Conversations

Conversations feel spontaneous. Words flow, topics shift, people laugh, disagree, interrupt, connect. On the surface, it all seems natural—almost effortless.

But beneath that surface, every conversation is doing quiet work.

People aren’t just exchanging information; they’re negotiating identity, status, belonging, and trust. Every sentence carries subtle signals: *Do I agree with you? Do I challenge you? Am I above you, equal to you, or seeking your approval?* Conversations are less about words and more about positioning.

This is where something like backbiting begins—not as an intentional act of malice, but as a byproduct of how groups maintain cohesion.

When two or more people talk about someone who isn’t present, it often serves a social function. It creates alignment. By sharing an opinion—especially a critical one—people test whether they are on the same side. Agreement strengthens bonds. Disagreement risks distance.

In that sense, backbiting becomes a kind of shortcut. Instead of building connection through vulnerability or shared goals, it builds connection through a shared target.

It also allows people to say things they wouldn’t risk saying directly. Direct confrontation carries consequences—conflict, rejection, discomfort. Indirect conversation feels safer. So thoughts that remain unspoken in one setting quietly surface in another.

Over time, this pattern normalizes itself. It becomes part of conversational rhythm. A name comes up, a tone shifts, and everyone instinctively understands the rules: what can be said, how far it can go, and when to stop.

What makes this particularly complex is that not all back-channel conversation is harmful. Sometimes it’s a way of processing frustration, seeking perspective, or understanding social dynamics. But the line between processing and undermining is thin—and often crossed without awareness.

The real issue isn’t that people talk about others. It’s that these conversations subtly shape reputations in the absence of the person being discussed. Narratives form, often incomplete or biased, and once established, they tend to stick.

So how do conversations drift into backbiting?

Usually, it starts small. A casual remark. A shared irritation. A moment of humor at someone else’s expense. If it’s received well—if it earns laughter or agreement—it gets reinforced. And what was once incidental becomes habitual.

Avoiding this entirely is unrealistic. It’s deeply embedded in social behavior. But being aware of it changes how you participate.

You begin to notice when a conversation is building connection at someone else’s cost. You become more deliberate about what you contribute, what you amplify, and what you let pass.

And sometimes, the most powerful shift is subtle—choosing not to add to a narrative that someone else isn’t there to shape.

Because conversations don’t just reflect relationships.

They quietly define them. 

How to function in groups

Functioning well in a group is less about fitting in and more about understanding the invisible rules that govern how people interact.

Every group—whether it’s a workplace, a classroom, or a broader social circle—operates on a mix of spoken expectations and unspoken dynamics. People often assume that competence or good intentions are enough to be accepted, but in reality, social navigation is a skill of its own.

The first shift is recognizing that perception matters as much as contribution. You may be doing excellent work, but if it isn’t visible, communicated, or aligned with what the group values, it often goes unnoticed. Functioning well means making your efforts legible to others—speaking up when needed, sharing progress, and ensuring your presence is felt without being overbearing.

Equally important is learning the balance between assertiveness and adaptability. Groups reward those who can stand their ground without becoming rigid, and who can adjust without losing themselves entirely. This isn’t about people-pleasing; it’s about strategic flexibility—knowing when to push, when to pause, and when to let things go.

Observation is an underrated skill here. Before trying to change a system, understand it. Who holds influence? What behaviors are rewarded? What is discouraged, even if unofficially? People who navigate groups well are often those who spend time decoding these patterns before acting.

There’s also the matter of emotional economy. Not every slight deserves a reaction, and not every disagreement needs to become a conflict. Groups function more smoothly when individuals can absorb minor frictions without escalating them. At the same time, knowing which issues are worth addressing is what prevents you from becoming invisible.

Another quiet advantage is reliability. In most group settings, consistently doing what you say you will do builds more trust than occasional brilliance. People gravitate toward those who are predictable in their effort and stable in their behavior.

But perhaps the most important principle is this: don’t outsource your sense of worth to the group.

Groups are inherently unstable. Opinions shift, hierarchies change, and acceptance can be conditional. If your confidence depends entirely on external validation, you’ll constantly feel off-balance. The people who function best within groups are often those who can engage without becoming dependent.

In the end, functioning well in society isn’t about mastering one personality or strategy. It’s about awareness—of yourself, of others, and of the space in between.

Because groups don’t just shape you.

You are also, quietly, shaping them.

The society and bullying

There’s an uncomfortable truth most people sense but rarely articulate: many social structures don’t just tolerate bullying—they quietly organize around it.

Not always in obvious ways. Not always through overt cruelty. But through subtler dynamics: exclusion, hierarchy, signaling, and control.

At its core, bullying is not just aggression. It’s a tool. A way to establish dominance, define boundaries, and assign roles within a group. And humans, being deeply social creatures, are constantly negotiating where they stand relative to others.

