Confessions of a 20 something drama queen...

i woke up one fateful morning...my eyelids still stuck together; trying hard to remember the vague dream i had last night . something about flowers and petals .... and a dress... the most beautiful dress i had ever seen. "some day i will buy that dress" i thought to myself . some day... when i am able to fit into it of course.

         i stumbled into the bathroom and forced my eyes open in front of the mirror. i looked at my ever growing waistline. " did it grow a little from the pizza i had last night?" i wondered. i remembered the dress again , yah right, someday....

my eyes slowly made its way up to my face... "aaaaaahhhhh!!! is that a wrinkle?????" i felt nauseous . the bathroom walls seemed to be spinning over my head and a little fairy was playing weird tunes next to my ear...

"thats a worry line u knuckle head. happy birthday..." that was my sister walking in to grab my spot in front of the mirror.

a worry line? yah thats for sure.
 " what do you have to worry about at your age?? " my mom always asks. "whats not to worry about???" i would think.

i am a full grown adult  but i still feel like the insecure little teenage girl i was years ago. i still believe in fairy tales with fairy god mothers and princes , but act like i dont.
" the perfect man ?? he doesnt exist!!!" i would say..but secretly believe that he will find me some day.
lets not forget the fact that at such moments ,i almost always assume that  I am the perfect girl....

i add background music in my head to any situation i m in. and laugh like a loony toon at the most unfortunate of times...
of course not everyone around me shared the same enthusiasm. i wonder why...

i look shocked when a school child calls me 'aunty' ,while i compensate by addressing her mom the same way...
i really have to join the gym!!!... someday....

i spend hours singing my favourite songs around the house over and over again, while my sister begs me to shut up...
even though i know i sound exactly like the original singers i wonder why i never get selected into those reality shows.??? hmmm.....must be an inside job.....


and finally as i was standing in front of my birthday cake , with just 5 candles ( too many candles spoil the beauty of the cake) and looking at my loving family smiling at me and showering me with gifts, my worry lines deepened as i wondered if the the cake underneath the icing was chocolate or vanilla.......










         

IF Only....

The charachters portrayed in this short story are purely fictional.  Resemblance to any person living or dead is only co-incidental...

"You will disgrace us completely if you keep doing this Ananya!! why on earth do you keep regecting every proposal we bring for your marriage. do you not want to get married at all?!!"
          Ananya slowly stood up and with out uttering a word she walked out of her parents room. she took her mobile and began dialling ...
"hey nancy... when are you comin over to pick me up. sudhirs party is tonight right?"

 "yes dear... i'll be over by 6"

In the evening as ananya rushed out of the house... she caught a glimpse of her mother weeping... she quickly closed the door behind her and galloped down the stairwell.

Ananya had been waiting for sudhirs party for a long time. it was the day she was going to meet all her friends from medical school after 2 years... a day for going back to the time when everything was so beautiful.when everyone were so innocent and happy; so clean, so indestructible, unscarred by the realities of life.
     she had also been waiting for this day because she was going to see Ashwin again. She had remembered how he tried to convey his love for her time and again and how she would always turn him down... because her family would never accept. but he never stopped, nor did she ever tell him how much she truly loved him.
 she had been counting the days until when she would just get to see him once more;  until a week ago. after when nothing seemed so important or exciting anymore.

"Great party sudhir!!!" screamed nancy from across the hall and then walked over to the rest of their gang.
" so whens your next appointment, ananya? " sheela asked .
" Tomorrow. " answered nancy " at 2"
" so when is the big day sheela? " ananya asked
" we havent decided yet. but jagdish is leaving for US in two months so i hope its before that!!"
" did i hear music around here somewhere? " jagdish walked into the little circle and swiped sheela into his arms. "what are we talking about? "he asked cheekily...
ananya walked over to a chair and sat down... she slowly let her eyes wander over to all her friends around who were trying so hard to keep her occupied. they hadnt let her alone for one moment that whole night. tried to keep her spirits high, but all she could manage to do was to keep herself from going insane. all night she had noticed ashwin smiling at her from a distance. but all she could feel was pain. not the pain of love, or of separation. This pain was different,  which even ashwins kind smile could not heal. the feeling of a sharp knife boring down her central being, not just once but repeated stabs with the blade twisting down her core each time....

