The Teething Intern

1

It is 03:30 on a Saturday morning. I stand in casualty with three cases pending results, and three cases pending admission. Suddenly the doors of the hospital crash open; it’s a three month old baby, completely flat. No pulse, dry as a bone. My head is spinning; I am still going on two cups of coffee, my supper.

My first instinct is to run for the door before it closes. My second is to grab the valium heading towards that fitting patient and just inject it in my arm. I choose the third which is trying to put a drip in this child that is already at heavens door.

Over the next half hour the baby has a drip up, fluid running into her bone marrow, we get a pulse, she is stable, she goes down to the ward. The fitting patient is now in lala land, where I would like to be. My three cases pending admission are all admitted now, finally. My three cases pending results are all normal and they are discharged with tto’s.

It’s a good call; no it’s a great call. No one died, yet. I got to eat, well drink something and a baby is alive because of me. My MO or medical officer, Dr Okuvango aka dodge man is nowhere to be found, casualty is quiet. I look at my watch, its 5:40. I can still get some sleep before preparing for rounds if I am lucky.

Not to be, I put my head down 1 missisispi 2 missisipi 3 missisipi, phone rings, Sister in paeds ward. The baby I resused has crashed. I run down, to the wards. The baby is cold, pupils dilated, no pulse again, I look at my line. It is out. I try to put up a line while the nurse bags. I call dodge man. He says look at the clock and call it. The mother has tears sliding down her cheeks. She is not crying, she is not weeping. Her complexion is apoplectic. She looks me in the eye. Another one I will not forget.

Ward rounds are a nightmare. Half of my bloods have clotted. This means they all have to be repeated. Two more patients are waiting to be transferred to the no go zone, palliative HIV care and all I know is I need to find a bed. I look at my watch, it reads 09:55. The last few hours of that call as always are a blur. I look at my watch, its 12h55, Jenny; another intern on day shift saves my ass again and tells me to head off. She will take care of my shit, and boy is there a lot of shit, I am grateful though. I could not, would not have lasted much longer although I have had to before and will have to again. All in all I was on call for 30 hours, and then some, scary I know, but that’s the norm here in South Africa.

I am a year and six months into my two year internship. At this point in my life, I can proudly say I am safe. Well, relatively safe. As a doctor that is.

I did not even introduce myself. Hi, I am Ali Sha. This is the story of my intern life thus far. I started writing this when I knew I had to find an outlet to survive the devastation of my everyday existence. Where to begin? It all started with a mad rush of matric final exams, everyone asking what you doing next year? This is truly the worst time of anybodies life. Anyone who has been through the matric experience or that final grad year can attest to this. You are tentative. You are afraid. Some afraid of failing. Some afraid of not accumulating enough points to begin lifes dreams. Me, I was just afraid I would/or would not get into medical school. Sometimes lifes journeys are decided with simple tests. I know what you are thinking. What a loser? But hey we all have problems. Some not as big as others, but they are important to that particular person. This I have learnt is called empathy. Walking in another mans shoes, and boy does it pain. You will know when you have done it too.

Since most of my family was either Doctors or Accountants, I did not have an easy way out of becoming the first actor in my family. You see, as an Indian and even more so as a Muslim we are taught to look at the practicalities of life. As I grew older I have learned that this is true for all races and creed. We are thought to dream small, live life small. Most of us programmed to get a good job, study hard, work your way up the ladder. The safe route. After reading the book rich dad poor dad, I realized that it was those who dreamt big and believed in themselves and their dreams; these were the people who lived their true success stories. And only some of them were seen on TV, not all. I guess there is still hope for this pessimist. Now many people have laughed at me for that. I did believe back then that I could have been the first breakthrough in history. The first Indian Muslim South African in Hollywood (back when I as 10 maybe). How drastically my outlook on life has changed since then. Anyway to become an actor in South Africa you would either have to have contacts, or be stunningly gorgeous (which are traits required in any profession as I later found out). But seriously can you imagine me telling my parents and my brother, that I am going to be an actor. The thought of it alone makes me piss in my pants. I have always had a problem fitting in with everyone which I have become accustomed to now. The less I say the less trouble I get into, same goes for the less I do. The only problem with this was I loved saying and doing things all the time. I was not a true extrovert but I had my opinions. They changed from time to time but the fundamentals were as solid as the earth which I was made from. I dreamed of being on television. A dark brown thin frail frame, times two pimples one on each cheek, tall (5 foot 8 inches if that counts), long straight hair, dark brown eyes. I mean, come on people blue and green eyes have been killed, its time for the dark brown to rise. It is time for normal to be cool. Here, here.

