Learning the Language

August 1993

While the terms and the language of Anatomy are flying way over my head, I start to pick up an entirely different language altogether-The Language of Jipmer.
Soon, I know that I am a bastard, a bugger and an asshole.
This is not personal, I quickly realize, as it dawns on me that everyone in Jipmer is a combination of these three things at all times. The language, or lingo that I hear all the time are as follows:


A) Where the people are from:
1) Tambis-From Tamil Nadu
2) Gults-From Andhra.
3) Kanjis-From Kerala

4) Bongs-From Bengal. (All Bengalis are Bongs but only 2 people are actually called "Bong", both senior. Out of the 2, the Junior Bong is the one whom I met on the first night)

5) Bihari-Self Explanatory. I am a Bihari too, having being born in Patna, but I have been told that I don't speak like one. This is supposed to be some sort of compliment.

The above terms are never used in a derogatory sense. This is just where the people are from.

B) Special Terms

1) EP- is usually reserved for guys who take classes and give all the marks to the girls and ask all the questions in class to only the boys, who usually know nothing. It stands for "Enlarged Prostate" though I'm unable to see a connection. Bad marks in exams are always because they were marked by an EP. 

2) Bastard-Anyone at all. Casual greeting. Day Scholars are also called Bastards because they usually escape ragging and get great marks in the first few tests. 

3) Asshole-As Above.

Points 2 and 3 above are are also used to refer to people who actually do a lot of studying and get good marks. 

4) Baby Juniors-The new batch , which is us. 

5) Macha or Machi- Another casual greeting, usually between friends.  

6) Bugger-

Used usually as a greeting...."Hey Bugger, come here you Bastard", or "Hey Bugger, why the fu** did you puke all over my bed last night?" and such variations, which is all I hear all day and all night. 

Bugger can be a noun but also a verb or less commonly, an adjective, as in " I got buggered today man". "Bugger" is therefore a very important word useful in any situation.
Juniors get buggered by seniors, seniors get buggered by anything one gets buggered by, bathroom doors are buggered if they don't shut properly, food (or grub, in lingo terms) in the mess is always buggered. One can get buggered at any time, in class, in the wards, in campus, outside campus but usually by someone senior to you.
I almost feel that "Bugger" defines Jipmer Lingo. 

7) "Screwed my happiness" -A more descriptive alternative to "buggery".
8) Grub-Means the food served in the mess. "Bugger, had grub"? etc. Food elsewhere, as in the restaurants and joints in town is not grub.
9) Mugging and Reading-Very commonly used, and ragging is often cut short because a senior has to read or mug. When exams are not that close (about one week or more away), one "reads". Get a bit closer and it becomes "mugging". People who mug and read with no exams in sight are either irrelevant or simply "bastards" or "assholes".  When the exam is the next morning and one hasn't done too much about it, one "mugs one's ba**s off".
10) Night Out-A usual state of affairs where the entire syllabus needs to be covered in one long marathon session all night. The session is usually punctuated by trips to the "shacks".
11) Psyched out-Usually reserved for high stress situations in or just before exams. Usually when one hasn't read or mugged enough. It does not mean "excited"-quite the opposite.
12) Shitting bricks-Similar to "psyched out". Therefore, one mugs (or not), gets psyched out and then shits bricks, mostly after a night out.
13) Cockroach: A sputtering, crowded, cramped 3 wheel contraption capable of holding as many people as can safely hang on. Moves at 5 km per hour and takes people from campus to town.

A sample conversation, an example of many that I've heard so far might therefore go like this: 

A has just arrived back in the hostel after an Anatomy test disaster (which is a universal phenomenon). A meets B, a senior, or a classmate who bunked the test.

A: Hey bastard

B: Oye Asshole ( or anything other similar word). Passed or failed?

A: I got screwed man. Total buggery.  

B: Who came for your viva? 

A: So and So

B: Him? He's an EP of the highest order. 

 Silence for a few minutes while both of us get some water from the cooler.

B: Chal, lets go booze. 

A: Ok, where. 

About half an hour deciding on the "where", A and B disappear and life is normal again.

C) Hostels:

1) Lister and Osler House-Boy's hostels. The 2 hostels face each other across the Inter-Hostel Road.
2) Curie House-Girl's Hostel, located opposite Lister House. Occupants of Lister and Osler are often found here, waiting for their counterparts.
3) Aschoff House-Another hostel located next to a road called "Lover's Lane". Interns live here and I'm too scared to visit.
4) Harvey House-The PostGrad Hostel. The residents here are apparently too senior to bother us but who wants to find out.  I am told that the mess fridge officially keeps beers. This place is a no-go for Baby Juniors unless one is a masochist.

D) Hostel Parts:

1) Floor-There are 4 floors in Lister and Osler. Ground to Top. Each is a long corridor with a staircase running up near either end. 5 double rooms are on either end and in the middle are 13 single rooms. The hostel rooms start from "7" and go upto "31" numbered 107 or 331 etc.
2) Annexe-Each hostel has a smaller similar building perpendicular to the main hostel. The rooms here are all double, numbered from 1 to 6, as in 101 or 406 etc.
3)Wing-Each collection of rooms,double or single, is a wing. Parties are either floor parties or wing parties or just random parties, usually in rooms or the rooftops.

4) Top-Top floor of any hostel. As in "Lister Top" etc. It's never 3rd floor, ever.

5) Common, as in "Lister Common etc". Movies are screened here every weekend. The Common Room has chairs and a TV set. The movies are followed by a "Space Thriller" or a "Gorimedu Sinusitis". These movies are the climax of the evening. The volume is turned down a bit for these.

E) Places in and around the campus

1) Shacks-A collection of small shops selling snacks and drinks (no alcohol) 24 hours. There are a few of these located right outside the campus across the road from the main gate. They are frequented by patients and Jipmerites. Buses to Chennai or elsewhere often pick up passengers by the roadside here. 