"i have to go home" she said and quickly disappeared down the hall.

..........

"hello Mr Harsh.i am Dr Ananya, i will be taking your blood today for sampling. can you hold your hand like this for me please.. good.. this will just take a minute. she took the syringe into her hand and pressed the needle into his vein. dark blood gushed into the syringe.. pleased with herself for doing such a good job she slowly pulled the needle out ...
" hey Ananya!!!!"
 Startled by the voice calling out to her as she tried to turn the needle accidently piecered deep into ananyas skin...
 Ananya woke up suddenly with sweat all over her body. she took slow deep breaths trying to get some air. she rested her head on her pillow again hoping  that the dream would not return.

"Hey how long have you been waiting? have they called you yet? " sheela asked as she walked into the waiting room. Nancy and jagdish followed her in.
"nope. but i am next i guess"
"ok" they said in unison and sat beside her...ananya silently placed her head on jagdishs shoulder. a tear trickled down her eyes.

after an hour in Dr Randy's room, nancy, sheela and jagdish walked out of the hospital silently with anaya...nancys hands tightly around anaya.

the next day ananya went to the lake, hoping to find the peace that so many claim to feel when they r out there. all she could feel was the urge to run fast . to run and run and run and to not stop until she jumped into the lake. she felt herself drowning deeper and deeper. she wanted to come up again but something just kept pushing her further down. ananya was gasping for breath when she opened her eyes . she looked around and realised she was on dry land and yet she did not feel releaved.

for the past whole week she had kept replaying that fateful day a year ago over and over in her head.. if only that intern had frantically called her name a lot earlier to warn her that the patient was HIV positive. if only she had worn some gloves. if only she had been more careful. if only she had listened to her friends when they told her to take post exposure prophylaxis immediately.  but it was all an ' if only'  now. she had been infected. she had been in a state of shock and denial. it had taken three days for her to walk over to the STD couselling centre to ask for her options. by that time it had become too late. 72 hours too late.
 " The chances of transmission this way is minimal dear. dont worry about it." her friends said trying to counsel her. she had believed them and had let go.

her past had come back to bite her when she went for a general serology check in order to apply for post grad schools . and ever since her future had taken a complete turn in the opposite direction. she had not even figured out a way to tell her parents. they thought she was rebelling against the idea of marriage. the thought of getting married was the last thing on her mind.  she felt so lost. it was not so long ago she had felt indestructible. even a cold or a cough was a rare event in ananyas life. but now she had to get used to the idea of disease.... and death just a few years away.

as the days went by ananya began to understand herself. she still had time. she had her health and her strong will. and so she slowly began making her plans. one little step at a time.she began concentrating on her medications, her diet, her purpose for the little time she had before the viral load would spike up and the CD4 count would spiral down.
but she never had the courage to tell her family. what would i say? how would i say it? what about their hopes and dreams....?will they be able to survive through this with me? her throat would always clog in when she thought about it...and she would stop.

two months later....

"I am finally married!!!" sheela screeched as she ran down from the marriage pandal. the gang was together again after a long time. the girls all hugged each other and did a silly dance when ananya noticed ashwin walk towards sheela and jagdish. she quickly pulled herself away and sat down on a chair nearby. she noticed that he congratulated them and began pacing towards her. she quickly got up to go when she heard him call her name. she felt paralyzed.

" how much longer are you going to run from me ananya? " he said
"you already know what my answer is ashwin. please, just leave me alone."
"ananya. i know....."
"what are you talking about?"
"i know how you feel about me ananya."
"i have better offers now ashwin. why would i even consider you now. you were just a college crush for me."
"dont lie to me. nancy told me everything...about everything. so stop acting like a stubborn child and let me in atleast now. please dont push me away . let me show you how much i love you."