Then it happened, the call that changes ones destiny. It was a medical school, a prestigious one at that. I was in. Now I would not say I was intelligent. But what I gained in the field of intellect I lacked in just about every other field. Socially inept, maybe. Spiritually controlled, yes. Financially, dependent. A quick way of taking stock for me is to look at these fields. Social, financial, spiritual, intellectual and physical. I mean basically if you have these bases covered, you are doing alright. At that time I was not, and as time went on things did not get much better.

So here I am this normal cool guy. This normal cool guy, who started of with a 100% of his soul, when he left school. This normal cool guy, who on leaving medical school was full of soul. Now almost two years in as a practicing doctor in South Africa I have lost a bit of that soul. I think…

You know when times are tough in life and you become all nostalgic. You reminisce of the good old days. Everyone has a good old day. I cannot remember my last good old day. I do remember my last leave though. Ahh leave… vacation leave that is, I will come to that later.

I do remember my buddies from medical school. We had a dictum or questions, that I use everyday and will use everyday till I die. Who am I? What am I doing here? And did I have a nice day? I won’t say I have found any answers yet but I am working on it. And I am slowly finding my way, my canvas is taking shape slowly but surely.

Now back to my friends. There was Surety man aka Jameel. He was always there when you needed a friend. He was the kind of guy everyone hated. First class A student, always with a beautiful girl on his arm, he wishes. He was a great conversationalist and good listener too, Ok pushing it there. If he had one pitfall, his kryptonite was woman. Don’t get me wrong, he loved woman. He just sucked at social interactions with woman. None of us ever had the heart to tell him. He had the athletic frame six foot tall fair and handsome. He just had no idea what to do with it. I do believe through his varsity years this became more and more apparent. No matter how hard he tried he just could not get that balance. Still he was awesome guy and I miss having him around now at work. I think it would have been unfair for God to bless a man with so many things. Everyone and I mean everyone has a shortfall in some category. That I have learnt. Usually it is those you are most jealous of, that surprise you. Jameel qualified with me.

Then there was Kubin. Kubin was like your girlfriends or sisters food when she was learning how to cook. You had to take it in short spells. But as time wore on you got used to it and eventually you not only ate it, you liked it. He was loud, narcissistic and overly self confident. He was thoroughly entertaining to be around and that’s why whenever I needed a pick me up, Kubin was my man and still is. He and I met on day three at medical school. He was hitting on some hot chick at the stairs of the great hall of Wits main campus. The conversation was that of a typical jock. Don’t I know you from somewhere? The girl’s reply, Yes you probably were at my recent engagement. I was nearby laughing. He asked me if I had a problem, I said no and walked away. An hour later we were put in the same tut group for chem 101 and we became sort of friends. He told me of his crazy expeditions of girls, drugs, and hours of a misspent youth. I would listen and laugh, knowing that possibly 90% of it was untrue. But all the same he was funny and he became a loyal friend.

And a most recent addition Stevie, a tall lanky white dude. He was a fairly new addition to my social circle. Nevertheless he was an invaluable one.

So, here I am post call on my way home. This is as we refer to it, the golden time. It is a time when a sense of relief sets in. You realize not only have you survived another call but you get to go home and do the four sacred rituals that is every human beings god given right. You get to shower, you get to shit, you get to eat, and you get to sleep. In that order. Post call, you smell. You look like road kill. A normal person should be able to spot the post call doctor 10 meters away. He is the guy with one lazy eye. He has drool over his scrubs. Oh yeah, I forgot he has scrubs on in the morning that look like they need a thorough hand wash. He keeps on asking the same dumb question. What time is it? He most probably is the man who will be performing your proposed surgery today. Just kidding, then again maybe?. He is usually the guy who will be taking your blood and doing your routine work up. And I am not kidding about that. He is me today. He was me.