From school playgrounds to corporate boardrooms, similar patterns repeat. A few individuals set the tone. Others align, not necessarily because they agree, but because alignment feels safer than resistance. Laughter becomes currency. Silence becomes complicity. And gradually, a structure forms—one where power is maintained not just by strength, but by collective participation.

Why does this happen?

Because groups need order, and hierarchy is the fastest way to create it.

Bullying, in many cases, becomes an informal sorting mechanism. It identifies who can be pushed, who resists, and who commands attention. It’s crude, often unfair, but effective in establishing social rankings quickly. And once those rankings settle, people adapt to them.

There’s also a psychological economy at play. By participating in or tolerating the marginalization of someone else, individuals signal belonging to the dominant group. It’s a trade: empathy in exchange for security.

What makes this particularly insidious is that it rarely feels like “bullying” from the inside. It feels like humor, like tradition, like “just how things are.” The language softens the reality. Teasing replaces targeting. Banter replaces belittling. Culture masks coercion.

And those at the receiving end? They’re often told to adapt, toughen up, or prove themselves worthy of inclusion—further reinforcing the structure that excluded them in the first place.

Yet, not everyone conforms.

Some people step outside these dynamics, refusing to participate or internalize the hierarchy. Interestingly, these individuals often disrupt the system—not through confrontation alone, but through non-participation. By not rewarding dominance with attention or fear, they weaken its currency.

But this path is costly. Social systems rarely reward those who refuse to play by their rules, at least not immediately.

So why do such structures persist?

Because they are stable. They replicate easily. And most importantly, they distribute discomfort unevenly—protecting the majority while concentrating harm on a few.

It’s easy to condemn bullying as an individual flaw. It’s harder to recognize it as a structural feature.

And perhaps the more uncomfortable question is not why bullies exist—but why systems so often make space for them.

Because until that is addressed, the pattern doesn’t disappear.

It just evolves.

The Myth of Support

 People often like to believe that society runs on kindness, collaboration, and mutual support. It’s a comforting idea—that if you try hard, others will notice, help you, and lift you along the way. But step outside idealism for a moment, and a different pattern emerges.

At a fundamental level, human behavior is deeply self-preserving. People prioritize their own survival, comfort, reputation, and growth—often unconsciously. Support is conditional. Attention is selective. And encouragement is frequently reserved for those already showing signs of success. It’s not always malicious; it’s simply how we’re wired.

You see it everywhere. A struggling artist is ignored until their work gains recognition. A student’s ideas are dismissed until validated by authority. A startup is ridiculed until it becomes profitable. People don’t rally behind potential—they gather around proof. And proof, unfortunately, comes late.

This creates a paradox: those who need support the most receive it the least.

So how do some people still succeed?

The answer lies in a quiet, often invisible trait—self-sustained momentum. Successful individuals tend to operate in the absence of external validation. They build, practice, fail, and repeat long before anyone is watching. They detach their effort from applause. In fact, many of them expect indifference.

Instead of waiting for encouragement, they generate their own. Instead of relying on networks, they create value that eventually attracts one. They understand a subtle truth: support is not the starting fuel; it is a byproduct of visible progress.

There’s also an element of selective blindness. Successful people often develop the ability to ignore noise—criticism, comparison, or the absence of recognition. Not because they are immune to it, but because they’ve decided it’s irrelevant to their trajectory.

Ironically, once success begins to show, the narrative flips. The same world that was indifferent starts appearing supportive. People call it “community,” “network,” or “luck.” But what they’re really seeing is delayed alignment—humans gravitating toward what already works.

This isn’t a cynical view of humanity; it’s a practical one. Self-interest isn’t inherently evil—it’s efficient. But understanding it frees you from unrealistic expectations. It teaches you not to wait.

If anything, the real edge lies in accepting that most people won’t support you early on—and building anyway.

Because in the end, success doesn’t emerge from collective belief. It emerges from sustained effort in its absence.

The Religion of Shivani: Coffee, Cortex, and Controlled Chaos

Tagore was out here doing Nobel-level metaphysics. I’m just a sleep-deprived neuroanesthesia resident with too many markers and not enough serotonin. So, naturally, I decided to reframe his majestic “Religion of Man” into:

The Religion of Shivani: Coffee, Cortex, and Controlled Chaos

1. Man’s Universe → Resident’s Universe

Tagore:  

“Light as the radiant energy of creation started the ring-dance of atoms…”

Me:  

Light as the radiant phone alarm at 5:15 a.m. starts the ring-dance of neurons in one extremely confused DrNB brain.

The planets in his story emerged from baths of fire; my days emerge from:

- Bath of OT scrubs,  

- Bath of ICU monitor alarms,  

- Bath of “Madam, case add ho gaya.”

Tagore’s “gigantic Inert, dumb and desolate” universe?  

That’s my brain when I open a DRNB viva book after night duty.

And then life appeared as a tiny cell, facing the enormity of existence.

Same, honestly.

Just replace “cell” with “final-year resident” and “enormity of existence” with “entire neuroanesthesia syllabus, thesis, and two pending manuscripts.”

