Emergency Medicine resident, AIIMS New Delhi.
Joint Secretary, AIIMS New Delhi RDA 2024-25.
Special interests - ECGs, EM, Evidence Based Medicine & Sports.
Ultra high dose NTG in a really bad case of SCAPE!
Total 9 mg of NTG boluses and infusion of 76mg!
Truly remarkable case. Presented by my seniors.
@NaaziaSiddiqua
Over the past 3 years, I've very rarely gone home and for good reason.
After my parents passed, I don't have any real family waiting for me there.
Instead of a "Our son has finally come home" greeting, I get to enjoy an empty house with enough dust to make me cough.
There is no single day that goes by without me missing my parents. They never got to see me graduate MBBS. Get PG in AIIMS. They'd made so many sacrifices for me.
I'm yet to receive a single call from home in 2 years just to ask how I am. Neither do I ever expect to get one.
The handful of times I do go home, I mostly try to find a family feeling somewhere. Anywhere.
My old UG college. The old hospitals I used to work. A friend's house. It worked for a while but such places don't stay the same for long.
There are no easy solutions for sadness.
Completed MD Emergency Medicine, AIIMS New Delhi.
Years of blood, sweat and tears went to get here. Only child who lost both parents. Financially broke. 3 years post-MBBS in rural hospitals. Volunteered for Covid duty. All that before getting PG.
Onwards to the next
The house isn't even mine. It's just a place one of my uncles lets me stay because they felt sorry for me after my parents passed.
I was thrown out of my original home so that my relatives could sell it for money.
Every time I come home, it ignites painful memories.
One of my SRs joined MBBS the same year as me. He's about to complete SRship in a few weeks. While I'm still in final year of JRship.
Despite that, I don't regret what happened one bit. Because I did what I needed to at the time. I chose family over my career.
Home sweet empty home.
This is why I don't come home often or even take leaves. My job is a distraction from past trauma I can't fix.
Travelling a long way to be welcomed by an empty, dusty house reminding you that you have no family to speak of.
It never stops hurting.
When I think back on all those years I took care of him, the regret is always that I couldn't do more. I sacrificed everything I could for my father. In the end, it wasn't enough.
Real love is when you only care about what's best for the other person.
Happy Father's Day.
3 Central lines, 2 intubations, 2 chest tubes, a pigtail catheter insertion, an arthrocentesis, an LP, transcutaneous pacing and a pericardiocentesis all in one night shift.
Emergency Medicine is never boring.
@DrDatta_AIIMS
Rank 169.
It's been a long journey for me. UG in a little known private college. Lost both parents in the past few years. Live alone. 3 years after passing out. 1 year in NRHM. Stopped studies in between to take up Covid duties. Had to fight and claw my way up to get this far.
A NEET PG horror story of my UG batchmate. Really beyond words. The last minute emotional turmoil is unimaginable. Not to mention spending 50k to write an exam.
Something has to be done to ensure this never happens again.
@DrDatta_AIIMS
@boneteacher
@docrohan
@sumersethi
One of my old teacher's son is in first year MBBS. During biochem viva, he was answering everything beautifully until he decided to mention something he heard on House.
This is the first time I'm hearing of someone failing practicals because of a TV show.
One of the best feelings in the ER - young pt -> arrested -> ACLS started -> multiple shocks -> revived after 15-20 min.
Few days later - pt completely neurologically intact, walking around in the ward. These sort of wins make the bad days worth it.
One of the strangest things I've seen in a hospital was 4 years ago when after a snakebite, the bystanders brought the snake to the hospital but not the guy who got bitten. 👀
@anushsweth
I know there is a fascination with the central institutes (me included, that's how I eventually ended up at one) but every college has its own adv and disadv.
Simply joining a particular college doesn't guarantee career success. It's what you do with the chances you get.
Looking back, the regret was never that I never got PG sooner. It was that always got home tired after some 12 hour shift. When you're that tired, I didn't have the energy left to show the kind of love & support my father needed.