Right about now I reach home. Home sweet home. As Gerald Durrel put it, a place of my family and other animals.

Home is quiet now. It is peaceful, except for the maid. In South Africa having a maid or domestic worker is fairly common, and we had Clementine, a lifesaver on most days and family now too. Clementine and I are like the pommies and the French. We had our hundred year war, but although we suffered massive casualties (my Levis jeans, my puma t-shirt, my prized possession, a chain from a former fling). We have penned our Geneva Convention. We are in a state of civil peace, well most of the time. You see Clementine had a couple of inconvenient habits. No. 1—You know that part of the morning when you are just floating in hyperspace, which is when she comes in to my room to get the dirty clothes and vacuum. No matter how I have attempted to sabotage her mission, she always finds a way in. I locked the door. She banged on it, till I was awake. I left the dirty clothes out on the floor outside my room. Mum seethed when visitors came over and saw this. Now I except she will come in, but as quietly as possible. And, no vacuuming till after ten. We also have a strange greeting in the morning. I look her in the eyes as she does me. We nod, we grunt, we move on. If I said I was I not a morning person that would be an under statement. I believe all work should start after nine. Come on who is with me. The hospital kick of is generally around 7h30 which to me translates to a 7h23 wake up call. Brush, wash, pee and go. Sometimes if I am lucky I can grab a muffin on the way out.

But then there is ever steady Dad, Abdul Sha. My father is a mans man. We have had our ups and downs. He has always been there for me solid as a rock. One thing is a dead certainty everyday, sure as the sun that rises; I will have my Dad making sure I read my prayers. My saving grace through the rough days. My dad was the type of man who was self made in every way. He knew what his strengths were and he stuck with that. And his strengths were my mum, amongst other things. Now many of you may find this amusing but I do believe modern man and that is man in the last fifty years or so has become a bit of a sell out. It’s the female of the species who seem to be excelling now more than ever. And big ups to them. We have become mummies boys (including myself) and the macho self reliant, self aware alpha male has fallen a bit to the way side. My dad is up everyday at 5h00 does his daily morning prayer, sorts out the lunch and is of to work. He built up a business from scratch, made it and keeps running it like a 25 year old, except that my dad is well into his fifties. He is the sort of guy who quietly gets the job done. He is a constant gardener. The thing about my father, though is he probably has the right approach to life. He knows his responsibilities. He cares for his family and he lives in the moment, everyday is just another day to be grateful for. I do believe I envy him for this. It is difficult for me to understand his constant demeanor. But your feelings towards your parents are steady yet malleable. And so too people change, and my dad due to circumstance has changed over the years but I remember him the way he was when I was growing up.

It is just gone 2pm when the final step of my ritual kicks in. I lay down close my eyes and am instantly in rem sleep.

I awaken. It is getting dark outside. A little shiver slithers slowly down my back. It is chilly. Winter is on the way. I had that dream again, always the same dream. I am called to a resus, it’s a person I know. I never see the face as it is turned away. I stand there not knowing what to do. I see the monitors bleeping, I hear the sisters screaming Doctor what do you want? I know I should act but I can’t. I don’t know whether it is I cant or I don’t want to. The person dies, they cover the face and I wake up, shivering and cold.

It is supper time. Everyone is home now. There is the usual hustle and bustle of the kitchen. I can hear the pots clickety clanking and I am waiting for it. That moment before your name is going to be called; Ali come and eat.

This is a good time of the day. I sit down and I tell everyone about my day, they tell me of theirs. No one is allowed to do anything but eat, talk and listen. I have come to be filled by this gathering. It was not filling just from the food but for the soul. It was a routine but one of the happy ones. It is time to relax, be laughed at, have fights, make up, express opinions, everyday you never knew what you were going to get.