2. The Divine Unity → The Holy Fellowship WhatsApp Group

Tagore:  

“The divine principle of unity has ever been that of an inner inter-relationship.”

In my world, the “inner inter-relationship” is:

Residents + Fellows + Consultants + OT list + ICU census + the unspoken rule that no one is allowed to truly go home on time. ( just kidding ) 

Multicellular life forms “larger cooperative units” through complex inter-relationships that maintain coordination.

We do the same:

- One cell: the nurse/posting resident.  

- Another cell: the fellow arguing about BP targets.  

- Third cell: neurosurgeon saying “short case hai” (known falsehood).  

- Fourth cell: Shivani trying to standardize anything with an Excel sheet and trauma.

Together, we form:

A larger cooperative unit called “NANCC,” whose primary function is to defy circadian rhythm and generate publishable chaos.

My “multi-personal humanity” is the sum total of:

- Neurointervention circus,  

- Neuro OT drama,  

- Neuro ICU existentialism,  

- And the one quiet moment at 2 a.m. when I sip hot coffee and think, “I really love this.”

That’s my “divine principle of unity.” Plus, Wi‑Fi.

3. Immortality → Papers, Paintings, and Question Banks

Tagore:  

“In this ideal of unity [man] realizes the eternal in his life… It inspires in us works that are the expressions of a Universal Spirit.”

Me:  

Look, I’m not sure about eternity, but I know this:

- A half-broken laptop full of drafts,  

- A terrifying Google Drive of data sheets,  

- A sketchbook of brains and aneurysms,  

- A folder called “DRNB FINAL – PLEASE GOD” on my desktop

…are the closest I currently get to immortality.

Tagore says we touch the eternal through:

- Art,  

- Science,  

- Philosophy,  

- Service.

In NANCC life that becomes:

- Art → me painting neurons instead of reading ICP chapters.  

- Science → me pretending my Excel sheets are “robust databases” and not emotional support files.  

- Philosophy → the 3 a.m. corridor walk where I question why I exist, then go back and titrate norad.  

- Service → the 40 little things we do every shift that never go in a paper but quietly keep someone alive.

If I ever leave something “immortal” behind, it’ll probably be:

- A meme-laced teaching PPT,  

- A scoring system with too many variables,  

- And stories of “that neuroanesthesia madam who kept asking for exact BP numbers and bullied people out of writing ‘stable only’.”

4. Truth, Tables, and ICU Monitors

Tagore:  

“The table… appears as a table for man through his special organ of senses and his special organ of thoughts.”

Me in ICU:  

The “table” is actually the monitor.

- To relatives: a scary screen with random numbers.  

- To a tired resident: “Okay-ish, I think, HR not red, BP not red, SpO₂ not red, chal raha hai.”  

- To an examiner: “Kindly enumerate all parameters, their significance, and management of derangements, in less than 15 seconds while I stare into your soul.”

Tagore says science gives us one version of reality, senses give us another, both reconciled in human personality.

In my life:

- Scientific truth: ICP 22, CPP borderline, sodium 131, something must be done.  

- Emotional truth: “If one more thing goes wrong, I will lie down on this floor.”

Both are valid. Only one goes in the chart.

And his line about logic being “machinery of thinking created by man”?

In my world:  

Logic is the anesthesia workstation.  

The “machinery of coping” is chai.

5. Reason vs Heart → Viva vs Why-I-Started

Dostoyevsky:  

“Nature, the soul, love, and God, one recognizes through the heart, and not through the reason.”

Tagore:  

We have senses for the physical world and “luminous imagination” for wholeness and immortality.

Me, trying to revise for DRNB:

- Reason: “You must memorize 300 pages of neurophysiology or you will perish in the viva.”  

- Heart: “You love this field because of that one moment when a patient wakes up, moves all limbs, and smiles at their family.”

Reason is my exam prep, my protocols, my references, my careful ICP/CPP calculations.

Heart is:

- Sitting by a recovering patient’s bed at 2 a.m.,  

- A neurosurgeon quietly saying “Good call,”  

- A junior asking, “Didi, how did you know what to do?”  

- The absurd joy of a neat art line, a clean extubation, a well-managed SAH.

Reason fills the answer sheet.  

Heart writes the blog.

Reason gets me through the exam.  

Heart is why I haven’t run away to open a small art café in the hills. Yet.

6. Relationship as Fundamental Truth → Group Photo with Dark Circles

Tagore:  

“Relationship is the fundamental truth of this world of appearance.”

In my personal nonsense universe, that translates to:

- I am not just “DrNB candidate.”  

- I am the sum of every senior who taught me, every colleague who covered a break, every nurse who saved me with one quiet, “Madam, dekho ye accha nahi lag raha,” every patient who trusted me without knowing my name.

My “truth” isn’t separate from them.

It’s:

- Sheen and Laila laughing about chaos.  

- Penelope’s exam-topped calm eye of the storm.  