Shacks consist of a shop selling vadas and the like, a medicine shop, 2 "Casinos"  and another one which makes great coffee.

I get the feeling that Jipmer would lose its character without these shacks. They provide tea, coffee, food and a place to sit and chat and waste time, ALL the time. They almost never shut down. They are ideal places to rag, get ragged, recuperate after work, get ready for work, or waste time in between work. 

2) STD Booths-There are 2 STD booths from where one can call home. They are called "Raj" and "Grace", named after their owners presumably. There are huge queues here on occassion and timing is everything. This should not be confused with places where one might get an actual STD. Those exist too, apparently.

3) Town-The city, starting about 2 km down the road and marked by a junction or for Jipmerites, the "Muruga crossing". Town is for escaping from mess grub, a movie or anything else. For baby juniors like myself, trips to town are not possible in the first few days.
4) Lover's Lane-A stretch of road with no lights, good for lovers or for spotting them behind bushes from behind different bushes.
5) Stadium-A huge field with no grass next to Lister House. It's covered by the red clay that is all over Pondy. Sports events in Spandan will be held here. 

F) Students and Associations:

1) Baby Juniors-As above.

2) FSA-Foreign Students Association...We have students from Maldives,Malaysia etc. 

3) HSA-Himalaya Students Association, which includes students from the North East.

4) JSA-Jipmer Students Associaltion. This is the body that organizes Spandan, InterClass etc and is basically the whipping post for everyone. It consists solely of students from the batch 3 years in (Vikrant's batch). It consists of a President, a Speaker (who often takes his job too literally) and Secretaries of various Committees. Shom is the Speaker of the current JSA.

I have had the pleasure of attending one such JSA meeting where there was much shouting, much debating and for me, a complete torture because I had to be there as a Baby Junior and I had no clue or interest in what was going on. And I was getting ragged at the same time. Shom, as the Speaker, was doing plenty of speaking.

A Special mention on On the Use of Tones in Lingo:

Reading the above, one might think that all we ever say is "Bastard",  "Asshole" and "Bugger". This is not entirely true. While some normal words have their place in conversation, the TONE with which one says words like "Bastard" carries a lot of importance and varies according to context.

The word "Bastard" for example, can be used in various ways.
1) Flat tone-No inflection.
You walk across to someone and just say "Hi Bastard". Nothing is happening so it's just a normal greeting.
2) Rising tone-(BaasTurrrd, with the Turrd part ending on a higher note than the Baas part).
This is sometimes used when one sees classmates after vacations or when someone unexpectedly passes an exam.
"Hey BaasTurrd, I passed/failed it!! Yippeeee"...etc
3) Falling tone-(BaasTd, the T and d are very closely spoken, with no emphasis).
Serious situations, eg, booze has run out and it's 1 AM. "Hey BaasTd, the booze is over man". Or when it's discovered that a particularly nasty examiner is coming for University Exams. So with a resigned face, " Hey BaasTd, B is coming and we're all going to get screwed.
4) Falling and Rising- (BaasTurrrrrrrrrrrrrrrrrd). The tone is lowest at the "S" in Baas. Denotes that someone has buggered somebody else and the latter has found out.
At this point, the 1 point agenda of the latter was to "Screw the Happiness" of the former.
Common situations include (but arenot limited to):
  -Eating other people's food
  -Losing notes or Lab Records
  -Losing someone's bike keys
  -Losing your own bike or room keys
  -Finishing someone's last cigarrete without permission. This, I gather is a CARDINAL sin.

Ragging, therefore has an enormously useful purpose. Apart from getting to know the seniors, I am now slowly talking in Lingo. Slowly, but surely, I am becoming a true blue Jipmerite. 

Chapter 75-The best years of our lives

Jan-April 1998

Neil Diamond, the man with that incomparable voice, has grown on me since Vikrant introduced him to me 3 years ago when life still had exams and tests, attendance was always an issue and wing parties were just a conversation away.
And Vikrant was still around.

That evening, as on so many other evenings, as the light faded and the corridor tubelights came on, I found myself leaning against the corridor parapet right outside Vikrant's closed room, cigarette in hand and making plans for dinner with Rahul, Bong and Shom with strains of Neil Diamond coming from within. As the clock struck 730, signalling the start of dinner in the Mess, he came out  and the Neil Diamond turned from background music to full blown rock, if you can call it that. Neil defies genre.
That was the start of my Neil Diamond education. The song was called "The Best Years of Our Lives", the title song off the album and had rousing choruses of "Oh Yeah" interspersed with guitar riffs and of course Neil's voice.
What a voice.

I kept that tape with me after Vikrant died, his name scribbled on the inside front cover and if you ever feel down, I suggest this song. It kept me from slipping into depression before many an exam, a deluding escape from reality and impending doom.
"Impending doom" is probably the most consistent emotion an MBBS student experiences.

3 years on and the doom has passed. I am an Intern, making plans to play tennis with Prashant and drink afterwards. Vinay is our partner in this latter activity and while he prefers to make an ass of himself on the basketball court, Prash and I go about exploring the tennis court.
It turns out that there is a coach here, or rather someone called a "marker", in charge of maintaining the court, the nets and the lines. With Prash on his moped and me on my occasionally sputtering Yamaha, we find his house, a small flat 5 minutes away.
Once the Chief Secretary angle is explained, Natarajan (or Nattu, as he came to be known), is all smiles and more than eager to help. More than anything, I think he was thrilled that his uselessly but meticulously maintained court would finally be played on.