Some scientists say the way we are is pre-determined, genetically speaking. Some believe we are product of our environment. Most believe it is a mixture of the two. Now I have a third possibility, what if God enforces destiny upon us to mold us and change us as time goes by. I do believe this is what happened to my mother, Fathima Sha. My mother was a special woman. She was a very outgoing woman in her younger days. She had an old bunch of records that we used to dance to as kids. She used to take us to the movies with our friends. We had parties on our birthdays. I mean small immediate family parties. She was someone we could always talk to. However over the last couple years she has become enriched with a spiritual vitality. It has rubbed on from my dad. He was the first to bite the religious apple. You could say as most things occur, you wonder if there is a reason for them and I have the answer, time. Why did this happen? Why did this person change? They grew into it. In this case as in most, there were a number of causes. Experiences mold us into who we are. It was not an overnight phenomenon. First it began with my mother reading her morning prayers everyday on time. She would then soon read all her five daily prayers everyday on time. She would always be caught with an Islamic book in hand. She then started fasting every Monday and then every Thursday. I cannot say I did not notice it. It never bothered me or interfered with my life. My mother was always a devout Muslim. More than most I suppose. As a child, even as a young adult one never really contemplates ones death. It is not a thought that crosses your mind. It is like losing someone close to you. You don’t realize that it will happen. It must happen. I believe you choose to suppress any notion that it will. When it does Kubler Ross’s five stages kick in: Denial, one of the strongest human emotions. Anger often seen, rarely understood. Bargaining, some thing kids and adults in corners do alike. Depression, one of the major problems of our society today and in the future. Acceptance, you want to, you will to, but for most of us it is more of autumn’s leaves blowing by. I think many of us just keep on channeling through one of these five when tragedy strikes. We are in an elevator going up and down with these thoughts and emotions everyday. To let go, to hold on, is it not one and the same. And so it is the mystery that death shrouds us in, is as perplexing as what may follow it. Islamically we believe in life after death as do most of the major religions. Thus one is inclined to do good, be good, in this world, now, and reap the benefits later. I can’t say I have done this to any great effect. Then again, I do fall into the category of youth wasted on the young. I just think of death as an event that will happen later. I am too young now. I have dreams to fulfill. I have places to be, people to meet. I have life to live. Most of us who have not been confronted with mortality feel this way. It is often too late when we do finally accept that death is not just a word. It is a finality that will come. It should not be carried like the shadow on ones back. It is not to be feared. It should be like a smile, something that you can control and can used to brighten the day. Death as a smile, most would say that is crazy. But, you can be prepared for this event. If you lived accordingly, death is but a smile. It is but a greeting to a new world, is it not?

The food for thought ends as does every supper, as does everyday. I stand up, walk over to the sink, and begin the wiping process as I usually do. Chores are here to make the time pass by. I do them as one does what one is accustomed to. I like to help clean up.

It is a wonderful experience to clean something that was once dirty. To make it new, almost. The soap and water runs through these dishes as a shower skims over your skin. I rub hard over the marks and most are removed. However some of these stains are permanent. No matter how hard I try I just cannot rid this plate of them. They are ingrained. They are apart of this plate now. They are a make-up, a dress me down. They are strength, a weakness. I know them well, struggle with them daily.

I vegetate the last few hours before bed. I believe 90% of man has become part vegetable. In front of the television I switch off, I disappear, and so does time. Rarely do I learn anything that will aid me in this life or the next. It is the cheap thrill of knowing what happened in this week’s episode of the big bang theory. I sit there watching this show and sometimes I think of my patients. Mostly, I try to blot it out. The seductive bliss of a half hour without any contact is pivotal to my day. This is my time to unwind.

But, I see the faces; try to work out their problems.

