Third-Year Syndrome in Medicalised Society

Dr. Swaraj lucidly explains the adage, little knowledge is dangerous. He tells us about Google Baba, third-year syndrome, and more, laced with wit and humour. An exclusive for Different Truths.

The Covid pandemic has caused endless misery, devastated economies, and social life. Equally importantly it has not only medicalised but even pathologised everyday life. The unceasing, nightmarish Covid ‘breaking news’ has led to massification of fear and neurosis. Even an injectable nerve tonic also sells as ‘Neurotic Plus’.

Social media has greatly helped in democratising disease, psychiatry, in particular. Many people have become both clinicians and patients. This condition is akin to what was once known as third-year syndrome in medical parlance. In fact, pathology as a subject formed a part of the third year MBBS curriculum.

Young medicos exposed to pathology for the first time fell a prey to this syndrome. They would often start correlating their own symptoms with what they read. But after learning the ropes, they would come out of it. Now, this syndrome inflicts many people, a dear friend being one of them. Even I had also fallen in the trap once-upon-a-time.

Out of Sorts

A couple of days ago, I received a message from my friend. He wanted me to meet him urgently.  I had to go. He appeared to be out of sorts. On trying to probe the reason, he replied, “I think I’m bipolar.” I could not make out what had hit him. Trying to laugh away the whole issue I said, “Are you a magnet with two poles? Surely you aren’t. Then how can you be bipolar? But you’ve irresistible charm about you. That’s why people get drawn towards you like iron filings to a magnet.” He did not respond. I asked, “What makes you think so?” “Well, I know my symptoms. I’ve read everything on the internet.” The whole thing was clear like daylight.

A devotee of Google Baba he sought all help from him. Google Baba, we all know, is a know-all. Pose any question to him and presto, he comes up with a million answers. During the pandemic, the number of his devotees has increased exponentially. Google Baba’s efforts are ably supported by the ‘University of Truth – Nothing but Truth’.

There is one and only one such university, the WhatsApp University. The fluorescence of YouTube also burns bright in Baba’s support. Of late, the Baba has developed even Extra Sensory Perception. In modern terms it means Artificial Intelligence. Now he knows all our preferences. In fact, he knows more about us than we know about ourselves.

Google Baba

My friend, like most other people’s friends, often seeks medical advice from Google Baba. Lest I be misunderstood as excoriating friends, let me clarify one thing. Not only our friends, we all consult the Baba. He is a modern day shaman, mystic and Sufi. He is a historian, a scientist, a climatologist, in fact what not. 

What if we ever lose our way in a forest and our compass does not work? As it happened with me once? There’s nothing to worry. The Baba has all the maps to help us navigate our way out. It is a different matter that he may put us in a loop sometimes. We go round and round and round and still don’t reach the destination.

He becomes our moral compass in such difficult times. He wants us to realise that the earth is round. He prompts us to “Behold the great rondure” like Whitman. We thank the Baba for endless circumambulations. And then we may follow a wild animal or a bird to lead us out. 

Bipolar or MDP

My friend went to the Baba complaining of some mood disturbances caused by ‘breaking news’. The Baba came out with multiple possibilities. Bipolar or Manic Depressive Psychosis (MDP) being one of them. Bipolar sounds very exotic too. With the self-diagnostic kit provided by the Baba, diagnosis is always picnic. My friend put a seal on it.

When I asked him about how he felt, he replied, “Manic one day, depressive the next day.” When he said this, his face lit up for a second. But the next moment the daylight was gone. In a few days, he had mastered the art of pendulating his full mood spectrum. Well, on his day he could easily break Armand Duplantis’s Olympic pole vault record. Or that of any champion scuba diver without oxygen support, the next day.

I tried my best to get him off the hook and look beyond the poles. I talked about circadian rhythms, hormones, neurotransmitters and unfathomable ways of the unconscious. But he remained unimpressed. His long face remained long.

Third-Year Syndrome

Before giving up on him completely, I made one last ditch effort to persuade him. I said, “You’ve third-year syndrome.” His long face became just a little less long to accommodate a smile. A smile being horizontal, always does a world of good to a long face.

He asked enthusiastically, “Is the third-year syndrome a subset of MDP?” His mind, driven by Google Baba was in overdrive. I don’t know why the Baba is misunderstood as mere search engine by ignorant people? Trying to clutch at the flicker of hope my friend’s smile had offered, I continued, “No, no. It isn’t what you think.”