- Neurointervention fellows calling my data sheets “side quests” and still filling them (badly, but love is imperfect).  

- Neurosurgeons roasting my forms but turning up to help with the project anyway.  

- The weird, immortal tradition of Artemis neuros and NANCC producing people who top exams while looking permanently half-dead.

If Tagore has “The Religion of Man,” I have:

The Religion of NANCC:

- Thou shalt not write “BP normal.”  

- Thou shalt not plug EEG into defib.  

- Thou shalt accept that “short case” is a lie.  

- Thou shalt love thy coffee, thy patient, and occasionally thy colleagues.  

- Thou shalt turn thy exhaustion into stories, thy data into papers, and thy burnout into questionable humor.

And somewhere in this mess — between the science and the silliness, the cerebral and the completely deranged — there is:

- A tiny sense of immortality,  

- A feeling of unity,  

- And the quiet knowledge:

This is my little corner of the universe.

Ridiculous. Exhausting. Beautiful.  

A ring-dance of atoms, aneurysms, and absolutely unnecessary Excel columns.

Signed,  

Shivani Fotedar  

Neuroanesthesia, Neuro ICU, and Nonsense Theology.

The NANCC Chronicles 2.0: The Freshly Baked Chaos

(Featuring: New Fellows, Old Trauma, and a Recycled Piyush)

The Neuro Dungeon had changed.

Brad Pitt (a.k.a. Arm Pitt) was gone. Rachel had escaped. Samuel had defected to a place with actual staffing and functional machines and was now flying abroad. The aura of unhinged stupidity, however, had respectfully stayed behind.

Only one veteran remained.

Penelope.

Penelope, who had just topped the ISNACC fellowship exam, thereby single-handedly ensuring that Artemis maintained its terrifying tradition:

Last year Rachel topped ISNACC. This year Penelope did. Somewhere, examiners were whispering, “What are they feeding these people?”

Rachel 2.0: DM Edition

Rachel, now Dr Rachel “DM Neurocritical Care” Somewhere-Fancier, lived in Penelope’s WhatsApp notifications.

Daily messages included:

• “Remember to bully your juniors into reading.”

• “Please tell your new fellows not to plug EEG into defib.”

• “If anyone calls EEG ‘brain ECG’, disown them.”

Penelope would stare at her phone between cases and sigh.

“They’ve sent me children,” she muttered one day.

Laila and Sheen looked up, interested.

“New fellows?” Sheen asked.

“New era,” Penelope replied. “Same department. Less brain, more Wi-Fi.”

The New Cast of NANCC

With the old chaos exported to other institutions, the Neuro Dungeon summoned new demons.

Enter:

1. Dr. Aruna Chatterjee – ISNACC Fellow, Batch of Eternal Confidence

Speaks like UpToDate is personally sponsoring her. Starts every sentence with, “Evidence suggests…” even when asking for chai.

1. Dr. Meera Singhal – ISNACC Fellow, Silent Assassin

Looks sweet, talks soft, writes notes like M&M minutes. You will not realise you’re being audited until you cry later.

1. Dr. Ishani Verma – DrNB Neuroanesthesia & Critical Care ( just joined ) 

Has the lost-puppy energy of a first-year and the sleep schedule of a trauma pager.

And then there was…

1. Dr. Piyush Patel – DrNB, Alleged Reincarnation

Named Piyush. Neuroanesthesia. Same specialty. Same department. Same glasses. Only difference: this one used memes.

Everyone called him “Piyush 2.0” behind his back and “Sir” to his face, just in case the original Piyush’s soul was actually inside and marking karma-based internal assessments.

The First Morning Rounds: Welcome to the Circus

It was 8:15 a.m. in the Neuro ICU. The usual state: three ventilators alarming, one infusion pump blinking in existential crisis, Sheen looking like she’d fought the DRNB syllabus in hand-to-hand combat and lost.

Penelope stood at the foot of bed 5, tablet in hand, exam-rank aura radiating like a halo and also like a threat.

“Okay,” she said. “Let’s see what we’re working with.”

Bed 5: postop aneurysm clipping.  

Na: 136.  

ICP: 12.  

BP: 130/70.  

Documentation: emotional damage.

Penelope turned to the newbies.

“Aruna, summary of the case?”

Aruna straightened her shoulders.

“Ma’am, this is a 54-year-old female, post-op ruptured ACom aneurysm clipping, day 1, stable vitals, on norad 0.05, GCS E4VtM6, pupils equal and reactive. Evidence suggests that early mobilisation—”

“Aruna,” Penelope interrupted gently, “we haven’t even extubated her yet.”

She blinked.

“Yes ma’am, but evidence suggests—”

“Evidence also suggests we should use our eyes,” Penelope replied. “Try that first.”

Meera’s Audit Aura

At the next bed, Meera handed Penelope a neatly written sheet.

“Ma’am, I made a checklist,” she said.

