The Feeding Jejunostomy Lesson

Non Medicos version

Dr. Tarun Kumar Chaturji (Fictional Name) had joined as a junior resident doctor in the Dept. of Surgery, AIIMS, New Delhi. A patient suffering from cancer of the food pipe (esophagus) was admitted in his unit. Due to the cancer tumor blocking her food pipe she was not able to take liquids or even drink water. The patient and her relatives had delayed in seeking proper medical attention. At the time of admission, the patient was sick and in a moribund condition. 

Dr. Chaturji discussed with his senior resident about the feasibility of making a feeding jejunostomy. 

For Non-Medicos: In feeding jejunostomy, the abdomen is opened and a small tube is inserted in the small intestine (bowel). The patient can be given liquids diet through this tube directly into the small intestine. This improves the patient’s nutritional status and allows the patient to be kept and managed even at home.

Since the general condition of the patient was very poor, the anesthetist, refused to give general anesthesia to the patient. 

For Non-Medicos: Anaesthetist is a doctor specializing in putting patients to sleep at the time of operation and keep the patient unconscious and pain-free. In general anesthesia, drugs and inhaling gases are administered to the patient, so that they remain unconscious and pain-free at the time of operation. 

Since Dr. Chaturji did not want the opportunity to operate on the patient to be missed, he along with another fellow junior resident, took up the patient for surgery under local anesthesia. 

For Non-Medicos: In local anesthesia, certain drugs are injected around the area where the doctor is operating to make only that area of the body insensible to pain. 

In the Operation Theater, they injected the local anesthetic drug and started to operate on the patient. Initially, the patient made some sounds to show here discomfort. Since some amount of discomfort is inevitable while operating under local anesthesia, they did not pay much attention to it and got busy in finishing the operation as soon as possible. 

Near the end of the operation, they noticed that the patient has stopped making sounds of discomfort. They assumed that their local has worked well, congratulated themselves on giving such good local anesthesia and continued their operation. 

When they finished their operation and removed the clothes covering the patient, they found the patient was not breathing. She did not have a pulse and her heart was not beating. She was dead. 

Since the patient was already very sick and in a moribund condition, the patient’s relatives accepted the news of her death without blaming the doctors. The head of the unit did not take this so coolly and Dr. Chaturji received some heavy verbal reprimand from the unit head.

Do not operate on sick patients without adequate monitoring and back up facilities. For example, it is now standard medical protocol to have a dedicated doctor monitoring the patient’s condition, such as pulse rate, blood pressure, respiration, even when operating under local anesthesia.

The same holds true in a variety of situations in life. 

Perhaps you have joined an organization and you have not been given any major or important project or duty to handle. You may be tempted to take up something which others may be avoiding. If you carry out it well, you may get recognition. If you fail, it may be a disaster for someone just starting his career. So before going in for a do or die situations, take care to adequately cover yourself. 

When you are engrossed in an activity, you may not able to see the complete picture. You may miss the forest for the trees. In such a situation it is invaluable to have someone to monitor the complete picture and place your efforts in the right perspectives. 

 (Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The Anatomy Atlas

There was a small Unit library, with various surgery books, maintained in Doctor’s Duty room of Surgery Unit III in AIIMS, New Delhi. 

The books there were donated by the doctors themselves and some by patients. The books were kept in an open locker which was accessible to all the doctors of the unit 24 x 7. Yet there was no pilferage or loss of books as all the doctors of the unit used to follow strictly the rule of the unit head Dr. Tarun Kumar Chaturji (Fictional Name) regarding the unit library. 

The rule was that under no circumstance the books from the library will be taken outside the Duty room, not even in the ward.

The library was a boon to the doctors as they can consult it even during odd hours, such as late-night when they were on emergency duties. Even the faculty members, including Dr. Tarun Kumar Chaturji, used to come in between operation or before going to Operation theatre to brush up or review the steps or anatomy of the operation.

For Non-Medicos: Anatomy is the basic branch of medicine which deals with the structure of the human body, such the various tissues, organs, blood vessels, muscles, bones, etc. Thorough knowledge of the anatomy of the part/region being operated by the surgeon is must to avoid any injury to important structure and perform the operation perfectly.

