakrishnan….all about why he would never allow his child to become a doctor. He even goes on to mention that he wouldn’t mind her being a pole-dancer, but never a doctor (with the little qualifier –‘in India’)
“It’s like a dancer who uses sticks” I fudge, like you normally would to an 8 year old. By now reinforcement arrives in the form of my bitter-half, who changes the channel on the ever-running TV in the background to cartoon network (from Arnab going red in the face demanding ‘India wants to know’ something as usual) to distract my daughter’s attention.
“Oh…I thought it was one of those ‘badly’ dressed ‘aunties’ dancing around a pole” She innocently returns to the more serious business of watching Oggy and the cockroaches (with Oggy doing that irritating Shahrukh Khan accent as usual).
Both me and my wife remain in suspended animation, mouths half  open for a minute.
OK. The point is kids these days are much smarter than we ever were. You really don’t need (or can) tell them what to do with their life. If they are really in the mood they may just indeed become a pole-dancer, a dacoit, a politician (in increasing order of notoriety I guess)……or even a doctor. And you never know, 20 years down the lane that idiot Aamir Khan might come back in Satyameva Jayate season 23 claiming that pole-dancers are the biggest scourge affecting the balanced growth of the nation. What is important I guess is to try to give a balanced opinion regarding your kid’s career choice…but let them decide things ultimately…and once they do, just support them wholeheartedly.
I return to my coffee and my wife get ready to return to the kitchen to her ‘weapons of meat destruction’ (the menu - ‘chicken-something-something ’ apparently is something outsourced from a Whatsapp group of her friends from medical school days who very humbly call themselves ‘masterchefs’.....that’s a story for another day though)
“So you guys earn less that these pole-dancer guys?” return of the motor-mouth.
Technically I suppose that should be pole-dancer girls, but in these days of gender equality....
Wife parks herself back into the sofa with a helpless look, I choke again on the coffee.
“Um, depends” I say ““Most doctors make more money than most pole-dancers I think”.
The way starting salaries are going for junior doctors in India I might have to revise that comment though. I’d like to ask my wife how much a good pole-dancer makes, but I suppose I would get bludgeoned on my head with a pole, so I drop the idea.
Doctors do have a tough life….especially in the period right after their graduation. There is a lot of work, a lot of insecurity regarding the future and very little money. This is the period when a good percentage of doctors start wondering why the hell they are doing what they are doing.  When I was doing my internship (where you 48 hour shifts were quite common)  I had to survive on a monthly stipend of around 2000 bucks… friends in engineering were by now into five figure salaries. The 2000 bucks of course would last about half a month, after which it was something on the lines of ‘Papa..pyaar ke naam pe kuch de de papa’ or ‘Mama, pyaar ke naam pe kuch de de mama’…..and usually mama or papa did respond favourably to the undisguised begging ….not so much because of the ‘pyaar’ thing, but because they wanted to get this irritating ‘pyaar ki nishaani’ of theirs out of their hair. Pretty much the same during the residency too….salaries were in the range of 4000 to 5000 Rs, which could just about make ends meet (ends of course including the mandatory weekly dinners and  first day-first shows )….and it continues even after the residency till a couple of years at least when you finally settle down in a good hospital or get a stable private practice going or end up in the ‘gelf’ to make money in Riyals or Dirhams (the last one especially if you are a mallu).
“Is it easier to be a pole-dancer or a doctor?” She seemed possessed by Arnab’s spirit.
“Every job needs a lot of training” I answer philosophically “Doctors need to train longer and much harder though” . Wifey seems to have a strange expression on her face. The “I’ve given up on both of you” kind....which is quite usual in our house anyway.
But pole-dancing I suppose does not require an entrance test at every level where hundreds of rats compete in a rat-kill-rat free for all. And when you do get through you have to face a hundred assorted exams, a equal number of thick text-books and  crazy examiners (exposing you to an incredibly delightful variety of sado-masochism....the only thing common being that you are the passive partner). At the end of all this you can’t really blame doctors for kind of hoping to be treated with a bit more respect and of course being paid  a bit is strange how people would not mind dishing out a few thousand bucks to service their car, but an extra hundred on the doctor’s bill is met with all kinds of nasty remarks about the ‘greedy doctor’.  Incidentally defensive medicine is the in-thing mainly because no doctor wants to labelled as the guy who missed a diagnosis. So they end up ordering all kinds of tests just to get things documented....something which would normally not have been done a few years back when patients simply trusted their doctors much more.