The top was titled:

“Common Reasons This ICU Will End Up in a Journal or a Legal Case (Provisional List)”

Items included:

• BP charted as “okay”

• ICP written as “stable”

• No one knowing actual sodium

• “Ventilator settings as per previous” (previous what? previous life?)

• GCS documented as “same as before” with no baseline

Penelope read it in silence.

“Very good,” she said. “This is both horrifying and accurate.”

Sheen, hovering near the workstation, muttered, “You guys are writing dark comedy and calling it quality improvement.”

Piyush 2.0: The Glitch in the Matrix

Later that day, Sheen walked into OT and froze.

At the head end, prepping for a neuro case, stood Piyush 2.0. Same name. Same field. Same academic seriousness in the forehead wrinkles. Except… this one was humming Bollywood songs and had a phone wallpaper that said:

“KEEP CALM AND TITRATE NORAD.”

Sheen whispered to Laila, “He looks… familiar.”

Laila whispered back, “Don’t say it. If the old Piyush sir hears it through cosmic Wi-Fi, we’re dead.”

Piyush 2.0 adjusted the ventilator and asked, “Sheen, target EtCO2 for this case?”

Sheen, DRNB-burned but not dead, replied, “Between 32 and 35, sir.”

He nodded.

“And target heart rate?”

“Emotionally or numerically?”

Piyush grinned. “See, this is why you people worry me.”

He added, “By the way, I’ve been told there was another Dr Piyush Patel before me.”

Everyone pretended to be very busy.

“Legacy is important,” he said serenely. “I am here to carry forward the name.”

Sheen’s brain: You mean respawn?

DrNB + Fellows = One Shared Brain Cell

That night, the Neuro ICU was run by:

• Meera, on call

• Ishani, on call

• Laila, post-call but still physically there because DrNB prep had blurred the line between “duty” and “self harm”

• One resident from general ICU looking like they’d been thrown into a parallel universe

At 2 a.m., alarm symphony started.

Ventilator: BEEP BEEP BEEP  

Syringe pump: BEEEEEEP  

Monitor: dramatic flat-ish tones for artifact

Ishani stared at the monitor like it was a zodiac chart.

“Sheen, is this… real VT or just artifact?” she asked.

She squinted. “Check the patient. If they’re talking, it’s artifact.”

Meera, while adjusting norad, asked, “What’s the urine output?”

Ishani checked the chart.

“It says ‘adequate’.”

Meera blinked slowly.

“What is adequate?” she asked.

“Uhh… adequate?” she replied.

“Sheen,” Meera said softly, “take my pen before I write something impolite in the notes.”

Aruna’s Evidence Attack

Next morning, during handover, Aruna started presenting with her usual flourish.

“Overnight, we optimised hemodynamics,” she began. “Evidence suggests that early goal-directed—”

Penelope raised an eyebrow. “What goal did you direct exactly?”

Aruna looked at the notes.

“BP 120–140,” she said quickly.

Laila added helpfully, “Documented as ‘BP: fine only.’”

Penelope sighed. “Whose fine? Yours? Mine? The patient’s? There is no universal fine.”

Meera whispered, “Writing that on a sticker,” and did exactly that:

“BP FINE ONLY = NOT A NUMBER”

She stuck it on the monitor.

Sheen’s Art Attack

Meanwhile, Sheen was coping with DRNB prep, duties, and the neurologically hazardous presence of three new trainees by returning to her old habits: painting, animation, and academic nonsense.

In her bag were:

• A neuro painting of the NANCC team as glial cells (Laila and Penelope were, of course, astrocytes-in-chief)

• A half-finished animation of an ICU monitor warning, “If you write ‘GCS same,’ I will report you”

• A notebook with DRNB topics and exactly three completed pages, one of which just said: “I HATE VIVAS”

During a mid-shift lull, Piyush 2.0 saw her doodling a brain with a coffee cup.

“Is this… creative coping?” he asked.

“It’s either this or I intubate myself,” Sheen replied.

He nodded. “Art is fine. As long as you also know CPP formula in your sleep.”

“I do know it in my sleep,” Laila said. “I don’t know it when I’m awake.”

Rachel’s Ghost Messages

Every time something ridiculous happened, Penelope’s phone buzzed as if Rachel, from her lofty DM program, could sense the stupidity in the air.

One evening:

• Ishani had written “ICP stable” with no number.

• Aruna had said “Evidence suggests…” three times in one handover.

• Meera had quietly compiled a list titled “Things That Will Give Me Migraine Before Age 35.”

Laila sent a photo to Rachel: a whiteboard reading:

“IF YOU WRITE ‘GCS SAME’, MAY YOUR COFFEE ALWAYS BE DECAF.”

Rachel replied instantly:  

“Good. Fear is an excellent teaching tool. Carry on, Artemis tradition.”

Samuel, observing from afar via occasional texts, sent:  

“Has anyone died yet?”

Penelope: “No.”

Samuel: “From stupidity?”

Penelope: “Almost.”

