Dr. Vasanthi Namala Talks Acute Medicine, Telehealth, and Lessons from the Pandemic (Part-2)

Dr. Vasanthi: Dealing with sick patients first is always a priority. I have learnt to delegate tasks to juniors based on their skill set. And I have also learnt to ask for help from colleagues-anything to ensure patient safety and care.

Dr. Vasanthi: I had to put a lot of effort into learning the skills for this. Most of the times, the patients or families already have an understanding that something bad is going to happen. Just questioning their understanding about the events paves the way for hard conversations. And again, empathy is important. Giving them enough time and staggering the information also helps.  

It is tricky when the news is sudden, like for example, someone very healthy was diagnosed with cancer on routine tests. Making sure they have some support system in terms of family or friends is hugely helpful. It is never easy, but we learn to do it. 

Dr. Vasanthi: Complex conditions require a lot of team work. There is always another colleague who knows that diagnosis better, a colleague who has a way with words, a nurse who has an excellent understanding of patients needs. I try and learn from everyone involved and educate the patients as well. Building a good rapport with the medical team is very essential for this. 

Dr. Vasanthi: We have teaching sessions every week, which I attend religiously. Also, in NHS, there is an annual system of appraisal for all staff, wherein they look at the overall learning in an year-teaching, research, clinical skills. To get through the appraisal you have to make sure you keep up-to-date. Also, I actively use BMJ (British medical journal) best practise to keep myself up-to-date with latest research. 

Dr. Vasanthi: I genuinely love medicine. It is intellectually very stimulating and there is always something new to learn. But nothing beats the smile and thank you, when patient’s leave the hospital healthy. In that one second, you have made a difference in their life and that’s what matters the most to me.  

Dr. Vasanthi: Nothing really. I might have said the crazy work schedule and odd shift timings, but I was very well aware of these before I opted Internal Medicine. In fact, the thrill of uncertain and fluctuant work times made me pursue this branch. I always hated monotony, and this seemed like a perfect branch to break it.  

Dr. Vasanthi: As a doctor, the challenge was dealing with the unknown. When COVID hit, no one had a clue on what to do, doctors included. We fought against a new virus with no previous guidelines to fall back on. That was the most difficult part. It was devastating to see patients die, even before you figured out how best to treat them. Medicine expanded to tele-medicine during COVID, which is both a boon and a curse.  

The only life lesson I learnt at this time is that sometimes you don’t have the answers to everything. We can do the best we know, to the best of our ability and pray, it is enough at times.  

Dr. Vasanthi: It is very variable. Doctors especially are the extremes of patient population. They are either too involved in their care and question every single bit of what you do or they are completely uninterested. I have never met a doctor patient who behaves like an average patient.  

Being in Medicine, I have a good understanding of all branches of medicine. Patient me tries to restrain myself from asking too many questions when I visit the doctor. But it sometimes cannot be helped. 

Dr. Vasanthi: In India, there is no acute Internal Medicine yet. It started in UK around 15 years ago and now majority of the hospitals are run by the acute med units who take patients, plan their care and then shift to base wards. The future looks very promising. I believe it will be a huge branch in India too, in the future.  

Dr. Vasanthi: I would say, do it to the best of your ability. Everyone has their own skill set and it is especially true for doctors. Some have great clinical skills but zero communication skills or vice versa. Always play to your strengths. You have to identify your skill set and work on it. Medicine is gratifying but do have your own personal non-medicine space for yourselves. There is always a world outside the hospital and treat it like a job, if you can.