Just Another Day

By Suman D. Chaudhry

They do not need a reason to act selflessly since they have pledged to do so, their love for mankind is unconditional; under the greatest adversity exists their tremendous potential to heal the sick, wounded, and those in pain. Time magazine illustrated them as ‘Warriors’ during the worst-hit Covid era of 2020. At last, they earned their lifelong overdue recognition. They may not change the entire world in a day but certainly change life for many unknown and unrelated irrespective of their colour, caste, and creed. For them each day is ‘Just Another Day’ of their existence – utterly different, demanding, and instilled with extenuating adoration, sacrifice, and hard work, totally oblivious to a common man. What does it take to become one of such kind amidst the egotistical, narcissistic, and defying modern-day world? Dedicated to all anaesthesiologists and critical physicians around the world. Based on experts’ true events.

• Language: English
• Publisher: Austin Macauley Publishers
• Release date: Dec 16, 2022
• ISBN: 9781398458451

Suman D. Chaudhry

The author is an accomplished Consultant with four decades of involvement in Anaesthetics (Anaesthesiology) and Critical Care; the latter two decades in NHS, UK. Currently, she is devoted to Health Research Authority, England. With her correlation to fast pace advanced specialisation and global exposure, she recites her first-hand experience of the exponential development, radical transition and metamorphosis during this phase necessitating immense insight, adaptability clubbed with skilful proficiency to keep abreast and grant best treatment strategies to those in need. An enlightening confession of everyday defiance, defeats, convictions unexplored and oblivious to the majority; an exciting glance into the everyday life of ‘front line’ healthcare warriors.

Book preview

About the Author

The author is an accomplished Consultant with four decades of involvement in Anaesthetics (Anaesthesiology) and Critical Care; the latter two decades in NHS, UK. Currently, she is devoted to Health Research Authority, England. With her correlation to fast pace advanced specialisation and global exposure, she recites her first-hand experience of the exponential development, radical transition and metamorphosis during this phase necessitating immense insight, adaptability clubbed with skilful proficiency to keep abreast and grant best treatment strategies to those in need. An enlightening confession of everyday defiance, defeats, convictions unexplored and oblivious to the majority; an exciting glance into the everyday life of ‘front line’ healthcare warriors.

Dedication

Dedicated to all Anaesthesiologists, Critical Care Physicians and Health care workers who devote their lives to humanitarian self-effacing professionalism.

Copyright Information ©

Suman D. Chaudhry 2022

The right of Suman D. Chaudhry to be identified as author of this work has been asserted by the author in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publishers.

Any person who commits any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

The medical information in this book is not advice and should not be treated as such. Do not substitute this information for the medical advice of physicians. The information is general and intended to better inform readers of their health care. Always consult your doctor for your individual needs.

A CIP catalogue record for this title is available from the British Library.

ISBN 9781398458444 (Paperback)

ISBN 9781398458451 (ePub e-book)

www.austinmacauley.com

First Published 2022

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Acknowledgement

My heartfelt gratitude to seniors, teachers, colleagues at All India Institute of Medical Sciences, Royal College of Anaesthetists London, Royal Victoria Hospital Belfast, Transplant Team at Mayo Clinic Jacksonville, Florida

This manuscript may not be a story to be elucidated but a trail to be followed by future generations who often find themselves on crossroads with no indemnity. Hope my ‘reflection’ can render them anticipation and spectacle light in darkest of times amidst utmost desperation. Just keep walking and roll out that day. It is Just Another Day!

I am deeply indebted to the excellent team at Austin Macauley Publishers Ltd UK for recognition and acceptance of my manuscript which could never have reached the public domain without their navigation and spontaneity. Jasmine Smith and Vinh Tran have been a great support to achieve completeness and perfection to my ambition.

Part I

1. Introduction

There are millions of professionals worldwide. They walk through different paths and undoubtedly put in relentless hours and days of hard work and dedication. However, some journeys are exceptional, more so if one had travelled down in deep dark woods at a time in life which was meant for sunshine. For that person to continue or in fact start another challenging, and defying mission requires exceptional motivation and determination to go on unimpeded seeking greener pastures. The routes to professional advance are in no way traditional by any yardstick since they demand extreme incomprehensible benefaction, and one is unfailingly liable to walk in solitude majority of the times especially so in fast lane.

This book is one of such a commuter who despite having travelled an unprecedented fierce and stormy aisle chose to take the most defiant option – she took life one day at a time and said to herself – it’s ‘Just another day’! A true persuasive tale bound to inspire future generations indoctrinating integrity, tenacity and perception interspersed with humour and enigma!

‘Just another day’ illustrates exhaustive, all ranging experiences in life of a busy clinician. It encompasses day to day participation, challenges, and struggle from commencement of medical training as a junior doctor or Trainee up until fulfilment of career and is based on true experiences and incidents of an ambitious, visionary young girl who encompasses her career as an Anaesthesiologist and Critical care physician. It unravels the struggles to succeed at every single step in a protracted four decades ‘ramble’. Each chapter encompasses a true event faced which in turn formed a learning curve swaying her to move forwards. She soared up to a new start every single day more deterrent and defiant to face a first-hand challenge the next day.

2. Learning from Myths

This was the last day of my Anaesthesiology posting as an Intern in year 1977. ‘Anaesthesiology’ during those times was an extremely underestimated speciality. Only the last batch of candidates on the merit list was urged to accept this as their fate. No wonder they never seem to impress an ordinary person. Medicine, surgery, and obstetrics gynaecology – Yes, these three were the prominence of medical profession and only the elite toppers or first fifteen to twenty candidates in a batch of 150 could be fortunate enough to be allocated to one of these three specialities as their lifetime career. Thus, it was a common conception that these three subgroups of medical professionals were by far intellectually superior and more deserving than their peers. Wistfully this myth also had been engrained into me for a time equivalent to my learning years which was apparently long enough to implement it in my own life.