The Great On-Call Night From Hell

Inevitably, the Universe scheduled a perfect storm:

• One ruptured aneurysm

• One decompressive craniectomy

• Three ventilated patients

• One angry relative

• One infusion pump that decided to beep continuously with no actual error

• Two ISNACC fellows and one DrNB brain cell trying to multitask

At 3 a.m.:

• Aruna was quoting a paper while half-asleep: “Evidence suggests that sleep deprivation—”

• Meera was labelling lines and tubes with serial killer precision

• Ishani was asking, “If patient is intubated, do we chart ‘speech: absent’ or is that rude?”

• Sheen was trying to read for DRNB with her eyelids at 10% battery

• Piyush 2.0 walked in, looked around, and said, “Ah. Controlled chaos. Very good.”

A nurse pointed at the monitor.

“Sir, BP is 90/50.”

“Who’s on this bed?” Piyush asked.

“Meera, sir,” the nurse replied.

“I meant… the patient,” Piyush said calmly.

“Oh. Yes. Also Meera,” Sheen muttered.

They resuscitated. Adjusted fluids. Titrated norad. Fixed triggers. Stabilised ICP.

At 5 a.m., the ICU was quiet again.

Aruna leaned back and said, “Evidence suggests we will all die young.”

Meera replied, “Please write that with a reference.”

The Tradition Lives On

By the end of the month:

• Penelope was still the reigning ISNACC topper.

• Rachel had officially started DM Neurocritical Care and was sending “spot diagnosis” CTs at random hours.

• Piyush 2.0 had become a myth: half man, half déjà vu.

• Aruna had learned that not everything needed “evidence suggests” in front. Some things as she already knew just needed common sense.

• Meera had a growing folder called “Things That Should Not Be Charted but Were.”

• Ishani had finally stopped writing “stable only” and started writing actual numbers—after being spiritually beaten by Penelope’s eyebrow.

And Sheen?

She was somehow juggling DRNB prep, research drafts, watercolour scans of neurons, and a new animation of a brain yelling:

“IF YOU SAY ‘NEURO ICU IS CHILL’, MAY YOU NEVER FIND A VEIN AGAIN.”

One afternoon, as they wrapped up rounds, Penelope looked at her team.

“You know,” she said slowly, “Rachel topped last year. I topped this year. One of you will have to keep the tradition going.”

Aruna swallowed.  

Meera blinked.  

Ishani dissociated.

Sheen pointed at all three. “Good luck, my condolences, and may your examiners be postprandial and mildly hypoglycemic.”

The Neuro Dungeon rolled on:

New fellows, same chaos.  

New Piyush, same trauma.  

New batch, same ancient curse:

Artemis NANCC will always be 50% brains, 50% comedy, and 100% sleep deprivation.

And somehow, amidst the alarms, jokes, and existential dread…

They still kept patients alive.

Sheen v/s the great DrNB hibernation

(Featuring: Artemis Neuros, Unsolicited Opinions, and Zero Actual Studying)

If anyone tells you, “Beta, just focus on your DRNB prep, these are the best years of your life,” understand one thing: that person has never opened a Neuroanesthesia viva book after 12-hour duty.

At Artemis Hospital, Sheen was discovering a new kind of suffering.

Not hypoxia.

Not raised ICP.

Not intra-op aneurysm rupture.

Worse.

Systematic, prolonged, soul-dissolving… exam preparation.

Sheen vs. The Syllabus That Won’t End

Sheen sat in her room with:

• One coffee mug that had seen things.

• Three highlighters that had given up.

• And nine open PDFs, all saying the same thing in slightly different fonts.

Day 1 plan (as written on paper):

“Revise cerebral physiology, ICP, SAH, TBI, vasospasm, monitoring, ICU protocols, write one mock answer per topic.”

Day 1 reality:

• Read half a page of cerebral blood flow.

• Dissociated.

• Stared at wall.

• Considered alternate careers: pottery, secret Himalayan cafe owner, non-medical cousin.

Every time she opened a chapter, the book responded like a gaslighter:

“You knew this once. If you loved me, you’d remember.”

Sheen sighed, flipped a page, and did what any reasonable final-year would do in such a crisis.

She opened a new PowerPoint.

The Art of Productive Procrastination

Sheen was now an expert at Academic Avoidance With Just Enough Guilt to Call It Productive.

In one afternoon, instead of reading invasive ICP monitoring, she:

• Designed a research data sheet version 17.3 titled “FINAL_final_THIS_ONE_OK.xlsx”

• Made a watercolor wash of an aneurysm that looked suspiciously like a cosmic tomato

• Started animating a little brain that got vasospasm whenever someone wrote “BP normal” in case notes

Her logic was simple:

“If I’m not studying, I must at least be doing something that can go into my CV.”

Enter: The Neuros Men

She wandered into the Neurosciences floor “just for a five-minute break.”

Everyone knows this is how entire projects, burnout, and three new sub-studies are born.