" its going to be very hard ashwin.."
"i know. i am a doctor too silly. and thats why i know it will be difficult to face it alone."
"i will grow ugly, and skinny"
"i will be by your side holding your hand until the end....." he slowly took her  hand into his... " so you want to go tell your parents now?"
the clog in ananyas throat began to build up...but somehow it was easier to bear this time...she looked up into his eyes... "yes" she said. she slowly followed as he led her out of the wedding hall into her future......
                                                          
                                                      THE END

this short story was not meant to scare anyone...... but docs... remember PREVENTION IS BETTER THAN CURE.....

• use universal precautions
• treat every patient with unknown serology to be a positive patient.
• the risk of HIV transmission through percutaneous exposure is 0.3 %... very little but possible.

The following scenarios warrant Post exposure prophylaxis.

• Two Drug PEP Recommended
• Three Drug PEP Recommended
• exposure to asymptomatic HIV+ person via deep puncture from a large bore hollow needle
• a puncture from a needle with visible blood on the needle
• a puncture from a needle used in a patient's vein or artery.
• exposure to asymptomatic HIV+ person by solid needle stick or superficial injury that break the skin
• a mucous membrane exposure to a large volume of HIV infected blood that's source is asymptomatic (consider for a lesser volume, a few drops)
• a mucous membrane exposure to a small volume of HIV infected blood that's source is symptomatic.

Three or More Drug PEP Recommended

• any needle stick exposure from any type needle used on a symptomatic HIV+ person
• a mucous membrane exposure to a large volume of HIV infected blood whose source is symptomatic.

Preferred Two-Drug Regimen

• Option 1 - Retrovir (zidovudine, AZT)+ Epivir (lamivudine) twice daily. Combivir (Retrovir + Epivir)twice daily is typically substituted for ease of administration. This twice a day regimen is a bit harder to take but is recommended in pregnancy.
• Option 2 - Truvada (tenofovir + emtricitabine) taken once daily. This one drug regimen is easier to take but does have the risk of liver toxicity.

Preferred Three-Drug Expanded Regimen

• Basic two drug regimen option 1 or 2 above with the addition of Kaletra (lopinavir + ritonavir) twice daily.

any mistakes in the above information please let me know so that i can correct it......

                                                                                         


     

Sway with me...

' A jack of all trades ...'  thats what they used to call me... but as the saying goes..i also happened to be the Master of none.
     Be it singing, dancing, writing poems, short stories, sketching, painting, photography, one month of playing the guitar, another month the piano, collecting stuff... i ve tried it all... not to mention the fact that my interest in these activities would grow most often as the examinations grew near...
        ' you can do them after the exams are over!!! my mom would scream ' of to your books now!!
     ' its not important to try everything and then leave them!!' she would say.. 'but to try your best in one field and excel!'
  so what if i was not a master... i had the confidence that i could do anything, if i wanted to... not coz i was good at it.. but because it was an adventure each time i tried... '

but that was a long time ago...

now,  i'm just a lost wanderer with a medical degree with apparently no time for anything else but to obssess over my future...something u or i have no freakin control over. what post grad am i going to do ?.. where am i going to do it..? how soon am i going to buy a home or atleast a car? when will my parents take a sigh of relief..? i left all my adventures behind to answer these questions .or else i would feel so guilty. coz thats whats more important isnt it... or is it...?

when my mom urged me to join singing classes or dancing classes during my medical internship, i laughed saying ' i have no time for that'!!

sigh....!!dancing... !!
when i remember the days on  stage, clad in heavy make up , bright lights adorning the face , with smile so huge u can see all  32 teeth,   hands and feet navigating around in rythmic fashion.. i remember what it feels like to be free...
          whether it is the strict posture maintenance required in bharathnatyam, the graceful swaying in kutchipudi or strong footwork required in kathak, the feeling of ecstasy that surrounds your soul transends the aching that every small muscle in your body would be suffering...no inhibitions , no fear of looking foolish, because u r there just to dance. to lose yourself in the story and  glory of it all.....

