The First Hernia Operation

As an intern, Dr. Dev was posted in the Surgery Department of AIIMS, New Delhi.

For those who are not aware, after passing the final MBBS exam, the students are provisionally treated as a doctor but are required to work under supervision for one year in the hospital in various departments which is known as the internship. After successful completion of the internship, the intern is recognized as a full-fledged doctor and can then practice independently.

By his hard work, inter-personal skill and his clear aim of becoming a surgeon later in life, he convinced the senior resident to let him do an operation of an inguinal hernia as the chief surgeon.

When the patient was under the influence of the anesthesia, Dr. Dev proudly walked and stood at the place of chief surgeon at the patient’s side. On seeing this, the assistant nurse asked the senior resident with dismay, “Sir, are you going to let him do the operation? Please don’t bore me to death and do the operation yourself fast.”

Dr. Dev looked at the nurse with anger and annoyance at the fact that even though she is qualified as a nurse, she is questioning a doctor’s competence. Then he quickly looked with pleading eyes at the senior resident, silently imploring him to not listen to the nurse and let him do the operation. 

Luckily the senior resident stood true to his word and guided Dr. Dev as he performed his first hernia as an intern under the watchful judgemental eyes of the assistant nurse.

The great (and the not so great) among us had to start humbly at some time. The teachers and masters of today were students and neophytes of yesterday. At the beginning of one’s career, one may have to face criticism and ridicule by persons in lower post or less qualified by us. Instead of getting disheartened and distracted by this, concentrate on improving and learning your subject to reach the pinnacle of your field.

(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 Hernia Reduction Lesson

You must be aware of what is an abdominal hernia.  Simply put in an abdominal hernia, the muscles of the abdomen becomes weak or they develop some defect from which usually the intestine (bowel) or the omentum (known collectively as the contents of a hernia) comes out and resides below the skin.

The omentum is a fat-laden curtain like organ present between the abdominal wall and the other organs in the abdomen.

Gently guiding the contents back into the abdomen is known as reduction of a hernia. Now an interesting thing occurs when you try to reduce a hernia.

If the hernia contains small bowel or intestines, the first part is difficult to reduce, i.e. push back inside the abdomen. But once the first part has gone in the last part goes in easily.

The opposite occurs when the content is omentum. The first part goes in easily but the last part is very difficult to push back inside the abdomen.

Similar things occur frequently in life in other situations also. If faced with a difficult problem, once the first part is resolved the later parts get solved or done easily. The opposite also occurs frequently. The first part gets tackled easily but the last parts need much time and effort.

So in life when faced with a problem if the problem initially appears easily solved do not get overly confident but keep some time and effort in reserve to use if there are difficulties at the end of the problem.

If faced with a problem which appears quite unsolvable at the beginning, then don’t lose hope. It is quite possible that once the initial part is deciphered the latter parts will fall in place on its own.

(Based on true observations)

— 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 Special Guard

This incident occurred around 15 - 20 years ago. Dr. Prem Kumar (Fictional Name) was a famous surgeon of Udaipur City. He had a large house in which he had converted a portion into a small operation theatre with a three bedded ward. He used to perform small operation there in addition to major cases he used to operate in the hospital to which he was attached.

Dr. Prem Kumar’s entire family was going for a trip of around one week. He did not want to leave his house unattended and asked few of his friends to arrange some guard to look after the house and water the garden in their absence. Unfortunately, he could not find a guard who will stay in the house for the week at the reasonable rate.

When he came back from the trip his friends asked him whether he was able to arrange a guard for the house and at what rate. Dr. Prem replied, “I arranged two guards to stay and look after my house for Rs. 3000.” Please note, as this occurred 15 - 20 years ago, it will be around Rs 8,500 today after with adjusting for the inflation.

“It appears a tad expensive compared to the ongoing rates.” remarked his friend. “Also, why did you hire two guards when one would have been enough and you could have saved some money?” inquired his friend.

With a smile, Dr. Prem Kumar told, “You don’t get it. It did not pay them a single paise (cent). It is they who paid me Rs 3000!”

“What!” exclaimed his friend. “How is that possible?”

Dr. Prem Kumar explained, “Just 2 days before we were going to leave, a patient suffering from an inguinal hernia came for operation. He was accompanied by his brother. As he had some family problem, he wanted to get operated urgently so that he could go back to his village early. He paid me Rs. 3000 to do the operation in my home-cum-hospital." 

"Being a fit man, the patient was up and about the very next day. I started him on oral tablets and explained that I have to go out of the city for urgent work. The patient and his brother can stay in the ward on their own and I will cut his stitches after coming from the trip. I locked the residential and the operation theatre portion of the house leaving the ward open. The patient with his brother stayed in the ward on their own taking good care of the house. I gave them the number of my resident to contact in case of an emergency. And the house was well cared of in my absence, much better if I had hired some security guard in my absence.”

In the good old days if the patient blindly trusted doctors, then the reverse was also true. Even the doctors had a high trust in patients. Dr. Prem Kumar did not hesitate to leave his house in the care of ‘strangers’ as they were his patient.

(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 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
© 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 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. 

If viewing from Mobile, switch to Webpage view to see a list of popular posts and index of topics of previous posts.

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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