“So who is happier finally? The pole-dancer or the doctor?” Seems like the lady was into her concluding argument
“Hmmmmmm” Now that was the most difficult question of the lot.
Happiness is quite relative (basically I am happy even if I am in deep shit as long as the ‘other guy’ is in deeper shit)
I finished my MBBS in the year 2000 and in our batch of around 200 students I would say that more than 90% are pretty happy with where they’ve reached and what they’re doing – both in terms of professional satisfaction and financial security (at least going by the Jaguars and Audis on display in our last reunion) and honestly as far as job satisfaction is concerned I guess being a doctor out-scores most other jobs (even more so if you are into teaching I guess).So yes, most doctors are happy and most doctors do have some regrets....which is pretty much what you get in any other profession too.
And of course you have a higher chance of being sued, beaten up or both if you are a doctor. I mean theoretically it would be a bit difficult to sue a pole-dancer for negligence I guess. The beating up part is getting quite common in India these days. I sincerely feel that martial arts should be one of the compulsory subjects in the medical curriculum......along with communication skills. Most ‘beating up’ incidences are usually traced to poor communication skills...but if things get bad anyway the martial arts should come in handy. Jokes apart, doctors are human beings and they can make mistakes. If they work under fear getting man-handled for every mistake, quality of medical care will naturally suffer. It’s like trying to talk to a pretty girl with your wife watching. You would never do it properly and would anyway get a dose from your wife at the end. Doctors need to work under better security and it is really important the ‘doctor beaters’ are dealt with promptly and properly. We are almost scaring our next generation into not choosing medicine even if they have a passion for it......
Actually any wannabe doctor I suppose is quite aware of all the problems associated with choosing a medical career. More so now, with the net and networking savvy present generation. So in spite of all these negatives  if my daughter still wants to be a doctor, so be it …and I’ll support her in anyway I can. Besides getting into medicine is not really like the Mumbai underworld where once you’re ‘in’ you simply cannot leave. I have quite a few friends who finished their graduation in medicine and then moved to totally unrelated fields like business management and even software engineering (Maybe easier said than done but basically isn’t this what most engineers these days do?….they muddle their brain  4 years studying core engineering concepts and then end up writing code or doing business administration).
All said and done, we doctors will always be under a bit of extra scrutiny because ultimately we deal with human beings...not machines, but then that is exactly why each day in medicine is an interesting adventure in itself...because human beings have so much of variety unlike machines.
One lil piece of advice I would like to give to wannabe doctor is to choose your specialty wisely. Many young doctors get that extra bit frustrated because after all this trouble they go into a specialization without being really sure if they have an aptitude or a passion  for it and later find that they just can’t handle things. So basically do what you have a passion for. An old friend used to tell me that it doesn’t matter whether you are a space scientist or  a sweeper…what is important is how well you do your job. Another thing is always make time for your family, friends and of course yourself. Keep a hobby for stress relief, take a  vacation once in a while, read normal books too once a while...and generally try to smile a few times each day.
I always tell my students that being a doctor is never going to be easy……it wasn’t meant to be…you will always have unsatisfied patients, scratchy colleagues, irritable bosses and Aamir Khans……but somehow every grateful patient that you treat makes up for all these negatives. So be proud of the fact that you are a  doctor…. keep healing and keep smiling (and keep ignoring the Aamir KhansJ..they’re simply not worth it!)

Thursday, January 29, 2015

Is there a doctor on board?

Few days back I was returning home from  a short trip abroad. I had just settled in to watch Kate Winslett heroically battle cute viruses in ‘Contagion’, when the PA system announces the “Is there a doctor on board thing”. My split personality starts getting active…the ‘good doctor’ in me wants to rush across the aisles to the patient in distress and execute a dramatic recovery act, but the more practical shady side (the usually dominating one) wants to dig the ear phones deeper into my ears to block out any further announcements, hoping that some other quixotic idiot will take the call. After 30 secs the announcement comes up again. The ‘good doctor’  wins for a change and I hesitantly remove my seat belt and my earphones, say  a heavy goodbye to Kate Winslett and the viruses and head towards the back of the plane where some kind of hectic activity is going on. In the back of my mind I try to revisit  the revised steps of CPR (incidentally now after years they suddenly realize that getting the circulation thing going is more important than the airway…so the classical ABC –airway, breathing,  circulation is now CAB).  Thing is I am not too much into emergency medicine, unless you count sudden and severe itching as an emergency. Besides if I really wanted to handle such life threatening situations I wouldn’t have opted for dermatology, I would have probably chosen surgery… or a second wife. In fact it’s at deep moments like this I sometime reflect on my career choice –
(Here are some of  the most important reasons I could recollect.
1.       I  was/am/will be lazy
2.       I hate getting disturbed in the middle of my sleep – afternoon or night (I don’t mind disturbing others though….my snore-storm  affected nuclear family will attest to that)
3.       I  was/am/will be lazy
4.       I love my thick skin (some unmentionable roles in some unmentionable college skits will attest to this)
5.       I  was/am/will be lazy
6.       I wanted to work with charity foundations to eradicate all  the suffering in the world  due to itching
7.       I  was/am/will be lazy
8.       I like getting under other’s skin (Who doesn’t?)
9.       I  was/am/will be lazy…………..)