As interns we were entitled to two weeks’ leave every calendar year (January to December) and hey it was already mid-September. A great planning went into how make best use of this fortnight and yet not lose acquisition of any teaching or clinical skills at professional front. Anaesthesiology posting; two weeks leave and almost ending internship – perfect plan. So, the well-deserved ‘time off’ was applied for and duly granted. The working week typically comprises of six working days – Monday to Saturday in Asian continents. I spent the entire time leisurely on cloud nine without pondering about my professional commitments but dropped into hospital on last day to make an appearance to the learned senior ‘Gas men’. The ‘leave’ had been a good break from usual killer norm. Long days with no respite and uncertain night-duties, shadowing the house officers – collecting blood samples, running to laboratories for results, blood banks to fetch blood products and two consecutive weeks in labour room assisting the registrars in caesarean sections. Mind you, we as interns just held retractors and made sure the chief operating surgeon had a wide-angle view of patient’s anatomy. The generous registrars or faculty depending on their mood and urgency of surgery would then teach you the affiliated subject and procedure. This was more of probability in an elective case during broad day light. That day use to be godsend; gave an elated feeling of involvement. Emergencies were real urgent scenarios for sake of patients’ welfare, patient’s and baby’s safety in obstetrics. This had to be followed by the arduous writing task of documentation which was manual during those days.

I vividly recall the times of a ‘Routine’ schedule – whereby gynaecology wards were being perpetually full and the morning rounds with consultant, gynaecology team and nursing staff took at least three hours to complete. How can I forget the allocated duties of a ‘House officers’ who were meant to be senior to us in terms of responsibility and accountability? They were perpetually absent or ‘Off sick’. I along with another intern were then pampered and praised for our efficiency to fill in the gap and take on the additional burden and dual liability. By three-weeks’ time we could smell the rat but were too shy to revolt and retaliate; interesting enough there were no extra perks except elating our ego!

So, the ‘fortnights’ annual leave subsequent to this crazy routine had rejuvenated me enough and here I was on the last day of my anaesthesiology posting as an intern dressed in scrubs simply to get signatures from the faculty as a gesture of fulfilling my Logbook or attendance. Funnily, had guessed it to be a simple straightforward process. I was standing next to my other colleagues who had religiously attended each day of this stint and gave me canny look making me dubious. It took me very little time to ascertain something concerning was on the cards and discovered soon (to the utmost scare of my life) that we were to have a stringent test before being signed off for next posting. My colleagues were all exchanging notes as to ‘boiling points’ and ‘lipid solubility’ of different anaesthetic gases, names and classification of anaesthetic circuits and characteristics of various vaporisers. It was all French and Latin for me. The option of leaving this most unexpected horrific scenario subsequent to my initial presence was worst decision, I was bound to stay on – needless to say, every second of waiting was distressing and fraught with utmost anguish.

In no time my student number was called, and I entered the office of chief and head of anaesthesiology to encounter a middle-aged gentleman with thick glasses and gazing eyes. ‘Hmm,’ he muttered, ‘so you are S D (my maiden name). At last, I got to meet you. So, shall we proceed?’ The most inappropriate thing for me was to say ‘yes’.

‘So, smell this agent and tell me what it is?’ On the hindsight, recalling that moment now, it was certainly Ether, but I was clueless then. Next, he handed me various anaesthetic circuits, valves, airways, and Endotracheal tubes in quick succession. My response was as blank to every single piece. Lastly, just to pin me down and make me feel most wretched he enquired about the anaesthetic management of patient undergoing Tonsillectomy. By this time, I had accepted how worthless I was, and more pertinent that this speciality had something unique and exclusive; those who were practising this domain were the indeed ‘the wise men’. ‘Thank you, you may leave now,’ he said with utmost desperation. I took no time to leave my seat to avert facing him. No sooner I reached the exit of the room, I heard a voice calling my name. It was him again the great professor of anaesthesiology. ‘Just to let you know you have got a zero, a big zero.’ (He drew that number in font 48 on a blank paper).

‘Never ever try to opt for this speciality, it’s not for you.’

With my heart pounding at the fastest pace, I left the room– but his advice had been taken on board – most profoundly and earnestly – the other way around!

3. Welcome to the Real World

The last three months of internship commenced. I was still mesmerised by events of the preceding day, leaving me numb and feeling meritless. This was more so because the misconceptions and myths of society regarding one of the most vital specialities of medicine were unrecognised, underrated and ridiculed at. Ironically there had been no stint or classes of anaesthesiology in five years of training as a medical student due to same reasons. No one could ever imagine that in coming decades it will be the most competitive, challenging, and highest paid sub-speciality for patients as well as medical professionals in terms of their indemnity and penalty for negligence and litigation. The irony is that today for any complex medical dilemma anaesthesiologist’s word is the ultimate. However, in corners of world some wise men had come to realism of this crude fact which lay dormant under dangerously dark deep layers of earth, and they were out to excavate it to expose it the sunshine of day, impart its applicability, renaissance and rejuvenation to this world. Not because of its usage and relevance being only felicitous to individuals under knife but it was the mere recognition of this virtuosity as ‘Acute medicine’ – where imminent, right treatment at most appropriate time made a difference in eventual outcome in terms of life or death; where early resumption of cardio pulmonary resuscitation could make an individual survive or conversely make him brain dead within three minutes of active remedial measures and where human beings could be made to live longer and have life-threatening surgeries safely. I do consider myself to be fortunate to belong and witness that era of steep exponential rises of