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1. |
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Rapid Response team to the 7th floor,
Rapid Response team to the 7th floor,
Must be a patient knocking on heaven’s door,
It’s only one patient- we got about 11 more
Plus 4 more in the ER- getting triaged,
The excitement electrifying like this guitar,
But our mentality’s old just like a sitar,
We ran 7 flights- never felt my heart beat this hard,
Breath this hard- couldn’t believe I came this far,
Now or never- All or nothing- it all comes down to this, bra!
Have no fear- the doctor is here,
I ain’t just talking about me- I’m talking about all my peers,
It’s a way of life- this is more than a career,
Scared but prepared- when the chief said clear!
With moments to spare – I start to think clear,
And this freshman takes control like its senior year!
This is my Statement – My Personal Statement
V2
Hmmm? Is it confidence or arrogance?
Am I cocky or is it that I am convinced?
Is it insecurity- or assertiveness?
Just shake that nervousness- prevent it from surfacing,
Working it- prophylactic against the turbulence,
Just when you think it’s a fast ball- the pitcher’s curving it,
Swerving it- like I’m sleep deprived- in driver’s seat,
The highly-team oriented facility says I’m relieved,
Mentally – top one percent - USMLE,
One Third Of One Percent - it’s on the census sheet,
To be a physician – is not to be a politician,
Those conditioned to be corrupt like the system,
A system in which we keep fighting diseases,
Earn a patient’s trust before the treatment,
Is it for world peace- or a piece of the world? Please!
Before we become disease-free – rest in pieces!
My Personal Statement
Copyright © Pramanik Bharadwaj, M.D., 2010. All Rights Reserved.
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2. |
Put In Work
02:53
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I put in work - ever since the day of my birth
I put in work - making what's important now first
Cause there's nothing to really gain if it don't hurt
But if it hurts - it could be worse - I'll make it work
I put in work - see the sweat soaking my shirt
I put in work - only with this stetescope and my thirst
Got my eye on the ball - everything else is a blur
For what it's worth - I see it's worth - I'll make it work
I put in work.
The first day of clerkship's like the first day of school
Got my short white lab coat - stethoscope's my tool
Something new - with Something More - and something to prove
with Step One in my pocket along with the Maxwell pocket guide
I got my route mapped out - so let the topics fly
Positive - even though my kind is scrutinized
International Medical Grad - but never mind
Sometimes the only way to the top - is to climb
And I'm up for the challenge - down and dirty til round 30
like a never-ending journey - but I'm forever learning
Distractions - tune them out - like I tune my tuning fork
One day at a time - represent like my uniform
Prepared and ready - they can pimp me all they want
Ain't no stopping this train - I'm simply on a run
A lesson lived is a lesson learned - a lesson taken
You're half-way there - picture your destination and
I put in work - ever since the day of my birth
I put in work - making what's important now first
Cause there's nothing to really gain if it don't hurt
But if it hurts - it could be worse - I'll make it work
I put in work - see the sweat soaking my shirt
I put in work - only with this stetescope and my thirst
Got my eye on the ball - everything else is a blur
For what it's worth - I see it's worth - I'll make it work
I put in work.
Clinical medicine based on clinical evidence
History and physicals – to catch the significant relevance
Signs and Symptoms – my mind’s momentum
Like I’m an intern – and I might enter
The Universal scut work primary center
Don’t worry about cut-throats – try not to miss lecture
The power of compassion is so ever-lasting
Practice – like I play – play like I practice
Proper bedside manners – got my reflex hammer
If I don’t understand – open the Washington Manuel
Pocket Pharmacopia – just a bit of diplopia
Systemically desensitize all of my damn phobias
Curiosity didn’t kill the cat – it brought it back from the dead
So I’m glad I let it out of the bag
Discipline stricken – ready to take on the toughest critic
Up in the clinic, ED or the ICU setting,
I put in work - ever since the day of my birth
I put in work - making what's important now first
Cause there's nothing to really gain if it don't hurt
But if it hurts - it could be worse - I'll make it work
I put in work - see the sweat soaking my shirt
I put in work - only with this stetescope and my thirst
Got my eye on the ball - everything else is a blur
For what it's worth - I see it's worth - I'll make it work
Copyright (c) Pramanik MD. 2010 - 2018. All Rights Reserved.