We put up the net, make sure the lines are regular and Nattu supplies balls. We start at 430 every evening, mainly singles matches with Nattu and Prash and carry on till nearly 9 PM, with the court bathed in artificial floodlight. Short breaks are taken for "moseys" (defined as a short, lazy walk) and they turn into "smoseys" (short lazy walks with smokes). Prash is a good player, having played for his school in Delhi but I am no slouch and the matches are intense, competitive and fully deserves the drinking sessions in Fillo, Urvasi and Seagulls that last from 930 PM till whenever they decide to chase us out.
Nattu is very good too and it give me great satisfaction to beat him on occassion. He seems less than thrilled but is always sporting. He is off on Sundays and is kind enough to leave the keys of the locker where the net is rolled up and stored, so on a Sunday, Prash and I do the net unrolling and tying ourselves. Nothing, except for the odd rain shower, stops us.

Prash's parents are very accomodating and it is a joy to eat the mini dosas and sundry stuff his cook dishes up when the two of us, all muddied and sweaty after 4 hours on a red clay court, land up. It turns out that my father's elder brother and Prash's father are batchmates. although in different services and the world shrinks a little more.
Then we discover Scotland Yard.

The board game has been lying in Vinay's room for a while but we have never seen reason to play it before. Now, there are 3 of us and the game is brought over from the hostel to the outhouse at the back of Prash's house where the three of us take turns playing "Mr X", sipping whisky and abusing the hell out of each other. Ram joins us sometimes and games go on till 2 AM at the very least.
Ramanthpuram in the day, tennis in the evenings, whisky after, Scotland Yard to round off the day. It's not a bad existence.

Routine, however, can be a game changer and in our case, literally so. After a month of Mr X being chased all over London strictly by the rules of the game, Scotland Yard changes into something MB should seriously consider looking at.
There are helicopters, motorboats, double crosses, aeroplanes and hidden routes. London becomes a city ten times more exciting as with every game that is played, new rules are made, old rules are modified and the game starts resembling a high speed chase around Central London rather than the staid turn by turn game it was originally meant to be.
Vinay is bad at Mr X. His mannerisms are a dead giveaway. When the detectives (me and Prash and sometimes Ram) are far away, he'll lean back with a smug expression and say "IllTakeATaxi"...
When we are hot on his heels, he'll lean forward, no expression on his face, stare at the board and with one hand extended, an urgent voice will say "Golu, pass a cigarette".
It's so predictable that soon enough we tell him and then he tries to bluff us, which is something he's quite bad at as well.

Ramanthpuram, meanwhile is coming to a close. I have spent a few glorious weeks here, watching sunsets by the dam, biking and walking all over the countryside, getting initiated to toddy and of course, getting a small taste of what a real doctor feels and does. This posting in particular will mean different things to different people and already I have seen a few grumble about the relative isolation from civilization, the ennui that can strike when there is truly nothing to do and many other things, from the ultra spicy food Karunanidhi specializes in to the small, cramped bathrooms. I, thankfully, have happier memories.
Our 6 week posting draws to a close and I leave with mixed feelings. This will probably be my most cherished posting but there is a lot to look forward to, professionally and personally.

Our next posting is in the Urban Health Centre of Kurchikuppam, a small well stocked outreach kind of clinic near the beach. I soon discover that while Ramanthpuram was perfect for nursing the soul after the battles of Final Year, Kurchi is best enjoyed when the scars of Internship have begun to show, not now when I'm sinking slowly into sloth and gluttony.
For starters, we are back in the hostels, back to the mess food and back to Jipmer. Our day starts at 9 or so when we make the 15 minute ride to Kurchi, and ends by 12 PM when the options include sweets in Mithai Mandir or beers in Seagulls or, on many occassions, both.
Kurchi is headed by a Chief Medical Officer and has a whole table to himself while we sit on benches and conduct an OPD similar in nature to the Ramanthpuram one. It's simple enough-the odd painkiller, stomach infections, anemias, vaccines and the like. But the similarities end there. There is no village, no green fields to soothe tired eyes and no back roads to explore. It's in the middle of Pondicherry and the ride to and fro, although pleasant and fast enough, is full of autos, cycles and the ubiquitious lord of the road-the pedestrian completely oblivious to anything not on 2 feet.

Free afternoons and evenings, of course are a major perk and there is much sleep to catch up on and much tennis to be played, rounded off as always by dosas in Prash's hoouse and the rapidly evolving Scotland Yard that now almost bears no resemblance to how it was designed to be played.
Sometime in early April, Prash strains his shoulder and that is the end of 3 glorious months of tennis on the red clay courts of Indira Nagar-our version of Roland Garros in the erstwhile French Pondicherry.
The days pass by rapidly, the relative speed at which each day passes increasing as the the Sun turns westwards. Time flies when one is having fun and there is more fun to be had playing tennis than vaccinating kids in Kurchi.

If tennis is what we play, then cricket is what we watch on TV and when India is playing Australia in Sharjah with a semifinal berth at stake, I run over and Prash and I make a dash for the nearest bar with a TV-Fillo. Fillo is dark and slightly smoky and might be termed seedy by some. However, seedy is normal and we grab the chairs nearest to the TV and proceed to watch the start of the Indian chase. 2 vodkas and 2 sprites are ordered and they come in 4 similar glasses. As Ganguly starts proceedings with a beautiful trademark flick to fine leg for four, I mix the drinks and discover that I have no vodka in my drink. Prash, on the other hand, has no sprite in his and much mixing and remixing follows while Ganguly hits a few more and then gets out.

And then the Fillo management, in all their wisdom decide that it's closing time and shut the TV.
There is no time to waste. Bills are paid and we run (literally) with a quick bathroom stop enroute to the bike and I then gun the bike in full race mode to Ajantha, the seaside place whose rooftop we have frequented on occassion.
The whole process, from bill paying to reaching Ajantha takes about 5-6 minutes and after convincing a somewhat bewildered Receptionist that we MUST see the TV, we see the rest of the match sitting on a sofa in Ajantha.