I just wanted to lie down and sleep.
My mother passed away while I was in final year MBBS. That was awful enough as it was, but then my father severed a massive stroke just before I was supposed to start internship.
An only child, I was not prepared to become the provider of the family at that point in time.
Things were better after MBBS. I could pay the bills. But barely. Before I got a govt job, I used to run around 3-4 different hospitals in the city just to make ends meet. Because some didn't pay on time, I couldn't rely on one.
I was working 7 days a week.
New academic junior resident joined today.
"Why did you choose the branch?", we ask.
"I don't want the branch, I just wanted few months of experience before going for USMLE."
😕😕
Mind-boggling. Same thing could have easily been achieved by becoming a nonacademic JR.
When your nursing staff can read CTs and do FAST exams and are truly interested in what's happening with the pts, you know you've developed the right work culture for a trauma centre.
I still managed to do what I thought was best for him. Get home nurses that would push to do physio even if he didn't want to. Cut down on his junk food intake. His A1C went from 9 to 6.
But I could never manage to remove the depression that came from being paralysed.
I needed at least 35k each month. 18k for the home nurse. Another 8-10k for the cook. Rest for medicines, travel expenses.
I cut down on all unnecessary expenses - new clothes, going out etc. PG entrance coaching was out of the question.
There is nothing I hate in life more than asking for handouts. But at that point in time, I had little choice. There were no savings.
At one point when salary was delayed for 4 mths, I woke up with 0 money in the bank and didn't have enough for food.
My father was not just hemiplegic. 75% of one half of his brain got infarcted. His personality completely changed. More child-like. He was no longer able to take any life decisions on his own.
It was impossible to take care of him with 10k/mth intern salary. Had to take loans.
Clearly evil person asked this ECG during a final year MBBS viva. Great way to make students give up on ECGs for life.
People asking about CNS T waves to UGs should be banned from exams.
Infraorbital nerve block for severe trigeminal neuralgia done by my junior today.
Pain score reduced from 8/10 to 0 and pt discharged with a smile on his face.
There's a reason our profs are always going on about these blocks. Amazing pain relief.
My mother was always the first person to wish me on my birthday when I was a kid.
Now, every year is a reminder that she's gone forever. Some people in our lives can never be replaced. Or forgotten.
Exam stress has never really felt the same after my parents passed.
Failing an exam is bad but it can always be taken again.
Losing a parent is forever. There are no 2nd chances. Rarely even a proper goodbye.
You don't get overly worked up by an exam after such pain.
When I sacrificed all short-term joys to take care of my bedridden father many years back, it was the obvious decision. Life was not easy but I put his health above everything happening in my life.
The soul crushing part was that ultimately, it wasn't good enough.
Theory exams in medicine disproportionately favour those gifted with better handwriting.
Often presentation is more important than actual content. Rarely do people actually read the whole thing.
I love procedures but they are only one part of patient care. I see many juniors who only want to do intubations and central lines without any interest in understanding the nuances of managing sick pts. They will struggle in the future managing cases on their own.
Patient with 9/10 abd pain due to acute on chronic pancreatitis. Not responding much to usual pain meds.
Bilateral erector spinae block given in the ED -> patient completely pain-free in minutes.
Very satisfying for both patient and doctor.
Last day with the Father of Emergency Medicine in India, Praveen Aggarwal sir.
It was an honour to be able to work under him. Not only a wise clinician but also a true gentleman in every sense. Hope to carry his legacy forward.
35/M arrived to the ED in the jaws of death. Gasping for air, Hb of 1.6, lactate of 26.
After a day and a half of Resus, almost everything normalised. You can achieve quite a lot by managing the ABCs well.
Can you imagine working 3 years in residency with 0 pay? That's exactly what foreign residents in AIIMS Delhi are continuing to endure. A travesty of justice that is too convenient to ignore for many.
Young man presented to the ED today in cardiac arrest -> 40 min CPR. Multiple shocks given. Intraarrest thrombolysis done as MI was the likely cause. Pt revived. Vitals improved. Slowly started getting conscious after few hours.