Its bedtime, a time to rest before the craziness begins again. I go to my room. It is a peaceful place. It is warm, comfortable, and familiar. It smells of me although I don’t know what I smell like; I know it smells of me. It was the room I grew in, it holds my past. I hate to say it but I have become attached to these bricks, paint and other objects. There is a soft glow, of a lampshade in the corner. On my bed stand is a picture of my buddies from med school. Next to that is a picture of my parents and brother. I don’t really notice the spider in the corner of the ceiling. I just look forward to that moment when one jumps in to bed, when one is free from the day at last. The highlight of my day, ironically, sleep. Oh, how I take you for granted. My flower soft fluffy blanky pulled over me, in this dark quiet room. The feeling of floating on a cloud in utter silence. Time stands still here. I rest. I yearn for this rest. This is the forgiving rest. I close my eyes and sleep. A true joy to sleep easy.

2

I awaken two seconds before the alarm goes off on my phone. My body is programmed to wake up at this time. I wake up at this time on most days. The phone reads 06h57. I walk over to the bathroom look at myself in the mirror. There he is you handsome, sexy… what the hell is that? My right eyelid is swollen like Angelina Jolies lips. The white of my eyes is a crimson red. I spend five minutes with some ice over it. It improves by about a millimeter. I am a doctor and this was freaking me out. I call him, the Boss.

-Hello boss, I mean Professor Saloojee, It’s me, Ali the intern covering casualty. I have a swollen right eye. It does not look too good. I was wondering…

-are your hands Ok?

-yes

-can you walk?

-yes

-can you see?

-yes

-so I guess I will see you at eight

-but Prof I just wanted to know… (The line was already dead) if I could come in a bit later, when my eye stops looking like a monkeys ass, the pink one.

I rock up to work, with my stethoscope, my bible (not what you think, it’s my medical handbook), and my red eye. Oh man I forgot my white coat. I have two options here now. Face the grilling of a lifetime for being late while I go back home to get my lab coat or hope that there is one left in the change rooms at mains. Mains is short for the main theatre. The place horror stories are made of. This place smells of sweat of cyclists of the tour de France. It looks like prison except in prison you get food through your mouth and there are no tubes and bleeping machines around. Then of course there is the spacemen. I am one of them now. Every time a patient enters this freezer all I can think of is better you than me guy, better you than me. In our lovely third world meets the bush setting there is never a lab coat. There is a cream overall type jacket that once resembled a lab coat. It smells of old people for some reason (perhaps used by a previous generation) and it is also a true absorbent. I had one of these babies on last year and instead of acting as barrier it sucked up blood like toilet paper does you know what. I will go on about Mains another time. Right now I am late, and guess what no lab coat for me. I am done for. It has already begun the ward round. Prof G watches as I walk in with his heat seeker missile eyes, the clock reads 08h01.

-you are late Dr Sha.

-Yes Prof Saloojee

-Where is your lab coat

-Funny story that, I had a patient yesterday who… ( white lie coming up)

-You don’t give a damn about medicine, do you? (Getting a little loud here). You cowboys don’t care about your families. You carry germs around like the mess that is your hair. What is that gel? You are a disgrace. How do they graduate you punks?

He goes on about what it was in his day. I will spare you the ten minute lecture. But I assure it was not pretty. I should have gone home and got my damn lab coat. Worse still as I was last and, I wasted ten minutes of our precious time with this lecture. I got the dreaded D ward. Themba turns to me:

-nice one Ali. Thanks for putting him in a good mood.

I have not known Themba too long. He has however managed to irritate and annoy me since we were partnered together. He is tall lanky black dude. He has a great array of one liners like the one he just gave me now. He at least does his work and disappears. I have had worse experiences. The rule we made on day one was whoever is last or messes up on ward rounds does D ward. It is the post intake ward. The way it works is that last night whoever was on call admitted a humongous number of patients to this ward the big D. Naturally that person on call did the bare minimum of investigations to look good and keep the patient alive till the morning, allowing a trigger happy MO who could have ordered every blood test known to man. The onus now falls on yours truly to pull bloods on derelict delirious and dying patients. It was going to be a long day.

You see what no one tells you in medical school, is that by the time you reach year five, you are at ground level of the medical towers. If you struggle through the next five