They are the "Best Years of My Life" . But however good they are or seem to be, it will be sad if this is as good as it gets.
It's strange that when one is unfortunate enough to lose someone close to them, certain things and memories attach much more strongly and more specifically to them than any other. For me and Vikrant, it is this song, this album and that evening outside his room 3 years ago.

The Best Years of Life may be happening, but I hope the Best Years lie ahead.

Chapter 74-The Arrival of Prashant

Jan-April 1998

Pondicherry-a mad medley of bikes, scooters, cycles, the odd car and the all-important-pedestrian. A town of crazy traffic, duty free alcohol, ambrosiac food and an old world charm that refuses to be cowed down by the chaos and randomness of a growing, pulsating, alive seaside city. A town steeped in French heritage, a town of dosas and sausages, toddy and Bordeaux (often in the same shop), where names are still spelt as Anandakirouchanane and Latchoumibady and where you can get to the Romain Rolland Library via Ellaipillaichavady and Mission St.
I have another 10-11 months to go in this town and in this College and I now feel that I am a part of this place. Pondicherry-with all it's sights, sounds and that intangible feel, is now much more familiar to me than Chandigarh has ever been. For me Pondicherry has become a person-a city with a soul, a city, that, even when I am sober, I imagine welcoming me back every time I return from a trip back home.

The RHC posting, with it's siesta afternoons and lazy evening bike rides gives me ample opportunities to be contemplative and dreamy. I know that this phase will end soon, in April to be precise, when I will enter the real world Internship of Medicine with it's endless night duties, torturous ward rounds and a daily grind spent largely in collecting X-Rays and blood reports. For the time being though, Ashley and I spend many evenings wandering aimlessly in the areas around the Jipmer campus around Indira Nagar, and just beyond, in the wide empty spaces and fields still untouched by the growing house construction phenomenon that's becoming increasingly apparent over what were once verdant, untouched pieces of land.
Indira Nagar is a small housing colony just opposite to Jipmer campus and consists of pristine, well-kept double story independent houses resident to the bureuacratic machinery that governs Pondicherry. The name plates read like a Who's Who in Pondy Administration and at the end of this small lane lies the biggest house of them all, earmarked for the Chief Secretary of Pondicherry.
Just off this lane is a well maintained Tennis court, ostensibly used only by the Indira Nagar VIP residents and therefore, not at all. It is made of red clay and just begs to be played on. There is a net, the lines are well marked and the clay is well swept, but the gate is locked and I've never seen anyone play here. I am a keen tennis player and last year, in a fit of optimism and a fleeting desire for fitness, I had asked Dr Thapa, the Head of Dermat, if he could please get my tennis racket with him on his way back from a Conference in Chandigarh. And he had kindly obliged.
My racket-a beautiful, Wilson Pro Staff 95, 6.1 SI, was lying untouched in it's black case and here was this pristine tennis court lying unused with no one to play with, a court apparently reserved for the VIP's of Indira Nagar.

It was here, in the Chief Secretary's House, that I had lunched with Rahul 2 days prior to joining Jipmer  and it was here, one late evening as I was staring at the tennis court, that I found myself face to face with a thin unkempt looking, moped driving, very familiar guy coming out of the gate. He had a bluish-green bag slung over his shoulder, sandals on his feet and a beard that needed a good trimming.
This was Prashant-the son of the current CS of Pondicherry and someone I had met briefly last year through Rahul.

We exchange startled abuse laden greetings. Prashant is a graduate of the Jamia Millia Mass Comm Institute and is here trying to make some sort of a documentary in Auroville. Every morning, he mopeds off to Auroville, does his stuff and mopeds back. He knows no one here and over the course of a conversation conducted perched on a Yamaha and a moped, I discover that he is a keen tennis player too. Add the fact that his father happens to be the de facto head of the Pondicherry Govt and the locked gates of the tennis court open magically.

Prashant is like no one I've ever met. Of course, all my acquaintainces thus far have been variants of book toting, trivia spouting, occassional partying medical students so Prash, as he likes to be called, is a complete breath of fresh air. He talks wisely, has his fundas clear. Apart from making his documentary, which I discover is just an excuse for him to visit Pondicherry, he is doing nothing and has nothing planned. He is single and loving it. He just goes with the flow.

And he plays tennis.

What can be better?

Chapter 73-Bonds and Vagabonds Part 2

Jan-Feb 1998

We've been in the RHC for 2 weeks and it's time for the Pulse Polio Programme.  Held every year, this essentially consists of catching every under-5 kid and making them drink a few drops of hopefully properly cold-chained Oral Polio vaccines. This serves a very important purpose of course since in many parts of India, where shit mixes with the great outdoors, the ingested vaccine is also  excreted. This is then transferred by whoever eats the food contaminated with this vaccinated shit and they get immunity in turn. This can be massive, reaching many villages and areas within a reasonable radius. This is called "herd immunity" and is a concept that has been drilled into us during the course.
Essentially, if you can't improve the sanitation, flood the shit with polio vaccine. Polio will be eradicated by eating shit-that's the national strategy- and judging from the results coming in from various surveys, it seems to be working remarkably well.

