I have been in India now for just over two weeks, and have started to
settle into a routine here, at LV Prasad Eye Institute. The days
begin with a resident lecture at 7 am, sharp; at just 1 minute past
the hour, the doors of the auditorium are locked closed, and no one
can come in or out, attending or resident alike. These lectures are
followed by post-operative rounds that are held in the “OPD”, the LVP
name for clinic. The postoperative cases from the day prior are
brought into the exam rooms by the optometry students, who serve as
ophthalmic technicians, and worked up in preparation for the fellows.
The fellows flit from room to room, finding their post-ops and
assessing their outcomes and status. Next, the attending performs the
final assessment and signs off on discharges and plans for further
management. Shortly thereafter, those delegated to the OR retreat to
their posts, and those destined for the clinic begin the task of
working up, examining, and managing what will amount to 70-100 patient
encounters for that day. The OR day will last until 7 or 8 in the
evening. The clinic will last just as long, and there will be
postoperative and preoperative rounds to perform before anyone can
retire for the evening.
I can only compare stepping into this frenetically-paced machine to swimming against the current amidst a massive school of fish determined to make their way to their ultimate destination. It’s disorienting, and confounding. All the moving parts look familiar, but the direction isn’t intuitive. And, how to align
one ’s self so that you are moving in the same direction, contributing to the mass movement rather than creating a drag on it, is not clear in the slightest. I have been seeing patients in a high volume clinic as an ophthalmologist for over three years. To feel the ineptitude of the unfamiliar within a setting you’d felt you’d conquered is deflating. I was a newbie in a foreign clinic, whose best effort was a hindrance to the fellows tasked with making the day run smoothly.
So, I decided to do what this year has been slowly, sometimes painfully attempting to ingrain into my nature: Wait. Watch, listen, learn, and only then, act. I spent the first few days trying to pick up the flow of the place, until realizing, finally, that that wasn’t my job. That was not why they had invited me here, nor why I had come. I had come to learn, not to be a part of the system.
For the first time in my life, I was within an academic system without shouldering any of the responsibility of turning the cogwheels. The effect was freeing. I begin to slip from room to room, inquiring about the pathology, thumbing through the chart, staying if there was something to glean, quietly excusing myself if it was a pathology I felt I had mastered. In the OR I assisted on cases that held the most gain, and spent more routine surgeries reading up on the interesting cases to come, or asking questions about the strategy of the surgical plan. What a thirst quenching task I have for the next few months: to spend time at work dedicated to the sole pursuit of knowledge for no other reason than pure intellectual curiosity.