         the perfect part comes ,when the freshness you would feel after an hour of dancing is like a pathway that opens in your mind, allowing every book that u study flow in like a beautiful river of fresh water. (not to ignore the fact that i scored better in exams during my dancing years!!!)
     
  how many times have you heard a foot tapping song while you were in a crowded area and wanted to just stretch your hands , wave your hips and lose yourself in the beats.... how many parties have you stood at the corner clapping your hands pretending to be shy when all u wanted to do was the exact opposite.
dance may seem difficult, tiring, stupid or even a waste of time ...but try it, when u can ...cause it can set you free....

         well... am i going to stop with the indian cultural forms?...  two weeks ago i saw an advertisement in the paper for latin dancing... would i risk ' wasting' my time taking these classes? the salsa, mambo, merengue, ball room dancing ... when i see the pussycat dolls swaying away with their slender long legs (well thats something i reeeeally need to work on ;-)) it makes me wonder... can i pull it off? or should i rather be using my time preparing for a future i have no idea about... we'll just have to live life and see,  dont we...?

my first successful intubation....a lesson well learnt.

"Dont be afraid Doctor Archana ... endotracheal intubation is not difficult. its not the muscle strength but the technique that matters. once you master the technique...you'll be an intubation expert!!"  thats what came from my senior doctor after i had struggled through my 15th unsuccessful intubation. he had to intubate the patient instead of me coz i was 'taking too much time' as described by the frustrated nursing staff .

          intubating a gasping patient just followed by effective CPR is an art i have always wanted to master from the first day i started medical school. How many ever other procedures you may have performed on a patient, i always new that  performing this procedure will leave you completly satisfied that you have actually saved a patients life that day. you have brought him back from the doorway of death. thats what completes a doctor... and thats what would complete my purpose...

          but somehow i never seemed to get a hang of this timely act. an arresting patient when brought inside the icu, almost always can be saved if intubated at the right moment.....and then there are the 'DNR' patients of course..
          the word DNR means 'do not resuscitate', which in certain institutions, is a desicion made either by the patient themself ,if in sane mind , or by the patients relatives. but in certain instituions where there is almost always a shortage of beds due to the heavy influx of patients everyday ,this term is an unspoken code used for those patients who, if put on ' the machine' to be kept pumping would only cause a lot of physical, mental and emotional stress to the relatives and the doctors themselves. such patients can be kept alive only mechanically. the machines breathes in and out for them and and thus the heart is forced to pump blood. this only goes on until the heart tires out. this is what is called brain death, as the patients brain must have stopped working a long time ago.
       and as the saying goes;  ' a doctor should be able to tell the patients relatives that they did everything they could to save him or her' and so thats what they do ; ..everything. but sometimes trying to save someone who can definitely not be saved is a waste of hands when some one in some other part of the hospital who can be saved needs to be resucitated right away.
      it is these DNR patients that we young doctors are allowed to intubate at first, as this art needs to be mastered when required at the right moment.
      i am one of those young doctors , who has tried intubating many gasping patients desperate to get it right each time but has never been able to take it till the end as i lacked the stamina as i thought it to be. my senior doctor would always have to finish it for me.
 ' Not again!!!'  i thought, as i was walking away from my 15th attempt.
" You have one more intubation you can try ' said my senior with a ray of hope. "Its the patient on bed number 2. She has been pulling on for a long time but she looks a bit bad today. Unfortunately there is no point in bringing her back as she will not be able to survive the night anyway." she said apologetically. "so there is no urgency. but it is important that you learn soon as you have many more lives to save."
           i moved towards bed number 2. a woman in her late 60s, her hands and legs tied up to the sides of the bed so that she doesnt disturb the infinite array of tubes attached to her body.
not a pleasant site to see. i flinched as i looked onto her face. she probably would have been a pretty face during her healthy days but now all i could see were the remains of a worn out face battered by disease and misfortune. i gazed into her charts ; chronic kidney disease stage 5 , ischemic heart disease, hypertension, diabetes.
      her heart rate  was decreasing by the minute.i was instructed to try intubating after her loved ones had a chance to say good bye. i quietly walked outside the ICU rehearsing in my mind what i would say to her relatives. ' i believe you have already been explained about the seriousness of her illness. i am sorry to say her condition is getting worse .........' i have done this a number of times , passing of bad news to loved ones. i have seen different reactions; sudden outbursts of grief, some fall at your feet begging you to save their life somehow, some silently listen and take in the information you have just given them.
            this time , her son listened to what i had to say, his eyes gettingg wet and quietly walked of. he came back with his family. a young lady similar to the son probably her daughter, an old man himself in his 60s and an old lady around the same age as well. i noticed that each one silently walked to her, one at a time. after whispering a soft prayer into her ears they stroked her hair slowly,and then her feet. as each walked out i saw the glistening of tears down their cheeks.
           it was my turn. i had requested the nurse to place the intubation tray next to the bed so i could start my little lesson. i saw her heart rate drop down to a minimum. i saw her taking slow, shallow but peaceful breaths. i put on my gloves and touched her forehead. she moved a little. but this time i saw her face for the beauty she really was. i saw the hearts she had touched. the love she would be leaving behind. 'please be at ease' i whispered into her ear. i didnt want to cause her anymore discomfort than she already was in.
         i slid the scope into her mouth and into her throat when she slowly flinched. her eyebrows drew closer to show her discomfort. as i held the scope a little higher i visualized the epiglottis and vocal cords.i pushed the tube in with comfort and checked the entry of air after connecting it to the ambu bag. i was in. i had done it at last... i had intubated a patient. i kept pushing the ambu bag to keep her chest moving in and out as i saw the reading on the ecg monitor reduce into a straight line.
         as i walked out of the ICU that day i felt myself fighting back tears. as she left this world ,she made me feel like a complete doctor. she helped me learn so that i could help save many more lives. as i walked past soft weeping sounds at a distance, i heard the shreaks of a relieved mother falling at her doctors feet because his timely action saved her sons life...
             
