Well guys, finally tomorrow is the last day of my PSM rotation. Kyaa…PSM nahin jaante?? Well it’s not your fault actually. This field has so many names, just the way it has so many national programmes, policies and guidelines. This monster is also known as preventive and social medicine, community medicine, public health and few other weird names, mentioned in uninspiring detail in the bible of this subject: Park’s. Throughout my MBBS I wondered why this book is called Park when in fact it’s written by opnaa baungalii baabu?? Anyone with suggestions? Anyways, back to the PSM experience.

So my rotation. Well since it is community medicine, we are supposed to work in community. So this meant separating from our stronghold of hospital environment and suddenly we find ourselves in unconquered territory where we are no longer the bullies , where jee-hazoori of patient is foremost and prescribing meds on patient discretion the norm rather than exception!! So, the 2 months of my PSM rotation were divided into 4 “lovely and romantic” fortnights. First in slums of ITO (Balmiki Basti…the great sage Balmiki used to take medicines from our center), then in rural fields of Barwala (famous for its numerous Bars and pubs, you see Bar…Waala), followed by yet another urban slum of Gokulpuri (situated near Yamuna, the place where Krishna used to come for seeking cure for his ever so frequent burning micturition, considering his not so safe sexual practices , and from where Taj Mahal can be seen in Delhi…that’s the Majnu Ka Tila gurudwara, which gives illusion of a mini Taj from distance) and lastly Delhi gate which is more famous for its delicacies than our humble health center, which was discovered by Indiana Jones (what??? you haven’t heard about Indiana Jones and Lost PHC…the only best movie of all times!!! Dude, you need therapy).

Well, one thing I accept. No matter how redundant and boring the job might be, we got scot-free by 2pm almost always. But then we were so sapped by Delhi heat and frustration that at least I used to doze off almost every noon. This makes me feel guilty even today, but then I am just a 60kg, lean, thin fellow and I get tired easily!!! So it’s excusable, isn’t it!! Now what I used to do in the posting. Hmmm…interesting as soon as I come to know about it, I will write back. He..He..Ok, on a serious note here is a not so serious guide to 4 PSM centers and their “workload”

 

Balmiki Basti:

Step 1: Reach center at 10 am. Snail pace recommended.

Step 2: Settle down. Please take your time.

Step 3: Listen to occasional bhaashan from the resident. Inattentiveness highly desirable.

Step 4: Wait for the one or two patient who comes to center. Aree yahaan bhi dawaa khanna hai…chalo dikhaa letaa hoon!!

Step 5: Scribble down something on the “prescription” only at discretion of resident. Your job is just to write and listen to his/her daant. Feel depressed about your apparent lack of knowledge.

Step 6: In free time, play Dum-Sharrat (the game where one guesses movie names by signs, yaar…)

Step 7: Pack up and give attendance. Maximal attention advised. Altruistic behavior strongly discouraged.

Step 8: Run off as if there is no tomorrow.

Step 9: Reach college by noon and go home.

Step 10: Repeat next day.

Barwala:

*** Barwala samosa’s are awesome. Must be relished daily***

Step 1: Reach college to catch the Barwala RTV by 9am.

Step 2: Chill with friends on the backseat of RTV.

Step 3: Reach Barwala after 1 hour of bumpy ride. Heavy meals recommended, as studies have shown better digestion and food grinding in subjects on Barwala RTV than those not.

Step 4: Rush to loo. Urine becomes frothy. Etiology uncertain?? (or do I know!!)

Step 5: Settle down. Seat far away from resident and towards the other side of table and 3 rd last from corner strongly advised. Better fan airflow, minimal chik-chik and easy dozing…

Step 6: Be extremely cautious while writing prescription as pharmacist at center has been specially trained to be anti-Intern.

Step 7: Send out few of your friends after 1 hour of hectic work (really, its hectic) for procuring those samosa’s…

Step 8: Relish samosa and ladoo and chips in the AC room, specially designed for this purpose. Full satisfaction of taste buds mandatory. Don’t leave until satisfied.

Step 9: Pack off and attendance.

Step 10: Ride back to college. Open your tiffins (yaar samose to sirf appetizers the) and go on a bumpy eating frenzy.

Step 11: Food digestion guaranteed. Go home for lunch at 2. (ab baar baar appetizers khaake, bhoom to lage gi naa!!!)

Step 12: Repeat every day.

Step 13: Consult orthopedician for slipped disk. Frothy urine disappears mysteriously…

Gokulpuri

Step 1: Curse your luck. This center is much closer than Barwala and the ride is relatively smoother. This means more work and more fit doctors.

Step 2: Chill with friends on back seat of RTV. Yamuna view is spectacular and so is Taj.

Step 3: Reach Gokulpuri. The halaal meat shop next to center has a different daily attraction. Must see.

Step 4: Listen to center incharge’s stupid jokes. Laughing with him highly recommended, lest he will pester you with horrendous questions. (His laugh by the way resembles starting a rickety Bajaj chetak scooter!!)

Step 5: Start the dukaan. This center is very heavy!!! Differences between friends bound to rise.

Step 6: Must take a Jaapani pankhaa with you. No fan for interns, sob..

Step 7: Finish off the patient load. No pesking pharmacist though!!!

Step 8: Return to the incharge’s room for the noon dose of laughter (if taken casually) or boredom and sadness (if “le liyaa dil par“).

Step 9: Return to college. The food fest should continue as in Barwala, though no refreshing samosa’s as in Barwala.

Step 10: Repeat next day.

Delhi gate

Step 1: Depart from college at 10 am. Hiding steths in pockets strongly advised, as many of our previous Interns have disappeared mysteriously!!

Step 2: Control you urge to eat kachodis, gullab jamuns, chaat et al. on your way.

Step 3: Offer daily prayers to your god of choice. (Hanuman prayer strongly advised. Best returns!!)

Step 4: Climb the stairs to reach center. The only place where you feel on top of community.

Step 5: Highly recommended to sit at the extreme corner of room. Most patients are of URI and it will get boring to prescribe CPM and PCM again and again.

Step 6: The center’s resident is relatively better than other PSM folks. Warrants detailed investigation for a possible mutation.

Step 7: The pharmacist is another bright student of anti-Intern training academy. His mole on cheek looks really irritaing. Control your urge to bash him, though he does go home alone….

Step 8: Pack up at 12:30pm, longest working hours in PSM.

Step 9: Must stop over daily at delicacy shops in and around Daryaganj for quality lunch. Kulfi falooda and Badam milk near Mithaas highly recommended.

Step 10: Return to college and home or make a plan to visit some place nearby for an evening with friends…

Step 11: Repeat next day. Don’t come if you bashed the pharmacist.

 

So that’s it guys. Hope you liked my STEPS approach to PSM centers. There is still another month of PSM posting, but that will be after 3 months. Till then I will begin (and hopefully enjoy) my surgery, psychiatry and one undecided rotation. Overall PSM was fun and I did manage to do a lot of meaningful stuff in these 2 months (will write about those later), but then I have seen better days!!!

And certainly there are much better way to spend scorching Delhi summers than PSM!!