Chapter 67-The Final Climb

Dec 1997

I've finished 2 days of exams. I think I've done well enough to pass though one can never say. Unfortunately the news is that many people on the 2nd of Surgery seem to have run into trouble and are not expecting to pass. That's the problem with Final Year. Together with the study load and the nature of the exams, the indescribable stress and the narrow margins for error combine to make a heady mix of disasters waiting to happen. Internal Examiners try to smoothen wayward vivas and rampaging Externals but too much attempted smoothening can also backfire. The Internal Examiners often walk a tightrope and it must be a tough job.
It's also a fact that for Undergraduates, most lecturers/Consultants/Professors are known not by how good they are in class but how they behave in exams. Some are out-of -the-way helpful, some are brutally fair, some are too junior to make a difference. Some are downright nasty, though thankfully there aren't too many of those.
Many an exam story is laced with "....And I passed even though So-and-so came for the exams"...Respect for seniors goes up when such an examiner falls in the brutally honest or nasty category.
Some of the time between Send-Ups and Univs is spent praying for a particular set of examiners to arrive.

The morning comes. This is it-my last exam and I hope that for the next few hours, I can keep it together and get through this nightmare. OG is a logical, less demanding subject though again, small slip ups are plentiful and there have been numerous anecdotes from previous years to keep me honest.
There are 2 cases-one from Obstetrics and one from Gynae and we will take them one after the other, presenting each to a different set of examiners.
Our exam is in Ward 12-the Obs ward. We troop in there at 8 and are shunted off to the Procedure Room-one of the small rooms in the corridor leading to the Ward. Rajeev meets us here and takes one last, very quick revision class on basic instruments and some vital Labour Room type questions. This kind of thing can be either deflating or confidence inspiring and thankfully, I'm OK.

We're off. There are 12 Obs and Gynae patients lying opposite each other. Naveen and I are together. He starts with Gynae and me with Obs and half an hour later, we shift cases. One hour later, I'm done.

I start with my Obs viva. I remember to wish the patient, get a screen, drape the patient and warm up my stethoscope. I follow protocol exactly and ask all the proper questions in hsitory. I take an accurate fundal height. I'm asked to demonstrate grips and this goes off well too, making sure to not follow the order of grips described in Dutta, which for the Dept's purposes, are incorrect.
The usual questions on Labour Room management follow-Partograms, Oxytocin drip maintainance, episiotomy suturing etc and apart from a few minor hiccups, it goes off quite smoothly.

Then, it's Gynae time. I get a UV Prolapse and sit in front of Dr GR and an external who looks benign but starts off with all kinds of questions I find myself struggling to answer. The viva continues like this. I'm asked a question-Dr GR gives me a hint and I answer. Then GR asks me a question and the External gives me a hint and I answer. And this goes on for the next half hour, punctuated by expressions of profound exasperations that Madam GR is known for.

Then. It's over.
Except for the afternoon viva. And this time it really is in the afternoon.
We start by 3. There are vivas on Instruments and X-Rays and one on Deliveries with a dummy baby and pelvis. One more on contraception methods.

In my Send-Ups, I had been given a pair of Obstetric forceps. These are long, gently curved blades designed to hold a baby's head if it's got slightly stuck. The blades articulate in the middle but I'm given 2 blades which are not.
I'm told to articulate them. I spend the next 5 minutes desperately trying to get these 2 blades to slot but all I manage is a non stop sound of steel hitting steel. And then suddenly, after 5 minutes of rattling, the blades slot. Just like that. I'm asked a few questions and then told to disarticulate them and leave.
But the blades won't budge. So after 5 very awkward minutes of trying to disengage them, a frustrated GR asks me to leave anyway.

This time I'm ready.

The vivas are fine. Instruments is benign as is Contraception and the dummy delivery. Then the last Viva of my MBBS life. X-Rays.

We have seen the usual X-Rays that can come. There is a stock of these and we have had a revision class so that all of us can identify them at a glance. Of course, one is expected to actually read an X-Ray the proper way with the type of X-Ray, the view etc. My turn comes. The X-Ray is displayed on one of the viewboxes and I look at it for a second and turn to face the examiners.
"Yes?"
"Sir, it's anencephaly"

Now, I had spent a second looking at that X-Ray and I knew what it was. But the external is not happy.
"You looked at that for ONE second! You cheated. You have been told the diagnosis!"

Oh God! This is not what I need, not now. So I deny any cheating. Then I'm told to go and look at the X-Ray properly and come back. So I make this big show of taking 2 minutes and really looking at an obvious anencephaly. And I come back and say all the right things.

Just like that, it's over.

It's all over. All of it.

I get back to the room. It's 4 PM and only our group has finished the exam. The Medicine and Surgery boys are still in the exam.
I'm like a zombie. There are no thoughts, no feelings, no emotion. I stare at empty space while I lean against the ledge. I am still in my white coat with my steth around my shoulders and I stand like that for a long time. Then I get my chair and sit like that for some more time.
 I had imagined so many things for this moment- the moment that pass or fail, all of us had been waiting for many months, dreaming about it, just willing it to come.
I had imagined I'd get beers and go lie on the beach and just sit there all night. I'd imagined I'd be in Ramanathpuram under a starry sky. I'd imagined getting drunk stupid. Shouting. Screaming. Going crazy.
But nothing happens.

More than anything I feel like crying. Maybe this is what it feels like when you finally achieve something that has consumed your existence for so long. Just an emptiness. A vacuum.

Freedom.