I’M A DOCTOR NOW: THE LIFE OF AN INTERN, Dr. OTOM V/S Dr. HAZO
If you ask anyone in any profession all over the world which was the toughest moment of their professional lives, I’m guessing more than 90% will tell you it was being an intern. This is the period in your career where you will definitely be overworked and underpaid, if you get paid at all.
Being a medical officer intern is no different. It is one of those things you start thinking about even before you are sure that you will graduate. The question is always, “where will I go for my internship?” Then years after when you are talking to your students as a consultant or to your grandchildren as a Wise man, you will tell them tales of how it was being an independent doctor for the first time in your young life.
It is the period that defines your future in medicine, it is where you pick your ‘weapon’.
It’s usually very easy to identify an intern in any hospital setup. The guy moving up and down, running everywhere in a not very clean lab-coat and has no time for small talk in the corridors of the hospital. Their beards are not usually well kept, and they may be sweating every time you see them. The ladies without makeup on, or whose hair looks like that of a freedom fighter… that is a medical officer intern in a Kenyan public hospital.
Their lives are hard, tormenting in fact, the only consolation being the fact that unlike other interns elsewhere, including the clinical officers, these ones are actually paid.
thedoctor got a chance to talk to some of these beasts of burden in two very exclusive one on one chats, with two very different yet similar young doctors, working in two different yet very similar hospitals in Kisumu and prepared the following write-up: Dr. Otom Lavender and Dr. Hazo Oginga.
Dr. Otom is currently an MO intern at JOOTRH while Dr. Hazo is an MO Intern at KCH (Kisumu county hospital) both of them having graduated from the University of Nairobi, class of 2016.
Dr. Otom is a tall dark skinned Luo lady with sharp striking eyes. She is very jovial and talkative; her confidence is overwhelming. Dr. Hazo on the other hand is a calm cool guy. Doesn’t talk much but actually quite perceptive.
theDoctor: please tell us about your early life.
Dr. Otom: I was born in Kitui county on 18th July 1992. (laughing) I share a birthday with Nelson Mandela by the way. Both my parents were working there as nurses at the time. I’m the second born in a family of 3 girls.
We lost our dad in 1994 to a road accident, when we had just moved to Kisumu from Kitui, so life was a little tricky for my now single mom. It wasn’t easy handling the kids and work at the same time. I remember I missed school a lot during my early school years because I used to go to the village and stay with my grandmother during the school days. I only used to come back when exams were approaching. It was tough but we managed.
Dr. Hazo: I was born right here in Kisumu in 1991. I am the second born in a family of 4. We later moved to Nairobi and that’s my current home. My mom is a nurse and my Dad is a business man.
theDoctor: How was early education for you?
Dr. Otom: I had a poor foundation. I went to Rainbow Nursery school, it had only just started by then, it did not even have a primary school. Then I went to PEFA primary from class one to 3. The problem there was staff. There weren’t enough teachers. From there I moved to Arya primary just opposite United mall where I sat my KCPE.
Dr. Hazo: I started school right here in Kisumu at Xaverian Primary school up to class six before my parents moved to Nairobi. Then I went to some boarding school in Siaya called Gaya Academy until I did my KCPE.
theDoctor: High school?
Dr. Otom: hee! (positioning herself) my High school was story is a very interesting one: all through my primary, I wanted to go to Starehe girls. However, I didn’t do as well as I expected in my KCPE. In fact, I wanted to repeat, but my mother wouldn’t let me. So when I received my calling letter and it was actually Starehe girls, I was overjoyed. I couldn’t believe it. I knew there were other people who deserved it more than I did.
So when I got to there and met all those brilliant girls who had done so well, I knew that I had to fight to fit in. I worked hard and finally got my footing in form 2.
Dr. Hazo: I went to Mang’u high school. It was quite the place where Men were made from Boys. It was such a good experience being there. It made me who i am today
theDoctor: were you in any co-curricular activities?
Dr. Otom: yes. I was all over (laughing): I was in music and drama, I used to do hiking and camping, and I was a house captain. In fact, my teachers used to complain that I should reduce on my off- academic activity, but I could balance so…
Dr. Hazo: Very much, I played some football and a lot of basketball.
theDoctor: At what point did you decide that you wanted to become a doctor?
Dr. Otom: (giggling) it’s funny that during my early life growing up, at the Russia quarters, I wanted to become a doctor because I used to see them all over in lab-coats and I really thought they had good lives. However, when I got to high school I met chemistry and I just fell in love with it. I never really liked biology.
Actually, throughout my high school, I wanted to do something related to chemistry. Top on my list was chemical engineering and that’s what I applied for. However, after my high school I went to work with Equity bank and that’s where I changed my mind back to medicine.
theDoctor: how was that?
