The majority of the population feels a certain sort of disgust about bodily functions that is totally absent from the fraction of us who are in medicine. My first inkling of this was when a classmate told me about how her cousins had freaked out when she happened to mention the consistency of her diarrhoea to them (watery, brown in colour, 5 episodes). They had apparently been rather vociferous in their declamation of their disgust, because my friend was actually pretty confused and hurt.
“I mean, we talk about this all the time. I didn’t realise that they’d react that way. Yaar hum log kitnay ajeeb hain.”
I reassured her about our non-ajeebness and then promptly forgot about it. That is, until yesterday, when I excitedly texted a non-medical friend about a case I’d seen, without realising how weird it must have seemed to him. The conversation went something like this:Fy: I’m home today! Sh: Great. Does that mean you’ll be free tonight? 😉 Fy: haha Sh: 😛 i saw a guy in the clinic today with balls swollen to the size of a watermelon. He had a disease called elephantiasis. Fy: U saw his balls? Fy: Lmao! Sh: Uh yes. And the consultants kept making dick jokes and I just stood there trying not to laugh Fy: He consultants or she? Sh: Male consultants na. Sh: It was so big man, his dick wasn’t even there, it was part of his giant balls. Fy: Ewwww. Sh:[realising about the graphicness, trying to justify it] uh well general surgery is mostly ew stuff. Balls, asses, intestines, hernias. Rarely other stuff. Fy:Lol. Keep it up!
Later embarassment aside, I’m glad I had this conversation. It reminded me that not everyone is interested in discussing giant balls (even though they should be – it was such a rare interesting case!). It also cautioned me from mentioning this story to another non-medical person – like my mother, for instance. I have a habit of discussing interesting cases with her, even though she doesn’t understand all of it. But she was grossed out enough by my description of hemorrhoid ligation banding – giant balls would just be too much 😛
Of course we weren’t always this beghairat. I remember sitting outside waiting for my car one day in first year, and listening to a senior in the Ob/Gyn rotation telling her group about this lactating woman’s breast discharges in a loud voice and perfectly comfortably, though the group had a lot of guys in it too. Professionalism aside, I was still rather scandalised. I hope we’re not going to discuss things like that so openly, I thought.
That was until this year, when KK told our group a popular joke about the couple who came to fam med for infertility issues and were found to be ‘doing it wrong’. In a group of seven, with three of those guys. And while we were all laughing, it didn’t even occur to me how much and how easily I’d lost all that shame.
Laughing is another issue. While I suppose there are crude jokes in every profession, in medicine they seem to abound. And the funny thing is in a mixed gathering one is often unsure of how to respond. Do you admit to understanding and laugh? Do you admit to understanding and put on a disapproving expression? Do you refuse to admit to understanding and simply look boggled? With one’s friends you can often laugh, but in a clinic setting and with the consultant it can get rather uncomfy.
This happened to a classmate of mine. Not only was she teamed with a particularly religious classmate when the doc made the quip, it was also early in the year when the beghairati was still underdeveloped. “So I’m like sir, isn’t morning stiffness (of the joints) characteristic of rheumatoid arthritis? And the consultant was like haan, haan but its not a big thing, then he winked and nudged R and said ‘Morning “stiffness” tou kabhi kabhi humein bhi hoti hai na’. And then he starting laughing and it was so embarassing because even though R understood, he was sort of looking confusedly at me to see if I understood, and I wanted to laugh but I just sort of stared off to one side pretending I hadn’t heard’.
Nonetheless, it still doesn’t mean we’re completely insensitive as far as performing the examinations is concerned. One does not do things like genital examinations or rectal examinations unless absolutely necessary. As students we often weasel out of these examinations anyhow, leaving it to the consultant or resident to do. But in the long run the experience is actually necessary and unless you take something like radiology you have to do this stuff someday. Even in radiology there are PV ultrasounds and other stuff, come to think of it.
And its not always about making fun 😛 we have a genuine reason to inquire. As a friend in general surgery remarked sadly once “They were examining him when the dude farted, and the consultant was so ridiculously happy about it – ‘The patient passed gas! It means we have been successful.’ Yaaar. I have never seen anyone so happy about farting.” In general surgery in particular, the patients’ inside functionings and malfunctionings are the central topic of our discussions.
This is separate, of course, from patient confidences, which are often depressing rather than funny, and which are rarely made active fun of in a general setting. I think there is a line between becoming a little beghairat and making jokes just so we can tolerate all the shit that we face daily, and outright brute insensitivity. The first is merely a result of having been exposed to so much of this day in, day out, much more than normal people.
Anyhow, I am going to be a little more selective in my descriptions in future. At least with non-med friends 😛