Chapter 1: Kabir, Guardian of Guilt

Kabir found her sitting at the workstation, scrolling through guidelines with all the enthusiasm of a patient reading bowel prep instructions.

“You’re on study leave,” he said. “Why are you here?”

“I came to… focus,” Sheen replied.

Kabir looked at the coffee, the half-open Excel sheet, and the very much closed exam notes.

“On what? Regression analysis or regret analysis?”

Sheen flipped her laptop around.

“Actually, I’m refining our aneurysm coiling-hemodynamics sheet. I added more variables.”

Kabir squinted. “You added ‘time from clipping/coiling to surgeon’s first existential sigh’ as a column.”

“It could correlate with outcomes,” Sheen argued.

Kabir thought for a second.

“Fine. But if you can refine 180 columns of data fields, you can revise 18 viva topics. Consider this my RCT of your priorities.”

He handed her an old question bank.

“Do one thing,” he said. “For every SAH patient, you must answer three SAH viva questions. Prospective stress study.”

Sheen stared at the book like it had just insulted her ancestors.

Chapter 2: Rohit, Meme-Based Counselling

In the angio suite, Rohit caught Sheen hunched over her phone.

“Are you reading?” he asked.

“Yes,” Sheen said, too fast.

Rohit leaned over.

Her screen clearly showed: an animation timeline with a tiny brain character walking into an OT and fainting at “case posted as elective, turned out emergency.”

“This doesn’t look like Miller,” he said.

“It’s… visual learning,” Sheen replied defensively. “I’m making educational animations.”

Rohit nodded with mock seriousness.

“Of course. ‘Perioperative Hemodynamics in Aneurysm: A Storyboard.’ Very cutting edge.”

He sipped his coffee and added,

“Did you at least open your notes today?”

Sheen thought hard.

“I opened the app where the notes are.”

Rohit: “So, login-level preparation. Good. By exam time, you’ll reach chapter titles.”

He patted her shoulder.

“Don’t worry. If everything fails, we’ll make a meme-based viva book. First question: ‘Define brain.’ Answer: ‘Organ that stops working 3 months before any exam.’”

Chapter 3: Double Arjun, Double Advice

Sheen entered the Brain Room with her books, laptop, and face of a woman who has read the same paragraph six times without absorbing a single ion.

Arjun Singh glanced at her.

“Reading?”

“Yes, sir.”

“What topic?”

“…everything.”

He nodded with the sympathy of a man who had once suffered.

“Dekho,” Singh said, “there are two kinds of exam prep: planned and honest. Planned is your schedule. Honest is what actually happens.”

“Which one worked for you?” Sheen asked.

Singh stared into the distance.

“Neither. God worked for me. And last-minute panic.”

On the other side, Arjun Saxena put down an MRI.

“Don’t listen to him,” Saxena said. “Strategy is simple: solve past questions, make structured answers, revise them thrice, and appear calm.”

He paused.

“Did I do that? No. But I strongly recommend it.”

Sheen showed them her notebook.

Inside were:

• Half an answer on cerebral autoregulation

• A quarter of an algorithm for TBI

• And a full-page detailed drawing of a brain saying “No.”

Saxena squinted.

“This is… artistic, but the examiner won’t give internal marks for shading.”

Singh added, “Unless you draw their face and label it ‘Source of Stress.’”

Chapter 4: Deepak, Lord of Long Cases

Deepak walked in, looking like a man who had just finished a “short” 8-hour case.

“Madam, study leave?” he asked.

“Yes, sir,” Sheen said, instantly guilty.

“And you’re here?”

“I thought I’d read in the department.”

Deepak laughed. “This place is a randomized trial of distraction. Did you at least finish one topic?”

“I revised half of SAH… intro,” Sheen said.

Deepak nodded thoughtfully.

“Good. Now imagine your viva examiner is like me, post-call, with five more cases lined up. Will half SAH save you?”

Sheen remained silent.

Deepak continued, “Do one thing. For every SAH you’ve ever seen here, you owe yourself one full-length, structured written answer. Background, classification, management. No skipping.”

“Sir, that will be a lot,” Sheen protested.

“Exactly,” he said. “That’s how you know it’s the right plan.”

Chapter 5: Bobby, Auditor of “Timepass”

Bobby found Sheen later in the day surrounded by:

• A sketchbook with half a craniotomy scene in watercolor

• A tablet open to an animation app

• A closed exam book acting as a very expensive paperweight

“What’s this?” he asked.

“Break time, sir,” Sheen replied.

“How long is this break?”

She checked the clock.

“Three… hours.”

Bobby smiled the dangerous consultant smile.

“Ah. That’s not a break. That’s a lifestyle.”

He picked up her sketchbook.

“Nice painting,” he said. “You know who else will do watercolor if you don’t study?”

“Who, sir?”

“You. Of your own tears, after the exam viva.”

He sat down.

“Look, do whatever you want—research, painting, animation—but one thing: for every ‘timepass’ hour, do one serious hour. Balanced hemodynamics of the soul.”

Sheen blinked.