Whole team felt we did something special.
One of the more sobering realisations you'll come to in life is that whatever pain you feel, the loneliness in your life, the grief, everything still remains even if you achieve something big career wise.
You're the same person before and after. Nothing changes.
2 different ECGs, 2 different patients, both read as "normal" by the machine during the night shift.
Peaked T waves d/t hyperkalemia in one, significant ST elevation in the other. This is a good reminder that you cannot rely on the machine read of the ECG.
Was talking to a few of my UG batchmates. Couple of them who were just as good if not better than me academically back then are still struggling to get a PG seat.
Makes me wonder how much of the whole rat race is down to luck. The competition just keeps increasing each year.
I've taken only around 10-15% of the leaves I'm allowed to have over the 3 years here. That too mostly in the last couple of months after my exams were done.
Still had a colleague say that "Mehul takes quite a few leaves".
Amazing how people judge you like this.
40-something old lady presenting with chest pain since past 4 days, worsened in the past 3 hours.
You see this ECG at 2am after barely sleeping for the past 48 hrs. What's the most important finding here?
Peripheral AIIMS have the potential to be become great institutes with time but there needs to be an acceptance that you cannot go from 0 to apex institute immediately.
Eg - what's the point of a separate trauma centre when the main ED is not even functional 24/7?
Honoured to have been elected as Joint Secretary in AIIMS New Delhi RDA 2024-25.
Under the leadership of
@DrISP111
as President and
@Raghuaiims
as General Secretary, our team is ready to work for betterment of the campus, improve coordination with other RDAs & address national
One of the 1st things I learnt as JR - putting the tube in is probably the easiest part of intubation in most patients.
Resuscitating the pt well enough prior and during the procedure to make sure they don't arrest during or just after intubation is often much more difficult.
How far do you go in chest pain?
39/M, known HTN, coming wjth chest pain since past few hours. Retrosternal. 3-4/10 severity.
ECG normal, trop negative.
Junior thinks "something's off here". POCUS reveals nothing special until a suprasternal view revealed a dissection flap!
This is not surprising but going through residency without any form of family support is not a fun experience.
Bad days happen but I rarely have anyone to talk about it to. Going home for a break makes no sense when it's an empty house that awaits you.
Met my mother's old work colleague the other day.
"She was always worried about the long learning curve in medicine with you," she said. "If only she could see where you are now."
It's heart-breaking when your parents don't live long enough to see you reach your potential.
Just shocked. Feel so empty inside reading this.
From the little we interacted here, you could tell Jay had such a strong sense of right and wrong and the kind of empathy that you won't see with 99% of doctors you'd meet.
But unfortunately, we work in a system where that kind
#Heartwrenching
India lost a Brilliant mind Doctor!
Dr JAI SAVLA
3rd year Medicine PG resident Safdarjung hospital (Delhi) died due to
#suicide
.
He was Top level Black belt martial artist, International rated chess player along with active presence on all the social issues!
Nothing more saddening than when your department is given only 2 seats in counselling (while you have 4 units total) and then one of those who gets alloted says "I'll be leaving after joining".
Yaar phir option kyu diya? ☹️
I get it's their choice but it sucks for us man.
Saddened to read some of the generalised doctor hating tweets in past few days.
As well as being a doctor, I'd been a bystander for my parents for 10 years in various hospitals across 2 states. I can understand the frustration and helplessness but doctor hating isn't the answer.
If you're a doctor who might have to manage acute pulmonary edema cases, I highly recommend this talk by my seniors Dr Jyothi sir and Dr Naazia ma'am on SCAPE.
Watching SCAPE pts improve rapidly is one of the most satisfying parts of EM.
It's been 8 years since my mother passed away after a 6 year long battle with cancer.
I'd like to say the pain got better with time but it didn't. This was something I wrote more than 5 years ago.
Just because a death isn't unexpected doesn't mean it isn't painful.