Dr. Dev (Fictional Name) who was a junior resident in the Surgery Unit III noticed a new book in the unit library locker. It was Giant Atlas of Anatomy (Fictional Name). The atlas had excellent diagrams and photographs of the anatomical structure of the human body. He found to it to be an excellent book to learn and revise the anatomy while on duty in the unit.

He noticed that even Dr. TK Chaturji consult the book in between cases and even otherwise. His respect for the book further increased after seeing Dr. Chaturji using the book.

After a few months, he noticed that the book was suddenly missing from library locker. As he was busy in the daily ward work he did not pay any attention to it.

 A few days later, Dr. MK (Fictional Name) a junior resident, who was senior to Dr. Dev, was assisting the senior resident in an operation in the operation theatre (OT). Other unit doctors were standing and watching the operation in OT. 

Dr. Tarun Kumar Chaturji suddenly stormed in the OT. Looking angrily at the unit doctors, he demanded, who has taken the ‘Giant Atlas of Anatomy’ from the unit library?

It appeared that Dr. Chaturji wanted to revise the anatomy related to a certain operation which he was to do later in the day. When he searched for the atlas of anatomy, he was surprised to not find it in the library locker. Knowing Dr. Chaturji strict rule of not taking any books outside even the duty room from the departmental library, everyone was stunned. 

All work stopped in the OT and everyone silently looked at each other, as if enquiring by their eye, who was the culprit of this felony?

After few seconds of silence, Dr. MK hesitantly replied, ‘I had taken the atlas to my hostel room.’

Dr. TK Chaturji angrily remarked, ‘Look at this creature. Taking the atlas to his room, when he does not study anything at all’ and angrily left the OT.

After Dr. Chaturji has left, the surprised unit doctors looked at Dr. MK and asked, ‘Why did you take the atlas to your room when you know Dr. Chaturji does not like the books to be taken even outside the duty room?

Dr. MK replied, ‘I took the atlas to my room as it was my personal book!’

It happened that Dr. MK had purchased the book during his second year of junior residency. As he was most of the time in the hospital due to heavy patient workload, he had placed the book along with the other books in the unit locker to read whenever he gets some time. 

When his third year of residency had started and he found more free time to spend in his hostel room, he took his atlas book to study in his room. Nobody had noticed his name written in the first inner page of the book and everyone assumed that someone had donated the book to the unit library.

So Dr. MK got scolded for taking his own book to his room.

If you bring some book, equipment, article to your office or workplace, better keep it separate from the official articles. It is not the just junior staff even senior employees and doctor may get blamed for taking their own things back with them outside their office building. See another example of senior doctor: The Slide Projector

(Based on allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm.

The Special Tea

Dr. Mayank (Fictional Name) had newly joined as a junior resident in the surgery department at AIIMS, New Delhi. Being the junior most the task of preparing the tea for the unit head Prof. (Dr.) Tarun Kumar Chaturji (Fictional Name) was given to him.

After the ward round was over and the academic discussion was going on in the duty room. Dr. Mayank placed the cup of tea prepared by him with special care in front of Dr. Tarun Kumar Chaturji.

Dr. Chaturji took one sip and exclaimed, “Why is there so much milk in my tea? Do you think I am a kid and you want me to feed milk?”

There are two kinds of people in India. One prefers lots of milk in their tea, loving the rich taste of milk in their tea. The other prefers minimal milk in the tea, as the excess of milk may mask the delicate and subtle flavor of the tea. Unfortunately for Dr. Mayank, Dr. Chaturji was in the latter camp.

Like James Bond’s famous Vodka Martini, shaken not stirred, knowing the different variant of the tea/coffee/drink preferred by your boss may be one way to please your boss. But the plan may backfire if you overlook even some minor detail, creating a negative impression rather than a good one.

(Based on true incident)

— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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Which Book to Study? — 2

Dr. Dev (Fictional Name) while a junior resident, followed the advice of https://agnipathdoctors.blogspot.com/2018/06/which-book-to-study-1.html  and studied from the same book as his Surgery Unit head and Professor (Dr.) Tarun Kumar Chaturji (Fictional Name). 