It's good fun and all for a great cause. Polio is usually a mild illness but of course it can turn lethal and cause paralysis. Over the course of two nationally designated days, camps are set up in schools and villages and Health Centres, kids are identified in buses, trains and in houses and are given these drops to swallow down. Many people, from us Interns to family physicians, GP's, nurses, Health workers and all and sundry are involved in this process and it's a huge co-ordinated attack on the polio virus. The drops themselves are tasteless, and since the virus, although live, has been weakened just enough to provide immunity but not an actual infection, are safe enough. It does provide excellent community immunity and is a much more cost effective way of doing things. There are logistical issues related to the transport of the vaccine since the drops have to be kept at a certain temperature throughout the whole process from manufacturing to administration and great care is (usually) taken to see that this happens.
As Community Medicine Interns, we are allotted a village each and one Sunday, we make our way to these places where we find a school or a camp set up. I bike down to Thondamanatham and spend a pleasant day chatting with the school and health staff, vaccinating huge lines of kids and getting a first hand experience of a National Immunization Programme in action. The only hitch in this whole affair is that it also happens to coincide with an India-Pakistan cricket match being played in Dhaka, Bangladesh and I hop onto the bike and zip down to the RHC every hour to catch the score. It's a day/night match so by the time the crowds are dwindling and the sun is setting, Pakistan have racked up an impressive 300+ score. This is depressing so I stay put in the school for a while putting 3-4 drops of the vaccine into small open mouths but around 730, when it's dark and the camp is readying for pack-up, I give up and whizz back.

India are rocking the chase. It's a tense affair. The other Interns are also back and some are standing on the table chewing their nails to bits, shouting the choicest abuses, going into fits of ecstasy at every four or six and sinking into doom and gloom at every dot ball or wicket. Everyone is an armchair cricketer. Beers are passed around, smokes are brought in from somewhere, Karunanidhi is sent to make more Chilly Chicken. Finally, when no one can shout anymore, Badrinath hits the winning runs.
The place goes crazy.
Just a typical India-Pak cricket match. But a very atypical Indian chase. Very satisfying.

A few days later, the Dept of PSM arrives in a van and informs us of a cholera outbreak in the vicinity. We need to identify the source of this problem and that will mean going from door to door in the neighbouring villages and asking the residents if they have passed rice water stool recently. Shyam and I team up and are sent to Kodapakkam, the village with the booze shop. There will be 2 other teams with us and we divide the village between ourselves.
Kodapakkam is not a big place and Shyam and I find that our particular area has a few pukka houses and stretches of empty space in the middle. And with most of the residents of these houses away on work it's a piece of cake. Our interviews take less than an hour and while the others are sweating it out, we chill out drinking Mazaa Mango under a tree, killing time and convincing ourselves we've done our bit. Sure enough, the source turns out to be a water pump in the same village and we feel proud to have contributed to the general health of this area. A job well done.

In the evenings, we often walk around the village and I usually wear a white kurta-pajama-my standard night dress. One evening, while walking on the road in front of the RHC, a few villagers spot us, snigger a bit and say "Payee Payee". I understand that this translates to "Ghost" although I am pretty sure real ghosts wear other colours also. There is a strong ghost belief running through here.
We are also invited to the village chief's house for Pongal and head out there with the whole PSM Dept in charge. The hosts are very gracious and the food is quite good. There is a pooja and some general banter, none of which I catch because it's all in colloquial Tamil.

Once every few days, I am on call. This is more of a pain than anything because I can't stray away from the RHC and have to attend to every patient who lands up after OPD Hours with any complaint whatsoever, at whatever time. Most of the time, it's cuts that need sutures or aches and pains that drag me from the Dorm to the OPD  where I take a quick history, perform a quick check-up and spend a few minutes rummaging through the medicine cabinet for something suitable.
Suturing is fun. It actually feels like I'm doing something useful. It's a whole process of cleaning and draping, debriding the wound, opening appropriate sutures from their sterile packages and actually putting needle to numbed skin and forming loops around a needle holder and then finally knotting the suture neatly. The end results look OK and get better with every subsequent wound.
Most of these patients also require a Tetanus Shot since no one can recall when they last got a booster. The TT (Tetanus Toxoid) vials are kept in a fridge in one of the rooms and each room in this OPD Block has a separate key. This means that when one is called to the OPD to attend a patient, there is a bunch of keys to contend with. One night, I suture a wound and open a few rooms to get to the fridge and the vial. I find a syringe and a needle and take the 0.5 cc needed. I replace the vial in the fridge but after I finish, send the patient off and am ready to lock up and get back to sleep, I discover that the keys are missing. It's 2 AM and this is extremely irritating. I then spend the next 15 minutes hunting for the stupid keys and finally locate them inside the fridge.

There is a lot of debate amongst us Interns as to which sequence of postings in Internship is the best in terms of opportunities to study. Alas, passing Final Year and slogging one's balls off in Internship is no excuse for the protracted, painful drama of PG Entrance Exams still to come. We have started with PSM, inarguably the posting with the most free time and will move on to Medicine, Surgery and OG in that order-each very busy postings with killer night duties and hard taskmasters. Batch A, which starts with Medicine and will get to Community Medicine only in September think they have it good because all that free time will arrive just in time when they really get serious about the Exams.
Frankly, I don't care. I'm still basking in the glory of passing Final Year. But even though these exams are a year away, they are completely unavoidable and will decide what one does for the rest of one's career. Each exam is taken by about 5000 aspirants, all fighting for a grand total of 50 PG seats on offer. The catch is that, for any given individual, only 5-6 seats will be of real interest. I know of seniors who got great ranks in the exams but did not get a seat and subject of their choice. It can take more than a few attempts to get it right.

I thought Final Year was the end. It's not even close.

Chapter 72-Bonds and Vagabonds Part One

Note: The following descriptions may require a map of sorts for better readability of this post. 
Below you will find a map of the layout of the RHC. 

I am working on a map of the general area and that will be up soon. 