As I reach the   empty space towards the end of the cabin I see a small crowd of stewards and stewardesses mulling around the patient. One of the stewards eyes me curiously and almost accusingly says “Yes?”
The shady part of me wants to say “Nothing…where’s the loo?”  and go to the loo, back to my seat and Kate, in that order.
Anyway the ‘good doctor’ wins again surprisingly “I’ m a…doctor” says me….I myself am not too convinced.
“Oh…”  a look over and again a very expressive  “Oh!”
The steward,  apparently still not very convinced, hesitantly clears the crowd to direct me to the patient. The patient surprisingly turns out to be a stewardess….and her face is contorted with a mixture of pain and anguish as if she just  had an extra helping of  Arnab Goswami  and his “the nation wants to know”.
Anyway the good thing is she seems too young to have a cardiac arrest. I put on my best  false smile and my best false serious voice and ask her what the problem is. The patient doesn’t speak. Reminds me of our honorable  ex PM –MMS, in a time of crisis (or for that matter even in normal times).
The lady just points over  various parts of her body. Maybe she’s not happy with her body image…the dysmorphophobia thing….I want to tell her that I have the same problem,  but that you get used to it as you grow older. Anyway when she continues to point her index finger all over her body I take a closer look and notice the reddish raised skin lesions.
Aha, voila!…..urticaria…a dermatological emergency!!!….so now I smile even more broadly and take charge (incidentally also mentioning very loudly and explicitly at least twice that I happen to be a dermatologist). I take a quick history  - when, how, where, why , why not…..a little poor joke to lighten the atmosphere..and then a detailed examination followed by  a quick counseling session.
“ Don’t worry, it’s just an allergic reaction……I’ll just give you a little  injection and you’ll  be back in action in no time”
The ‘injection’ bit makes the lady go a bit pale, but I insist. Anyway, injection given (incidentally the first aid kits in commercial aircraft seem to be pretty well stocked), I get ready to go back to my cramped cattle class seat. I was hoping that the airlines staff would give me a free upgrade to business class considering my invaluable skin-saving act and significantly contributing to the health of its staff.
“Excuse me doc” a sweet voice calls out from the back.  I turn to find another petite stewardess with a pretty smile. OK, free upgrade here I come.
And then she starts frowning. Now I am confused… I hope I didn’t mess up the injection. The sweet lady holds her frown …actually frowns a little bit harder now. I look for the parachute hold.
“Doc, do you think I need to go for botox?”
Oh. That. The frown was apparently to help me assess her botox needs.
Now this is the other thing with dermatology nowadays…..either you are supposed to be an ‘itch doctor’ treating all kinds of assorted lovely itches on all sorts of assorted body parts…..or you are supposed to be a ‘witch doctor’  busy converting ugly ducklings into beautiful swans with a simple swish of a wand…and it happens to be one specialty where you are often asked to randomly opine on, diagnose and treat just about anyone and just about anywhere….a blurred ‘What’sapped  image’, facebook,  weddings,  mid-air………… .but what the heck, why bitch about it as long as the itch/witch makes you rich?!
I do the botox consult….and a couple of other similar cosmetic consults, everything is hunky dory and I turn around  ready to go back to my seat and Kate…..and of course there’s no free upgrade….maybe a little extra smiles when I exit the airlines……..but then, maybe that’s worth it too?!:)

On a more serious note, it feels nice to know that the popularity of Dermatology as a specialty choice continues to grow the world over. The little concern is that many opt for dermatology purely for the cosmetic part. While cosmetic dermatology is an interesting and satisfying part of practicing dermatology, I personally feel that it should not come at the expense of good ol’ clinical dermatology….but then to each his/her  own!