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3. |
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V1
Up in the call room -- with a spoon fill of home-cooked food
Just got off the phone with grand moms, complaining she put too
much of her Indian spices -- real hot -- but just so cool
She pushed me to pull this medical resident school kid through.
My pager goes off -- it's the Emergency Room -- with a new admission
Patient was an elderly woman with an unstable condition
Finished my last bites -- and left the rest in the fridge
In less than a minute -- Im at her bedside -- with all my questions
Less than a second -- it took to realize what didn't need guessing
Her breathing was labored -- her knees were pressing her chest in
She had a history of long-standing dementia
Along with a long list of other conditions and standing right next to her
Her family... some tearful -- others firm and focused
Full code status -- so I made sure we tubed her throat
For the 5th time this year -- the end of near -- it's near the ending
Her situation's clear -- she was rapidly deteriorating
Most probably: Aspiration -- severe incapacitation
Regretful -- to tell the family, their loved one may not make it
They still ask for life-sustaining measures -- when her blood pressure
Dropped -- I placed a central line and started those damn pressors.
Hook
Sometimes I don't know why I feel so strange
As I go about my day -- I feel no pain
But as I look into the eyes of my patient there laying
I know that she's about to die -- I hope she feels no pain
You can ask all my people -- they feel the same
Caught in the middle of things -- its why we feel so drained
If he's on his deathbed -- I hope he feels no pain
And when he passes away -- I hope I feel no pain
V2
It never ceased to amaze me -- even at her advanced age.
My god mother in the kitchen -- managing pots filled with chicken,
Conducting a symphony of different delicious dishes,
The scent alone makes me want to take the top and just lift it.
But not before I get my hand slapped -- by that demanding chef,
I'm always snooping around -- sniffing what she's planning next,
She's making sure I don't compromise her space again,
She brushes me out of the way -- I can't have a taste again!
Damn -- I'm getting paged again -- my heart start to race again,
It's the same patient - coding -- now she's way past facing death,
I jump on the patient's bed -- and start with the chest compressions,[
Cracking her brittle ribs -- as my senior defibrillates her,
It takes us -- only one shock -- we get her back!
Let's call the family up -- 2am -- get 'em back!
The cardiac rhythm & hemodynamics- we got 'em back,
Even though I don't know -- how long we can hold that from going flat.
Hook
Sometimes I don't know why I feel so strange
As I go about my day -- I feel no pain
But as I look into the eyes of my patient there laying
I know that she's about to die -- I hope she feels no pain
You can ask all my people -- they feel the same
Caught in the middle of things -- its why we feel so drained
If he's on his deathbed -- I hope he feels no pain
And when he passes away -- I hope I feel no pain
V3
At one end -- is my attending reciting what sounds foreign,
"Despite our best efforts -- ain't no fighting the failing organs."
At the other end there's that patient's loving husband,
Who try's to explain -- he doesn't want any hospice comfort,
He doesn't want to pull the -- plug and let her go under,
By any and all means -- wants us to resuscitate her.
In caught in the middle -- riddled with questions -- with no answers,
Do No Harm -- it's that oath -- that I won't tamper.
But I know my own fam -- would look at me as their only doctor,
Only for proper guidance -- should this happen to my god mother,
Only God knows how much I love her -- I'll put no one else above her,
Sprinkle some false hope above that grim prognosis,
Then I'm reminded of all the futile interventions,
From son to physician -- frustrated by this transition,
Counting each deep breath -- I'll walk with her each step,
The only thing left to give is a gift or peaceful death
Hookx2
Sometimes I don't know why I feel so strange
As I go about my day -- I feel no pain
But as I look into the eyes of my patient there laying
I know that she's about to die -- I hope she feels no pain
You can ask all my people -- they feel the same
Caught in the middle of things -- it's why we feel so drained
If he's on his deathbed -- I hope he feels no pain
And when he passes away -- I hope I feel no pain
Copyright © Pramanik Bharadwaj, M.D. of Maven Med, Inc., 2010 -2018. All Rights Reserved.