Jan 1998

This is a good time of the year to be posted in Ramanathpuram. While Pondicherry is usually quite a hot and humid seaside town, the 2-3 months of winter are much more pleasant, helped no doubt by the rains that the retreating monsoons bring to the region at this time. On the odd occasion, cyclones pop up and we had one particularly furious one a few years ago when the Jipmer campus briefly resembled the set of a Jumanji movie.
The mid-afternoon sun, however, continues to be as hot as ever and most of these are spent hiding in the Dorms, getting a much needed siesta after after a tough morning OPD spent in vaccinating kids and gossiping with the village folk. The dorms themselves are pretty plain and functional. The area is notionally divided into 2 sections by a wall that doesn't quite reach the middle and each section has 4 of the iron beds and green mattresses that seem to be the norm in Jipmer MBBS residences. Next to the head end of each cot, above which is a small grilled window, is a smallish 3 section wall cupboard with a single wooden rod for hanging clothes and stethoscopes. Each shelf is occupied by sundry personal stuff and in many cases, cigarettes and quarter bottles of Ramanthpuram's finest spirits. The roof of this building is made of asbestos and gets very, very hot in the day. We suspect this is a deliberate ploy to keep us Interns away from the rooms in the afternoon when all we really want to do is catch our well deserved siesta.

The evenings are a different story.Our main source of entertainment in the evenings is driving around the region with 2 principal aims:
1. To explore the place and check out the surroundings
2. To hunt around for essential supplies, the definition of "essential" varying considerably.

Driving around one day, we come across a big partially dried up river bed, the result of a small dam holding back a lake of sorts. Lake is probably a generous description of the smallish water body formed as a result of this dam but this time of the year, it's full of water. Getting here is a 10 minute drive from the RHC with the last 100 feet or so on a muddy tree lined narrow path. This leads into a clearing from where one can choose to sit and see the sunset across the river with a few beers or go down some rocks and splash in the probably full-of-fungus expanse of water.
We head out one day and spend the evening in this lake and I can feel slime and mud under my feet. I don't know what else I am feeling since the water is really murky but it's good fun and we get back as it's getting dark. The next day I discover that I am not the only one to have grown bits of fungi and everyone seems to be scratching around various body parts. The place is still however, an excellent spot to just sit and chill out. 

Our kitchen runs exclusively on supplies managed and arranged by us. Essentials like eggs, bread and milk can be found here or in the nearby villages but for mostly anything else, the designated Mess Secretary and anyone who's interested board the weekly shopping Van and head off to Pondy. I, on the other hand,head off from the RHC in spirited pursuit of paper wrapped nicotine sticks. Now, the brand that one has got used to is often a vital determinant of success and failure in such matters and I hunt for Gold Flakes (King Size). On leaving the gate, I turn Right and about 100 feet later at a T junction I find a small shack selling tea and Gold Flakes (not King Size). This shop shuts by 7 PM, a point duly noted. I then turn Right and find myself on the main road where a Right turn will lead me to the Pathukannu bridge but to the Left lies the village of Thondamantham. I turn towards the latter and discover a small general store where volia!, I find the treasured sticks. A vital discovery. This is Thondamanatham's only claim to fame.

There are no bars in this place and finding any shop which sells something drinkable is the next mission. On more than a few occassions, some grateful villager has brought some toddy which we have equally gratefully accepted. We also learn, through trial and error that toddy is best consumed in the morning when it's fresh. Not when it has had time to ferment in the fridge. It tastes different, not too bad and makes for a great alternative to the morning tea. Toddy solves the morning issues but stocks have to procured for the evening. So, from Thondamanatham, still in search of a "Wine and Beer Shop", I turn around and head towards the Pathukannu V junction where instead of turning Left towards Ousteri, I take the other arm of the V formed at the junction here and about 500 m down, on the left, spot a sign for another village, Kodapakkam. Just off the road is a shop which sells some alcohol. Nothing fancy, but enough to satisfy underworked Interns too lazy to go shopping in Pondy.
We learn, sometimes the hard way, that it is vital to be aware of the opening and closing times of these shops and shacks. One can, of course, head back to Pondy to stock up at any time of the day or night to stock up but one does cut a rather desperate figure hunting for cigarettes this way and like all smokers in denial, when the stocks run out, we abandon the pretence of the "brand" and get along with whatever is on offer, filter or not. Gold Flakes (not King Size) or Wills or even Charminar will do.
We often travel back and forth from Jipmer, since even barely employed Interns need clean clothes and a change of scenery. However, the traditional route to Ramanthpuram via Ousteri Lake, while very well defined and used, is best avoided at night, especially if one is alone. There have been tales of villagers and farmers stringing lines of wire and rope across the road beside Ousteri lake, a particularly lonely and dark stretch, with the intention of tripping over unsuspecting motorcyclists. This can also be dangerous since the wire/rope can be at head level and may result in serious injury. I have not personally experienced this and I know of no one who has, but it's still not worth the risk. We therefore hunt for alternatives.

It turns out that there are many ways to get to Ramanthpuram. Shyam and I start from Jipmer one evening and turn Right on the main Tindivanam highway. The road is trafficked and single laned, dotted with the odd building and lined by many trees. A few kilometres down, there is a left turn which we duly take and then the road winds around many isolated green fields and patches of barren land before joining the original road just before it hits Ousteri. This is a very pleasant drive, with no traffic at all and just a couple of roadside factories interrupting an otherwise endless view of rural Pondicherry.  Alternatively, one can also turn Right at one spot and then a much smaller back road winds around Ousteri and enters Thondamanatham from the other side. This route, we think is also probably not a good idea at night and this is confirmed one late evening when a tyre punctures and it takes half an hour of hunting to locate a puncture repair shop. Being a Sunday just complicated matters. 
Back at the Ramanthpuram end of things, one exits the RHC and after a short hop across a small canal one reaches the Pathukannu bridge where the road diverges into a V.  The left arm of the V is the road around Ousteri while the right one goes past the village of Kodapakkam and it's booze joint and joins Vilianur, a small village which some massive temples. From here one can take the State Highway, with it's constant traffic and unmarked speedbreakers, or zig-zag through Vilianur and enter Pondy at one end of the 100 feet road at the other end of which lies Muruga Theatre. This Vilianur route is a favoured one when returning at night although on more than a few occassions, I forget the potential dangers of head high wires and ropes and go via Ousteri anyway.
This other arm of the V, past Kodapakkam, is a lovely completely unlit stretch of road and on this road at night, my heart starts beating just slightly faster than normal. It's a deserted but a very cool and silent road and just driving at night under a brilliant rural sky, with only the sound of my 2 stroke Yamaha for company is chicken soup for my soul. After exactly 2-3 minutes, a  small yellow light appears, getting bigger and bigger as I approach Kodapakkam and the Pathukannu bridge. 