Joining a branch in a top college but later finding out it's not what you actually wanted in life is understandable.
It's a completely different thing to have no intention of continuing the course from the outset and waste a seat that could have gone to someone who actually
When I first joined, interns were nowhere to be seen and no one particularly cared.
This past year though, most of them showed up. Our SRs stopped signing for faces they'd never seen and the ones who came found the dept useful with residents willing to teach whenever free.
1 year ago - special 72 hour "Cyclone Burevi Duty" began for me at Ponmudi, Trivandrum. Around 400 people evacuated from the hill station as a precautionary measure with help of KSRTC buses.
Thankfully no cyclone came in the end. Rural medicine is full of such surprises.
If you want to work in a branch that takes care of acutely ill patients, you need to be able to handle constructive criticism.
Not everything is in textbooks. Mistakes will happen. But refusal to listen to even the mildest criticism will mean you'll keep repeating them.
Fail an exam? You can always give another try next time.
Lose a loved one? You'll never get a chance to tell them how much you love them again.
There's a reason I don't really feel exam stress like others. There are much more painful things in life than a failed exam.
Spotted a tension pneumo in an intubated patient very quickly because of close monitoring of vitals. Sudden unexplained BP fall with increase in HR.
Needle decompression done, ICD placed and certain cardiac arrest averted. Simple things like monitoring is everything in the ED
How many govt hospitals do we have where something like this is possible? Can't think of many. This pt was eventually discharged and walked out of the hospital.
This is only possible because of an academic emergency medicine department.
@NaaziaSiddiqua
@shreeshan96
Young man presented to the ED today in cardiac arrest -> 40 min CPR. Multiple shocks given. Intraarrest thrombolysis done as MI was the likely cause. Pt revived. Vitals improved. Slowly started getting conscious after few hours.
Whole team felt we did something special.
School CPR training class. Was wonderful interacting with students.
With just an hour or so training, 12th STD kids were giving high quality chest compressions. Need more of these classes all over the country to raise awareness.
A super sick pt that we had to cardiovert and later intubate few days back got better, extubated and walked out of the hospital on discharge.
Such a big win this as an ED doc.
It sucks when you have to give an explanation for not being in a good mood.
Residency is hard.
Life is hard.
Mental exhaustion happens.
Sometimes you just don't have the energy at the end of the day to pretend to be fine.
I thought I had found the one and had the perfect love story. Then it all fell apart in less than 2 months because of caste and her ex coming back.
Sometimes we are too blind to see the danger signs in a relationship. Until it's too late.
Does FORDA really represent the interests of all the Resident Doctors of the nation?
AIIMS Delhi as well as several other RDAs will be continuing our strike tomorrow.
#WATCH
| Delhi: After meeting Union Minister JP Nadda, Federation of Resident Doctors' Association President Aviral Mathur says, "We just met Union Minister JP Nadda at his residence and presented our reformulated demands and before him... He assured us that he would provide a
This was the ECG a couple of a hours earlier in another hospital before they referred to us.
Sometimes ECG changes can spontaneously resolve for some time only to return again.
This is why observation & serial ECGs + Trops are so important.
@psychedamygdala
Agreed. My mother got married in her early 30s all the way back in the early 90s. Put her studies first. Always had huge respect for that.
@spiritsarelow
It's been more than 2 years since I've been alone after my father passed (mother passed in 2016). The pain will always be around the corner.
Just keep fighting to stay positive (and it is a fight no doubt). Keep busy always and try to find comfort in whatever way you can.
My junior and other staff got assaulted in the ER yesterday. Patient in question had taken around 4 tabs of Alprax & was vitally stable. They had to wait extra 5 min as my junior was attending a patient with stroke within window period. This was enough to trigger this attack.
@P8823539822520
Can't say I have enough free time in my usual life to do that regularly. I do donate to charities monthly.
I've tried every possible distraction over the years.
One of the most beautiful parts of medicine is watching someone who struggles with something become quite good at it over time through sheer hard work.
Teaches you to be humble and not judgemental.