His smile faded and he looked questioningly towards me. “Just listen to me, even I had it once,” I said. He interrupted, “You never told me that you had had it?” Then with a glint in his eyes, he said, “Third-year syndrome! Did it last three years?” I smiled, but for a different reason. I was happy that till then he had not consulted the Baba about it. “Well, if you’re so keen to know, then here it goes. Now listen,” and I started.

Diploma in Pharmacy

“It happened in 1976. I was doing internship after completing Diploma in Pharmacy course at Govt. Medical College, Patiala. I became friends with a young doctor. We both were on emergency duty in the hospital. One day I borrowed Robbins’ book of pathology from him. Not having studied pathology in Diploma course, I wanted to read it.

“Soon I was digging into it to unravel mysteries of our ailments and bugbears. I had no idea of the miracle that was in the making. My own body was turning out to be a pathological minefield. On day three, I discovered that my occasional heartburn was caused by peptic ulcers. The aetiology of peptic ulcers lay in psychosomatic disorders like anxiety neurosis. One major cause of high blood pressure was anxiety neurosis. Even if I did not have high BP, I was going to have it soon.

Migraine or Brain Tumour

“My occasional bouts of headache were manifestations of migraine. And migraine could be a symptom of brain tumour. A bit of abdominal discomfort after a sumptuous meal of chana-bhatura pointed towards Crohn’s disease. Now chana-bhatura is a much loved Punjabi dish of spicy chick peas served with deep fried, leavened bread. But the book made no mention to chana-bhatura. It talked only about abdominal discomfort and Crohn’s among other causes. Other causes being quite common, they did not interest me.”

As my knowledge graph shot up, my mood became a sine curve of high frequency alternating current. My fecund imagination had started flirting with outlandish pathological states. I saw what started as mere footsie blossoming into an all-consuming love affair. I was turning into a poet of my own diseases.     

To cut it short, I ended up on a big doctor’s examination table. He knew I was a qualified pharmacist. He heard me out very patiently. He auscultated my chest and heard the sounds my heart made. He felt my pulse and checked the blood pressure. Palpated my abdomen and examined the fundus to rule out brain tumour. Then he took a deep breath and smiled. He declared that I was fit as a fiddle.

An Aspiring Lover

He asked me if I had met frustration in love. I was alarmed. Had he pried into the sanctum of my heart and heard some lugubrious murmur emanating from there? I assured him that I was just nineteen and an aspiring lover. Misadventures and frustrations were to follow later. He declared with a deadpan face that I had third-year syndrome. I confessed that it had escaped my attention.

He queried, “Have you been reading pathology?” I agreed. “Who gave the book to you?”, he snarled. I had to tell him. He swore under his breath and said, “Go and ask him to explain it to you. You leave now as I’ve some genuinely ill patients to attend to.” Showing me the door, he growled, “Mind you, if you ever come here again with your complaints, I’ll have you thrown out of the hospital.”

Deeply Mortified

Deeply mortified and feeling cut to more than my size, I left in a huff. I knew nothing about schizophrenia at that time, therefore my word for him was ‘Janus-faced’. The insult was too much to pocket, but it could not be worn on the sleeve either. I simply smiled to all and sundry I met after my expulsion.

Nikalna khuld se Aadam ka sunte aaye hain lekin
Bahut be-abroo ho kar tere aspatal se hum nikle
 
(I’d been hearing about expulsion of Adam from heaven
But disgraced much more than that did I leave your hospital)

I narrated my story to my doctor friend. While my eyes were ready to rain Ganga-Jamuna, his laughter was a coruscating cascade. After laughing all his laughter, he explained to me the third-year syndrome.”

Nosophobia Now

When I had finished my story, my bipolar friend said, “I’ll read about the third-year syndrome. Sounds interesting.” I cautioned him, “Sure you’ve it. Your knowledge about diseases is really up to date. But it was called third-year syndrome then. Now some psychiatrists prefer the term nosophobia.” His hand inadvertently went to his nose. Rubbing it with his index finger, he said, “Great! I will google it.”

I realised that it was beyond me to exorcise Google Baba’s spell. I just wished him good luck. When I was taking leave of him, he was already googling something. I am sure, it was nosophobia.

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