This whole area, largely devoid of traffic, noise and shops is only 15 minutes from Pondy but it seems like a completely different world-a world I am blissfully happy to be in.

One night, driving back along this Vilianur Road, with Ravi my co-Intern as pillion, my bike sputters a few times and then stops. My bike, a 2 Stroke Yamaha RXG, is barely 18 months old, has enough petrol and has never given me trouble before and so, standing in the dark, with the RHC at least 10 minutes away and with no way to contact anyone, I can do nothing except try to kick it back to life. Amidst growing uncertainty and the seed of panic, I kick and kick and 50 kicks later, the engine comes back to life. We rush to the RHC before something similar happens and no one there can shed any light as to what might have happened.
The next day Ashley, my ex-room mate decides to drop in and discover that he is also a victim of this unique bike problem no one else seems to know about. He, however has a solution.
When the bike engine stops, take the key out of the ignition, open the petrol tank, count to 3, close it, insert the key back and turn it on. Then kick the starter and it will come back to life. All of this is done while the bike is moving.
The bike problem still happens on and off but Ashley's solution works beautifully and I almost forget that the bike actually does have a problem I should let a mechanic check out.

The Dept of PSM, with it's Senior Residents and Consultants pop in regularly and organize some village meet-ups and projects to keep us occupied. One of these is a reported Cholera/Typhoid outbreak in the area and we will be tasked to find out the point source.
The Pulse Polio program will be starting in a few days and we will be designated to various villages as the drop administrators.
Pongal is approaching and by tradition, the Batch posted at Pongal time will be invited over to the Village Chief's house for dinner.
Dr Rajan, our CMO drops in to the Dorm with some food and a chess board. He finds Reddy for company while we sit around just doing nothing.
A patient walks over and one of us on Call saunter across, unlock the OPD and do whatever needs to be done.
My first salary, all of Rs 2340, is due on the 31st.

6 of us are forming bonds that will be strongest here and will, unfortunately, become looser with time, space and distance.

It's a peaceful existence. But Internship is just starting.

Chapter 71-Rural Ramblings

Jan 1998

Note: RHC-Rural Health Centre
Below is a hand drawn sketch of what the layout of the RHC was in 1998. This may have changed a bit. 

Ramanthpuram is about 20 minutes away by bike (or van or ambulance) and is separated from Pondy town by a medium sized lake called Ousteri, expanses of barren red mud, and other greener expanses of well cultivated fields. These 20 minutes of driving, from a bustling coastal town to a quiet, peaceful, serene village, is something I have wanted to do many times over the last few years. However,  I have managed to visit this place all of twice, once on a Dept trip and once to scare the bejeezus out of Rahul who was posted here last year.

Our briefing over, the Dept has organized a Van to take us to the RHC, get organized and settled there and will return in the evening. We get back to the hostel to pack and get ready for 6 weeks of residential rural bliss. Of course, we will come back to campus off and on during the posting but it is strongly encouraged to be in residence as much as possible. It is supposed to be residential posting after all, but a few choose to live on campus and  make the commute to and fro the campus every day, a journey that in my mind defeats the purpose of the posting.
The route to Ramanthpuram is fairly standard and we get on our bikes and head off, following the PSM Van as it makes it's way past the many factories lining the main road, past and around Ousteri lake, taking a Right turn at the Pathukannu bridge towards Thondamanatham and then a final Left turn into Ramanathpuram and the RHC. It's quite remarkable how suddenly the scenery changes from the hustle of a coastal town with it's traffic and noise, transitioning through quieter roads with a few factories and their blue shirted workers heading to or from work on cycles, to just scattered collections of thatched huts, bales of straw, random animals and vast green fields that characterize the rural surroundings we find ourselves in 10 minutes into our carefree journey. There are no hoardings or horns here. Just a gentle breeze coming across Ousteri lake with a huge banyan tree just before the Pathakannu bridge, the junction itself hosting a typical tea shack with a few casual tea drinking village inhabitants whiling away yet another day. And as we reach the RHC, always a few curious onlookers waiting to see the fresh batch of excited, fairly incompetent Interns who will become their points of reference for all matters medical.

It is a normal, ordinary village-green fields, quiet back roads, starry skies. Semi naked kids running around, dogs chasing these kids, cows munching away in the middle of the road. It has a few thatched houses and a couple of cemented ones belonging to the village chief. There are a few scattered shops and one of the early priorities is to figure out which ones sell the booze and Gold Flakes (King Size). We are taken on a quick tour of the campus, a large squarish walled compound. There is the Main OPD Block which also has 2 or 3 beds for Emergencies. There are various rooms inside this Complex for dressings, injections and also a Delivery Room in the rare but extremely exciting scenario of a lady in Labour, usually brought on a bullock cart, who cannot make the journey to Jipmer in time. There are the usual Nurses and Social workers, many of whom have been here for a very long time and know some of the village inhabitants very well indeed.
We walk along a red brick path to our Quarters and look around. The Male and Female Dorms are housed in one asbestos roofed single storeyed building, guraded by a flimsy barbed wire fence and accessed through a creaky iron gate. 3 steps lead into a small common landing and we turn Right to our Dorm. Off to the left is the Dining room with a TV, a few chairs and a table, a fridge and an Aquaguard set-up. Leading on from here is the Female Dorm, which, of course, is out of bounds. Karunanidhi, the resident cook, and his protege, Ganesha, greet us and they promise to make anything we desire.
This place is truly our own. Once a week, we will take turns to go into town and shop for supplies-vegetables, groceries, booze, fish-anything that can be bought on our budget and stored in the fridge. After 4 and half years, we decide what we will eat and how we will eat it. When we will eat it. And with what we will wash it down.

