The 'Pushpa' CTVS Surgeon

Recently the movie ‘Pushpa’ was creating waves in India. One of the famous scenes in the movie is when the protagonist/hero of the movie vehemently declares that he will not bend. His dialogue reminds me of a great cardiac surgeon who was in AIIMS, New Delhi.

While doing his junior residency in MS General Surgery at AIIMS, New Delhi, Dr. Dev (fictional name) was posted in the Cardio-Thoracic-Vascular Surgery (CTVS) department on rotational posting during. Once, he was assisting in the operation of CABG, cardiac bypass grafting, in which the vein of the leg was taken and attached as a bypass graft between the Aorta and the heart arteries for blockage of the heart arteries. While the chief surgeon was busy doing the main part of the operation in the chest region, Dr. Dev was suturing the skin and subcutaneous tissue in the leg. 

As the leg was at a lower level than the chest, Dr. Dev bent at his waist level and was stitching the wound. Dr. Murli (fictional name) who was his batchmate and was posted in the adjoining operation theater (OT) came to see what was going on in that theatre.

On seeing Dr. Dev bending while applying the stitches, he remarked, ‘Dr. Dev you are lucky that you are not posted in my OT with Professor Sampath Kumar. Dr. Sampath is very particular in having a good posture while working in OT. According to him a surgeon should always stand straight and never bend while performing surgery. If he sees some trainee surgeon take a stitch while bending, he will ask the trainee to remove the stitch and apply it once again while standing in the correct posture.’

Not just for surgeons but poor posture at work if ignored and not actively avoided can lead to chronic pain, fatigue, poor performance, and productivity. This is so important that a branch of science, Ergonomics is devoted to the study of people in their working environment to improve safety and reduce chances of injury. 

Some recommendations for people working for a prolonged period while sitting at their desk are:

Choose a chair with good lower back support.

The chair should be adequate width and depth with proper padding. There should be a gap of around 2 inches between the edge of the chair and the back of your knees.

The chair should have an adjustable armrest so that your arms rest gently on them with your shoulders in a relaxed neutral position.

While sitting, the thighs should be parallel or slightly inclined upwards so that your knees are at the level or slightly higher than your hips. Your feet should rest flat on the floor. The height of the chair should be adjusted or use a footrest. You can use other items such as a small stool, empty boxes, etc. if a proper footrest is not available. 

Keep routinely used objects such as your telephone, mouse, highlighters, stapler, etc. close to you to minimize twisting, bending, or overstretching to reach them.

Use a speakerphone or headset to use the phone while working. Avoid cradling the phone between your head and neck.

The monitor should be directly in front of your eyes, around 2 to 2½ feet from you. The top of the screen should be slightly below your eye level as our eyes are most comfortable position while seeing objects 10-15 degrees below the eye level. 

The monitor and the keyboard should be in a straight line.

The keyboard should be about an inch above elbow level.

The mouse should be close to you and on the same level as the keyboard. Try to learn using the mouse with both hands and alternate between them.

There should be adequate space under the desk for your knees, thighs, and legs. The legs can be easily moved and stretched.

🎯 Be aware of your posture while working. Avoid bad posture even if it is easy in the short term. Learn and practice good posture so that it becomes a habit. Take the service of a physiotherapist or ergonomist to get professional advice if needed. You can also search on the internet for specific advice for your particular job or working condition.

 Lastly, if Pushpa was the resident of Dr. Sampath Kumar he might have said something like this: 

Professor Sampath is my Guru's name

This disciple will not bend

 NB: This is not a scientific article. Please verify the facts yourself before trying anything.

— ND

(Based on allegedly true incident.)

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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. 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 NMC and other Board norms.

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NB: This is not a scientific article. Please verify the facts yourself before trying anything.

— ND

(Based on allegedly true incident.)

© Author. All rights reserved. 

Please share this post on WhatsApp, Facebook, Twitter, Pinterest, etc.

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You can receive a notification on the latest post by subscribing via clicking on the bottom of the page on the Subscribe to: Posts (Atom)

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. 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 NMC and other Board norms.

 

The Pandit Shiv Kumar Sharma Concert

One of the things I greatly miss from my days at AIIMS N. Delhi was the frequent musical programs held there with some of the biggest names in Indian classical music. I had the good fortune to attend a live performance by Pandit Shiv Kumar Sharma at AIIMS, Delhi, who recently left for his heavenly abode on 10th May. He was a santoor maestro, a stringed instrument.