“Sir, that sounds like a therapy line.”

“Exactly,” Bobby said. “This profession won’t give you mental health. You have to schedule it.”

Chapter 6: Mihir, Clip Collector of Concentration

Mihir walked in carrying his beloved clip box.

“Studying?” he asked.

“Trying,” Sheen replied.

“For what?”

“Orals, sir. Everything neuro. ICP, SAH, TBI, MCA territory, basilar, vasospasm, autoregulation, monitoring—”

“Good,” Mihir cut in. “Tell me the classification of aneurysms.”

Sheen brightened.

“Saccular, fusiform, dissecting, mycotic—”

“Wrong,” Mihir said. “Correct answer: ‘Those that rupture when you are calm, and those that rupture when you are already exhausted.’”

He settled down next to her.

“Listen. You’ll never feel prepared. Just know enough to not embarrass yourself, and speak with confidence. Aneurysms and examiners—both can smell fear.”

Chapter 7: Vikram, Neurosurgeon Slash Psychologist

Vikram entered with his usual “who needs serotonin when we have DBS” energy.

He saw Sheen scrolling through Pinterest-style color palettes for her next animation.

“This doesn’t look like journal club,” he commented.

“I’m making an animation on peri-op BP trends,” Sheen said defensively. “It’s… educational.”

Vikram nodded.

“And how many viva questions will that animation answer?”

Sheen hesitated. “Emotionally, many.”

Vikram pulled up a chair.

“Tell me, what’s the problem? Content or concentration?”

“Concentration,” Sheen admitted.

“Okay. Then we treat this like functional neurosurgery,” Vikram said. “You can’t change the exam. You modulate the circuit.”

He grabbed a piece of paper.

“DBS protocol for exam prep:

• 45 minutes study

• 15 minutes allowed nonsense: painting, animation, scrolling

• Repeat.

• Every time you finish a topic, small reward. Coffee, chocolate, one meme from Rohit.”

“Will this… work?” Sheen asked.

Vikram shrugged.

“If not, we’ll actually put electrodes. But try this first.”

Chapter 8: Farid, Quiet Quality Control

Farid eventually appeared, like a calm audit in human form.

He noticed Sheen’s table: books, laptop, paints, stylus, highlighters, one lone read page.

“How’s the studying going?” he asked.

“Slow, sir,” Sheen said. “Very slow.”

Farid nodded.

“Show me your plan.”

She handed him a crumpled paper labelled “Study Schedule (Ideal Version)” with hour-by-hour targets.

“This,” Farid said, “is like expecting perfect documentation on a Sunday evening.”

He drew a line through half of it.

“New protocol,” he said. “Fewer topics per day. But complete. Like a good operation note—short, clear, and real.”

He added, “And one more thing. Exam is like research. No one cares how dramatic the journey was. They look at your final answer.”

The Final Evening: Excel, Paint, Panic

By the end of the week, Sheen’s life looked like this:

• Morning: Read one topic, write one structured answer, question own existence.

• Midday: Enter data into the aneurysm hemodynamics sheet, curse every “BP normal” entry.

• Afternoon: Make a short animation of a brain raising its own ICP while reading past papers.

• Evening: Watercolor some cathartic chaos—angiograms turning into galaxies.

• Night: Stare at ceiling, mentally recite SAH grading systems, fall asleep halfway between Hunt-Hess and WFNS.

The neuros team watched this circus with varying reactions:

• Kabir: “At this point, your study pattern needs its own statistical model.”

• Rohit: “I’ll make memes for your exam week. Caption: ‘Patient stable, candidate not.’”

• Singh: “Just remember, in viva, start confidently. Even if your brain is on bypass.”

• Saxena: “Whatever you do, don’t say ‘as per condition’ to the examiner.”

• Deepak: “If they ask you ‘short case,’ assume it’s a lie. Prepare for long.”

• Bobby: “Think of it like OT. Preparation, execution, and then pretend it was always under control.”

• Mihir: “And never forget aneurysms. They never forget you.”

• Vikram: “If your heart rate spikes, consider it live hemodynamic monitoring practice.”

• Farid: “Read, write, revise. No shortcuts. But also, no melodrama.”

Epilogue: The Real Primary Outcome, Again

One day, months later, whether Sheen passes with flying colours, average colours, or just surviving colours, the result sheet will show only numbers. ( she doesn’t want to imagine failiure ) 

It will not show:

• The 3 a.m. watercolor of an aneurysm that looked like a galaxy having a bad day

• The Excel sheet that knew more BP trends than most residents

• The tiny animated brain who fainted every time someone said “viva”

• The unsolicited life coaching from 9 neurosurgeons with 19 contradictory strategies

But everyone in Artemis Neuros will know:

The real primary outcome was this:

Sheen didn’t lose her mind completely.

She just turned it into data, paintings, and slightly unhinged animations.

And somehow, between BP charts, joke variables, and skull base watercolors…

She actually studied.

A little.

Enough.