Title: V.Q.E
Paperback: 224 pages
Publisher: Ingramspark/US
Pothi.com/India
Publication Date: Nov 1, 2018
ISBN: 978-1-64467-978-4 (sc)
ISBN:978-1-64467-854-1 (ebook)
Price: $7.99; Rs 299 (India) $2.99 (kindle) Rs 99 (India
Author: Vivek Gumaste
Link https://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3Ddigital-text&field-keywords=VQE
https://pothi.com/pothi/book/vivek-gumaste-v-q-e
Was Great Britain of the 1980’s a welcoming place for a young man hailing from its former colony? How did the National Health Service exploit the vulnerable physicians from a newly independent and struggling India to fulfill its needs? What were the flaming hoops that a foreign physician had to jump through to further his professional career in the UK en route to a final destination in the United States? Read about all this in a gripping, event filled narrative- VQE– an acronym for the dreaded Visa Qualifying Exam, a grueling 2-day test that all foreign physicians had to pass to practice medicine in the United States.
The author is a physician who graduated from a prestigious medical school in India more than 35 years ago and has practiced medicine in three countries- India, UK and USA. He holds numerous postgraduate qualifications- he is a Member of the Royal College of Physicians of Ireland (MRCP-I), a Diplomate of the American Board of Internal Medicine and Gastroenterology and has a degree in Health Care management from Harvard University.
In 1980, after completing medical school in India, he landed in Britain in pursuit of his dream to get to the United States. He was young, a full 26-year-old, ambitious and opinionated. The two and half years that he spent in Britain were eventful years and this book captures that period
This dazzlingly original book set in Great Britain of the 1980’s. does not subscribe to any set genre. It is a unique chronicle that weaves the current events of those times with the memoir of a young foreign physician in an alien land to produce a piece of work that is informative, touching at times and entertaining in parts. It captures the despair, the hopes, trepidations and travails of this young man from a financially indigent India of the 1980’s as he charts his way through the land of his colonial masters and the innumerable challenges of this tumultuous period of his life: professional setbacks in the form of certifying exam failures, joblessness as he moves from one part of Britain to another changing cities sometimes every two weeks in search of work; a cataplexic agoraphobia as he tries to come to terms with racism on the streets. Meanwhile in the background a host of remarkable events are being played out- Lady Diana’s wedding, inter-racial riots and the British-Argentina war over the Falkland Islands.
In a span of 224 pages the author captures a host of personal emotions, a medley of diverse encounters and a series of professional challenges to present to the reader an interesting event filled narrative that is painted against the backdrop of tumultuous times in UK.
His keen sense of observation picks up instances of British snobbery in exchanges like this: “In my nervousness I blurted out, “Can I make a telegram?” For a moment, there was dead silence at the other end. Then a cold female voice sternly admonished me, “You don’t make a telegram, you send one!”
The narration takes recourse to a humorous riposte to underline subtle British elitism: Overwhelmed by this 28-letter south Indian tongue-twister (Tiruchirapalli Krishnamachari), Dr Rogers, the consultant queried Dr Krishnamachari whether he was okay with the moniker of ‘Chris’. To this, Dr Krishnamachari politely replied that it would be acceptable as long as he too had the license to address Dr Thomas Rogers as “Tiruchirapalli Rajagopalachari”. “
One afternoon, caught alone in an isolated subway compartment he experiences an ugly episode of British racism; his description is both gripping and introspective: “I glanced at the raucous group through the corner of my eyes. They kept casting looks in my direction, gesticulating and making remarks. Initially I could not hear what they were saying but soon the remarks got louder, ‘Paki’ being the only discernible word that was repeated.
A welter of emotions gripped me as I tried to come to terms with this unexpected and unpleasant encounter in a new land. Looking back now, I realize how unprepared and reckless I had been when I had embarked on this venture to Great Britain. I had no idea of the social tensions that existed and shockingly had made no attempt to educate myself about this important facet of travel to a foreign land.”
Concurrent with social challenges, this young physician has to deal with other hazards, logistic as well as professional: “Being unemployed as a junior physician in the UK brought with it more mundane travails. It meant being homeless as well: housing came with the job. No job meant no place to stay: I had to vacate my apartment. Where would I go? Where would I stay?”
The medical challenges that he experiences as a trainee physician when called upon to handle an emergency alone is graphically and touchingly narrated: “He (Derek) was sweating profusely from head to foot as he begged me to help him. I could see his condition deteriorating rapidly before my eyes; each breath seemed more labored than the previous one with every muscle in his neck stretching itself to overcome this deficiency of oxygen. The image was frightening.
For a moment I was transfixed, completely overwhelmed by the situation at hand…. I sized up the kit, jerked myself out of my trance and got down to work. Every second was important. I had no time to lose. The chest X-ray hanging on the view box told me that the pneumothorax was on the right side……. Then holding the chest tube with one hand and the trocar firmly clenched in my other fist and with a prayer on my lips, I thrust the tube through the incision. Once I was sure the tube was in the pleural cavity I removed the trocar gingerly, positioned the tube and swung around to look at the underwater seal that was connected to its other end. I could see bubbles of air making their way up to the surface of the water indicating the success of my procedure. I heaved a sigh of relief. I listened to his lungs with my stethoscope to ensure that adequate air was entering the lungs, ordered a chest X-ray to confirm the position of the tube and quickly walked out of the room. I didn’t want Derek to see the perspiration on my face. Once outside I pulled out a handkerchief from my pocket, wiped off the beads of sweat trickling down my forehead and sat down on a chair to calm my racing heart “
Interspersed amongst this personal account are interesting tid-bits of medical statistics: “Doctors’ sloppy handwriting kills more than 7,000 people annually.” And that “sentinel events” (a sentinel event is defined by the Joint Commission as any unanticipated event in a healthcare setting) are in two-thirds of cases caused by miscommunication between health care providers. Other asides about the invention of the stethoscope make for informative reading.
Woven into this personal chronicle are insightful observations on prevailing political and social tensions. He calls Britain’s Falkland war, Britain’s ‘Goa moment’ and quotes a British TV personality to show how the British hold immigrants responsible for their social tensions like the riots of 1981: “This language which is wholly false, which is this Jamaican patois that has been intruded in England and that is why so many of us have this sense of literally of a foreign country.”
This is a rich book that is provocative, informative and touching; it will be an interesting and compelling read for everyone in general and physicians in particular.
Vivek Gumaste Blog 