The perks of passing Final Year don't end with working in a hospital.

On one side of the Dorm building is the CMO quarters, the haunt of many a haunting. The RHC has a reputation of ghost sightings and unexplained door bangings and things going bump in the night and even though the PSM Department, at the insistence of the village wise men, had organized a pooja of sorts, we are convinced that all is not solved. We actually look forward to some supernatural excitement.
There are large empty spaces in front which are hosts of impromptu cricket matches and a newly acquired net strung between 2 lamp posts signals the start of a wind affected badminton game. A tall water tank stands proudly off to one side and a few rooms for Karunanidhi and his protege, the ever smiling morning-tea-bringing Ganesha completes the campus.

The CMO (Chief Medical Officer) drops in once in a while to check on things. He will always be in-charge of the OPD sessions which is a good thing since I am sure, that we, swimming in a vast sea of newly acquired knowledge and eager to show off will end up misdiagnosing things like simple headaches for brain aneurysms or perhaps, and more importantly, missing one. Kids come here for vaccinations, village elders come to gossip, chronic headaches and body aches land up at 3 in the morning and on the odd occassion, when all is quiet and the mood is complacent and mellow, someone will land up with a badly lacerated head or hand or in shock or in Labour. The pattern is of mostly peaceful and quiet days and nights with unforseen excitement right around the corner. Jipmer is a phone call and a 20 minute Ambulance ride away, but one has to account for missing Telephone operators, unavailable Ambulances and the prospect of a life in your relatively untrained hands.

I am in Ramanthpuram. In my first few days of my last year in Jipmer.

Chapter 70-Ramanthpuram! Here I come

Jan 1998

1st Jan arrives and with that, I start Internship. We have to complete 365 days of Internship-a missing day, for whatever reason, will result in an extension for the required number of days. The end of Internship makes one a full fledged Registered Doctor but that doesn't really count for much in the real world. An MBBS degree merely makes one eligible to take the Post Graduate Entrance Exams, which, by all accounts are very painful and frustrating experiences.
One of these is the PGI Entrance Exam held in Chandigarh in June and December. I will be eligible for the December version but only if I finish Internship on the 31st of December. Chandigarh happens to be my hometown and I would love to do my PG there but if Internship carries over to the next year one is ineligible for that PGI Session. Which means that I cant afford any extensions. Which is rather frustrating.

Out of the 75 who joined Jipmer in 1993, about 45 of us have made it as Interns on time. Some failed in the 1st year exams and went into the Additional Batch and 23 were casualties of  Final Year Exams.
In practical terms this means more work per Intern and more frequent calls and duties. More stress and more hassle. Depending on how one looks at it, it is also a chance to get more chances to do procedures, operate and be more actively involved.

We have been divided into 4 batches and each batch will start a different posting. The sequence is Medicine, Surgery, OG and Community Medicine, each for 12 weeks. We also get a 4 week Elective posting where we are free to choose from the specialties available. Some, especially those destined for the US or the UK choose Psychiatry, while the lazy bums choose more benign ones like Forensic Medicine. I start with PSM-Community Medicine. This consists of 12 weeks of bliss, split between the Rural Health Centre in Ramanathpuram and the Urban Centre in town in a place called Kurchikuppam. This will then be followed by the Elective, which I have not decided on yet and the 3 major postings, finishing with OG in December.

In many Colleges, Internship is treated as a preparation ground for PG Entrance Exams. Coming to work is largely notional. Reading for PG Exams at the expense of Internship time is actively encouraged. But not here.Life as an Intern here is very very busy and I will just have to squeeze time in to read for PG Entrance. Internship here is all about learning basic hospital functioning by becoming a part of the system. It is being a Doctor in every sense, but since we are the bottom of the barrel, so to speak, our responsibilities and liabilities, while very real, are grounded largely in terms of personal ethics. In the ultimate analysis Interns are not responsible for any screw-up that might happen. We are in training after all. We aren't even registered licensed doctors.
There is always a choice. One can scoot off from work,  massage a few egos and goof off, scurry off to read for PG Exams or just bunk. One can shirk work and make excuses. One can extend vacation time for no proper reason and leave Co-Interns high and dry. One can "forget" to do things and make the 1st or 2nd Yr PG suffer the consequences.
There are no impressions to make, no exams to conquer.
But Jipmer has a culture and an ethos. Most people do their respective Internships sincerely because that's how it's done here and always has been. It's one of the many small things about Jipmer that make me glad I came here.

There are 6 of us who will start Internship in the RHC. We troop in to the Department at 10 AM and are given a briefing on what they expect from us and what we can expect from this posting. In a nutshell, we are expected to be residents in the RHC for the next 6 weeks and indeed, there is a fully functional Dorm with a cook, satellite TV and Aquaguard water to take care of us.
We will conduct an OPD in the morning and the Dept may organize some field trips to nearby villages etc  for Community Heath Camps. The Pulse Polio programme will be starting in 15 days and we will be expected to be an active part of it. We will be essentially the only doctors for Ramanthpuram and surrounding villages and that is a slightly scary thought.

But for the most part, though the PSM Dept does not see it that way,  it will be about spending 6 joyous carefree weeks in an idyllic rural hamlet away from books and the hospital. I have been looking forward to this day for a very long time and now it's here.

And I think I deserve it.