Dr. Otom: I met people, including doctors and those who had done chemistry courses and somehow I saw the sense in being a doctor. Plus, my mom was on my neck with threats that I dare not do that course hehehe!
Dr. Hazo: As a child growing up I wanted to be an engineer. I wanted to do civil engineering. But I got to high school and biology just fascinated me. then I came to look at it from a very different angle: I realized that when you are a doctor you actually have a direct impact on someone’s life unlike other professions that involve just money or something like that. You actually have a chance of directly helping people. And that was the turning point.
theDoctor: how was it like for you in medical school?
Dr. Otom: Quite enjoyable actually, by then I had discovered how my mind worked and I knew how to go around my exams, so I didn’t have a very big problem.
I had discovered that I could actually read and understand when I had the time, but when it was last minute to an exam I could also open that pharmacology book and grasp everything overnight.
Dr. Hazo: first year was marathon for me. There was so much pressure and the fact that you just got there is enough to keep you on toes. we used to look at second year students like some kind of heroes. But once I got used to the system it became a smooth ride.
theDoctor: what were your favorite subjects?
Dr. Otom: I enjoyed biochemistry quite much in the pre-clinical areas and I loved I-med during my clinical training.
Dr. Hazo: community health (laughing), that was a smooth ride. But actually my all-time favorite was physiology and I also liked surgery.
theDoctor: please describe how your internship has been in one word.
Dr. Otom: Hell. (Bursts out laughing) but don’t write that.
Dr. Hazo: Interesting.
theDoctor: Why did you choose JOOTRH/ KCH as your internship center.
Dr. Otom: I think I wanted to get that fulfillment of working for and helping my people and being close home.
Dr. Hazo: actually I wanted to do it at JOOTRH. I couldn’t even remember that this hospital existed here, but a friend of mine “chanuad” me and I decided to pick KCH. There was too much competition for limited slots in JOOTRH and this hospital wanted 4 and only 5 of us applied so I had better chance of getting it.
theDoctor: but why Kisumu?
Dr. Hazo: there’s higher chance of being retained when you work in your home county, thanks to devolution. So that’s why I wanted to come to Kisumu, tarmacking is not good. But otherwise I would probably have gone to the coast.
theDoctor: where do you guys stay as interns?
Dr. Otom: the good thing about JOOTRH is that they give us houses. We stay in nice apartments and they are quit affordable. Only 2500.
Dr. Hazo: I stay in a single room apartment in Nyalenda. There are no houses for those of us in KCH.
thedoctor: speaking of rent, how did it feel like receiving that first cheque?
Dr. Otom: (laughing) that was overwhelming. You know, you check your current balance and compare with what was there initially, and it’s breathtaking.
Dr. Hazo: (laughing) it was a nice feeling, having enough money feels good.
theDoctor: So what did you do with it? What did you first buy?
Dr. Otom: I furnished my house. As an intern you have to have a big TV, you know (laughing). I also started a small business. And the most important thing is to save.
Dr. Hazo: (laughing) it’s still there. I have to save, because I really don’t know how things will go after internship. You cannot go back to your parents after you’ve had a year being on payroll. But I had a good time with my friends during the doctors strike, because there wasn’t much to do in the hospital, so we traveled the country and “said sorry to the body”
theDoctor: generally speaking, how has internship been?
Dr. Otom: My internship has been a great learning experience but it’s not for the faint hearted. This is where you forget all the theory you used to cram in medical school and start the practical medicine. The workload is overwhelming. When you’re on call, your phone can’t just stop ringing and no matter what time it is you will have to wake up and sort out whatever it is.
theDoctor: who calls?
Dr. Otom: literally everybody: the midwives in labor ward, the Medical officers, the nurses, even the security person calls. And sometimes, the most disappointing thing is when you are called and you disrupt your sleep only to find there was no real emergency.
Dr. Hazo: My internship has literally been enjoyable. I can’t complain, its not as bad as i thought it would be. I think the biggest survival trick is having good PR with everybody including the nurses. Especially the nurses!
theDoctor: what was your favorite rotation?
Dr. Otom: I-med. I loved I-med. It’s the one place where you get an opportunity to think around patients. When one thing doesn’t work you have to go back and rethink to see that the patient is improving. I also liked working around great doctors like Dr. Ndinya.
Dr. Hazo: Surgery, for me surgery was somehow relaxing because I really like the field. The consultants are also quite encouraging. I got a chance to do things other interns elsewhere don’t do.
theDoctor: what was the most fulfilling moment as an intern?
Dr. Otom: that must have been in obs &gyn. That moment when you successfully conduct a Cesarean section on a mother in distress and you hand the baby to her in the ward, the look on her face alone is very fulfilling. In fact, I had a baby named after me and I felt very proud.