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4. |
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It’s a broad and complex field, seeking to understand
The mechanism of cellular injury and how the body can
Respond and repair – cellular adaptation
Of which 7 causes are identified – let’s make haste
Most common is hypoxia – second is infectious
Hypersensitivity – autoimmune are next – run the check list
Congenital, chemical, physical forms of injury
Nutritional or vitamin – excess or deficiency
V1
Cause on the cellular level – the responses to injury
There’s adaptation or injury reversibility.
If irreversible, cell death’s the diagnosis,
Either by apoptosis or necrosis
LCGF2C
Life Can Get Far Too Complicated
So let’s see the 6 types of Necrosis:
Liquefactive, Coagulative, Gangrenous, Fibrinoid, Fat, and Caseus.
The craziest and most common form is Coagulative.
Need an H&E Stain and microscope to examine it
To see the cytoplasmic proteins denatured;
Loss of nucleus with a preserved architecture.
Lyrical Lectures and cellular destruction
By hydrolytic enzymes – Liquefactive Necrosis –
Occurs in abscesses – brain infarcts – or pancreas
(i.e.) Leukocyte enzymes causing pus is the fanciest.
Caseus – just a combination of the first two.
Friable and cottage-cheese – it’ll hurt you and the nurse, too.
In the case of TB – quarantine the fella…
Ella… Ella… like Nelson Mandella.
Fibrinoid – histologically resembles fibrin
Surprisingly – homogenous – microscopically dive in
Gangrenous tissue is sort of like a hybrid
Dry is coagulative – Wet is liquefactive.
Hook
It’s a broad and complex field, seeking to understand
The mechanism of cellular injury and how the body can
Respond and repair – cellular adaptation
Of which 7 causes are identified – let’s make haste
Most common is hypoxia – second is infectious
Hypersensitivity – autoimmune are next – run the check list
Congenital, chemical, physical forms of injury
Nutritional or vitamin – excess or deficiency
V2
The most common is hypoxia – defined as lack of oxygen
The cell’s inability to synthesize energy
Or ATP by aerobic oxidation
3 major causes of this hypoxic creation:
First is Ischemia – or loss of a blood supply
(i.e.) Arteriosclerosis – Thrombus – or Thromboemboli
2nd is Cardiopulmonary Failure
3rd is Decreased Oxygen-Carrying Capacity – Anemia.
Bacteremia, Viremia, Parasitemia
Another cause of injury is Infectious – like fungemia.
Direct infection or production of toxins
Or the induction of the host inflammatory responses.
Congenital disorders are sort of in-born errors
Of metabolism – inherited Autosomal Recessive manner:
Genetic defects involving enzymes more common than
Defects in Structural Proteins by Autosomal Dominance.
Hook
It’s a broad and complex field, seeking to understand
The mechanism of cellular injury and how the body can
Respond and repair – cellular adaptation
Of which 7 causes are identified – let’s make haste
Most common is hypoxia – second is infectious
Hypersensitivity – autoimmune are next – run the check list
Congenital, chemical, physical forms of injury
Nutritional or vitamin – excess or deficiency
V3
Chemical injury includes Drugs and Poisons;
More than noise pollution – occupational exposures
Asbestosis – carbon monoxide poisoning
Social/lifestyle choices – alcohol/cigarette smoking
Illicit drug overdosing and recreational potions.
Physical forms of injury include blunt force and
Penetrating trauma – like gunshot wounds.
Pressure changes – radiation – burns and frostbite, too.
Nutritional/Vitamin imbalances causes injury,
Either in excess or by a deficiency.
Inadequate calorie or protein intake like neglected
Kids with Marasmus or teens anorexic.
Excess calorie intake leads to Obesity:
Increased risk of atherosclerosis & Diabetes.
Vitamin deficiencies – from A to Z
I’ll cover it all – this is Pramanik, M.D.
Hook
It’s a broad and complex field, seeking to understand
The mechanism of cellular injury and how the body can
Respond and repair – cellular adaptation
Of which 7 causes are identified – let’s make haste
Most common is hypoxia – second is infectious
Hypersensitivity – autoimmune are next – run the check list
Congenital, chemical, physical forms of injury
Nutritional or vitamin – excess or deficiency
Copyright (c) Pramanik Bharadwaj, M.D. 2010. All Rights Reserved.
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Pramanik MDMC New York, New York
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Music-Driven Medical Concepts
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