The Internship Ritual

‘Whose was it?'
'He who is gone.'
'Who shall have it?'
'He who will come.'
'Where was the sun?'
'Over the oak.'
'Where was the shadow?'
'Under the elm.'
'How was it stepped?'
'North by ten and by ten, east by five and by five, south by two and by two, west by one and by one, and so under.'
'What shall we give for it?'
'All that is ours.'
'Why should we give it?'
'For the sake of the trust.'

It is this curious recital as part of a strange custom called the Musgrave Ritual from the Sherlock Holmes Adventure of the same name that came to my mind when I was asked to write my first “delivery notes” as an intern. The Musgrave Ritual requires every new chief of the family to recite and learn by heart this puzzle. None of the generations of young Musgraves ,who assiduously passed on this enigmatic code, cared to unravel its hidden purpose.  Since the vast majority of deliveries were normal the same “note ritual” had to be carried on drearily. None of our predecessors cared to pause and think why, what for or should we?
Posting in labour room is highly satisfying to the fledgling ego of the ‘doctor in the making’, as it initiates them into real action! Somehow this mundane clerical ritual seemed to be a blemish that spoiled the beauty of an otherwise fulfilling experience. Someone brought this up during a coffee chat. A few of us brainstormed and came up with a pragmatic solution. Why not make a rubber stamp with which we can print delivery notes. The variable segments can be left blank to be filled up according to the respective cases. Will they allow it? Unlikely! Gynaecologists are the last of the specialists likely to encourage creativity of an intellectual kind, being at the receiving end of more than their fare share of creativity of the biological kind!

The Rubber Stamp We Made
So we decided to invoke the “Good Samaritan rule” and acted in best faith (without presenting a dilemma to the head of the department by asking permission). We made the seal (show in the picture) and started using it. It was an instant hit with interns and sisters. It was used only for normal delivery. One advantage was that it was possible to classify a case as normal by a single glance in case sheet.

We used it for 17 days. On 17 th day O1 and O2 met each other during ward rounds. O2 sarcastically congratulated O1 on the new role of seal with some unsavoury  anatomical connotations thrown in! O1, of course, was awestruck and ordered immediate suspension of “sealing” and an enquiry. A faculty member who sports a nick name extolling her alleged beauty, confiscated our seal; mercilessly ignoring our shared monetary investment in the project!.Thus ended my first tryst with what, in contemporary parlance, can be called “process re-engineering” ! e-Governance experts would say that it was a wrong initial choice of speciality
I found consolation in having been spared of the fate that befell the butler who broke the code of the Musgrave Ritual.


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