Dr. Hazo: for me its pediatrics. It’s my last rotation and even though getting those IVs in was tricky at first, the moment you watch a baby who came in in severe distress play around, alive and well, it’s very rewarding to me as their doctor.
theDoctor: is there a worst, or saddest moment?
Dr. Otom: getting roasted for something that is not my fault. That one never gets old for me. Sometimes you do all the right things on your side but if a nurse or someone else fails to do their part you have to carry the cross during a consultant’s round.
Dr. Hazo: that was during my very first days here. I didn’t know how the system worked yet. We had a patient who needed urgent treatment. So I worked her up and sent samples to the lab before I could start her treatment. Sadly, I was told that this patient had to pay before any test was done. She also had to pay before receiving any medication. My patient had no money and no relatives nearby. The hospital does not bill in the file. I was frustrated. I tried to get the hospital administration to waive for her but that too is a tedious and long process. By the time it was done, my patient had already died. It really hurt.
theDoctor: how do you deal with loss of a patient? They don’t teach die 101 in med school, do they?
Dr. Otom: It hurts, but with time you get used to it. I lost my first patient when I was in my final year in campus and I really grieved over it. But I looked around and the rest of the people were ok going about their daily activities as usual. So I talked to a senior colleague and I got over it.
Dr. Hazo: you have to get used to it. Even in campus you would clerk a patient in the evening preparing to present them the next morning in the ward-round, and when you come in the morning, they’re gone just like that. Here you see it real time. Especially in the medical ward, patients die at a very alarming rate and you have to get used to it.
theDoctor: how do you deal with relatives?
Dr. Hazo: that’s a very tricky situation. Sometimes the patient comes in with stage 4 disease and there’s not much anyone can do no matter how cooperative they are. So the relatives will shout at you and accuse you of doing nothing while their patient is dying. Dr. Wafula has taught us to give them the prognosis as soon as they come so as to avoid giving any false hope to both relatives and yourself.
theDoctor: How do you deal with other senior doctors?
Dr. Otom: They are the ones we learn from so you have to respect their seniority. Sometimes I get goosebumps when I’m supposed to talk to a senior consultant with whom I’ve never met before but when we get closer it becomes a smooth ride. the secret is, you have to know how each doctor likes to deal and handle them appropriately.
Dr. Hazo: I really like our MOs here. They are always available. When you get stuck, call them and they’ll be there within no time. The consultants are also very approachable.
theDoctor: best or favorite consultant for you?
Dr. Otom: I don’t really have a favorite; they are all very good at what they do. But I think I like Dr. Akula the most. I feel he really appreciates the interns for what they do. He would even actually just call you and say thank you. And then there’s Dr. Wafula! Dr. Wafula really inspires interns.
Dr. Hazo: Dr. Wafula.http://thedoctor.co.ke/one-on-one-with-dr-wafula-nalwa-the-cardiologist/ He gives you so much, at the end of a round with him, you have accumulated quite the knowledge. And he knows his patients very well. There was a time he made up all contribute just to buy a needy patient drugs. I also like Dr. Mitei, The Gynecologist, he relates with the interns at a very friendly level.
theDoctor: what was the biggest challenge for you as an intern?
Dr. Otom: The lab. Our labs at JOOTRH are not functioning optimally. They only work for 8 hours during the day and they do not even have all the standard tests. I think the administration needs to increase the number of labs and make them function 24/7. It will go a long way in improving patient care.
Dr. Hazo: everything. KCH needs serious administrative and structural transformation.
theDoctor: where do you see yourself in 5 years?
Dr. Otom: God willing I should be doing my Mmed in Internal medicine by then.
Dr. Hazo: surgical residence most probably.
theDoctor: what do you do when you are not in the wards?
Dr. Otom: (laughing) mostly I sleep. But I also like to take photos, in another world maybe I’d have been a model. But sometimes I attend to my business: I sell body accessories and many other things. We also have a cereals business with my family. I also do motivational talks. I also like movies a lot. And we have a breast and cervical cancer screening project with some friends.
theDoctor: you miss your friends!
Dr. Otom: Yes, I do, we call ourselves ‘we three’. We’ve been friends since campus. We used to study together. But we do chat a lot
Dr. Hazo: I travel. Me and my friends we go places, I like places with a good view and fresh breeze: Places like Dunga beach, Hill camp in Kisumu, and even as far as Rusinga island. I used to play basketball, and id still love to but it’s very tricky with the internship pressure. By the time I leave the hospital I am totally worked out.
The chat between theDoctor and these two great doctors was a big eye-opener and I hope that it makes an impact not just on individuals but the hospital management systems as well. theDoctor wishes Dr. Hazo, Dr. Otom and all their colleague interns all the best in their endeavors.