Going quite early before the program was scheduled to start I was able to get a seat near the front of the stage. When Pandit Shiv Kumar took his place on the stage and started his performance, I could not believe I was attending his live performance and not dreaming. A feeling I believe was shared by the rest of the audience sitting in that auditorium.

After some preliminary performance on the santoor, Pandit Shiv Kumar started a crescendo of notes. He progressively and smoothly started increasing the loudness and tone of the musical notes. After reaching the peak he started slowly and gradually reducing the amplitude of the notes till they were barely audible. At the display of such smooth and gradual build-up of the musical notes and then an even superior decrescendo the audience broke out in loud applause (clapping) to show their appreciation of such a masterly performance.

A visibly hurt Pandit Shiv Kumar looked up from his instrument and told the audience, ‘Please don’t clap in between the performance. Just keep quiet so that you can listen and appreciate the fine soft notes in the music.’

I was just stunned. Until now almost all the performers I had watched were hungry for the audience’s positive feedback, especially in form of loud clapping. In fact, some directly cajole the audience to clap loudly to show their appreciation. But Pandit Shiv Kumar Sharma was completely opposite.

We read and listen to such advice as:

‘Be your own judge and critic. Don’t get swayed by others’ evaluations of your performance. Or 

‘If someone praises you, you become happy. If someone criticizes you, you become sad. Do not let the switch of your happiness be in another’s hand’. 

But before Pandit Shiv Kumar Sharma’s performance, I had not met any person who truly was committed to giving his best performance without caring for others’ praise.In fact to him it was a distraction to be strictly avoided.

The rest of the audience was stunned like me at this contrarian behavior of Pandit Shiv Kumar and become silent and attentive to his performance.

After some time the audience which had become enthralled by the musical notes coming from his santoor had forgotten his request not to clap, started once again to clap.  Without stopping his performance, Pandit Shiv Kumar looked up at the audience as a mother looks admonishingly at her mischievous child. The audience understood his message and the applause quickly died down and they maintained pin-drop silence for the rest of his performance. The ovation of the audience at the end of the show was another matter.

Through his exceptional behavior, Pandit Shiv Kumar Sharma gave the lesson: Give your best performance without paying attention or getting influenced by others’ praise. Be your own judge.

NB: A request to musically inclined persons to suggest correct words where appropriate.

— ND

(Based on allegedly true incident.)

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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. 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 NMC and other Board norms.

 

Dr. Kas Nova’s BP Recording

 

A person’s blood pressure can increase temporarily under emotional situations but persistently high or elevated blood pressure (hypertension) is a serious medical problem. Hypertension significantly increases the risk of heart attack, stroke/paralysis, kidney failure,  blindness, and premature death. As a person can be having high blood pressure (BP) without any symptoms, regular blood pressure measurement is the key to detecting and treating this silent killer.

In between two cases in the operation theater (OT) there was a delay and the OT was empty without both the patient and the anesthetists. Dr. Kas Nova (fictional name) decided to make use of this opportunity to get his blood pressure (BP) measured by the automatic anesthesia’s multi-para machine. He asked his resident to switch on the machine and help him in taking his BP recording with the machine.

Being unfamiliar with the machine as it was operated only by the anesthetist, they were fumbling with the switches and settings when one of the anesthetists entered the OT. Noticing them struggling, the helpful lady volunteered to help them.

Standing close to Dr. Kas Nova, in the congested space between him and the anesthesia machine, the lovely anesthetist expertly warped the BP machine around his arm, set the parameters on the machine, and started the process of the BP recording. Within a minute the monitor displayed Dr. Kas Nova’s blood pressure reading on the screen.

It was perfectly normal. In fact, it was towards the lower side for someone of Dr. Kas Nova’s age as the blood pressure tends to increase with increasing age.

The anesthetist went outside the OT to continue her work.

After she had left, Dr. Kas Nova looked at the BP recording on the machine and sighed, ‘I really must be getting old.' The resident standing nearby overheard him and asked with surprise, ‘Why sir, why are you saying such a thing? Your BP reading is perfectly normal!’

‘That is the problem,’ said Dr. Kas Nova, ‘Such a beautiful lady was standing near me and yet my blood pressure did not shoot up.’

Different persons may have different ways of looking at the same thing. What may be a good thing for someone may be perceived as a bad thing by someone else.

— ND

(Based on allegedly true incident.)

© Author. All rights reserved. 

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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. 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 NMC and other Board norms.