This was an easy decision as for ages there was only one minimum standard textbook for surgery recommended for both Undergraduate (UG) and Post Graduate (PG) students, at AIIMS, New Delhi. For post-graduates, this textbook was to be supplemented with other advanced textbooks and scientific review articles.

Once during ward round Dr. Tarun Kumar Chaturji while discussing hemorrhoids (piles) asked what is pecten band? Dr. Dev tried to recall such a thing but he could not recollect reading such a thing in his book. So he told truthfully that he had not read anything like this. At this Dr. Tarun Kumar Chaturji got angry that the PG residents today are not studying even the basic recommended textbook at the UG level. Dr. Dev at night consulted his textbook copy but he could not find any mention of pecten band.

Sometimes later, during ward rounds, Dr. Tarun Kumar Chaturji asked the change in heart rate in a patient with jaundice. Again Dr. Dev and other residents were stumped as there was no mention in the standard textbook regarding this. They told if the patient develops an infection of the stagnant bile in the case of jaundice, then the heart rate may rise. Dissatisfied with this answer Dr. Chaturji, said there may be bradycardia, i.e. a decrease in the heart, as a depressive action of the bile salts on the SA node in the heart.

The residents collectively said that such a thing is not written in their books. At which Dr. Chaturji countered, “It may not be in your textbook, but it is written in my textbook.”

Enlightenment dawned on Dr. Dev. That night he went to BB Dixit Library in AIIMS and traced a dusty old copy of the textbook which he used to read, but the edition around 20 years old. 

In that old edition, he found the mention of the bile salts action on the heart, the pecten band which was reported by Miles in 1919. Many of the things were found not to be true later on and over the time had been removed from the subsequent edition of the book.

So to impress Dr. Chaturji, Dr. Dev searched the old and second-hand booksellers of Chandni Chowk and Daryaganj and finally managed to buy a copy of the book around 20  years old, of the edition Dr. Tarun Kumar Chaturji used to study.

Now he read from the latest edition of the book for up-to-date knowledge and from the old, ancient edition to answer Dr. Chaturji’s special question.

So, read not just the textbook which your examiner has read, but also read from the same edition.

Remember:

'Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer' — Charles Caleb Colton

(Based on true incident)

— ND
© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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The Ballabgarh Hernia

Professor (Dr.) Tarun Kumar Chaturji (Fictional Name) ward rounds in AIIMS, New Delhi, on free days were ‘tough’. Even the junior consultants used to fear them. After one such ‘tough’ ward round the junior residents were sitting dejected in the duty room. Feeling pity for them Dr. Chaturji told them a little story to boost up their morale and brighten their hope of becoming a great surgeon someday.

Dr. Tarun Kumar Chaturji was posted in the community health care center in Ballabgarh, Haryana, as senior resident in surgery as part of his rotational posting. Compared to the hospital in AIIMS, New Delhi, it was a new experience for him. The operation theatre was far removed from the ones in AIIMS. There were no junior residents to assist during operation and look after the patients in the post-operative period. The ward and nursing staff was also not comparable to that in AIIMS, New Delhi.

Dr. Chaturji operated on hernia patient there. The patient had a bad hospital course in the period after the operation (Dr. Chaturji had declined to comment on the actual details). While leaving the hospital, the patient said, that if he knew he had to face such problems, he never would have got himself operated upon by Dr. Chaturji.

Tip: Even the great face problems at the beginning of their career. So don’t get disheartened by problems or failures in the early part of your career.

Tip: When you go in a setup that is different from what you are used to working or where you were taught, mistakes are bound to occur. Take care to minimize your mistake. Be dynamic and adapt to the condition at hand.

Tip: Also, it takes someone with great self-confidence and courage and a genuine need to encourage you to talk about any setbacks or misfortune in the early part of their career. Treat them with the respect and love they deserve.

(Based on true incident)

— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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The Smoker Examiner

Dr. Tarun Kumar Chaturji (Fictional Name) was appearing for his Master of Surgery (MS) exam in AIIMS, New Delhi. The external examiner for the practical exam in between taking the viva of candidates used to smoke a cigarette. Dr. Tarun Kumar Chaturji and other doctors were impressed that the examiner smoked the most expensive brand of the Indian cigarette available in the market.

