Agnipath

Thursday, 7 December 2017

The Hydrocele Class

Dr ASY (fictional name), while a junior resident in the Surgery Department AIIMS, New Delhi, was demonstrating a batch of Under-graduate (UG) students a patient with hydrocele, in the surgical OPD (out-patient-department).

Dr. ASY warned them that hydrocele could be easily confused with a hernia, but a good doctor can easily differentiate between the two, if he pays adequate attention and knows clearly the differences between them. The interested undergraduates eagerly asked him to teach them the differences.

For Non-Medicos: Hydrocele is collection of fluid in the scrotal sac, while in hernia the intestinal bowel loops comes down into the scrotal sac. Hydrocele can be operated under local anaesthesia in minor operation theatre while hernia needs operation in the major operation theatre under local or spinal anaesthesia.

While Dr. ASY was midway between explaining them the differences, Dr. MDB (fictional name) came from the minor operation theater adjacent to the OPD. He was accompanied with a patient who was carrying an OPD card with Dr. ASY’s signature.

Dr. MDB demanded, “ASY, why have you sent this patient suffering from hernia to minor operation theatre with the (mis-) diagnosis of hydrocele?”

The best among us may sometime commit mistake. This can be usually traced to lack of attention to the task at hand or getting over-confident or not applying the knowledge you know . Paying complete attention and avoiding shortcuts helps in avoiding such mistakes.

It is not enough to know the rules, but also to apply them, no matter how senior or experienced you become. This may help prevent embarrassment occurring to you, as it happened to Dr. ASY, who failed to apply something he knew quite well.

Dr. N. K. Dewanda's Law of Medical Misdiagnosis: You are most likely to make a misdiagnosis when it will cause you maximum embarrassment.

(Based on true incident)
— ND
© Author. All rights reserved.

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Saturday, 19 August 2017

The Table Hopper

Please Note: This article is intended for 1^styear medical students.

A simple but smart way to improve you performance in gross anatomy viva exam is to go table hopping.

In the gross anatomy dissection hall, usually students are divided in batches and allotted one particular dissection table. The students are expected to stay only at their allotted table and dissect and study the cadaver allotted to them.

The problem with this approach is that, student get so familiar with the cadaver allotted to them that different muscles, blood vessels, nerve, etc. get memorized to them by sight.

In exam, when asked questions on different cadaver specimen, the students gets confused.

It is like you can recognize your friends instantly, but get lost for words if you are asked to describe them accurately to a stranger.

So, the smart students go to different dissection tables and try to identify the structures there. This exercises their brains and teaches them the scientific method to identify the body structures. The students also get to see the different variations in normal anatomy, which will help in exams.

For example, in their dissection table, the student knows where the radial nerve is, but when he goes to a different table, he has start from step one, i.e. identify the posterior surface of the arm, identify the triceps muscle, look below it to find the nerve, which will be radial nerve.

They can also ask their fellow students at the different dissection table, to point out the important structures to them, so easily revising the anatomy.

And if someone comes to your dissection table and ask you to demonstrate the various anatomical structures, don’t take this as an intrusion in your territory. Make use of this occasion to demonstrate the various structures to your visiting fellow student as this provides an opportunity to practice for your own anatomy viva again improving your marks.

But beware, table hopping can be seen as sign of indiscipline by the teachers, which may be counter-productive in exam. In our time, Dr. M. L. Ajmani, used to particularly frown upon such table hopping. So, move and stay invisible like a ninja.

(Based on true experience)

— 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 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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Tuesday, 15 August 2017

The Donkey Resident

Dr. Tarun Kumar Chaturji (fictional name) was professor of Surgery at AIIMS, New Delhi. One of his favorite ways of expressing displeasure at the junior residents working in his unit was to call them donkey (ass). His way of saying donkey in his mother tongue, Bengali, in a long drawn out manner ‘Gadahaaa’ was quite famous.

Dr. Dev (fictional name) was junior resident in Dr. Tarun Kumar Chaturji’s unit. Needless to say he was one of the favourite residents at the receiving end of being called donkey.

Once, during a through academic ward round, Dr. Tarun Kumar Chaturji, was unsatisfied by the answers provided by the junior residents during the round. While sitting in the Unit’s duty room, after the round, sipping a cup of tea, Dr. Chaturji said to the junior residents, “You all are donkeys. I feel sorry for the patients whom you all are going to treat in future.”

On hearing this Dr. Dev said, “Sir, You call us donkeys as if it is a bad thing. But, Chanakya had said that the ideal student should be like a donkey.”

(Chanakya was an ancient Indian teacher, writer, philosopher, and statesman)

“How?” asked a surprised Dr. Chaturji, as donkey is supposed to be the epitome of foolishness.

“Chanakya has written that the ideal student should be able to work long hours tirelessly like a donkey. He should not be bothered by the harsh working conditions and be satisfied despite all hardships like a donkey (ass).”

Dr. Tarun Kumar Chaturji become speechless. After that he stopped calling anyone donkey for some time.

But old habits die hard.

After a few weeks had elapsed, when he got angry at some resident, he once again started calling them donkey but started adding,

“If I call you donkey, even the donkey will get insulted.”

And, also,

“You are a donkey, but definitely not Chanakya’s donkey.”

Some more donkeysim at https://agnipathdoctors.blogspot.com/search/label/Donkey