                                                                  
                 


        

Romantic comedies ...and Me

"hi there...."
"hello..."
"what do you do to pass your time?"
"singing, writing, reading...but mostly watchin movies....!"
"so, what movies do you watch?"
"hmmmmmmm.. mystery, thrillers................ "  O what the HECK !! its only romantic comedies and romantic comedies alone!!!......


There used to be a time when i used to enjoy laughing my heads out watchin an occasional slapstick comedy, or a sci fi thriller here and an animation movie there.... now my interest in watching these genres have been phased out and is being governed by one main genre and thats 'Romantic comedies'!!

whats there to watch in these movies you would ask? its absolutely the same story round and round.....!!!!
first, it starts of with a workaholic, lonely protagonist which is either the hero or the heroine who is absolutely comfortable with what life has to offer, having no idea what they r missing untill the other one enters the scene. this person is usually the more carefree bubbly one... first, they fight ..then he or she makes the workaholic realize that the real happiness is in wearing shabby clothes to work, dancing on tables at bars, breaking traffic rules and getting arrested.......
             and of course theres the first kiss.....or an accidental one night stand...
           then there comes a moment of truth where the workaholic has done something to screw the relationship, and the bubbly one gets 'hurt'and leaves...
            then comes the perfect monologue.... the one paragraph that makes whatever crap this person did to create havoc would all just disappear away and let the other one come running into his arms
            the end would be the make up kiss ofcourse....

well.... but you should understand the beauty of these movies.... they are just windows that help every persons deepest dreams to have a breath of fresh air.
 well.... in real life you woul nt expect to hear violins or  Switchfoot playing  'dare you to move' faraway in the background when the boy you have been crushing on all summer was just about to kiss you....would you....
           