Sometimes later Dr. Tarun Kumar Chaturji was working as a surgeon in AIIMS, New Delhi after he had cleared his MS exam. Due to some work he had to go to the same medical college from which the external examiner had come. After his work was over he decided to go and meet the examiner and thank him personally for passing him in the MS exam.

When he reached his office, he found him relaxing while smoking a cigarette. Dr. Tarun Kumar Chaturji was surprised to see the external examiner smoking a mid-range priced cigarette.

Dr. Chaturji could not control his amazement and asked, “Sir, when you came to AIIMS as examiner you were smoking ‘that’ expensive brand of cigarette, but now you are smoking this cheap brand?”

The examiner replied, “This is the brand of cigarette I smoke routinely. I had bought that pack of expensive cigarettes especially for AIIMS, as befitting my status an external examiner there and impress the AIIMS doctors. I cannot smoke that expensive brand of cigarette routinely on my salary.”

People when going outside may project a more successful, rich or powerful image by various means. It is only when you observe them in their true surroundings that you see their true image.

NB: Needlessly to say Cigarette smoking is injurious to health and it is advised to stay away from them.

(Based on true incident)

— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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The MLA's Hernia

Once an MLA (Member of State Legislative Assembly) came to Prof. (Dr.) Tarun Kumar Chaturji, (Fictional Name) in AIIMS, New Delhi, with the complaint of Right inguinal hernia.

Dr. Tarun Kumar Chaturji examined the MLA and advised him to undergo operation. When the MLA asked Dr. Chaturji when he will operate on him, Dr. Chaturji, refused to personally operate on him. 

He said, “I do not operate on such minor cases as an inguinal hernia. You can consult the Assistant Professor working in my unit if you want to get it operated in AIIMS.”

The greatness is some person is not determined by what operation or projects he tackles but also by what he does not do and allots to his juniors. They are the lion among us, as there is an old Indian saying, ‘A lion will die of hunger but will not eat grass.’

(Based on true incident)

— ND
© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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The Lumber Sympathectomy

A patient suffering from Peripheral Vascular Disease, i.e. decreased blood supply to the limbs, in this case to the left lower leg and foot, was admitted to the surgical ward in AIIMS, New Delhi. Dr. Dev, (Fictional Name) was the 2nd year surgical resident at that time. Professor (Dr.) Tarun Kumar Chaturji (Fictional Name) had advised the operation of Lumbar Sympathectomy in this patient. 

In this operation, a group of nerves, known as Lumbar Sympathetic Chain is removed surgically. This increases the blood supply to the skin of the foot and lower leg.

All the residents were excited as Dr. Tarun Kumar Chaturji, usually, allow the residents to do this operation. Although there were two Senior Residents (SRs) and two 3rd year Junior Residents (JRs) senior to him in the hierarchy, Dr. Dev went to the AIIMS library and read about how to do the operation from 3-4 operative surgery atlas-textbooks till all the steps of the operation were clear in his mind.

The day came when the patient was posted for surgery. Professor Chaturji, being busy in some administrative work could not come to the Operation theatre (OT) on that day. Dr. Dev, the 2nd year surgical resident, Dr. Ramesh (Fictional Name) was the 3rd year surgical resident and Dr. Rajesh (Fictional Name) was the Senior Resident (SR) present at that time in the OT.

Dr. Ramesh, the 3rd year resident saw this as a golden opportunity. He requested the SR, Dr. Rajesh, to allow him to do the operation as the chief surgeon while the Senior Resident supervises him while doing the operation. The SR, Dr. Rajesh, was from the immediate senior batch in MBBS from Dr. Ramesh. They were also both living in the same hostel floor and were quite friendly even before joining Surgery Department. The SR quite readily agreed to Dr. Ramesh’s request and asked Dr. Dev to get ready to assist in the operation.

Suddenly, like a Ring-master entering the centre-stage, Dr. Tarun Kumar Chaturji, entered the OT. A silence descended in the OT. Dr. Chaturji walked up to the OT list stuck on the wall and reading it exclaimed with delight, “Ah, Lumbar Sympathectomy!”

Turning to the group of residents standing in the corner, he asked: “Which of you have come prepared to do this operation?” Dr. Ramesh, the 3rd junior resident, who was quite excited to get the opportunity to do the operation of Lumbar Sympathectomy suddenly became very quiet.

A word on Dr. Tarun Kumar Chaturji’s style of teaching operative surgery. Like ‘Life’ which takes the exam first and teaches you later, Dr. Chaturji used to grill you first then add some pearls of wisdom later.

He will first start asking questions about the history of the patient’s illness, the physical findings on clinical examination and the reports of the investigations done. If the resident is able to answer this question, he is asked to continue further and tell about the incision (cut) he will use in that operation. If the resident answers this satisfactorily, then he is allowed to start the operation.

If the resident continues to do the steps of the operation accurately at the same time answering Dr. Chaturji’s questions, he is allowed to proceed further till the operation is over. If at any stage the resident makes some mistake or is not able to answer Dr. Chaturji’s question satisfactorily, he asked to leave the OT or at least step down from being the operative surgeon to the position of the assistant frequently accompanied with a verbal blasting.

Dr. Dev looked at the SR and his senior 3rd year JR whether they will rise up to the challenge thrown by Dr. Chaturji. He wanted to tell Dr. Chaturji that he had studied to do the operation but he kept quite so as not to offend his seniors. But, the SR and the 3rd year JR on seeing Dr. Chaturji had become nervous and quite.

Since no one answered, Dr. Chaturji, once again asked, “Who had come prepared to do the operation?” Again it was met with silence from the SR and the 3rd year JR side. Seeing that his seniors were not venturing forth, with trepidation, Dr. Dev answered, “I had come prepared to do the operation.”

A surprised Dr. Chaturji looked at the relatively junior Dr. Dev and asked him to come forward. Dr. Dev complied. Dr. Chaturji taking the patient’s case-sheet in his hand started asking questions regarding the patient’s present illness, his physical finding and the investigations done. Dr. Dev managed to answer these questions satisfactorily.

Dr. Chaturji asked Dr. Dev to start the operation and the Senior Resident and the 3rd year Junior Residents to come work as the assistant in the operation. The SR and the 3rd year JR looked angrily at Dr. Dev but meekly complied due to the presence of Dr. Chaturji. So the junior most doctor became the Chief surgeon while being supervised by Dr. Chaturji, and his seniors became his assistant.

This how Dr. Dev performed the first Lumber Sympathectomy of his life.

Tip: If some interesting or unique operation/procedure/project come in your unit or department, keep your hopes high and study and prepare for it. You may be allotted the case even if due to your juniority this is highly unlikely. This will provide you with golden opportunity to impress your boss if you are well prepared.

Tip: Sometimes you may have to displease your seniors by volunteering to take on some challenge thrown by your boss. Well, you cannot please all the people all the time.

(Based on true incident)

— ND

© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behaviour illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behaviour illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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The Surgical-Radiological Conference

 Dr. Dev (Fictional Name) was Junior Resident in the Department of Surgery, AIIMS, New Delhi. One of the duties of Dr. Dev was to present cases at the weekly Surgical-Radiological conference (meeting).

For Non-Medicos: In the Surgical-Radiological conference, one particular surgical unit meet with the radiological faculty members and residents. The surgery resident presents the clinical data of few selected patients such history of the present illness, clinical examination findings and reports of other blood investigations. Then the radiological investigations are discussed such as plain x-rays, ultrasonography and CT and MRI scans films. The radiology department faculty then examines the films and clears any doubts of the surgeons.

Once it happened that the Surgico-Radiological conference was on the day following Dr. Dev’s Unit’s OPD and Emergency Admission day. The workload was particularly heavy with an emergency operation ending at 3.00 am in the morning. And as it happens, the number of patients whose x-rays, CT, etc. were to be discussed was also more than the usual average with many patients getting admitted late in the evening.

After grabbing only 1½ hour sleep, Dr. Dev worked fervently to complete the notes of the patient’s detail, collect and label the x-rays, etc. with the patient’s name and bed number and arrange them in proper order.