 right from the start, when the wind blows the hair off her face , the way he would be in a complete trance , awe-stuck by her beauty; the hours they would spend talking to each other like nothing else existed;   the momentary second when the whole world has stopped because their hands touched for the first time.
                when he describes in a long five minute dumbfounding voice,   the way she makes him feel..... and to add more pain to our tortured souls they would add perfect music in the background that would push us past the cliff....
      we experience our very own love story every day...
                

                   i absolutley  disagree when they say that romanic comedies ruin relationships or prevent single people from finding a good partner....       

        oh yes occasionally when a lively bubbly jane thinks  a silent mysterious guy is interested in her because he likes the way she is so carefree , what hes really thinking in his head is that she is childish and dangerous and he has to get away from her!! or when sad and depressed little Emma sits on a park bench everyday waiting there hoping for a prince charming in a suit to talk away her troubles, she is just busy getting even more sad and depressed.
             when nervous Sharon tries to act confident and aloof hoping to catch the attention of her boss, he is busy pulling her down cause he feels intimidated by her...

                i absolutley would never agree if you told me that these movies are the reason that many husbands sleep on the couch every night because either he hadn't  used charming, breathtaking words to describe how beautiful she looked that day or he had just picked lines right out of the movie she had forced him to watch ,two days ago because he couldnt make something up on his own...

               we all know these things would never exist in reality.... and thats why i watch them in this magical world... where everything is perfect... she gets him.. and they live hapiily ever after

                 well if you asked me if building these unrealistic fantasies was the reason i first look at the eyes of every propective match i meet...i will look the other way and still say no.....

                 and the occasional one that claims to show reality... where the loved ones dont get together..... well.... you wont find me watching that movie anytime soon.....

                                                                                                         the Romantic movie buff...

P.S.  Recommended watches: A walk to remember
                                              Before sunrise....
                                                                                                                 

          



                  



            

the 5 minute walk.... everyday

How would it feel like if you talked about the last time you stopped and  look back at a simple thing that you used to do every single day…. Something so simple as just walking from kahovskaya metro station to your hostel on a snowy day… the 5 minute walk…..

How ever bad your day was at college or how much laundry you had waiting for you back at your room… this short, straight pavement would bring the whole world to a stand still. While you walk into the cold night from the underground, your face feels so chilled and yet feels the warmth from the muffler clinging to your neck so tightly. Your gloved hands cozily tucked away into your pocket , you take baby steps with your jittery legs clad in comfortable jeans,  to avoid slipping on the frozen ice. There is  complete silence everywhere; broken only by your shoes breaking the frozen ice underneath and the soft  sound of snowflakes touching the ground. The momentary chills that run down your spine when you see two hulky figures at a distance , for fear you may be beaten up or stolen from….but as the figures grow closer, you see the baby blue eyes , pinked up cheeks of  smiling preoccupied teenagers exchanging amusing information you never understand…   The reflections on the snow glitter like diamonds that feels like your very own Christmas everyday..  every deep breath that sent down a cool wind down your throat that played as music in your ears…you walked to reach your hostel… everyday

How would it feel like if I talked about something I used to do three years ago , today… as I walk on the side of the road dodging every cycle that comes my way… trying to concentrate on the road so that  I don’t trip on any bump or depression while the cars and autos scream  their way through the traffic. As I cloth my face and seal it with a helmet for fear the wind may touch my face and scar it , as I swing my way thru the crazy traffic myself … everyday…

Does the past always seem so beautiful to you…? Coz I never felt this magical about my past when I was in it… but sometimes…your journeys also feel the way you feel about the place where it ends…

My hostel…. Each room had  a story.. a few happy parts , a bunch of sad parts…but everyone had a story to share, to hold your hand … to face your stories together. As I walked through the road to face an easy day or hard.. I always felt the same way…. God this should never end……!

It did … but I close my eyes and I can still hear the music in my ears, feel the snow touch my nose ,  the weight of the kvartal bags on my fingers, the pain in my head from giggling so hard with my friends…. Then a auto rushes past me , the driver screaming his lungs out.. ’hey!!! Watch where your goin!!!’ and I return back to today…. And walk on… everyday….