Working continuously Dr. Dev managed to complete his work by 8.00 am and reached the conference room in the radiology department at 8.05 am.

Professor (Dr.) Tarun Kumar Chaturji (Fictional Name), the Surgery Unit Head with the Radiology Professor was already waiting in the room as the meeting was supposed to start at 8.00 am.

Dr. Dev started presenting the cases. As was expected, mentally and physically exhausted, hungry (no breakfast), sleep deprived, Dr. Dev, made some mistake during his presentation. Promptly Dr. Chaturji gave Dr. Dev a verbal blasting. Used to such things, Dr. Dev continued presenting the cases. Again Dr. Dev made some minor mistake to which Dr. Chaturji responded even more aggressively than before. Dr. Dev got suspicious that Dr. Chaturji is being more strict than usual and tried to think what may have put in such a foul mood.

When Dr. Dev made his third mistake Dr. Tarun Kumar Chaturji himself confirmed the reason; “Look at this donkey. Making such silly mistakes and he had not even bothered to shave before coming to the hospital.”

Enlightenment dawned on Dr. Dev. Professor Tarun Kumar Chaturji was a staunch believer in that a smart doctor is a smart appearing doctor. According to him, a clean shave is must for a smart looking doctor. In his rush to complete the presentations, Dr. Dev had neglected to shave and came few minutes late to the meeting after the faculty members had already arrived. These two things had angered Dr. Tarun Kumar Chaturji and Dr. Dev’s even minor mistakes appeared to Dr. Chaturji as major infractions.

The surgical-radiological conference was finally over. Dr. Dev, Professor (Dr.) Tarun Kumar Chaturji and other faculty members and residents started moving towards the ward. When they reached the stairs near the junction of the AB and CD ward block, Dr. Dev gave the surgical-radiological conference register, the x-rays, etc. to his junior and rushed to the ward, situated at 7^th floor, by stairs.

Dr. Tarun Kumar Chaturji along with other members of the unit continued till they reached the private ward elevators (lift). This was time before the fast elevators were installed near the private ward for the use of the staff at AIIMS, New Delhi. They took the old elevator and reached the 7^th floor where the surgical ward was situated.

When Dr. Tarun Kumar Chaturji started the ward round he found Dr. Dev already waiting for him in the ward. Dr. Chaturji stared hard at Dr. Dev’s face. Dr. Chaturji started listening to the daily clinical notes of the admitted patient’s status at each of the bed one by one. But all the time he was staring at Dr. Dev’s face. Finally, by the 7^th patient he could not hold back and asked Dr. Dev in amazement, “You were unshaved in the radiological meeting in the morning, but how come you are having a shaved face now?”

To avoid what happened in the surgical-radiological conference, while Dr. Tarun Kumar Chaturji slowly walked to the elevators, which being morning rush hour stopped at each floor to slowly reach the 7^th floor, Dr. Dev had rushed to the 7^th floor by stairs. On reaching the duty room, he took his shaving kit from his locker and hurriedly shaved before the ward round started. Yes, Dr. Dev had completed shaving faster than Dr. Tarun Kumar Chaturji made his way from the conference to the ward. Needless to say, Professor Tarun Kumar Chaturji was now in a much milder mood during the ward round as compared the radiological meeting.

Most people keep on working until the last minute of the allotted time while preparing some presentation, reports, case-study, project, etc. It is better to stop working early and use the last few minutes to polish the appearances, whether personal or of the work.

Tip: It is better to present an incomplete but polished work than present a complete but unpolished work. Polish here means activities such as arranging the presentation material in proper order, checking for any spelling mistakes and uniformity of fonts and style.

Tip: People are more likely to overlook mistakes by polished presenter than one who is unkempt in appearance. Polishing your appearance means wearing a neat well-ironed dress, a clean-shaved face, well-groomed appearance.

Tip: And always reach the venue before time.

In Dr. Dev’s case, he should have stopped working at around 7.40 am, and used the time to arrange the patient’s files in proper order, should have shaved and changed his shirt and left the ward by at least 7.55 am to arrive at the venue at or before 8.00 am.

(Based on true incident)

— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behaviour illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behaviour illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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